Couple assessment: common problems experienced by couple

1. Lecture 2 Lecture 2: Couple
assessment: Common problems
experienced by couples
Couple Counselling Skills Level 6
Kevin Standish

2. The story of us
• https://www.youtube.com/watch?v=Ud2Z3F1m5LA

3. Learning outcomes
• identify Common living together issues: money, religion, culture, inlaws,
children,day to day work-living stress, communication break down
• Explore common presenting problems like:
• Sexual issues
• Infidelity
• Addictions
• Growing apart: Separation and divorce. The process of uncoupling.
• How to Assess couples presenting
• Marital Therapy/Couples Therapy: Indications and Contraindications
• Explore and discuss Domestic Violence

4. Common living together issues: 5 minutes
•Work in small groups
•Identify the adaptations and changes that a
couple must go through in becoming a couple
and in particular when children arrive
•Reflect on your own relationships, relationship
history and identify the areas of difficulties
encountered whilst being a couple

5. Some of the common area that couples
struggle with are:
• money,
• religion,
• inlaws,
• children,
• day to day work-living stress,
• communication break down
• Culture.
• What are the sources/causes of the struggles and
issues?

6. Sexual issues
• Sex is a very personal thing, and talking about it can be
embarrassing.
• But talking is often the best thing you can do to improve your
sex life.
• All couples go through phases where they don’t have the
time or energy for regular sex. It’s natural to want better sex
and sometimes there are specific psychological or medical
reasons for their difficulties.
• The media paints sex as easy and hot and makes it look like
everyone but you is having loads of sex.

7. Sexual issues
•At some point Everyone has sexual problems:
•Young newlyweds have sexual adjustment
problems.
•Couples with young children are often exhausted
and have trouble keeping the bedroom a priority
leading to fights and feelings of doom.
•Older couples struggle with menopause,
“malepause”, physical changes and old relational
resentments that shut down sex.

8. Sex therapy
• Fears about sex therapy: the sex therapist will suggest a threesome to
spice up our sex life, I’ll have to reveal all my past sexual escapades to
my spouse, I’ll be shamed for how little I know about sex, the sex
therapist will be some New Age
• Sex therapy helps couples talk about sex with each other. A sex
therapist feels comfortable talking about sex. While nothing is off-
limits and nothing is taboo to talk about, most people have trouble
bringing up anything to talk about when it comes to sex
• The top two problems: low sexual desire and frequency of sex
disagreements between partners.
• http://www.relate.org.uk/relationship-help/help-sex/sex-therapy

9. Sex therapy: Three levels of problems take
different lengths of treatment.
1. Sexually-oriented problems – For instance, a
young woman doesn’t know how to have an
orgasm, usually takes 2 sessions or less. Pre-
mature ejaculation is easily solved before
resentment sets in A question you can’t ask
anyone else. Single sessions that have relieved
people from a lifetime of wondering and worry. Is
it normal to think about x? Is it normal that my
penis has a curve? , etc..

10. Sex therapy: Three levels of problems take
different lengths of treatment.
2. Sexual problems entangled in the relationship –
the bulk of the couples have sexual problems tied
up in the knot of their power struggle with each
other. Sex serves as a perfect battleground to
work out deeper issues about how close each
wants to feel and how much autonomy they want
to be granted in the marriage or partnership. This
often takes at least 6 months and involves marital
therapy as well.

11. Sex therapy: Three levels of problems take
different lengths of treatment.
• 3. Trauma, childhood histories of neglect or abuse,
difficulties feeling connected to anyone – sexual
problems resulting from these issues can take several
years to resolve. Not every person who was molested
needs years or therapy to have a happy sex life but some
do, depending on who the abuser was, how long it lasted
and if violence was involved. Feelings of deadness
sexually are often a defensive pattern from childhood
vows to never trust another with one’s primitive needs
and often need a longer therapeutic treatment.

12. BASMT.ORG

13. Infidelity: Are we meant to be monogamous?
• The rates of cheating in our culture haven’t changed
much. Although studies vary, research has shown that
almost 60 percent of men and over 45 percent of
women will cheat at some point in their marriages.
Affairs affect 1 out of every 2.7 couples, which is almost
one third of all of us.
• Only 10 percent of affairs last even a month; and the
rest last, at most, a year or two. Very few extramarital
affairs last longer than three or four years.
• One third of these marriages end because of infidelity.
• What is the role and function of infidelity within a
marriage?

14. Addictions: Famous Last Words: “Mom, I can
change him.”
• Most drug users, especially the heavy users, have one great love:
their addiction. The more they get into drugs, the more time and
effort they put into feeding their addiction. Life becomes a cycle:
finding drugs, using them, and acquiring the means to use more. Love
of family–and time for family activities–take a distant second place to
love of drugs.
• If the impact on the family starts in particular has a clear, common
and determined path resulting in a power struggle over finances and
drugs. This is often called codependency

15. Addictions
• Alcohol
• Drugs
• Gambling
• What else comes to mind?
• Pornography
• Internet (facebook, twitter etc)
• Cybersex
• Are these addictions? Or relationship issues?

16. Growing apart: Life Course Factors Affecting
Divorce
1. Age at Time of Marriage: The younger one gets married,
the higher the risk of divorce.
2. Premarital Pregnancy and Birth: Becoming pregnant or
giving birth prior to marriage increase the likelihood of
divorce.
3. Cohabitation: Cohabiting prior to marriage increases the
risk of later divorce.
4. Remarriage: The divorce rate for remarriages is higher than
for first marriages.
5. Intergeneration Transmission: Person’s whose parents are
divorced have greater odds of divorcing themselves.

17. The Process of Separation
• Moving towards divorce is a process, not a single event.
• This process is referred to as ‘uncoupling.’
• Initiator: One person who is unable to find happiness in the
relationship and initiates the end of the relationship.
• Separation Distress:Distress caused by the absence of one’s spouse.
• Each person must create a new identity apart from the ‘couple’
identity. He /She must transition into a new routine and recover
from his/her distress.
• Many find that dating new people helps eliminate separation
distress.

18. Growing apart: Separation and divorce. The
process of uncoupling.
1. Emotional Divorce
2. When one or both spouses disengages from
the marriage
3. Legal Divorce
4. The court-ordered termination of a marriage
5. Economic Divorce

19. Growing apart: Separation and divorce. The
process of uncoupling
6. The dividing of property, money, and resources
7. The Co-parental Divorce
8. Deals with issues of child custody, visitation, and
support
9. The Community Divorce
10. The juggling of ex-in-laws and friends
11. The Psychic Divorce: When one again feels like a
separate individual

20. Consequences of Divorce
• Economic: No-fault divorce laws systematically impoverish
women and children.
• Women usually gain custody of children following a divorce
and are therefore responsible for their economic stability.
• Triple consequences of age, gender, and ethnicity.
• Maintenance support: A monetary payment a former spouse
makes to the other to meet his/her economic needs.
• Child Support: A monetary payment made by the non-
custodial parent to the custodial to assist in child-rearing
expenses.
• Employment opportunities for divorced women are often
constrained by the necessity of caring for children.

21. Assessment: Is couples counselling the
appropriate choice for the couple?
•A Counselling Assessment Process for Couples.
•An assessment for couple counselling often takes
four sessions (and can be experienced by the
couple as therapeutically beneficial – although it
is not counselling per se):-
•Session 1: all three meet to discuss an overview
of what is needed from counselling.

22. Assessment: Is couples counselling the
appropriate choice for the couple?
•Session 2: one partner meets with therapist
separately. This is to discuss their
perspective on the couple relationship, and
to discuss some personal history.
•Session 3: the other partner meets with
therapist separately as in session 2.
•How do you deal with “secrets”?

23. Assessment: Is couples counselling the
appropriate choice for the couple
•Session 4: all three meet again to discuss
what we have learned in the previous
sessions, and to begin to set a focus about
what the couple counselling should address

24. Assessment:
•the couples expectations,
• to determine the strength of their
relationship,
•the risk of collapsing degree,
•the motivation to stay together and
motivation to engage in conducting of positive
changes.
•He/she should meet the needs of each
partner,

25. Assessment:
• Precise determination of the therapy aim adjusted to
the couple’s expectations, needs
• emotional/intellectual capabilities of both partners
• Extremely important is also the division of
responsibilities:
• the therapist is responsible for the conduct of therapy,
• the therapist together with both partners share
responsibility for achieving goals,
• but the partners themselves take responsibility for
their relationship, that is, whether to continue it or to
end.

26. The main objectives of marital/couples therapy
•marital/couples therapies are proposed only to
pairs who declare their desire to maintain the
relationship.
•1. support of marriage/couple in identifying
sources of conflict;
•2. help to each partner in determining their own
participation in the conflict;

27. The main objectives of marital/couples
therapy
•3. help in realisation of the mutual
expectations;
•4. help in defining the rules of functioning of
a relationship, fulfilling roles, defining the
limits of internal boundaries (individual) and
external boundaries (separating the
relationship from the rest of the world);

28. The main objectives of marital/couples
therapy
•5. improvement in mutual verbal
communication (to avoid further
misunderstandings)
•6. nonverbal communication (to make it
easier and more clearly to express feelings);

29. The main objectives of marital/couples
therapy
•7. assistance in constructive conflict
resolution;
•8. help in deciding whether to continue the
relationship or to part (note: the
responsibility for this decision lies
exclusively within the spouses/partners).

30. Assessment: Is couples counselling the
appropriate choice for the couple?
• What are you looking for in this assessment process?
Safety of both partners is paramount
1. Domestic violence is a key indicator that standard couple therapy is not a
suitable. Domestic violence protocols would need to be followed to
support the couple.
2. Mental health conditions: does one or both partners have a serious
mental health issue that will impact upon their capacity to manage the
therapeutic process. Psychosis, severe personality disorders (antisocial
personality disorder, borderline personality disorder, narcissistic
personality disorder with, Asperger’s syndrome)
3. Drug and alcohol problems: anyone in active addiction needs to receive
treatment first prior to any couple therapy

31. Marital Therapy/Couples Therapy: Indications and
Contraindications Wolska(2007)
• Insufficient motivation to change relationships and behaviours,
• the threat of divorce,
• violence,
• deep emotional and/or psychological disturbances in one or both
spouses,
• the engagement of one of the partners in a relationship outside of
marriage