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Couples therapy (also couples' counseling, marriage counseling, or marriage therapy) attempts to improve romantic relationships and resolve interpersonal conflicts.


History

Marriage counseling originated in Germany in the 1920s as part of the
eugenics Eugenics ( ; ) is a fringe set of beliefs and practices that aim to improve the genetic quality of a human population. Historically, eugenicists have attempted to alter human gene pools by excluding people and groups judged to be inferior o ...
movement.Wendy Kline, ''Building a Better Race: Gender, Sexuality, and Eugenics from the Turn of the century.''Abraham Stone, ''Marriage Education and Marriage Counseling in the United States.'' The first institutes for marriage counseling in the United States began in the 1930s, partly in response to Germany's medically directed, racial purification marriage counseling centers. It was promoted by prominent American eugenicists such as
Paul Popenoe Paul Bowman Popenoe (October 16, 1888 – June 19, 1979) was an American agricultural explorer and eugenicist. He was an influential advocate of the compulsory sterilization of mentally ill people and people with mental disabilities, and the fa ...
, who directed the American Institute of Family Relations until 1976,Jill Lepore, ''The rise of marriage therapy, and other dreams of human betterment.'',
The New Yorker ''The New Yorker'' is an American weekly magazine featuring journalism, commentary, criticism, essays, fiction, satire, cartoons, and poetry. Founded as a weekly in 1925, the magazine is published 47 times annually, with five of these issues ...
, 29 March 29, 2010.
Robert Latou Dickinson Robert Latou Dickinson (1861–1950) was an American obstetrician and gynecologist, surgeon, maternal health educator, artist, sculptor and medical illustrator, and research scientist. Early life Robert Latou Dickinson was born on February 21, 1 ...
, and by birth control advocates such as Abraham and Hannah Stone who wrote ''A Marriage Manual'' in 1935 and were involved with Planned Parenthood. Other founders in the United States include Lena Levine and Margaret Sanger. It wasn't until the 1950s that therapists began treating psychological problems in the context of the family.Nichols & Schwartz, Family Therapy: Concepts and Methods. Fourth edition. Allyn & Bacon Relationship counseling as a discrete, professional service is thus a recent phenomenon. Until the late 20th century, the work of relationship counseling was informally fulfilled by close friends, family members, or local
religious Religion is usually defined as a social- cultural system of designated behaviors and practices, morals, beliefs, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that generally relates humanity to supernatur ...
leaders.
Psychiatrists A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their sy ...
,
psychologists A psychologist is a professional who practices psychology and studies mental states, perceptual, cognitive, emotional, and social processes and behavior. Their work often involves the experimentation, observation, and interpretation of how indi ...
, counselors and
social workers Social work is an academic discipline and practice-based profession concerned with meeting the basic needs of individuals, families, groups, communities, and society as a whole to enhance their individual and collective well-being. Social work ...
have historically dealt primarily with individual psychological problems in a medical and psychoanalytic framework. In many less technologically advanced cultures around the world today, the institution of the
family Family (from la, familia) is a group of people related either by consanguinity (by recognized birth) or affinity (by marriage or other relationship). The purpose of the family is to maintain the well-being of its members and of society. Idea ...
, the village or group elders fulfil the role of relationship counseling. Today marriage mentoring mirrors those cultures. With increasing modernization or
westernization Westernization (or Westernisation), also Europeanisation or occidentalization (from the ''Occident''), is a process whereby societies come under or adopt Western culture in areas such as industry, technology, science, education, politics, econo ...
in many parts of the world and the continuous shift towards isolated
nuclear families A nuclear family, elementary family, cereal-packet family or conjugal family is a family group consisting of parents and their children (one or more), typically living in one home residence. It is in contrast to a single-parent family, the larger ...
, the trend is towards trained and accredited relationship counselors or couple therapists. Sometimes
volunteer Volunteering is a voluntary act of an individual or group freely giving time and labor for community service. Many volunteers are specifically trained in the areas they work, such as medicine, education, or emergency rescue. Others serve ...
s are trained by either the government or social service institutions to help those who are in need of family or marital counseling. Many communities and government departments have their own team of trained voluntary and professional relationship counselors. Similar services are operated by many
universities A university () is an institution of higher (or tertiary) education and research which awards academic degrees in several academic disciplines. Universities typically offer both undergraduate and postgraduate programs. In the United States, ...
and colleges, sometimes staffed by volunteers from among the student
peer group In sociology, a peer group is both a social group and a primary group of people who have similar interests ( homophily), age, background, or social status. The members of this group are likely to influence the person's beliefs and behaviour. ...
. Some large companies maintain a full-time professional counseling staff to facilitate smoother interactions between corporate employees, and to minimize the negative effects that personal difficulties might have on work performance. Increasingly there is a trend toward professional certification and government registration of these services. This is in part due to the presence of
duty of care In tort law, a duty of care is a legal obligation that is imposed on an individual, requiring adherence to a standard of reasonable care while performing any acts that could foreseeably harm others. It is the first element that must be establi ...
issues and the consequences of the counselor or therapist's services being provided in a
fiduciary A fiduciary is a person who holds a legal or ethical relationship of trust with one or more other parties (person or group of persons). Typically, a fiduciary prudently takes care of money or other assets for another person. One party, for examp ...
relationship. See also
alienation of affection Alienation of affections is a common law tort, abolished in many jurisdictions. Where it still exists, an action is brought by a spouse against a third party alleged to be responsible for damaging the marriage, most often resulting in divorce. The ...
.


Basic principles

It is estimated that nearly 50% of all married couples get
divorced Divorce (also known as dissolution of marriage) is the process of terminating a marriage or marital union. Divorce usually entails the canceling or reorganizing of the legal duties and responsibilities of marriage, thus dissolving the ...
, and about one in five marriages experience distress at some time. Challenges with affection, communication, disagreements, and fears of divorce are some of the most common reasons couples reach out for help. Couples who are dissatisfied with their relationship may turn to a variety of sources for help including online courses, self-help books, retreats, workshops, and couples counseling. Before a relationship between individuals can begin to be understood, it is important to recognize and acknowledge that each person, including the counselor, has a unique
personality Personality is the characteristic sets of behaviors, cognitions, and emotional patterns that are formed from biological and environmental factors, and which change over time. While there is no generally agreed-upon definition of personality, m ...
,
perception Perception () is the organization, identification, and interpretation of sensory information in order to represent and understand the presented information or environment. All perception involves signals that go through the nervous system ...
,
opinions An opinion is a judgment, viewpoint, or statement that is not conclusive, rather than facts, which are true statements. Definition A given opinion may deal with subjective matters in which there is no conclusive finding, or it may deal with ...
, set of
values In ethics and social sciences, value denotes the degree of importance of something or action, with the aim of determining which actions are best to do or what way is best to live (normative ethics in ethics), or to describe the significance of di ...
, and history. Individuals in the relationship may adhere to different and unexamined value systems. Institutional and societal variables (like a social or
religious Religion is usually defined as a social- cultural system of designated behaviors and practices, morals, beliefs, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that generally relates humanity to supernatur ...
group, and other collective factors) which shape a person's nature and behavior, are considered in the process of counseling and therapy. A tenet of relationship counseling, is that it is intrinsically beneficial for all the participants to interact with each other, and with society at large with optimal amounts of conflict. A couple's conflict resolution skills seem to predict divorce rates. Most relationships will experience strain at some point, resulting in a failure to function optimally, and causing self-reinforcing,
maladaptive In evolution, a maladaptation () is a trait that is (or has become) more harmful than helpful, in contrast with an adaptation, which is more helpful than harmful. All organisms, from bacteria to humans, display maladaptive and adaptive traits. I ...
patterns to form. These patterns may be called "negative interaction cycles." There are many possible reasons for this, including insecure attachment, ego, arrogance,
jealousy Jealousy generally refers to the thoughts or feelings of insecurity, fear, and concern over a relative lack of possessions or safety. Jealousy can consist of one or more emotions such as anger, resentment, inadequacy, helplessness or disgus ...
,
anger Anger, also known as wrath or rage, is an intense emotional state involving a strong uncomfortable and non-cooperative response to a perceived provocation, hurt or threat. A person experiencing anger will often experience physical effects, su ...
,
greed Greed (or avarice) is an uncontrolled longing for increase in the acquisition or use of material gain (be it food, money, land, or animate/inanimate possessions); or social value, such as status, or power. Greed has been identified as und ...
, poor communication/understanding or problem solving, ill health, third parties, and so on. Changes in situations, like financial state, physical health, and the influence of other family members can have a profound influence on the conduct, responses, and actions of the individuals in a relationship. Often, it is an interaction between two or more factors, and frequently, it is not just one of the people who have been involved that exhibit such traits. Relationship influences are reciprocal: it takes each person involved to cause problems, as well as manage them. A viable solution to the problem, and setting these relationships back on track, may be to reorient the individuals'
perception Perception () is the organization, identification, and interpretation of sensory information in order to represent and understand the presented information or environment. All perception involves signals that go through the nervous system ...
s and
emotions Emotions are mental states brought on by neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure. There is currently no scientific consensus on a definition. ...
- how one looks at or responds to situations, and how one feels about them. Perceptions of, and emotional responses to, a relationship are contained within an often unexamined mental map of the relationship, also called a 'love map' by
John Gottman John Mordechai Gottman (born April 26, 1942) is an American psychologist, professor emeritus of psychology at the University of Washington. His work focuses on divorce prediction and marital stability through relationship analyses. The lessons d ...
. These can be explored collaboratively and discussed openly. The core values they comprise can then be understood and respected, or changed when no longer appropriate. This implies that each person takes equal responsibility for awareness of the problem as it arises, awareness of their own contribution to the problem, and making some fundamental changes in thought and feeling. The next step is to adopt
conscious Consciousness, at its simplest, is sentience and awareness of internal and external existence. However, the lack of definitions has led to millennia of analyses, explanations and debates by philosophers, theologians, linguisticians, and scien ...
, structural changes to the inter-personal relationships, and evaluate the effectiveness of those changes over time. Indeed, "typically for those close personal relations, there is a certain degree in 'interdependence' - which means that the partners are alternately mutually dependent on each other. As a special aspect of such relations, something contradictory is put outside: the need for intimacy and for autonomy." "The common counterbalancing satisfaction these both needs,
intimacy An intimate relationship is an interpersonal relationship that involves physical or emotional intimacy. Although an intimate relationship is commonly a sexual relationship, it may also be a non-sexual relationship involving family, friends, or ...
, and autonomy, leads to alternate satisfaction in the relationship and stability. But it depends on the specific developing duties of each partner in every life phase and maturity".


Basic practices

Two methods of couples therapy focus primarily on the process of communicating. The most commonly used method is
active listening Active listening is the practice of preparing to listen, observing what verbal and non-verbal messages are being sent, and then providing appropriate feedback for the sake of showing attentiveness to the message being presented. This form of liste ...
, used by the late
Carl Rogers Carl Ransom Rogers (January 8, 1902 – February 4, 1987) was an American psychologist and among the founders of the humanistic approach (and client-centered approach) in psychology. Rogers is widely considered one of the founding fathers of ps ...
and
Virginia Satir Virginia Satir (26 June 1916 – 10 September 1988) was an American author and psychotherapist,http://www.psychologistanywhereanytime.com/famous_psychologist_and_psychologists/psychologist_famous_virginia_satir.htm recognized for her approach to ...
. More recently, a method called "Cinematic Immersion" has been developed by
Warren Farrell Warren Thomas Farrell (born June 26, 1943) is an American political scientist, activist, and author of seven books on men's and women's issues. He is a leading figure of the Men's Rights Movement. Farrell initially came to prominence in the 19 ...
. Each helps couples learn a method of communicating designed to create a safe environment for each partner to express and hear feelings. When the Munich Marital Study discovered active listening to not be used in the long run,
Warren Farrell Warren Thomas Farrell (born June 26, 1943) is an American political scientist, activist, and author of seven books on men's and women's issues. He is a leading figure of the Men's Rights Movement. Farrell initially came to prominence in the 19 ...
observed that active listening did a better job creating a safe environment for the criticizer to criticize than for the listener to hear the criticism. The listener, often feeling overwhelmed by the criticism, tended to avoid future encounters. He hypothesized that we were biologically programmed to respond defensively to criticism, and therefore the listener needed to be trained in-depth with mental exercises and methods to interpret as love what might otherwise feel abusive. His method is Cinematic Immersion. After 30 years of research into marriage,
John Gottman John Mordechai Gottman (born April 26, 1942) is an American psychologist, professor emeritus of psychology at the University of Washington. His work focuses on divorce prediction and marital stability through relationship analyses. The lessons d ...
has found that healthy couples almost never listen and echo each other's feelings naturally. Whether miserable or radiantly happy, couples said what they thought about an issue, and "they got angry or sad, but their partner's response was never anything like what we were training people to do in the listener/speaker exercise, not even close."
Such exchanges occurred in less than 5 percent of marital interactions and they predicted nothing about whether the marriage would do well or badly. What's more, Gottman noted, data from a 1984 Munich study demonstrated that the (reflective listening) exercise itself didn't help couples to improve their marriages. To teach such interactions, whether as a daily tool for couples or as a therapeutic exercise in empathy, was a clinical dead end.
By contrast,
emotionally focused therapy Emotionally focused therapy and emotion-focused therapy (EFT) are a family of related approaches to psychotherapy with individuals, couples, or families. EFT approaches include elements of experiential therapy (such as person-centered therapy and ...
for couples (EFT-C) is based on attachment theory and uses emotion as the target and agent of change. Emotions bring the past alive in rigid interaction patterns, which create and reflect absorbing emotional states. As one of its founders, Sue Johnson says,
Forget about learning how to argue better, analyzing your early childhood, making grand romantic gestures, or experimenting with new sexual positions. Instead, recognize and admit that you are emotionally attached to and dependent on your partner in much the same way that a child is on a parent for nurturing, soothing, and protection. From the book, "Hold Me Tight" by Sue Johnson, Page 6.


Research on therapy

The most researched approach to couples therapy is behavioral couples therapy. It is a well established treatment for marital discord. This form of therapy has evolved into what is now called
integrative behavioral couples therapy Behavioral marital therapy, sometimes called behavioral couples therapy, has its origins in behaviorism and is a form of behavior therapy. The theory is rooted in social learning theory and behavior analysis. As a model, it is constantly being rev ...
. Integrative behavioral couples therapy appears to be effective for 69% of couples in treatment, while the traditional model was effective for 50-60% of couples. At five-year follow-up, the marital happiness of the 134 couples who had participated in either integrative behavioral couples therapy or traditional couples therapy showed that 14% of relationships remained unchanged, 38% deteriorated, and 48% improved or recovered completely. A review conducted in 2018 by Cochrane (organization) states that the available evidence does not suggest that couples therapy is more or less effective than individual therapy for treating depression.


Relationship counselor or couple's therapist

Licensed couple therapists may refer to a psychiatrist, clinical
social workers Social work is an academic discipline and practice-based profession concerned with meeting the basic needs of individuals, families, groups, communities, and society as a whole to enhance their individual and collective well-being. Social work ...
, counseling psychologists, clinical psychologists, pastoral counselors, marriage and family therapists, and
psychiatric nurses A mental health professional is a health care practitioner or social and human services provider who offers services for the purpose of improving an individual's mental health or to treat mental disorders. This broad category was developed as a ...
.Couples Therapy.The Harvard Mental Health Letter. Gale Group Inc.2007 The duty and function of a relationship counselor or couples therapist is to listen, respect, understand, and facilitate better functioning between those involved. The basic principles for a counselor include: *Provide a confidential dialogue, which normalizes and validates feelings *To enable each person to be heard and to hear themselves *Provide a mirror with expertise to reflect the relationship's difficulties and the potential and direction for change *Empower the relationship to take control of its own destiny and make vital decisions *Deliver relevant and appropriate information *Changes the view of the relationship *Improve communication *Set clear goals and objectives As well as the above, the basic principles for a couples therapist also include: *To identify the repetitive, negative interaction cycle as a
pattern A pattern is a regularity in the world, in human-made design, or in abstract ideas. As such, the elements of a pattern repeat in a predictable manner. A geometric pattern is a kind of pattern formed of geometric shapes and typically repeated li ...
. *To understand the source of reactive emotions that drive the pattern. *To expand and re-organize key emotional responses in the relationship. *To facilitate a shift in partners' interaction to new patterns of interaction. *To create new and positively bonding emotional events in the relationship *To foster a secure attachment between partners. *To help maintain a sense of intimacy. Common core principles of relationship counseling and couples therapy are: * Respect *
Empathy Empathy is the capacity to understand or feel what another person is experiencing from within their frame of reference, that is, the capacity to place oneself in another's position. Definitions of empathy encompass a broad range of social, co ...
* Tact *
Consent Consent occurs when one person voluntarily agrees to the proposal or desires of another. It is a term of common speech, with specific definitions as used in such fields as the law, medicine, research, and sexual relationships. Consent as und ...
*
Confidentiality Confidentiality involves a set of rules or a promise usually executed through confidentiality agreements that limits the access or places restrictions on certain types of information. Legal confidentiality By law, lawyers are often required ...
* Accountability *
Expertise An expert is somebody who has a broad and deep understanding and competence in terms of knowledge, skill and experience through practice and education in a particular field. Informally, an expert is someone widely recognized as a reliable s ...
*
Evidence based Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". The aim of EBM is to integrate the experience of the clinician, the values of t ...
* Certification and ongoing
training Training is teaching, or developing in oneself or others, any skills and knowledge or fitness that relate to specific useful competencies. Training has specific goals of improving one's capability, capacity, productivity and performance. I ...
In both methods, the practitioner evaluates the couple's personal and relationship story as it is narrated, interrupts wisely, facilitates both de-escalations of unhelpful conflict and the development of realistic, practical solutions. The practitioner may meet each person individually at first, but only if this is beneficial to both, is
consensual Consent occurs when one person voluntarily agrees to the proposal or desires of another. It is a term of common speech, with specific definitions as used in such fields as the law, medicine, research, and sexual relationships. Consent as und ...
, and is unlikely to cause harm. Individualistic approaches to couple problems can cause harm. The counselor or therapist encourages the participants to give their best efforts to reorient their relationship with each other. One of the challenges here is for each person to change their own responses to their partner's behavior. Other challenges to the process are disclosing controversial or shameful events, and revealing closely guarded secrets. Not all couples put all of their cards on the table at first. This can take time, and requires patience, and commitment to the repair of the relationship.


Novel practices

A novel development in the field of ''couples therapy'' has involved the introduction of insights gained from
affective neuroscience Affective neuroscience is the study of how the brain processes emotions. This field combines neuroscience with the psychological study of personality, emotion, and mood. The basis of emotions and what emotions are remains an issue of debate withi ...
and
psychopharmacology Psychopharmacology (from Greek grc, ψῡχή, psȳkhē, breath, life, soul, label=none; grc, φάρμακον, pharmakon, drug, label=none; and grc, -λογία, -logia, label=none) is the scientific study of the effects drugs have on mo ...
into clinical practice.


Oxytocin

There has been interest in use of the so-called ''love hormone'' – oxytocin – during therapy sessions, although this is still largely experimental and somewhat controversial. Some researchers have argued oxytocin has a general enhancing effect on all social emotions, since intranasal administration of oxytocin also increases
envy Envy is an emotion which occurs when a person lacks another's quality, skill, achievement, or possession and either desires it or wishes that the other lacked it. Aristotle defined envy as pain at the sight of another's good fortune, stirred b ...
and '' Schadenfreude''. Also, oxytocin has also the potential for being abused in
confidence trick A confidence trick is an attempt to defraud a person or group after first gaining their trust. Confidence tricks exploit victims using their credulity, naïveté, compassion, vanity, confidence, irresponsibility, and greed. Researchers have ...
s.


Popularized methodologies

Although results are almost certainly significantly better when professional guidance is utilized (see especially family therapy), numerous attempts at making the methodologies available generally via self-help books and other media are available. In the last few years, it has become increasingly popular for these self-help books to become popularized and published as an
e-book An ebook (short for electronic book), also known as an e-book or eBook, is a book publication made available in digital form, consisting of text, images, or both, readable on the flat-panel display of computers or other electronic devices. Alt ...
available on the web, or through content articles on blogs and websites. The challenges for individuals utilizing these methods are most commonly associated with that of other self-help therapies or
self-diagnosis Self-diagnosis is the process of diagnosing, or identifying, medical conditions in oneself. It may be assisted by medical dictionaries, books, resources on the Internet, past personal experiences, or recognizing symptoms or medical signs of a cond ...
. Using modern technologies such as
Skype Skype () is a proprietary telecommunications application operated by Skype Technologies, a division of Microsoft, best known for VoIP-based videotelephony, videoconferencing and voice calls. It also has instant messaging, file transfer, deb ...
VoIP conferencing to interact with practitioners are also becoming increasingly popular for their added accessibility as well as discarding any existing geographic barriers. Entrusting in the performance and privacy of these technologies may pose concerns despite the convenient structure, especially compared to the comfort of in-person meetings. Some resources include: *
John Gottman John Mordechai Gottman (born April 26, 1942) is an American psychologist, professor emeritus of psychology at the University of Washington. His work focuses on divorce prediction and marital stability through relationship analyses. The lessons d ...
's ''What Makes Marriage Work'' *'' The Five Love Languages'' - what spouses respond to. *''
Please Understand Me ''Please Understand Me: Character and Temperament Types'' (first published in 1978 as ''Please Understand Me: An Essay on Temperament Styles'') is a psychology book written by David Keirsey and Marilyn Bates which focuses on the classification an ...
'' - determining personal psychological makeup. *
Sue Johnson Sue Johnson is a British clinical psychologist, couples therapist and author living and working in Canada. She is known for her work in the field of psychology on bonding, attachment and adult romantic relationships. Career Johnson earned ...
's ''Hold Me Tight'' - 'Love demands the reassurance of touch. Most fights are really protested over emotional disconnection. Underneath the distress, partners are desperate to know: Are you there for me? *'' Love & Respect'' - emotional needs of spouses. *'' Divorce Busting'' - solutions for saving and restoring relationships.


With homosexual and bisexual clients

Differing psychological theories play an important role in determining how effective relationship counseling is, especially when it concerns homosexual and bisexual clients. Some experts tout cognitive behavioral therapy as the tool of choice for intervention, while many rely on
acceptance and commitment therapy Acceptance and commitment therapy (ACT, typically pronounced as the word "act") is a form of psychotherapy, as well as a branch of clinical behavior analysis. It is an empirically based psychological intervention that uses acceptance and m ...
or
cognitive analytic therapy Cognitive analytic therapy (CAT) is a form of psychological therapy initially developed in the United Kingdom by Anthony Ryle. This time-limited therapy was developed in the context of the UK's National Health Service with the aim of providing eff ...
. One major progress in this area is the fact that "marital therapy" is now referred to as "couples therapy" in order to include individuals who are not married or those who are engaged in same-sex relationships. Most relationship issues are shared equally among couples regardless of
sexual orientation Sexual orientation is an enduring pattern of romantic or sexual attraction (or a combination of these) to persons of the opposite sex or gender, the same sex or gender, or to both sexes or more than one gender. These attractions are generall ...
, but
LGBT ' is an initialism that stands for lesbian, gay, bisexual, and transgender. In use since the 1990s, the initialism, as well as some of its common variants, functions as an umbrella term for sexuality and gender identity. The LGBT term ...
clients additionally have to deal with heteronormativity, homophobia,
biphobia Biphobia is aversion toward bisexuality and bisexual people as individuals. It is a form of homophobia against those in the bisexual community. It can take the form of denial that bisexuality is a genuine sexual orientation, or of negative ste ...
, and both socio-cultural and legal discrimination. Individuals may experience relational ambiguity from being in different stages of the coming out processor having an
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
serodiscordant A serodiscordant relationship, also known as mixed-status, is one where one partner is infected by HIV and the other is not. This contrasts with seroconcordant relationships, in which both partners are of the same HIV status. Serodiscordancy contri ...
relationship. Often, same-sex couples do not have as many role models of successful relationships as opposite-sex couples. In many jurisdictions, committed LGBT couples desiring a family are denied access to
assisted reproduction Assisted reproductive technology (ART) includes medical procedures used primarily to address infertility. This subject involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), cryopreservation of gametes ...
, adoption and
fostering Fosterage, the practice of a family bringing up a child not their own, differs from adoption in that the child's parents, not the foster-parents, remain the acknowledged parents. In many modern western societies foster care can be organised by th ...
, leaving them childless, feeling excluded,
other Other often refers to: * Other (philosophy), a concept in psychology and philosophy Other or The Other may also refer to: Film and television * ''The Other'' (1913 film), a German silent film directed by Max Mack * ''The Other'' (1930 film), a ...
, and bereaved. There may be issues with
gender role A gender role, also known as a sex role, is a social role encompassing a range of behaviors and attitudes that are generally considered acceptable, appropriate, or desirable for a person based on that person's sex. Gender roles are usually cent ...
socialization that do not affect opposite-sex couples. A significant number of men and women experience conflict surrounding homosexual expression within a
mixed-orientation marriage A mixed-orientation marriage is a marriage between partners of differing sexual orientations. The broader term is mixed-orientation relationship, sometimes shortened to MOR or MORE (while mixed-orientation marriage is sometimes shortened as MOM) ...
. Couple therapy may include helping the clients feel more comfortable and accepting of same-sex feelings, and to explore ways of incorporating same-sex and opposite-sex feelings into life patterns. Although a strong homosexual identity was associated with difficulties in marital satisfaction, viewing the same-sex activities as compulsive facilitated commitment to the marriage, and to
monogamy Monogamy ( ) is a form of dyadic relationship in which an individual has only one partner during their lifetime. Alternately, only one partner at any one time (serial monogamy) — as compared to the various forms of non-monogamy (e.g., polyg ...
.


See also

* Counseling *
Counseling psychology Counseling psychology is a psychological specialty that encompasses research and applied work in several broad domains: counseling process and outcome; supervision and training; career development and counseling; and prevention and health. ...
* Family therapy *
Interpersonal psychotherapy Interpersonal psychotherapy (IPT) is a brief, attachment-focused psychotherapy that centers on resolving interpersonal problems and symptomatic recovery. It is an empirically supported treatment (EST) that follows a highly structured and time-limite ...
* List of basic relationship topics *
Relational disorder According to Michael First of the DSM-5 working committee the focus of a relational disorder, in contrast to other DSM-IV disorders, "is on the relationship rather than on any one individual in the relationship".Michael B. First, MD. A Research Ag ...
*
Relationship education Relationship education and premarital counseling promote practices and principles of premarital education, relationship resources, relationship restoration, relationship maintenance, and evidence-based marriage education. History The formal orga ...
*
Sex therapy Sex therapy is a strategy for the improvement of sexual function and treatment of sexual dysfunction. This includes sexual dysfunctions such as premature ejaculation or delayed ejaculation, erectile dysfunction, lack of sexual interest or arousal ...
* Social work *
List of counseling topics Counseling is the professional guidance of the individual by utilizing psychological methods especially in collecting case history data, using various techniques of the personal interview, and testing interests and aptitudes. This is a list of co ...


References

{{Authority control Interpersonal relationships * Marriage