Gay, Lesbian Couples Counselling (GLBT Services)

Do You Provide Couple and Marriage Counselling to Gay or Lesbian Couples?

I have provided couples counselling to gay and lesbian couples for over twenty years. Not all counselling services are supportive of gay and lesbian couples here in BC, and as a matter of fact one major referral service states they provide counselling to transitional marriages. The only school that offers a degree leading to registration as a marriage and family therapist in BC is a religious school which does not recognize gay and lesbian marriage. So, while we might see ourselves living in a very liberal and welcoming community here in BC not all organizations see it so.

I have been providing counselling and therapy services to the gay, lesbian, bi-secual and transgender community for over 25 years. This includes work with couples, marriages and families, work with children in those families and  work with many teens and young adults during their coming out or questioning periods.

In my office you will find a respectful, safe and supportive environment.

Issues that I work on include:

• Relationship issues
• Dating
• Life transitions
• Support when questioning your sexual or gender identity
• Abusing relationship
• Workplace or education related issues
• Depression, anxiety and stress

Techniques range from using Gottman Couples Therapy methods to Cognitive Behaviour Therapy for anxiety, stress and depression.

Please feel free to contact me or visit my web page:https://relatedmindsbc.squarespace.com/gay-lesbian-bi-sexual-and-transgender-issues

Couple Therapy and Intimacy

Often couples come in and want some basic help with renewing their sense of desire and intimacy. While Dr. John Gottman speaks in detail about the skills we all need to develop and sustain intimacy, and desire. But almost everyone wants something simple, short and clear. One of the best resources I have found for couples have difficulty with intimacy is this Ted talk by Esther Perel. It's about 20 minutes long, and get's right to the point. Clients have overwhelmingly found this helpful. But don't forget to look at the skills and knowledge provided by Dr. Gottman.




For more information on the services I provide as a Registered Marriage and Family Therapist, and Clinical Fellow of the American Association of Marriage and Family Therapy, please visit my web page at http://www.relatedminds.com/couple-family-therapy/

In addition to my Registration as a Marriage and Family Therapist I am also a Registered Psychologist in British Columbia. While MSP does not cover the cost of couples or marriage counselling or therapy, most extended health care services do cover these costs. Please contact your insurance provider for information.

I have offices located in both Burnaby and Vancouver, and provide evening hours for those with complex work schedules. Most information can be found at www.relatedminds.com

Couple and Marriage Therapy: Burnaby / Vancouver

People often come in to my office and scan my book shelf looking for some hint as to what and how I think about relationships. My bookshelf isn't the best place to get that information because I read a lot of books, and don't find all of them very useful. Some things I read about marriage and couple's therapy I find frightening  I originally became licensed in Marriage and Family Therapy in the early 80's. My license was specifically in that field, and so was my training. I trained for a while at the Ackerman Institute in New York, and then studied systemic therapy. Many of the things we did 30 years ago were not evidence based, that is, not scientifically based. In the field of relationship issues many of the leaders in the field worked under someone for years, then developed their own techniques that seemed to work, and then wrote a book about it. And I hate to throw books away, so there are a lot of those books on my selves (although lately I have finally been parting with some.)

For the past few years, actually the past two decades, I've been focused on two major ways of approaching couples and families in therapy. With Cognitive Behavioural Therapy - CBT, and with therapy based upon the work of Dr. John Gottman of Seattle. 

I am not "controlled" or overly "devoted" to a single method of therapy, but I do feel any therapist needs to have a very deep and firm grounding in some theoretical stance. My reasons for using these two methods as my primary way of approaching couples work is simple: these are the two methods most firmly grounded in evidence. Both of these methods have undergone examination and testing and show reasonable levels of success. Many others that you read or hear about have not.

Cognitive Behaviour Therapy

I don't stick with one method of doing couples therapy because couples often arrive at my office in very different states. Some Registered Marriage and Family Therapists would NEVER see on member of a couple alone, and would always insist on seeing them together. This is a "theoretical" decision on their part. I don't follow theory to that degree as sometimes one member of a couple may not be ready for couples therapy, and at other times the relationship is too fragile to expose the issues at the moment. Sometimes one member of a couple may need Cognitive Behaviour Therapy to get a handle on their irrational thinking processes before we can even begin meeting together (and sometimes I work with one member of a couple and send them to someone else for couples work). Sometimes we need to engage in psychoeducation - as I often work with couples where one member has Aspeger's Disorder or another cognitive disorder. Sometimes one member of the couple, or both, need to develop anger management skills before we can work together. For these reasons I often find myself using cognitive behaviour therapy (CBT) with couples in therapy, either before couples therapy starts, in in conjunction with couples therapy.

An excellent book on couple's therapy from a CBT perspective is Beck's "Love is Never Enough." But honestly, it's a long and difficult book for some.  Still, understanding the work of Dr. Aaron Beck is a good place to start.

Gottman Method Couples Therapy

For most couples I suggest reading one of two books by John Gottman 1) "The Seven Principles for Making Marriage Work," and 2) "Why Marriages Succeed or Fail."  These are excellent books that include exercises for couples to engage in help you both analyze your own relationship and apply specific skills to fixing it. These are short, easy to read books, and there are CD and audible.com versions to listen to if you prefer to listen.

The Gottman Method Couples Therapy is an evidence based form of therapy that is delivered in a fairly structured manner so as to attain goals outlined in the therapeutic environment. It helps couples in achieving a deeper sense of understanding, awareness, empathy, and connectedness within their relationships that ultimately leads to heightened intimacy and interpersonal growth. This is a simple process, but one that many couples will find essential to success in their relationship.

By combining therapeutic interventions with evidence based exercises, couples develop the tools necessary to remove the natural walls and defenses that hinder and prohibit effective communication and, most important, bonding. 

Goals and Principles of the Gottman Method

The principle goals of the Gottman Method Couples Therapy are to disarm conflicting verbal communication, to increase intimacy, respect, and affection, to remove barriers that create a feeling of stagnancy in conflicting situations, and to create a heightened sense of empathy and understanding within the context of the relationship. The Gottman web page explains this in detail.

Length of Therapy

I often suggest that couples come in weekly for 3-4 weeks, and then every other week for about 6-10 sessions. The number of sessions depends greatly on individual needs.

Cost of Therapy

Couples therapy costs $175.00 per session. While MSP does not cover this cost most extended health care plans do cover some or all. Speak with your provider to find out what they will cover. Most plans will not cover the services of a registered clinical counsellor or register marriage and family therapist. I am both a Registered Marriage and Family Therapist and a Registered Psychologist, therefore most insurance providers will cover the cost of my services.

For more information on marriage therapy or couples / relationship counselling please contact me through my web page at:

http://www.relatedminds.com/couple-family-therapy/

http://www.aamft.org/cgi-shl/TWServer.exe?Run:LOCATECN_2:TradeWinds_KEY=420

Depression Screening and Diagnosis in BC

I am often asked about on-line depression, anxiety, ADHD and autism screening tools, and usually warn against their use. The reasons are simple: A diagnosis of depression, anxiety, ADHD or Autism is a difficult thing. In the popular press you read about the problems with "misdiagnosis" all the time, and that is usually because a physician or psychologist haven't taken the time to do a comprehensive differential diagnosis - that is, they haven't attempted to "rule out" other disorders. What looks like depression can be any number of things, including something as simple as the need for a change in sleep habits or diet. But to determine that takes time and a comprehensive history. That takes time and expertise. So I always urge patients to "see your doctor." That being said there is still a cry for some sort of quick screen, and I have found one provided by "heretohelp" in BC to be especially useful, as it allows to to take the information you have put into the screener, print it, and take it with you to the doctor.  Here is the website to use the screener:

http://www.heretohelp.bc.ca/screening/online/?screen=depression

Heretohelp (or here to help's) online screener for depression is first of all anonymous. It doesn't record anything that can identify you as the person completing the form. It takes you through several steps: 1) You provide some information about you , such as gender and age, that are important because it will compare your answers to other questions with norms for gender and age, which change, 2) It then directs you to a type of screener based upon this information - there are different depression screeners for different groups, 3) You will answer questions about your symptoms, and depending upon how you answer these it may direct you to other questions you were not expecting about, for instance, mood disorders or mania, which are important to help with the "rule out" we just discussed, 4) Your results will be shown on the screen and you can print this out and take it to your medical provider.  Remember - an accurate diagnosis for depression or any other psychiatric disorder can only be made by a qualified medical doctor or psychologist! You need a medical examination to rule out many possible causes of your symptoms, but bringing this printout along with you can be very helpful for your physician to know what exams or tests he or she you administer.

Don't diagnose yourself. Don't let your friends diagnoses you because they "know someone with depression" or have had a psychiatric disorder themselves. See your licensed or registered medical professional.

For information about my services as a registered and licensed psychologist please visit my weebsite at www.relatedminds.com  I provide both diagnostic services and treatment interventions for depression, anxiety, ADHD and related disorders.


Dr. Jim Roche
Registered Psychologist

Couple Counselling and Marriage Counselling: Beginning with Gottman Couples Therapy

Where to start with Gottman Couples Therapy? I often suggest at our first couples/marriage therapy session that both members take a look through John Gottman's YouTube page and view several videos. Reading a book, especially while having relational problems, isn't easy.  And sometimes when we are reading about about behaviour, and we are reading it because of problems we are having with our spouse, we read and do little more than find what's wrong with them! - watching these videos, together - can be helpful.

Having trouble in a relationship means examining both yourself and the relationship. A difficult thing to do. And it means making some behavioural changes NOW, because our partners expect us to make some effort...right away. And they are watching. And trying to make changes themselves. All of this can be difficult and usually calls for the coaching and guidance of a professional training in couple and marriage therapy.

Still, watching the video of John Gottman and his wife working through these issues with others can be very helpful, and you will feel the support of having others in the same place as you...moving forward.

This video is only one of several on the internet. There are also videos that are more comprehensive and come in a "marriage and family workshop" format that formally walk you through the important steps of therapy. As a marriage and family therapist it is my goal to help you find resource and skills you can use on your own to address problems not only now, but in the future, and I work as quickly as possible at moving you from weekly sessions to a more informal coaching relationship were you can work on your relationship or marriage on your own. These videos are a great place to start.



In marriage or couples therapy sessions we work through many of the issues you will hear about on these videos. We also focus, intensely, on changing they way you interact and communicate in yor relationship.

Other books and videos I suggest about Marriage and Couples counselling can be found at my Amazon.ca Book List. Click here Dr. Roche Book Suggestions

Finally, for more information about my services, not only as a Registered Psychologist but also as a Registered Marriage and Family Therapist you can visit my web site directly at this link: Dr. Jim Roche at RelatedMinds  My American Association for Marriage and Family Therapy site is located at this link: AAMFT.

For those viewing the videos I also share an outline to help you understand the terms and components of what Dr. Gottman is speaking about.

Feel free to contact me for more information.

Dr. Jim Roche

Marriage and Couple Therapy: Burnaby / Vancouver

Marriage and Family Therapists: The Friendly Mental Health Professionals

I am often called and asked if I will see someone, or a couple, for "couple's therapy," or "marriage counselling."  Most of these calls are because I am a psychologist, and there is an assumption that every mental health professional has the same training and experience and can see anyone. This isn't necessarily so, as marriage and family therapy is a separate field of study and every US State and most Canadian provinces actually license or registered therapists in the field of marriage and family therapy.

Luckily , in addition to my license as a psychologist I am also a Registered Marriage and Family Therapist in British Columbia, and a Fellow and Clinical Member of the American Association of Marriage and Family Therapists (BCAMFT and AAMFT).  

A marriage therapist usually holds a graduate degree in marriage and family therapy, and has completed one or two years of full time supervised clinical internship in marriage and family therapy.  This includes60 semester hours of work focused on marriage and family therapy. Most "clinical counsellors" and psychologists have taken one or two courses in this area, and would not qualify to registration in marriage and family therapy.  This doesn't mean they don't have the clinical ability or experience to do marriage and family therapy, but it good to know that there are specially certified experts in the field, many of whom ARE psychologists.

To find a listing of Registered / Licensed Marriage and Family Therapists near you, including those who are additionally Registered / Licensed Psychologist, go to the "Find a Therapist" website of the American Association for Marriage and Family Therapists by clicking here: http://www.therapistlocator.net/iMIS15/therapistlocator/

To find out more about the differences between the various mental health professionals you can also visit this page, which explains what marriage and family therapists are in comparison to other mental health professionals. Click here: http://www.therapistlocator.net/IMIS15/Content/Consumer_Updates/Marriage_and_Family_Therapists.aspx

Briefly, from that page, you will see that: "Marriage and family therapists are mental health professionals with a minimum of a master’s degree and two years supervised clinical experience. Marriage and family therapists (commonly referred to as MFTs or family therapists) are trained and licensed to independently diagnose and treat mental health and substance abuse problems. Marriage and family therapy is one of the core mental health disciplines and is based on the research and theory that mental illness and family problems are best treated in a family context. Trained in psychotherapy and family systems, marriage and family therapists focus on understanding their clients’ symptoms and interaction patterns within their existing environment. MFTs treat predominantly individuals, but also provide couples, family and group therapy. Whomever the client, Family Therapists treat from a relationship perspective that incorporates family systems."

For more information about my practice as a Registered Marriage and Family Therapist and Fellow of the American Association of Marriage and Family Therapists you can visit my web page here: http://www.relatedminds.com/couple-family-therapy/ or my home page at http:www.relatedminds.com

I can also be reached at my office by calling 778.998-7975

About Couple Counselling and Marriage Therapy

I am often asked about the differences between a Psychologist and a Marriage and Family Therapist ( I am licensed | Registered in both fields). You can find this information on the web page of the American Association for Marriage and Family Therapists here:

http://www.aamft.org/imis15/Content/About_AAMFT/Qualifications.aspx

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What are the qualifications to be a Marriage and Family Therapist?

Marriage and family therapy is a distinct professional discipline with graduate and post graduate programs. Three options are available for those interested in becoming a marriage and family therapist: master's degree (2-3 years), doctoral program (3-5 years), or post-graduate clinical training programs (3-4 years). Historically, marriage and family therapists have come from a wide variety of educational backgrounds including psychology, psychiatry, social work, nursing, pastoral counseling and education. 

The Federal government has designated marriage and family therapy as a core mental health profession along with psychiatry, psychology, social work and psychiatric nursing. Currently all 50 states support and regulate the profession by licensing marriage and family therapists with the remaining states in the process of obtaining licensure laws.

The regulatory requirements in most states are substantially equivalent to the American Association of Marriage and Family Therapists Clinical Membership standards. After graduation from an accredited program, a period - usually two years - of post-degree supervised clinical experience is necessary before licensure or certification. When the supervision period is completed, the therapist can take a state licensing exam, or the national examination for marriage and family therapists conducted by the AAMFT Regulatory Boards. This exam is used as a licensure requirement in most states and provinces.

Who are Marriage and Family Therapists?

Marriage and Family Therapists (MFTs) are mental health professionals trained in psychotherapy and family systems, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems.

Marriage and family therapists are a highly experienced group of practitioners, with an average of 13 years of clinical practice in the field of marriage and family therapy. They evaluate and treat mental and emotional disorders, other health and behavioral problems, and address a wide array of relationship issues within the context of the family system. 

Marriage and Family Therapists broaden the traditional emphasis on the individual to attend to the nature and role of individuals in primary relationship networks such as marriage and the family.  MFTs take a holistic perspective to health care; they are concerned with the overall, long-term well-being of individuals and their families. 

MFTs have graduate training (a Master's or Doctoral degree) in marriage and family therapy and at least two years of clinical experience. Marriage and family therapists are recognized as a "core" mental health profession, along with psychiatry, psychology, social work and psychiatric nursing. 

Since 1970 there has been a 50-fold increase in the number of marriage and family therapists. At any given time they are treating over 1.8 million people.

What is Marriage and Family Therapy? 
A family's patterns of behavior influences the individual and therefore may need to be a part of the treatment plan. In marriage and family therapy, the unit of treatment isn't just the person - even if only a single person is interviewed - it is the set of relationships in which the person is imbedded. 

Marriage and family therapy is:

• brief
• solution-focused
• specific, with attainable therapeutic goals
• designed with the "end in mind."

Marriage and family therapists treat a wide range of serious clinical problems including: depression, marital problems, anxiety, individual psychological problems, and child-parent problems. 

Research indicates that marriage and family therapy is as effective, and in some cases more effective than standard and/or individual treatments for many mental health problems such as: adult schizophrenia, affective (mood) disorders, adult alcoholism and drug abuse, children's conduct disorders, adolescent drug abuse, anorexia in young adult women, childhood autism, chronic physical illness in adults and children, and marital distress and conflict. 

Marriage and family therapists regularly practice short-term therapy; 12 sessions on average. Nearly 65.6% of the cases are completed within 20 sessions, 87.9% within 50 sessions. Marital/couples therapy (11.5 sessions) and family therapy (9 sessions) both require less time than the average individuated treatment (13 sessions). About half of the treatment provided by marriage and family therapists is one-on-one with the other half divided between marital/couple and family therapy, or a combination of treatments. 

Why use a Marriage and Family Therapist?

Research studies repeatedly demonstrate the effectiveness of marriage and family therapy in treating the full range of mental and emotional disorders and health problems. Adolescent drug abuse, depression, alcoholism, obesity and dementia in the elderly -- as well as marital distress and conflict -- are just some of the conditions Marriage and Family Therapists effectively treat.

Studies also show that clients are highly satisfied with services of Marriage and Family Therapists. Clients report marked improvement in work productivity, co-worker relationships, family relationships, partner relationships, emotional health, overall health, social life, and community involvement.

In a recent study, consumers report that marriage and family therapists are the mental health professionals they would most likely recommend to friends. Over 98 percent of clients of marriage and family therapists report therapy services as good or excellent.

After receiving treatment, almost 90% of clients report an improvement in their emotional health, and nearly two-thirds report an improvement in their overall physical health. A majority of clients report an improvement in their functioning at work, and over three-fourths of those receiving marital/couples or family therapy report an improvement in the couple relationship. When a child is the identified patient, parents report that their child's behavior improved in 73.7% of the cases, their ability to get along with other children significantly improved and there was improved performance in school. Marriage and family therapy's prominence in the mental health field has increased due to its brief, solution-focused treatment, its family-centered approach, and its demonstrated effectiveness. Marriage and family therapists are licensed in 46 states and are recognized by the federal government as members of a distinct mental health discipline.

Today more than 50,000 marriage and family therapists treat individuals, couples, and families nationwide. Membership in the American Association for Marriage and Family Therapy (AAMFT) has grown from 237 members in 1960 to more than 23,000 in 1996. This growth is a result, in part, of renewed public awareness of the value of family life and concern about the increased stresses on families in a rapidly changing world. 

How can I find a Marriage and Family Therapist?

AAMFT Clinical Members meet stringent training and education requirements that qualify them for the independent practice of marriage and family therapy.  AAMFT requires Clinical Members to abide by the AAMFT Code of Ethics, the most stringent ethical code in the marriage and family therapy profession. This code delineates specific ethical behavior and guidelines for members to follow to ensure the ethical treatment of clients. Clinical Membership in the AAMFT signifies an MFT's dedication to his or her ongoing professional development. Each month, AAMFT Clinical Members receive important updates on current clinical and research developments in the field, as well as numerous opportunities throughout the year to attend professional development conferences.

Click here to find a Marriage and Family Therapist today!

I have been practicing in the field of Marriage and Family Therapy, providing couple, individual and family therapy for over 25 years. Visit my web site for information about my qualifications and services at: www.relatedminds.com​