Today I want to address some basics about how to find quality marriage counseling.
If you've bought a car, a pool, a house--just about anything--did you ever wonder how the car salesman, the pool vendor, or the realtor go about buying those things him or herself? What are the things that you'll never be told but could only find out from years of being "in the business?"
Caveat Emptor: Let the Buyer Beware
Marriage counseling is a big ticket item that has few clear benchmarks for quality.
I often hear uncertainty in voices of those that call seeking our counseling services. "I don't really know what to ask," is by far the most common concern that is voiced. Therefore it is critical that you do your homework about the marriage counselor you choose.
Previously, I wrote about the question, "Does the gender of your marriage counselor matter?" Next week I'm going to break down how much it really costs to do couples therapy.
The Basics: Valid Licensure
In order to provide the service of “therapy, counseling, psychotherapy, or marriage counseling” a person must be state licensed. This means the counselor has earned at least a master’s degree within the discipline and passed a national licensing exam, in addition to achieving a certain number of client contact hours ranging from 1,500 to 3,000 hours, while supervised by another licensed clinician. Here is a description of the different counseling disciplines that are governed by state health licensing boards.
Some counselors may practice as a “Resident,” meaning that his or her work is supervised by a licensed individual while hours toward certification are being met. I know some Resident marriage counselors that are proficient and attuned to the complexities of relationship therapy more than a ten-year veteran that never received direct relationship training.
There are many relationship services that are advertised with alternative names such as marriage coaching, alternative couples counseling, or variations of relationship education. According to Dr. Dawn-Elise Snipes, an expert witness for legal cases involving life coaches, coaches are unregulated by state boards and anyone can hang a shingle to offer advice as a coach.
Having a valid license is important because it means the counselor is accountable to a local licensing board for actions conducted during therapy. Most license board complaints are related to service providers operating with lapsed or revoked licenses. Having a valid license sets an important legal and ethical bar.
A great website called www.checkatherapist.com has links to all state health boards for license verification.
Problems with Under-Trained Couples Therapists
Even among licensed counselors, how can you tell if the person you are talking to really has any business giving advice about your marriage?
In his whistle-blower presentation, at the 1999 Smart Marriages Conferences, marriage counselor William Doherty outlined what he called the hazards of marriage counseling that is done in inexperienced hands.
Marriage counseling is considered by a majority in the field to be the most challenging form of psychotherapy to practice. To provide competent marriage counseling, it takes years of intensive training, critical supervision, and often a personal dose of attending professionally to one’s own marital baggage. Doherty cites many stories of marriage counseling disasters that are worth reading and may influence how you choose your marriage counselor. He especially warns of a prevalent mindset within many individual therapies that promotes self-empowerment without consideration of the relational context or consequences.
Even though Doherty's warnings were many years ago, they still ring hauntingly true today.
In another scathing critique titled Bad Couples Therapy, Doherty wonders how the majority of therapists offer marriage therapy if most graduate training programs don’t even require one course in relationship treatment. He states, “From a consumer's point of view, going in for couples therapy is like having your broken leg set by a doctor who skipped orthopedics in medical school.”
Some of the woes of marriage counseling done by under-prepared and under-educated professionals can include:
- Taking one partner’s side and beating up on the other
- Being too neutral or not being neutral enough
- Indirectly undermining the relationship by failing to actively offer alternatives to the present difficulty
- Directly undermining the relationship by telling couples they should not be together
- Pathologizing individuals who stay together in difficult relationships
In response to the support Doherty received through his effort to start a pro-relationship movement in the field of counseling, he founded the Registry of Marriage-Friendly Therapists.
5 Questions to Ask Before Choosing a Marriage Counselor
Doherty suggests several questions to ask before you begin work with a marriage counselor:
1) "Can you describe your background and training in marital therapy?" If the therapist is self-taught or workshop-trained, and can't point to a significant education in this work, then consider going elsewhere.
2) "What is your attitude toward salvaging a trouble marriage versus helping couples break up?" If the therapist says he or she is "neutral," or "I don't try to save marriage, I try to help people," look elsewhere. (I'd also run if the therapist says he or she does not believe in divorce.)
3) "What is your approach when one partner is seriously considering ending the marriage and the other wants to save it?" If the therapist responds by focusing only on helping each person clarify their personal feelings and decisions, consider looking elsewhere.
4) "What percentage of your practice is marital therapy?" Avoid therapists who mostly do individual therapy. Even better is to work with a practice that is know for having a high volume of couples.
5) "Of the couples you treat, what percentage would you say work out enough of their problems to stay married with a reasonable amount of satisfaction with the relationship." "What percentage break up while they are seeing you?" "What percentage do not improve?" "What do you think makes the differences in these results?" If someone says "100%" stay together, I would be concerned, and if they say that staying together is not a measure of success for them, I'd be concerned.
Trust Your Gut About How You Feel Talking to Your Prospective Marriage Counselor
In conclusion, it is critical not to rush into choosing a marriage counselor just because you need urgent help. There is definitely a risk that couples counseling or individual counseling could make things worse if done by the wrong person.
Some of the most consistent research about therapy outcomes says that the particular model of therapy matters far less than the personal bond you forge with your therapist.
Trust your gut about signals you get from your therapist.
For example, does he or she take time to answer your questions on the phone before you pay for a first session? Does the therapist start your appointments late, but end on time and charge you for the full session? Don’t overlook indicators like these of how attentive your therapist is to you.
Above all, don’t be shy about expressing your concerns to your therapist. Those of us who have had in-depth supervision are used to getting feedback--we will welcome and encourage it. If your therapist regularly gets defensive or angry about your feedback, it could be a red flag of inexperience.
What do you wish you knew before you attended couples counseling?
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