Gottman Couples Counselling

Answering calls from individuals looking for a couples counsellor or marriage therapist I am often asked ifI am a Registered Psychologist, rather than a Marriage and Family Therapist. This is important to many people because their extended health care plans only cover couple's therapy, relation counselling and marriage counselling offered by a Registered Psychologist, and not by a Registered Clinical Counsellor. They often wonder why and the answer is pretty simply: Registered Clinical Counsellors in BC are not actually "Registered" or regulated by the government, as are medical doctors and psychologists. They don't have a regulatory body but instead have an association which they have membership in. This is important to some insurance companies, and not to others, as a quality control issue. But still, I'm surprised so few people ask me about being a "Family Therapist." Here in BC, besides RCCs or "Clinical Counsellors," and Registered Psychologists we have a third important group of trained professionals, "Registered Marriage and Family Therapists" or RMFT. For information on how to find a RMFT near you I recommend visiting the British Columbia Association for Marriage and Family Therapy (BCAMFT) at this web site: http://www.bcamft.bc.ca/

One important issue to remember is that if your extended health care will only pay for services from a Registered Psychologist and your after marriage counselling or relationship therapy, many Registered Psychologists are also RMFT here in BC. Cross Registration is not unusual. That may serve as a solution to getting someone who qualifies under your insurance program AND is an expert in marriage and family therapy. Marriage counselling, marriage therapy and family therapy is a separate license in most US states and provinces in Canada because it's a specialized field of practice involving specific training in family therapy, couple counselling and 'systemic" based theory and practice.

The next most frequent question I get about couples counselling and therapy is "Are you trained in the Gottman method?" The Gottman method for marriage and family counselling or therapy is a very specific set of training, theory, practice and expertise. John Gottman began working with couples over 25 years ago, and unlike other counsellors and therapist who came to the problem of working with couples and relationships from a clinical point of view John Gottman started as a researcher and then became a therapist. He moved from theory and science based practice to therapy itself. John Gottman prides himself upon his "scientific" basis for his practice. Not everyone would agree that his research is as important and different from other ways of doing couple's counselling and marriage therapy, but overall after looking at what he has done and comparing it to other theories and practices in counselling it is far more research and science based. Not perfect, but so obviously better.

Because of this many couples want to use the "Gottman technique" in working on their marriages.

His theories would fall under the "communications, negotiation and conflict resolution" school of couple counselling. What you can expect when working with a therapist or counsellor using the Gottman method is  this: "Successful conflict resolution isn't what makes marriages work." That's a somewhat new and different point of view. Most couples come to counselling and therapy expecting that the primary ...sometimes the only goal of counselling and therapy is learn how to solve conflicts successfully. Gottman says there is more to a healthy marriage or relationship than that.

What Gottman actually says is that if you do this simple and basic things your marriage will work, conflicts or no conflicts. That thing is: Increase positive interactions. It's as simple as that, and as hard as that. This is not a new concept, and has been around as part of basic parent education programs for decades. Increasing positive interactions comes BEFORE solving conflict issues because doing this makes the solving easier, more likely and sometimes not even necessary. (Not necessary because the truth is most conflicts in most relationships aren't solved anyway, we most often agree to disagree. When we can't, there are other problems going on and it's not necessarily a problem with communication or conflict resolution -again- because in real life people learn to disagree.)

What are the ways that we can increase the positive interactions in our relationship?  First, Gottman says we need to know each other. We have to learn, or perhaps re-learn and become aware of again - each other's like's and dislikes, wishes, dreams and hopes. We don't have to share these, we need to know our partners. Second, we need to focus on each other's positive qualities (name them, be aware of them), be aware of the positive feelings we have for each other, and what positive experiences we have shared with each other. We do this through completing check lists and structured conversations and interactions. Finally, we need to do these positive interactions frequently, as often as possible. It isn't the big events that bring us together, it's the little things.

Gottman adds some more tradition components to his "Secrets" of successful relationships, including sharing power, communicating respectfully (don't jump in and try to solve things that can't be solved, all that is is a good way to lose respect for each other!), overcome the "gridlock" that is stopping you from moving forward and finally work actively at creating shared meaning (values, attitudes, interests and traditions).

While Gottman's method of marriage therapy and couple therapy may sound a little less radical that he portrays it, it still takes a very different point of view and focus than most traditional methods of couple counselling which are usually focused almost entirely on "communications training."

Gottman's work can be read about in some very useful self help books including his "Seven Secrets to a Successful Marriage." I highly recommend this book, and use it, along with Gottman specific training materials during couple and marriage therapy in my practice in Burnaby and Vancouver. But there is one more point, a warning from a number of therapists. Some therapist feel the greatest factor in couples being unable to use the Gottman materials independently (or to naturally interact as Gottman proposes) is individual psychopathology. One member of a couple may be hypersensitive to comments from the other due to low self esteem or personal history. One member may have ADHD, a learning disability or a difficult time expressing and understanding the emotions of others. One may have depression, an anxiety disorder or a more serious personality issue. For these couples the initial work needs to be one-on-one. Individualized treatment aimed at preparing them to take part in couples counselling or therapy. Sometimes there is simply such an imbalance of power within the relationship that it's impossible for one member to participate until they have skills and tools that make them feel safe and in control of their own destiny and decision making process. These are issues for someone with considerable experience in both couple and individual therapy, as well as using the two together.

For more information on the services I provide as a Registered Psychologist and Registered Marriage and Family Therapist in my Vancouver and Burnaby offices please see my web pages at: www.relatedminds.com or http://www.relatedminds.com/couples-therapy/
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KEYWORDS: Couple Counselling, Couple Therapy, Marriage Counselling, Marriage Therapy, Registered Psychologist, Gottman, Vancouver, Burnaby, New Westminster, Coquitlam, Maple Ridge

About Counselling and Therapy Services

As a Registered Psychologist I provide individual therapy and counselling services using the evidence based techniques of Cognitive Behaviour Therapy (CBT) and Rational Emotive Behaviour Therapy (REBT). Individuals are seen in both my Burnaby and Vancouver offices for a variety of issues including chronic pain, depression, anxiety, stress, panic, anger management, ADHD and work or relationship issues. 

I hold an Advanced Certificate in Cognitive Therapy from the Albert Ellis Institute in New York. If you are looking for a cognitive therapist you should ask what training they have in CBT, as many individuals claim they practice CBT after completing only a workshop or reading a book. The Advanced Certificate Program at the Albert Ellis Institute included extensive CBT readings, group and individual training and supervised practice of Cognitive Behaviour Therapy/Rationale Emotive Behaviour Therapy under the supervision of a licensed mental health practitioner. In addition to my practicum at the Ellis Institute I also focused on CBT during my graduate studies and post doctoral internship. Registered Psychologists undergo one year of of full time supervised practicum experience, as well as a year of post doctoral experience. Since graduation I have practiced counselling and therapy for over 20 years and have served as the program director and practicum supervisor in several hospitals, universities and community mental health centres.

FAQs:

Could you tell me more about Cognitive Behaviour Therapy (CBT)?

My primary mode of practice is rational-emotive/cognitive therapy. Cognitive Behaviour Therapy or CBT (including Rational Emotive Therapy) is a highly effective, research driven approach that helps people to combat and overcome such difficulties as high anxiety/stress, panic attacks, depression, anger, relationship problems, phobias, worry, obsessions, compulsions, addictions (food or drugs), social anxiety, sexual problems, ADHD and low self-esteem. The course of treatment is typically short-term (approximately 8-12 sessions), and people often enjoy rapid and enduring relief from their symptoms. I am also trained in other counselling and therapy techniques, and use these when and where appropriate. Overall I try to match  the skills and techniques to your needs. My office provides a supportive, caring and safe environment to work on change and focus on growth and future success.

I have heard about "Schema Therapy," what's that?

Schema-Focused Cognitive Therapy goes further, to help people address and break long-standing or particularly stubborn patterns of thinking, feeling and behaving that arise from deep-seated beliefs, such as “I’m unlovable,” “I’m a failure,” “People don’t care about me,” “I’m not important,” “Something bad is going to happen,” “People will leave me,” “I will never get my needs met,” “I will never be good enough,” etc. Remarkable results have been achieved via the Schema-Focused approach, even for people who have previously found other therapies to be ineffective. Results of course cannot be guaranteed, however, compared with other types of therapeutic intervention research has shown Cognitive Therapy to be effective.

Schema-Focused and Rational Emotive and Cognitive Behaviour Therapy do more than address symptoms, they address a way of thinking that causes you problems in life, work and relationships. In addition to individual therapy I often recommend readings which emphasize the personal growth aspects of cognitive behaviour therapy as well as those that focus on symptom relief.

Do you do any "Mindfulness" work?

In collaboration with other health related professionals I have recently (the past two to three years) begun to offer a longer and more intensive form of Cognitive Behaviour Therapy called Mindfulness Based Cognitive Therapy (MBCT). This method of therapy blends together features of two disciplines: Cognitive Behaviour Therapy (CBT), which aims to identify and alter cognitive distortions (irrational or inaccurate thoughts) and Mindfulness, which is a meditative (mental focusing) practice taken from Buddhism which aims to help people identify their thoughts, moment by moment, but without passing judgement on the thoughts. As with other medically based meditative interventions, this is not a religious oriented practice, but a scientifically supported methodology used in many medical and mental health centers throughout the world. This particular intervention is based upon Mindfulness-Based Stress Reduction (MBSR), an eight week program developed by Jon Kabat-Zinn in 1979 at the University of Massachusetts Medical Center. MBSR research has shown that this combined intervention method is enormously empowering for patients with chronic pain, hypertension, heart disease, gastrointestinal disorders, ADHD, as well as psychological problems such as anxiety, panic and depression.

More about Cognitive Behaviour Therapy

Albert Ellis and the Institute for Rational Emotive Behaviour Therapy

In 1955 Dr. Albert Ellis developed  Rational Emotive Behaviour Therapy or “REBT”  which is an action-oriented therapeutic approach that stimulates emotional growth by teaching people to replace their self-defeating thoughts, feelings and actions with new and more effective ones. REBT teaches individuals to be responsible for their own emotions and gives them the power to change and overcome their unhealthy behaviors that interfere with their ability to function and enjoy life.

Today the Albert Ellis Institute is a world center of research, training, and practice of REBT, its founder Dr. Albert Ellis remains one of the most influential psychologists of our time, and authored more than 70 books and 700 articles all designed to help people overcome destructive, self-defeating emotions and improve their lives.  Later Dr. Aaron Beck developed what is commonly called Cognitive Behaviour Therapy (CBT) along the same lines as REBT. Today these two cognitive based therapies are very similar, although some specific techniques may differ in the two schools of practice. Both are referred to as Cognitive Behaviour Therapy. I have received both my Basic and Advanced Certificates in Cognitive and Rational Emotive Therapy through the Albert Ellis Institute in New York City. For more information you can click here:

http://www.rebt.org Albert Ellis Institute in New York City

What will I be learning in Cognitive Behaviour Therapy (REBT/CBT)

and Schema-Focused Therapy?

You will learn to:

1. Identify the themes and patterns in your thoughts, feelings and behavior that cause you emotional wear and tear;

2. Learn how to handle your thoughts and manage your emotions so that you feel better and cope more effectively;

3. Learn how to handle problematic situations to maximize positive outcomes and experiences;

4. Prevent maladaptive cycles of thinking, feeling and behaving from repeating over and over again;

5. Find ways to reach your goals and get your needs met rather than running up against the proverbial brick wall.

Could you say more about Schema-Focused Cognitive Therapy?

Schema-Focused Cognitive Therapy is the approach developed by Jeffrey E. Young, Ph.D., who was a protégée of Dr. Aaron Beck. Prior to his founding the Cognitive Therapy Centers of NY and Connecticut, as well as the Schema Therapy Institute, Dr. Young served as the Director of Research and Training at the Center for Cognitive Therapy at U. Penn with Dr. Beck, where he trained many clinicians in the application of CBT. In working with clients, however, Dr. Young and his colleagues found a significant segment of people who came for treatment but had perplexing difficulty in benefiting from the standard approach. He discovered that these people typically had long-standing patterns or themes in thinking and feeling—and consequently in behaving or coping—that required a different means of intervention. Dr. Young’s attention turned to ways of helping patients to address and modify these deeper patterns or themes, also known as “schemas” or “lifetraps.”

The schemas (listed below) that are targeted in treatment are enduring and self-defeating patterns that typically begin early in life, get repeated and elaborated upon, cause negative/dysfunctional thoughts and feelings, and pose obstacles for accomplishing one’s goals and getting one’s needs met. Although schemas are usually developed early in life (during childhood or adolescence), they can also form later, in adulthood. These schemas are perpetuated behaviorally through the coping styles of schema maintenance, schema avoidance, and schema compensation. Dr. Young’s model centers on helping the person to break these patterns of thinking, feeling and behaving, which are often very tenacious.

In formulating the Schema-Focused approach, Young combined the best aspects of cognitive-behavioral, experiential, interpersonal and psychoanalytic therapies into one unified model of treatment. Through Young’s work and the efforts of those trained by him, Schema-Focused Therapy has shown remarkable results in helping people to change patterns which they have lived with for a long time, even when other methods and efforts they have tried before have been largely unsuccessful.

Schema’s that REBT / Cognitive and Schema Focused Therapy Focus on:

Emotional Deprivation: The belief and expectation that your primary needs will never be met. The sense that no one will nurture, care for, guide, protect or empathize with you.

Abandonment: The belief and expectation that others will leave, that others are unreliable, that relationships are fragile, that loss is inevitable, and that you will ultimately wind up alone.

Mistrust/Abuse: The belief that others are abusive, manipulative, selfish, or looking to hurt or use you. Others are not to be trusted.

Defectiveness: The belief that you are flawed, damaged or unlovable, and you will thereby be rejected.

Social Isolation: The pervasive sense of aloneness, coupled with a feeling of alienation.

Vulnerability: The sense that the world is a dangerous place, that disaster can happen at any time, and that you will be overwhelmed by the challenges that lie ahead.

Dependence/Incompetence: The belief that you are unable to effectively make your own decisions, that your judgment is questionable, and that you need to rely on others to help get you through day-to-day responsibilities.

Enmeshment/Undeveloped Self: The sense that you do not have an identity or “individuated self” that is separate from one or more significant others.

Failure: The expectation that you will fail, or belief that you cannot perform well enough.

Subjugation: The belief that you must submit to the control of others, or else punishment or rejection will be forthcoming.

Self-Sacrifice: The belief that you should voluntarily give up of your own needs for the sake of others, usually to a point which is excessive.

Approval-Seeking/Recognition-Seeking: The sense that approval, attention and recognition are far more important than genuine self-expression and being true to oneself.

Emotional Inhibition: The belief that you must control your self-expression or others will reject or criticize you.

Negativity/Pessimism: The pervasive belief that the negative aspects of life outweigh the positive, along with negative expectations for the future.

Unrelenting Standards: The belief that you need to be the best, always striving for perfection or to avoid mistakes.

Punitiveness: The belief that people should be harshly punished for their mistakes or shortcomings.

Entitlement/Grandiosity: The sense that you are special or more important than others, and that you do not have to follow the rules like other people even though it may have a negative effect on others. Also can manifest in an exaggerated focus on superiority for the purpose of having power or control.

Insufficient Self-Control/Self-Discipline: The sense that you cannot accomplish your goals, especially if the process contains boring, repetitive, or frustrating aspects. Also, that you cannot resist acting upon impulses that lead to detrimental results.

Reference: "A Client's Guide to Schema-Focused Cognitive Therapy" by David C. Bricker, Ph.D. and Jeffrey E. Young, Ph.D.,

Cognitive Therapy Center of New York. 1999

Summary

I hope you have found this very brief introduction to Cognitive Behaviour Therapy useful. In the office we discuss these issues, practice understanding our “automatic” and often irrational thinking, and learn to apply cognitive behaviour techniques to stop and change these debilitating thoughts. Progress is made through a combination of in-office counselling/therapy, readings and homework during which you apply what you have learned and practiced in the real world. While CBT may often be the primary therapy technique we use I often also involve psycho-education (direct teaching about your mental health issues), behavioural techniques and sometimes use my skills in Systemic and Family Therapy to address issues you may have with relationships, family or at work.

Fees

EAP and EFAP consignment, crime victims assistance program as well as extended insurance and self-pay are accepted. Session fees are $175.00 per hour. There is a sliding scale available to those will lower incomes. I also accept credit cards through on-line PayPal.

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Psychological services (including assessment, testing and therapy) provided in my offices include (covered by most extended health care insurance):

ADHD (click here: http://www.relatedminds.com/adhd-attention-deficit-hyperactivity-disorder/

Anxiety and Stress (click here:) http://www.relatedminds.com/anxiety-stress/">http://www.relatedminds.com/anxiety-stress/

Autism and Asperger's Disorder (Click here:)  http://www.relatedminds.com/autism/

Individual Counselling (click here: ) http://www.relatedminds.com/individual-therapy/

Child Counselling / Therapy (click here: ) http://www.relatedminds.com/child-therapy/

Couples Counselling / Therapy (click here:)  http://www.relatedminds.com/couples-therapy/

About Dr. Roche

I am a Registered Psychologist and a Registered Marriage and Family Therapist (RMFT) in British Columbia. In addition to my doctorate in clinical Psychology (The Union of Experimenting Universities), I hold a master's degree in family therapy from Goddard college, a certificate of advanced graduate studies (CAGS) in school and educational psychology from Norwich University, and have completed two years of post doctoral studies in neuro-psychology at The Fielding Institute in Santa Barbara, California. I am also a certified school psychologist, certified teacher of special education (New York and California), and a Clinical Member of the American Association of Marriage and Family Therapists (AAMFT). Finally, I hold a doctoral degree in law (JD) with an emphasis in medical malpractice and education law. Beyond my academic credentials, I have completed two years of supervised clinical experience in both hospital and community based clinics and two years of post doctoral training in neuropsychology. I have served as director of behaviour programming for several school districts, as a consultant on autism for the province, and have held numerous academic positions including Clinical Instructor in Psychiatry at New York University and Bellevue Hospital in New York as well as being a faculty member at NYU, Brooklyn College, SUNY New Paltz, and Norwich University.

My offices in Burnaby and Vancouver serve Burnaby, Vancouver, Coquitlam, Port Moody, Port Coquitlam, New Westminster and Maple Ridge. Clients often come to my Vancouver office from North Vancouver, West Vancouver and even as far as the Sunshine Coast. For more information on the location of my Burnaby and Vancouver offices, please see my "Office Location" page, which contains a Google map.

Key words

ADHD | Anxiety and Stress | Autism and Asperger's Disorder | Individual Counselling | Child Therapy | Testing and Assessments and Learning Disabilities | Couples Counselling | Depression | The Angry Child | Anger Management | Pain Management and PTSD | Forensic Services | Attention Deficit Hyperactivity Disorder | Vancouver | Burnaby | Coquitlam | New Westminster | Maple Ridge | Port Moody | Child Psychologist | Psychologist | Learning Disability | Assessment | Testing | Psycho-educational Assessment | Neuropsychological Assessment

http://www.relatedminds.com

http://Therapists.PsychologyToday.com/rms/70682

http://www.therapistlocator.net/member?183420

http://www.bcpsychologist.org/users/jimroche

http://www.actcommunity.net/jim-roche.html

Treatments for Anxiety and Stress

Anxiety and Stress

For both Anxiety Disorders and Stress Related Symptoms I offer individual counseling and therapy in my Vancouver and Burnaby offices (serving Coquitlam, New Westminster, Port Moody and Maple Ridge). In most cases we use Cognitive Behavioural Therapy (CBT) which is an evidence based, scientifically supported method for teaching individuals the skills and tools they need to overcome anxiety and stress related disorders. In addition to Cognitive Behavioral Therapy (CBT) I often also teach skills commonly called “Mindfullness.” Mindfulness is a set of behavioural and cognitive skills designed specifically to help reduce daily stress and anxiety and address the problem of relapse, often associated with anxiety or stress disorders.

Frequently Asked Questions (FAQ)
Isn’t anxiety or stress normal? Why am I having trouble with it now?
People often call asking just this question about therapy or counseling for anxiety. Anxiety and stress are actually normal parts of everyone’s life. They are normal reactions to stressful situations, for example, feeling anxious about a test. Anxiety is actually a helpful and necessary warning system we wouldn’t do well without. In some cases we might actually enjoy some level of anxiety, such as when watching a scary movie, reading a suspenseful book or riding a roller coaster. If there were no anxiety during these activities we wouldn’t be doing them! Sometimes, however, anxiety levels can grow to a point when it is hard to control, it might interfere with our thinking and mental processing, make it difficult to make decisions, and last much longer that the incident itself. In this way both anxiety and stress can cause significant difficulties in our daily functioning. We can also, over a period of time, begin to react with anxiety to things that should not be causing anxiety at all. The anxiety seems to spread to new areas of concern. When anxiety rises to this level it is likely that you have developed one of several types of Anxiety Disorder. Anxiety, luckily, is something we can provide both medical and psychological treatment for.
You should know that Anxiety Disorders are common, affecting approximately 40 million adults per year in North America alone. And most people are treated effectively with therapy, sometimes medication, or a combination of the two. Cognitve Behavioural Therapy (CBT) and Mindfulness have been found to be highly effective in most situations. (CBT and Mindfulness Training are offered in both my Vancouver and Burnaby offices serving Burnaby, New Westminster, Coquitlam and Maple Ridge.)

Are There Different Types or Kinds of Anxiety Disorder?

While the term Anxiety Disorder is often used, it actually refers to a family of anxiety problems which including the following: Generalized Anxiety Disorder, Obsessive Compulsive Disorder, Panic Disorder, Post-Traumatic Stress Disorder and Social Phobias.

Do You Treat Children with Anxiety Disorders?
Yes. We have new and highly effective means of teaching children as young as 5 the techniques of Cognitive Behavioural Therapy and often suggest texts and stories such as “When My Troubles Get Too Big,” and “The Incredible Five Point Scale.” Treating children and teens often involves the entire family and the school staff. I provide parent education, teacher training and school based consultations on stress, anxiety and related disorders. Most of the materials I use are available for classroom wide programs and are commonly found in school settings. Specialized programs addressing anxiety for children and teens with Autism Spectrum (ASD) and Asperger’s Disorder are also available. Children and adolescents are seen in both my Vancouver and Burnaby locations.)

Summary
Anxiety Disorders and Stress are treatable and often respond to medication as well as counselling and therapy, especially Cognitive Behavioural Therapy (CBT). Cognitive Behavioural Therapy (CBT) is an evidence-based form of psychotherapy that emphasizes the important role that our thoughts, beliefs (cognitions) and behaviors play in determining how we feel and behave. CBT has been shown to be effective in treating Anxiety Disorders. As a psychologist I have received specialized training in Cognitive Behavioural Therapy at the Albert Ellis Institute in New York, including over one year of clinical supervision in providing CBT and obtaining an advanced certificate in CBT from The Albert Ellis Institute.

LINK: Self-Help Tips for Generalized Anxiety Disorders (click here)
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Psychological services (including assessment, testing and therapy) provided in my offices include (covered by most extended health care insurance):
ADHD (click here: http://www.relatedminds.com/adhd-attention-deficit-hyperactivity-disorder/)
Anxiety and Stress (click here: http://www.relatedminds.com/anxiety-stress/ )
Autism and Asperger’s Disorder (Click here: http://www.relatedminds.com/autism/)
Individual Counselling (click here: http://www.relatedminds.com/individual-therapy/)
Child Counselling / Therapy (click here: http://www.relatedminds.com/child-therapy/)
Testing and Assessments and Learning Disabilities (Click here: http://www.relatedminds.com/testing/)
Couples Counselling / Therapy (click here: http://www.relatedminds.com/couples-therapy/)
The Angry Child (click here: http://www.relatedminds.com/dealing-with-angry-aggressive-and-explosive-children/)
Anger Management (Click here: http://www.relatedminds.com/anger-management/)
Pain Management and PTSD (Click here: http://www.relatedminds.com/pain/ )