Couples Therapy and Marriage Counseling

By Paul Lohkamp, MSW, LCSW
 
 

In couple therapy I usually meet with both partners together and separately.  It is important that I understand each partners concerns and
perspective.  Most often couples make the decision to ask for help when there is conflict that doesn't subside, even after they have made
serious efforts to change. Most often the conflict is driven by the hurt and anger that partners' feel when their most important dreams for
the relationship have been frustrated.
Sometimes couples seek counseling as soon as problems get out of hand.  Others wait sometimes for years before they seek help.  
Whatever your history of problems and attempts to resolve or repair, I hope I can help.  We will design a treatment plan for each couple,
but there are some patterns that I have found to be helpful for most couples. A usual treatment process is summarized below: ]

    First Session:  Partners meet with the therapist together, and describe their concerns, their strengths, and most importantly, the
    dreams and expectations they have for their relationship.

    Second & Third Sessions:  Each partner meets with the therapist separately to describe their perspective on the problems, and
    their own personal history, including a brief discussion of the family of origin.

    Fourth Session:  Using information from the first three Sessions, we will write a tentative treatment plan. It is important to make
    sure that this plan includes both partner’s perspectives.

    Subsequent Sessions:  The focus of the subsequent sessions depends on the nature of your problems and on your resources
    for coping with them. One constant is that the therapist’s help in the sessions actually   takes you deeper into key aspects of your
    problems and moves you further toward remedies and repair..

Who can benefit from marriage counseling?
No relationship is perfect. Each person brings his or her own ideas, values, opinions and personal history into a relationship, and they
may or may not match with their partner's. Those differences don't necessarily mean your relationship is bound for conflict. To the
contrary, differences can be complementary and the strength of your marriage.

But relationships can be tested. Differences or habits you found endearing in the beginning may grate on your nerves later. Sometimes
specific issues, such as an extramarital affair or loss of sexual attraction, trigger problems in a relationship. Other times, there's a
gradual decrease of  affective communication and caring.
Whatever the cause, problems in a relationship can create undue stress, tension, sadness, worry, fear and other problems. You may
hope your relationship troubles just go away on their own. But a bad relationship may only worsen and eventually lead to physical,
psychological problems or stress breakdown.  A bad relationship can also create problems on the job and affect other family members
or even friendships as people feel compelled to take sides.

Here are typical issues that marriage counseling can help you and a spouse or partner cope with:

    o        Infidelity                                                                                o        Divorce and separation
    o        Alcohol or Substance abuse                                           o        Physical or mental conditions
    o        Same-sex relationship issues                                        o        Cultural differences or clashes
    o        Finances or money management issues                     o        Unemployment and job problems
    o        Blended families                                                                o        Communication problems
    o        Intimacy or sexual difficulties                                           o        Conflicts about child rearing or parenting
    o        Anger and conflict                                                               o        Changing roles, such as childbirth

Domestic violence:  Counseling may also be of help in cases of domestic violence or abuse. However, if the abuse or violence has
escalated to the point that you fear for your safety or that of your children, consider contacting the police or a local shelter or crisis center.
We cannot proceed with marriage counseling until you are absolutely sure that you are safe and there is no risk of violence.

Strengthening bonds:  You don't need to have a troubled relationship to seek therapy. Marriage counseling can also help couples
who simply want to strengthen their bonds and gain a better understanding of each other. Marriage counseling can also help couples
who plan to get married. The pre-marriage or “new couple’s counseling can help you achieve a deeper understanding of each other and
iron out differences before a union is sealed.

How does marriage counseling work?
Marriage counseling typically brings couples or partners together for joint therapy sessions. We will pinpoint and understand the sources
of your conflicts and try to resolve them. You and your partner will analyze both the good and bad parts of your relationship.
Marriage counseling can help you learn skills to solidify your relationship. These skills may include communicating openly, problem
solving together and discussing differences rationally.  Read the article, How to Stop Being So Critical; which discusses several
perspectives related to this.  
In some cases, such as mental illness or substance abuse, we may work with other health care professionals to provide a complete
spectrum of care and counseling.
Talking about your problems with a marriage counselor may not be easy.   I will try to help so that sessions will not pass in silence as you
and your partner seethe over perceived wrongs. Or you may bring your fights with you, and we will set rules and boundaries so yelling and
arguing during sessions are manageable. I can act as mediator or referee and help you cope with the emotions and turmoil. I will always
try not to take sides in these disputes.
Sessions often take an experiential format, that is a focus on doing and experiencing the new methods or behaviors that you are
learning.  You may find your relationship improving after just a few sessions. On the other hand, you may ultimately discover that your
differences truly are irreconcilable and that it's best to end your relationship.  I will respect either decision.
   What if your partner refuses to attend marriage counseling sessions? You can go by yourself. It may be more challenging to patch up
relationships when only one partner is willing to go to therapy. But you can still benefit by learning more about your reactions and behavior
in the relationship.

How do you choose a marriage counselor?  Take care when choosing a marriage counselor or therapist. Not all are
licensed or certified, or have specialized training in couples counseling.
Look for a marriage counselor who is a licensed mental health professional. Many marriage counselors are specifically designated as
licensed marriage and family therapists (L.M.F.T.s). Licensing and credentialing requirements can vary by state. But most states require
advanced training, including a master's or doctoral degree, graduate training in marriage and family therapy, and training under the
supervision of other experts.
My continuing education or professional training focused on marriage counseling for three years between 2000 and 2003.  This included
the John Gottman Institute training, [www.gottman.com ]; Dan Wile, Collaborative Couple Therapy [http://www.danwile.com/] and Bill O’
Hanlon, [www.billohanlon.com]
 I would be happy to answer any questions you have about my training.


What questions should you ask when choosing a marriage counselor?
Before choosing a new marriage counselor, you can ask lots of questions to see if he or she is the right fit for you. Consider asking
questions like these:
    o        Are you licensed by the state or a clinical member of the AAMFT, or both?
    o        What is your educational and training background?
    o        What is your experience with my type of problem?
    o        How much do you charge?
    o        Are your services covered by my health insurance?
    o        Where is your office, and what are your hours?
    o        How long is each session?
    o        How often are sessions scheduled?
    o        How many sessions should I expect to have?
    o        What is your policy on canceled sessions?
    o        How can I contact you if I have an emergency?

Deciding to see a marriage counselor can be difficult.  Not making the decision can be worse.  Seek help rather than trying to ignore it or
hoping it gets better on its own.

Paul Lohkamp