Couple and Marital Counseling

Couple and marital counseling helps couples, married or not, identify problems, manage difficulties, and ultimately improve their relationship. The intensity of an intimate relationship makes it one of the most important relationships one encounters in life. Because couple and marital counseling deals with two people and the dynamics that exist in their relationship, the counseling is more intense and at times more complicated than work with individuals. Previously referred to as marital counseling, the term was limiting, as it did not include nonmarried cohabiting couples or committed same-sex couples. Subsequently the term couple counseling is often used to more broadly encompass any intimate, committed couple.

This entry provides an overview of the history of couple and marital counseling, approaches to couple and marital counseling, common issues in couple and marital counseling, and challenges often encountered in doing couple and marital counseling.

Historical Underpinnings of Couple and Marital Counseling

As a distinct professional counseling service, couple and marital counseling is relatively young. Broderick and Schrader trace the history of couple and marriage counseling in four phases: the pioneer phase, the establishment phase, the consolidation phase, and the formative stage. Prior to the pioneer phase and the couple and marriage counseling movement, marital counseling was done informally by friends, other family members, or religious leaders. Also, prior to the 1930s, the theory and practice of counselors and psychologists centered on helping the individual. As families in the United States became less centralized and more geographically expansive, extended family members and other community supports were less available, and relationship counseling became increasingly necessary.

Each of the phases listed above was marked by significant events. In the pioneer phase of the early 1930s, three professional centers for marriage counseling were established: a center in Los Angeles called the American Institute of Family Relations, a center in New York, and a center in Philadelphia called The Marriage Council. From these examples, other training, research, and service centers emerged throughout the mid-1930s to mid-1940s. However, an increased need for professional unity emerged. In 1945, professionals working with couples in a counseling relationship organized to form the American Association of Marriage Counselors (AAMC). This early association included professionals from diverse backgrounds, including clergy, physicians, social workers, and family guidance professionals. These professionals were primarily responsible for some other type of work but counseled couples as part of their primary role. This signified the emergence of the establishment phase.

To further develop the professionalism of this emerging field, standards for marriage counseling were published, and marriage counseling was established as a specialty of family counseling in 1949. Signifying the consolidation phase was the first legal recognition of the marriage counseling profession in California in 1963. In 1970 the name of the association was changed to the American Association of Marriage and Family Counselors (AAMFC), and in 1978 it changed again to the American Association for Marriage and Family Therapy (AAMFT).

For many years, most of the attention and focus in the field was on the family; however, over time the couple and marriage counseling movement advanced. In the 1980s, the Clinical Handbook of Marital Therapy by Jacobson and Gurman was published and contributed significantly to advancing the specialization of couple and marital counseling. The formative phase saw an increase in the number of education programs offering training specifically on counseling with couples. Additionally, the profession experienced major growth and a subsequent clarification of training standards and competencies for practice. Couple and marriage counseling is now considered a distinct approach with published research with information on the science of the relationship.

Approaches to Couple and Marital Counseling

There are many approaches to working therapeutically with couples. These approaches differ in focus, process, and goals. A comprehensive review of all theories in the couple and marriage counseling field is too broad for the scope of this entry. However, several will be discussed briefly.

Psychoanalytic couple counseling focuses on helping individuals recognize their own unconscious processes as well as those of their spouse or partner. This theory tries to uncover childhood conflicts that have gone unresolved and are therefore influencing the state of the current relationship. The psychoanalytic couple therapist attempts to understand current interactions and their connection with interactions that occurred at early developmental levels. One of the primary goals of this theory is to encourage each person in the context of the relationship to become a distinct individual self. The psychoanalytic approach views the individual as one who chooses a partner based on dynamics that existed in early parent-child interactions. As with traditional and individual psychoanalysis, this is a long and intense form of counseling.

Behavioral couple counseling is widely used and thoroughly researched and focuses on observable behaviors. This type of couple counseling focuses on improving the couple relationship by attempting to improve positive exchanges while decreasing negative interactions. Like individual behavioral therapies, behavioral couple counseling views the environment as a major influence on creating and sustaining the intimate relationship. The practitioner applying this theory pays particular attention to the cycles each member of a couple engages in to control the behavior of the other. Homework, assessment tools, and at-home and in-session observations are used regularly in this approach. In general, this is time-limited and symptom-focused counseling.

Cognitive-behavioral couple counseling focuses not just on the behavior of each person in the relationship but on the interpretation that each makes about the other person’s behavior. The goal of this counseling is to assist the couple in identifying the thoughts that contribute to the marital problems, to test whether or not the thoughts are valid or accurate, and to modify the thoughts accordingly. For example, when couples use language such as “always” and “never” when talking about each other, the counselor may encourage the couple to seek exceptions related to these statements. A cognitive-behavioral couple counselor might also seek to discover assumptions that are not accurate and assist the couple in discovering more accurate assumptions. For example, if someone believes happy couples never fight, the therapist might help him or her form more accurate assumptions.

Emotionally focused couple counseling views problems in the relationship as relating specifically to attachment. According to this theory, attachment problems that develop in the earliest stages of life interfere with the emotional connection of the relationship, and couples will hide emotions both primary (fear and insecurity) and secondary (anger and defensiveness). Relationship difficulties emerge when the relationship fails to provide security for one or both partners. Often, attachment difficulties lead to additional fears such as abandonment. A focus of counseling using this theory is on the feeling and expression of emotion. Through the expression of emotion, couples are more able to discover functional ways of interacting and ultimately satisfy their need for attachment.

Systemic couple counseling views the couple as a unique system in and of itself. Systems theory examines the context in which individuals live. Whereas individual psychology traditionally focused on internal processes causing problems, systems theory focuses on the family or couple system as the source of problems. Systems theory uses a holistic perspective, meaning the complexity of individuals in the context of their lives is considered when determining a problem’s source. The parts of systems interact with each other in a dynamic way, as each element in the system affects the others. A systemic couple counselor might use such techniques as having each person develop a family genogram (a diagram outlining family history and relational patterns) or sculpt family dynamics (a physical representation of couple dynamics and positioning), or the counselor might encourage the couple to discuss myths and stories. Homework assignments for the couple are an important part of this type of counseling.

The field of couple and marriage counseling has grown tremendously over the past 70 years, and in that time, theories related specifically to the treatment of difficulties in couples emerged. Many counselors do not rely on only one theory of counseling but use an integrative approach in response to the couple’s needs and to assist couples with many different types of difficulties.

Unique Process of Couple and Marital Counseling

The increase in divorce rates in the United States is one example of the complexity of an intimate relationship and the challenges in maintaining the intimate bond of a marriage or committed relationship. Often couples enter counseling when they feel they have no other options for maintaining the relationship, creating a greater intensity in the counseling process. It is typical with many relationships that when there are problems, each member blames the other for the problems and may even expect the other to make significant changes to make the relationship work. Because both members in the relationship are invested in being right, each may attempt to establish with the therapist that he or she is right. Therefore it is essential that the counselor remain neutral and objective, honoring the viewpoint of both, as both are the client in this regard. The counselor must recognize the contributions both make to the relationship struggles.

Because couple counseling is dynamic and intense, it requires the counselor to be active and direct. When negative interactions occur between individuals in a couple, the counselor must block their communications and redirect them to more facilitative, respectful, new patterns of communication. A positive counseling experience allows the couple an opportunity to explore new behaviors and practice the skills they learn.

A consideration unique to couple counseling is whether to see both members together at all times or to explore whether separate individual sessions would at times be helpful. Each couple and marriage therapist makes this decision based on his or her therapeutic approach. Some therapists first see the couple together and follow up with individual sessions to determine individual concerns. Often in these cases the counselor is also seeking to determine individual commitment to the relationship to assess the degree to which the counseling is likely to be successful. Other couple and marriage counselors see couples together only.

Secrets also are an important consideration for the couple and marriage counselor. Specifically, one partner may not be aware of how close the other partner is to ending the relationship, or there may be an undisclosed affair or some other secret that is impacting the relationship. Couple and marriage counselors differ on how to handle secrets in couple and marriage counseling. As mentioned above, some counselors only see couples together to avoid being drawn into a secret. Other couple and marriage counselors are willing to hear secrets so they know the information about the relationship, regardless. Often counselors inform the couples before the counseling begins how they will handle secrets, specifically whether they will reveal the secret to the other partner if a secret is revealed.

Common Issues in Couple and Marital Counseling

In general, when either person in a partnered relationship views the dynamics in the relationship as problematic, the couple may be appropriate for couple counseling. Although the list of reasons why a couple may seek couple counseling is endless, there are broad categories of problems that are common problems presented by couples.

A study conducted by Whimson, Dixon, and Johnson indicated that communication problems were the most frequently reported difficulties, with power struggles, unrealistic expectations of spouse, sex, and problem-solving being the next most frequently reported problems, in that order. A few of the couple problems that were ranked as most difficult to treat were a lack of loving feelings, alcoholism, extramarital affairs, and power struggles. There are several problems presented in couple and marriage counseling that require the counselor to make challenging decisions, and these often require a unique set of skills; specifically, these problems are intimate partner violence and extramarital affairs. Couple and marriage counselors face barriers such as secrecy, trust, and safety when working with couples on such difficulties. Additionally, with couples who experience violence in the relationship, secrecy is often an unspoken expectation that creates a large barrier in the counseling process.

Challenges in Couple and Marital Counseling

The practice of couple and marriage counseling is facing, and will continue to face, unique challenges as the nature of the intimate relationship also changes. Specifically, the field is responding to the demand for a broader definition of couple to address the needs of diverse couples. Diversity in relationships refers to cultural and ethnic differences not only between counselor and couple but between partners in the relationship. Diversity also includes religion, sexual orientation, couples remarrying, and the aging of couples. An additional challenge to couple and marital counseling is the prevalence of violence among couples. A call to the profession is to develop more programs for treating violence in the intimate relationship.

References:

  1. Bischof, G. H., & Helmeke, K. B. (2003). Couple therapy. In L. Hecker & J. L. Wetchler (Eds.), An introduction to marriage and family therapy (pp. 297-336). Binghamton, NY: Haworth Press.
  2. Broderick, C. B., & Schrader, S. S. (1981). The history of professional marriage and family therapy. In A. S. Gurman & D. P. Kniskern (Eds.), Handbook of family therapy (pp. 5-35). New York: Brunner/Mazel.
  3. Christensen, A., & Heavey, C. L. (1999). Interventions for couples. Annual Review of Psychology, 50, 165-190.
  4. Doss, B. D., Thum, Y. M., Sevier, M., Atkins, D. C., & Christensen, A. (2005). Improving relationships: Mechanisms of change in couple therapy. Journal of Consulting and Clinical Psychology, 73(4), 624-633.
  5. Jacobson, N., & Gurman, A. S. (1986). Clinical handbook of marital therapy. New York: Guilford Press.
  6. Lebow, J. (2000). What does the research tell us about couple and family therapies? Journal of Clinical Psychology, 56(8), 1083-1094.
  7. Whisman, M. A., Dixon, A. E., & Johnson, B. (1997). Therapists’ perspectives of couple problems and treatment issues in couple therapy. Journal of Family Psychology, 11(3), 361-366.

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