Finding A Couples Counselor
Most relationships begin with a phone call. While many consumers of therapy know they should be asking questions, many don’t have any idea what to ask. You probably want a chance to hear (briefly) how this person thinks, approaches problems, and inspires confidence. The following questions do not have right/wrong answers, but may give you some insight into how a therapist approaches a couple.
How active are you in the therapy process?
- Do you recommend if people should stay together or separate?
- If so, on what basis?
- What is your comfort level/experience with (as relevant):
- lesbian or trans couples
- affairs or polyamory
- sexual abuse
- domestic violence
- addiction problems
- blended families
- step children
- If you had to pick, do you have an orientation toward preserving the relationship and/or toward fulfillment of individual needs?
- What do you do if there’s an alcohol or drug problem?
- We have ___ sexual problem. If that something you have experience with?
- What do you think helps couples improve their communication?
From the therapist’s point of view, it is helpful to hear a brief statement of the problem, how long you’ve been together, if you’ve sought help before and your time/location needs. If one person is in serious distress, i.e. suicidal, or has an addiction problem, be sure to tell the therapist during the intake call.
“Should We See You Alone or Together?”
Once into a therapeutic relationship, many clients are confused about the “rules” governing whether they should be seeing their couples therapists for individual meetings as well. This confusion is actually quite appropriate for there is not a consensus in the therapy community about what these “rules” should be. The particular way a therapist makes these decisions has to do with her theoretical orientation, how she perceives what is happening with the couple, and, sometimes, pure instinct. Each of these bears closer examination.
Then there is the question of what is going on with the couple. A common example might be where one partner—let’s say the wife—is having an affair. The wife might want to tell the therapist what’s really going on. Again, different therapists regard this differently. Therapist A says she doesn’t want to know important information the spouse doesn’t know, for this may result in further betrayal and humiliation. She might be hoping that on-going therapy will generate enough tension that any secrets will resolve themselves or be brought up as couples issues. Therapist B says he will keep the information confidential, but will discontinue couples treatment until the client discloses her behavior. He might believe there is no point in anyone wasting their time as long as an affair is going on. Therapist C says she will keep the secret, with various contingencies, e.g. the wife needs to get individual therapy, the affair needs to stop immediately, etc. Which is “right?”
The therapist also has “instincts” for what he thinks is needed and/or can be tolerated, based on his experience. Some individuals may be quick to feel “ganged up on” if their spouse is developing an independent relationship with the couples therapist. Couples therapy is a lot about fairness. Others are not nearly so threatened. Conversely, sometimes the communication between two people has broken down so completely has become so negative that hardly anything can be said in the presence of the other without generating a near-reflexive reaction. An opportunity to develop one’s thoughts without so much threat can often be useful.
So out of this muddle, are there any guidelines? Yes. Most orientations move toward something equitable, assuming that both people have participated in making the situation the way it is. If there is a desire for individual sessions, it is not uncommon for this to be resolved by: 1) seeing the couple every other week, and individuals in separate sessions in between; or 2) continuing to work with the couple and suggesting they see individual therapists. While this is an expensive alternative, it may maximize the treatment effect in the shortest period of time.