Ask a Psychologist: What are some commonly used Couples Counselling Approaches?
Couples counselling has become increasingly common, given the increase in knowledge and psychoeducation in regard to what a healthy relationship looks like, and what resources are available to improve the wellbeing of a relationship.
What is couples counselling and what does it look like?
Couples counselling is not a one-size-fits-all, standardised approach. Rather, it is a family of different therapeutic approaches and theories developed to address and help with relationship challenges. Very much like individual therapy, each therapeutic approach is different, and psychologists often draw from different approaches depending on your needs. It is important to note that, while the client of individual therapy is the individual, the "client" of couples therapy is the dynamic of the couple. Couples counselling does not "take sides"; rather, it should address the individual challenges that contribute to the ineffective functioning of the (dynamics of the) relationship. At times, this means that the childhood and individual attachment styles (e.g., secure, anxious, avoidant, disorganised) of each person in the relationship are discussed, so that the challenges of the dynamic can be studied. For example, attachment theory suggests that someone with a more avoidant attachment style may tend to withdraw when conflict arises, while someone with an anxious attachment style may feel a stronger urge to seek reassurance or resolution quickly. Rather than placing blame on either of the individuals, the therapist may help each person understand their attachment styles and their contribution to the relationship challenges, and work with both parties to adjust their behaviours to reach an optimal way of resolving an issue effectively.
What do the first few sessions of couples counselling look like?
Similar to individual therapy, assessment usually occurs in the first couple of sessions, both individually, and together as a couple. Usually, relationship history, current stressors, precipitating factors of current difficulties, usual coping mechanisms, cultural and ethnic identities, etc., will be discussed.
Commonly used Couples Therapy Approaches
Emotionally Focused Therapy (EFT) for Couples
EFT is an evidence-based couples therapy that is developed from attachment theory. EFT holds that the functioning of romantic and intimate relationships (and some other interpersonal relationships) is similar to our early attachment to our primary caregivers. EFT helps each person identify their own attachment style, with the aim to identify an effective way to meet each other's needs. With this in mind, EFT helps to identify unhelpful relationship patterns, dynamics and cycles, and works on effective communication of emotions and needs. These can be vulnerable emotions such as fear of abandonment, which may be difficult to express, and is sometimes expressed as anger, which perpetuates the cycle of unhealthy communication patterns.
The Gottman Method
The Gottman Method is a well-known Couples Therapy approach. It involves some structured assessment at the beginning to identify unhelpful patterns in a relationship, which the researchers have named the "Four Horsemen": criticism, contempt, defensiveness, and stonewalling. It has been indicated that contempt is a particularly strong predictor of breakdown in relationships.
The treatment involved in the Gottman Method is highly skills-based, involving exercises and practices for the couple to act on between appointments. The treatment is structured around what Gottman named the "Sound Relationship House," which is to build fondness, manage conflicts, and create shared meaning. The Gottman Method would be suitable for couples who respond well to structure and homework, and those who commit to change by practising skills between sessions.
Narrative Therapy for Couples Counselling
Narrative Therapy is grounded in identifying the narratives and "stories" that couples may become entangled in about their relationships. With Narrative Couples Therapy, the aims are to help couples identify these narratives, reframe and manage these stories, and to focus on building connection, fostering understanding and, eventually, meaningful change.
There are a few interventions introduced in Narrative Couples Therapy, such as:
Externalising the narrative: naming and describing the presenting problem as separate from the couple and their relationship
Re-authoring conversations: identifying strengths and positive moments of the relationship
Writing letters: writing letters/narratives to each other or to the problem itself
Mapping the influence: identifying how the conflict and the problem affect their life, individually and as a couple
Which Couples Therapy approaches are suitable for me?
There are a number of ways that couples therapy can help and support our relationships. Seeing a trained and skilled professional is the first step, where assessment occurs to decide which approach is suitable. It is also worth noting that many Couples therapists are not "purists." This means they often use an eclectic approach and utilise a combination of interventions when appropriate.
If you want to find out more about Couples Therapy or relationship counselling, you can contact our Client Support Team for more information.