Working with Couples: a different focus

 I am not a specialist in couple counselling, but as a rural Community Health Social Worker I have found myself, over the years, in the position of needing to work with couples.

When working with individual clients we are usually processing individual issues, but with couples I have found it useful to change my focus to working with the dynamics between the people -- what goes on between individuals rather than within individuals.

A useful tool

I have found this worksheet to be helpful to explain to couples that we will be working with the unique relationship dynamics that are occurring between them. We begin, however, by naming each person and listing any already identified individual issues beneath each respective stick figure, so that these are acknowledged. These may be added to as the session continues. Then I explain that we will be changing the focus to the relationship dynamics and this is represented by the triangle above them. I add that this takes the blame out of the situation and gives them something to work on together.

Looking for patterns of interactions and underlying themes

Assessing for the issues that are creating repeated problematic patterns of behaviour between the couple is the next step.

Couples will often describe particular incidents, and may begin to argue about these. It is helpful to encourage them to take a step back to look for the underlying themes behind these incidents -- and we may need to identify and name these for them. This is like taking a helicopter view of the relationship, so that the couple becomes less involved with the detail at ground level. A worksheet on the helicopter view can be found at:

http://www.getselfhelp.co.uk/docs/HelicopterWorksheet.pdf

It can also be useful to track, on paper, a recurring pattern of a typical argument to externalise it, and then explore for alternative actions at each point in the argument cycle to allow it to be broken.

A useful article

There are many theories and approaches to working with couples, but an article that I have found especially useful is The multi-level approach: a road map for couple's therapy by Michele Scheinkman. It can be found in the journal Family Process Vol 47 No 2, 2008 and outlines four different levels of focus and interventions.

http://www.michelescheinkman.com/ScheinkmanMultilevelApproach2008.pdf