Friday, March 28, 2014

Cognitive Behavioural Therapy for Couples?

( For information on marriage, family and couple therapy please visit the American Association of Marriage and Family Therapist Website: www.therapistlocator.net/member?226046 )

What kind of therapy works best for couples, for people with marriage difficulties or relationship issues? That's hard to say, the answer really is: "It depends." Most people seeking couple or marital therapy look for a general counsellor, but first and foremost it's really better to find someone specifically trained in couple, marriage and family therapy. While many counsellors and therapists claim they do "couples work" many don't have very limited training in the field. A Registered Marriage and Family Therapist (RMFT), unlike a "counsellor," has 2 years of supervised experience in the specific field of marriage and family therapy.  Either go with an RMFT or ask and expect significant education and supervised experience in couples work. 
Besides having a significant amount of supervised experience you also want to know what "kind" of therapy your therapist does. Some people say, "I do CBT - cognitive behavioural therapy - but their training consisted of only a weekend workshop or one course. If your therapist says, "I do CBT," ask how much supervision in CBT they received. A good CBT therapist should have many months of supervised experience just in CBT.

And is CBT a good method for marriage or relational problems? Sometimes, and sometimes not. It depends upon what is causing the issues you are having as a couple. Right now CBT - cognitive behavioural therapy, and ACT - Acceptance and Commitment Therapy - are two of the most frequently used "methods" in the field of marriage and family therapy. Snother more recent therapy is Dr. John Gottman's approach - just called Gottman Couple Therapy. Again, most people doing Gottman Therapy should have some real training in this, and in spite of the fact you find people all over the internet offering Gottman Therapy, few have actual training in it. A therapist who offers Gottman Training should have at least completed parts 1 and 2 or the Gottman Training Program. Some therapist who are very interested in the Gottman technique complete a third level of training and submit to having some of their cases supervised. They complete an advanced training program and this can ultimately lead to certification in the Gottman Method.

Most therapy methods don't have route to certification, but it is a good idea for those who have little academic of therapeutic background. 

Another method you may hear about, especially from individuals who are trained traditionally in marriage and family therapy is "systemic" therapy. Systemic might mean a general approach to you as a couple thinking in terms of "systems" or a more specific therapy method called "Systemic." Thera are dozens of variation, Systematic Therapy, Bowen Family Therapy, Ackerman Therapy taught at the Ackerman Institute in New York. But in general, these are the most common forms of family therapy: CBT, ACT, Gottman, Systemic.

CBT is one of the more evidence based therapies, but some people are not familiar with it's use with couples. CBT, as the name suggests, is about what we think - our cognitions. CBT therapists believe that how we think about something leads to what we feel and that leads to how we act. Two different people can have two very different reactions to the same situation or event. The meaning we assign something affects how we feel and act in a situation. What we think is called a "script" or "automatic thought." We pick up these scripts over time and they can create real problems when we react to every situation by interpreting it in an irrational manner -we see situations in black and white, all or nothing -  projecting out how we think things will turn out - or assume what others mean based upon past experiences.

AnxietyBC has an excellent overview of CBT - Cognitive Behaviour Therapy and I suggest you look at their web page to get some good examples that put this theory in to real life situations. 
Most people think of CBT as a therapy method for individuals, but it is not limited to individuals. I have combined CBT and Gottman techniques for years, especially when working on the relationship requires first and foremost getting both parties to speak the same language and move away from false assumptions.

You can find a number of books of couples issues and CBT on line, and at the website of the Albert Ellis Institute, where I did my advanced training in CBT - Albert Ellis was the first to use these terms but CBT was called Rational Emotive Behaviour Therapy back then - REBT.  The other major figure in the field you are more likely to hear about is Dr. Aaron Beck. Dr. Ellis put his efforts into training therapists, and Dr. Beck put his early efforts into research proving the effectiveness of CBT.

As the AnxietyBC website states: "CBT is an evidence based psychological treatment proven to be effective through rigorous scientific research. This means that CBT is not based on what people think might work, but on what has been proven to work."

Research on CBT has shown it to be effective with a wide range of problems - depression, anxiety, chronic pain, disordered eating, low self esteem, anger management issues, . If your having trouble with your relationship these a very likely part of the issue, and often it is very difficult to deal with a couple's relational issues while anxiety, fear, anger and irrational thinking are in the way. So CBT makes an effective companion to other therapy techniques aimed at dealing with communication and feelings.

If you are interested in reading about CBT and marriage counselling or couple's therapy Dr. Aaron Beck has an excellent book called, " Love is Never Enough."  It has many insights, lots of great advice and exercises to help with a failing marriage of make a good relationship better.

For information about couples counselling, marriage or family therapy in my Burnaby office check out the information on my website: http://www.relatedminds.com or at http://www.relatedminds.com/couple-family-therapy/
Specific information on my training and certification in the field of couples counselling and marriage and family therapy can be found at the American Association of Marriage and Family Therapist website: www.therapistlocator.net/member?226046

No comments:

Post a Comment