The situation is a common one. A client comes for individual counselling or psychotherapy but either at the start or as the therapy progresses their partner also appears to be part of the struggle. Perhaps the client’s presenting problem appears closely intertwined with their significant other; for example, feeling depressed as a result of constant fighting at home. Maybe the client makes progress in their individual therapy but their partner struggles to accommodate their changing loved one. As a result the therapist may be left wondering if it would be helpful to include the partner in the therapy. However, most trainings – because they tend to concentrate on either individual or couple therapy – provide little guidance on how to manage these situations; either introducing the partner into the therapy dyad and thus changing to couple therapy, or adding a simultaneous individual or couple therapy to the original format. Without guidance it is likely the therapist will then either continue with what is familiar, hoping that it is adequate, or be faced with unknown territory if altering the therapy format is deemed necessary. This article explores that unknown territory in order to put together some best practice guidelines for managing these scenarios.
Should therapists consider the client’s partner in individual counselling and psychotherapy?
This is part one of a three part article. The content is adapted from a paper written by Jon Hay and Stephen Appel PhD entitled "From one person to two person psychotherapy: considerations and practicalities for including the partner in the treatment". The original article can be downloaded from the AUT University library website.
The first chapter in this three part article explores various views suggesting that if a client is in a relationship then the impact of individual psychotherapy on their partner should be a consideration throughout treatment. As will be seen, the first point raised suggests a bias in the literature to either an individual or a couple approach to therapy, but little mention to working with a blend of the two. Next, new problems that might arise in a client’s romantic relationship when they are in the process of individual therapy are considered, followed by a look at ways that significant others could resist or sabotage their partner’s therapy if they do not appreciate or understand the changes that are taking place. Finally, some ethical arguments are raised which suggest that psychotherapists should not ignore the impact that psychotherapy has on their client’s relationships.
Choosing and changing the therapy format
This is part two of a three part article. The content is adapted from a paper written by Jon Hay and Stephen Appel PhD entitled "From one person to two person psychotherapy: considerations and practicalities for including the partner in the treatment". The original article can be downloaded from the AUT University library website.
The previous chapter suggested that individual psychotherapy can have a significant impact on the partners of those who are in treatment and that in order to practice ethically, psychotherapists need to maintain an awareness of this impact and initiate the appropriate action should the need arise. It has not been suggested that all individual therapists should convert to couple therapists, and the importance of an individual psychotherapy treatment is not being minimised. As Mann and Lundell (1977) point out, when couple therapy methods are applied overzealously without proper assessment of individual needs, they too can have a significant detrimental effect on the therapeutic outcome. What is being suggested is that when a client comes for individual therapy who is in an intimate relationship, then in a sense it is already couple therapy whether the partner is physically present or not.
The following chapter will bring together some views and suggestions from therapists who have included client’s partners in various ways. The therapy formats considered range from the partner attending one or more sessions of the individual therapy, through to changing the format from an individual therapy to a couple approach. This chapter looks at factors that can guide therapists when deciding on a format near the start of the process as well as converting the format of an already established individual therapy.
One or more therapists
This is part three of a three part article. The content is adapted from a paper written by Jon Hay and Stephen Appel PhD entitled “From one person to two person psychotherapy: considerations and practicalities for including the partner in the treatment”. The original article can be downloaded from the AUT University library website.
Chapter 1 of this article looked at how individual psychotherapy can impact on the partners of those in treatment and suggested that psychotherapists should maintain an awareness of this potential along with an openness to adjusting the therapy format if necessary. Chapter 2 then explored how the therapy format can be altered to include the partner if the need arises.
If the therapist and client agree to include the partner in the therapy process, and the partner agrees to attend, the next decision is who should conduct the treatment? The choices are that either one therapist does all the work with both partners, or a referral is made to a colleague. Each approach warrants different considerations. If one therapist conducts both therapies, then confidentiality becomes the pressing issue. If two or more therapists become involved in the treatment, the main concern is how the therapists will collaborate and integrate the different treatments.