5 PRINCIPLES OF EFFECTIVE RELATIONSHIP THERAPY FOR COUPLES

If you’re part of a couple in distress, you may feel that there’s no way out of your troubled relationship. Myths about the low success rates of couples therapy and counseling only make your situation seem worse than it is. Recently, New York Times columnist Elizabeth Weil reinforced that unfortunate impression in her column “Does Couples Therapy Work?”  She concludes that, even regarding the most effective methods: “Both types of therapy are structured, and the results of both are well documented, at least in follow-ups for a few years. Still, the entire field of couples therapy suffers from a systemic problem.” The problem she refers to is real enough- couples often wait until very late in the game to seek intervention and by then, one or both may have decided to call it quits. It’s also true that, as she observes, being an effective couples therapist requires different skills than the skills demanded by being an effective individual therapist. Nevertheless, the data largely refute Weil’s claims.  When properly conducted, couples therapy can have demonstrably positive effects.

UCLA psychologists Lisa Benson, Meghan McGinn, and Andrew Christensen recently published a major review of over 40 years of research on couples therapy (Benson et al., 2012) in which they synthesized the approaches of the most successful methods of intervention. They’ve boiled down this massive amount of research to show that across major theoretical orientations within the field, couples can benefit when they receive treatment that follows five underlying principles. Although one therapist may ascribe to a behavioral approach and another to an emotional approach, as long as both use similar strategies to help their clients, both therapists can produce positive and effective change.

Evidence-based approaches are key to understanding effective therapy, whether for individuals or for couples.  This means that the therapy you are receiving was tested against alternative methods, preferably in randomized controlled trials.  Psychologists who provide evidence-based treatment don’t stick to one particularly theoretical orientation just because they learned it in graduate school. Instead, they adapt their approach to ensure that they are following the best evidence- both clinical and research.

Unfortunately, articles such as Weil’s reinforce the public’s view from television and movies that therapists suffer so much from their own human failings that they are unable to provide effective care.  Weil points out that being a couples therapist can be draining. In comparison to individual therapy, there’s less time to sit back, reflect, and provide a response to a client’s statements. If you sit back too long, the session may devolve into a shouting match, she claims.

Being a couples therapist does requires special skills but that is what the training is about. Individuals who go into marriage and family counseling or therapy take years of rigorous coursework and supervision, go through an arduous credentialing and licensing process, and continue to receive education throughout their careers to learn about the field’s newest developments.  There inevitably is self-selection involved in who decides to become a family therapist and, even more so, who stays in the profession. The chances are excellent that the couples therapist you see is someone who is providing this treatment because he or she is committed to helping couples enact positive changes in their lives.

Let’s turn now to those five basic principles of effective couples therapy, which, according to Benson and colleagues:

1. Changes the views of the relationship.  Throughout the therapeutic process, the therapist attempts to help both partners see the relationship in a more objective manner.  They learn to stop the “blame game” and instead look at what happens to them as a process involving each partner. They also can benefit from seeing that their relationship takes place in a certain context.  For example, couples who struggle financially will be under different kinds of situational stresses than those who are not.   Therapists begin this process by collecting “data” on the interaction between the partners by watching how they interact. Therapists then formulate “hypotheses” about what causal factors may be in play to lead to the way the couples interact. How they share this information with the couple varies by the therapist’s particular theoretical orientation. There’s empirical support for a variety of approaches from behavioral to insight-oriented.  Different therapists will use different strategies, but as long as they focus on altering the way the relationship is understood, the couple can start to see each other, and their interactions, in more adaptive ways.