How do you
do marriage/relationship therapy?
Ok, let's start with
the hardest question first. It is the most difficult for several different reasons.
While people often come into treatment with communication issues, there are
often many differences. Counselors have developed a variety of different methods
and techniques to address such problems. How I would work with a couple will
depend on many factors. Usually, I review treatment options with you so that
you can both decide which seems to be the best fit.
That said, my style
of treatment often uses a combination of different techniques. My original training
was in brief forms of strategic family therapy but I currently use many different
approaches. Essentially, I work to either provide safe havens where couples
can acquire new tools or to have some transformational experiences that will
enable them interact differently. Sometimes this involves some homework activities
and behavioral experiments. If you ever have questions about homework, please
call and not wait until your next appointment. Clarifying instructions can help
you progress more rapidly towards the change you both seek.
Typically, I will
meet with both of you on the first session. I will take a second and third to
gather social histories. A good social history is important because our earliest
family experiences and prior relationships often provide important clues into
the current situation. Sometimes, it might take more than one session to gather
a social history if additional time is required. After taking the history, we
are able to get quickly get to work.
Is it best to come in together with my partner or should I come alone the first time?
Coming in together initially helps people to feel like they are on the same footing. If people don't come in together they often fear that the therapist can become biased about the situation. While I do not think that is usually true, that kind of worry can coming in seem more daunting than it should.
After we are in the
work phase, it is sometimes wise to take some time to do some individual work
with each partner during one to four sessions to address particular problems
such as unresolved anger. There are some specialized techniques that can help
clients to make rapid progress. Information about these techniques are found
on other places here on the web site.
Should we bring anything to the first session?
Yes several items
would be helpful such as the following:
· If possible,
please complete your intake questionnaire prior to coming to the session. If
I am unaware that you have not completed the session, you may take 15-20 minutes
of your session, completing the paperwork. Most Employee Assistance Plans (EAP's)
and Insurance companies require this information to be gathered. Plus, it saves
time and leaves more time for us to talk. I recommend that you not email the
questionnaire back to me because the confidentiality cannot always be assured
on the Internet.
· If your
benefits come from an HMO or PPO insurance plan, it may be helpful to have brought
your insurance benefit card. Asking your insurance provider or referring EAP
company how many sessions you are authorized and whether or not you have a co-payment
is important. The documentation that some companies send often arrives a couple
weeks after we have met.
What Can We Expect At The First Session?
If this is your first
time in counseling, many are not certain what to expect. Counselors often use
the first session to become acquainted with you and how you both view your situation.
We often inquire about medical problems, and various habits such as sleep and
appetite problems. These questions are important because they help us to determine
if certain conditions might exist. In some cases, a counselor might advise a
medical evaluation to help rule out other physical causes for a symptom or to
prescribe medication that could be helpful.
During the first
session, couples may have been holding in some feelings for awhile. For some
it is the first chance in awhile that they have been able to speak their minds.
A counselor's job is to allow both participants to talk openly about their perspectives.
If emotions are running high, there may be some moments of tension that may
be similar to what happens at home. If so, that is useful for a counselor to
see so that they can help determine the best strategies.
Other questions might
ask about the following knowing more about your social situation and your goals
for future changes. Sometimes, I may recommend a referral to a support group,
your primary care physician, or other resource. We will conclude by scheduling
the next appointment for gathering your social histories.
Since problems develop
over time, it may take several sessions to see new changes take hold. Finally,
know that many couples have successfully navigated these same challenges in
the past. Doing so takes a willingness to try new things and to discover together
what is possible.