Couples' Counseling
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Couples therapy (also known as couples' counseling, marriage counseling, or marriage therapy) is a form of
psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of Psychology, psychological methods, particularly when based on regular Conversation, personal interaction, to help a person change behavior, increase hap ...
that seeks to improve intimate relationships, resolve interpersonal conflicts and repair broken bonds of love.


History

Marriage counseling began in Germany in the 1920s as part of the
eugenics Eugenics is a set of largely discredited beliefs and practices that aim to improve the genetic quality of a human population. Historically, eugenicists have attempted to alter the frequency of various human phenotypes by inhibiting the fer ...
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 counselling in the United States started in the 1930s, partly in response to Germany's medically directed, racial purification marriage counselling centers. It was promoted by prominent American eugenicists such as
Paul Popenoe Paul Bowman Popenoe (October 16, 1888 – June 19, 1979) was an American marriage counselor, eugenicist and agricultural explorer. He was an influential advocate of the compulsory sterilization of mentally ill people and people with mental disa ...
, 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 magazine featuring journalism, commentary, criticism, essays, fiction, satire, cartoons, and poetry. It was founded on February 21, 1925, by Harold Ross and his wife Jane Grant, a reporter for ''The New York T ...
, 29 March 29, 2010.
Robert Latou Dickinson Robert Latou Dickinson (February 21, 1861 – November 29, 1950) was an American obstetrician and gynecologist, surgeon, maternal health educator, artist, sculptor and medical illustrator, research scientist, author, and public health educator. ...
, and by
birth control Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth control only be ...
advocates such as Abraham and Hannah Stone who wrote ''A Marriage Manual'' in 1935 and were involved with
Planned Parenthood The Planned Parenthood Federation of America, Inc. (PPFA), or simply Planned Parenthood, is an American nonprofit organization
, as well as
Lena Levine Lena ("Lee") Levine (May 17, 1903 – January 9, 1965) was an American psychiatrist and gynecologist. She was a pioneering figure in the development of both marriage counseling and birth control. She was a close colleague of Margaret Sanger."Len ...
and
Margaret Sanger Margaret Sanger ( Higgins; September 14, 1879September 6, 1966) was an American birth control activist, sex educator, writer, and nurse. She opened the first birth control clinic in the United States, founded Planned Parenthood, and was instr ...
. It wasn't until the 1950s that therapists began treating
psychological problem A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...
s within the context of the family.Nichols & Schwartz, Family Therapy: Concepts and Methods. Fourth edition. Allyn & Bacon Relationship counseling as a distinct, professional service is thus a recent phenomenon. Until the late 20th century, relationship counseling was informally provided by close friends, family members, or local
religious Religion is a range of social- cultural systems, including designated behaviors and practices, morals, beliefs, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that generally relate humanity to supernatural ...
leaders.
Psychiatrists A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly ...
,
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 ...
, 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 ...
historically dealt primarily with individual psychological problems within a medical and psychoanalytic framework. In many cultures, the institution of the
family Family (from ) is a Social group, group of people related either by consanguinity (by recognized birth) or Affinity (law), affinity (by marriage or other relationship). It forms the basis for social order. Ideally, families offer predictabili ...
or group elders fulfill the role of relationship counseling; marriage mentoring mirrors these cultures. With increasing modernization or
westernization Westernization (or Westernisation, see spelling differences), also Europeanisation or occidentalization (from the ''Occident''), is a process whereby societies come under or adopt what is considered to be Western culture, in areas such as industr ...
and the continuous shift towards isolated
nuclear families A nuclear family (also known as an elementary family, atomic family, or conjugal family) is a term for 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 ...
, the trend is towards trained and
accredited Accreditation is the independent, third-party evaluation of a conformity assessment body (such as certification body, inspection body or laboratory) against recognised standards, conveying formal demonstration of its impartiality and competence to ...
relationship counselors or couple therapists. Sometimes
volunteer Volunteering is an elective and freely chosen act of an individual or group giving their time and labor, often for community service. Many volunteers are specifically trained in the areas they work, such as medicine, education, or emergency ...
s are trained by either the government or social service institutions to help those who need family or marital counseling. Many communities and government departments have their own teams of trained voluntary and professional relationship counselors. Similar services are operated by many
universities A university () is an educational institution, institution of tertiary education and research which awards academic degrees in several Discipline (academia), academic disciplines. ''University'' is derived from the Latin phrase , which roughly ...
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. Members of peer groups are likely to influence each others' beliefs and behaviour. Durin ...
. Some large companies maintain 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. There is an increasing trend toward professional certification and government registration of these services, in part due to
duty of care In Tort, tort law, a duty of care is a legal Law of obligations, obligation that is imposed on an individual, requiring adherence to a standard of care, standard of Reasonable person, reasonable care to avoid careless acts that could foreseeab ...
issues and the consequences of the counsellor 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 (legal person or group of persons). Typically, a fiduciary prudently takes care of money or other assets for another person. One party, ...
relationship.


Basic principles

It is estimated that nearly 50% of all married couples
divorce Divorce (also known as dissolution of marriage) is the process of terminating a marriage or marital union. Divorce usually entails the canceling or reorganising of the legal duties and responsibilities of marriage, thus dissolving the M ...
, and about one in five marriages experience distress at some time. These numbers vary between countries and over time; for example, in Germany only 35.74% of marriages ended in divorce, half of those involving children under 18. Challenges with affection, communication, disagreements, and fears of divorce are some of the most common reasons couples seek help. Couples who are dissatisfied with their relationship may seek help from a variety of sources including online courses, self-help books, retreats, workshops, and couples' counseling. Before a relationship between individuals can be understood, it is important to recognize and acknowledge that each person, including the counselor, has a unique
personality Personality is any person's collection of interrelated behavioral, cognitive, and emotional patterns that comprise a person’s unique adjustment to life. These interrelated patterns are relatively stable, but can change over long time per ...
,
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 syste ...
,
opinion An opinion is a judgement, viewpoint, or statement that is not conclusive, as opposed to 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 ...
s, set of
values In ethics and social sciences, value denotes the degree of importance of some thing or action, with the aim of determining which actions are best to do or what way is best to live ( normative ethics), or to describe the significance of different a ...
, and history. Individuals in the relationship may adhere to different and unexamined value systems. Institutional and societal variables (like social or
religious Religion is a range of social- cultural systems, including designated behaviors and practices, morals, beliefs, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that generally relate humanity to supernatural ...
groups, and other collective factors) which shape a person's nature and behavior, are considered in 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 ( /ˌmælædæpˈteɪʃən/) 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 maladapt ...
patterns to form, sometimes called "negative interaction cycles." There are many possible reasons for this, including insecure attachment,
ego Ego or EGO may refer to: Social sciences * Ego (Freudian), one of the three constructs in Sigmund Freud's structural model of the psyche * Egoism, an ethical theory that treats self-interest as the foundation of morality * Egotism, the drive to ...
,
arrogance Hubris (; ), or less frequently hybris (), is extreme or excessive pride or dangerous overconfidence and complacency, often in combination with (or synonymous with) arrogance. Hubris, arrogance, and pretension are related to the need for vi ...
,
jealousy Jealousy generally refers to the thoughts or feelings of Emotional insecurity, 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, he ...
,
anger Anger, also known as wrath ( ; ) or rage (emotion), 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 experie ...
,
greed Greed (or avarice, ) is an insatiable desire for material gain (be it food, money, land, or animate/inanimate possessions) or social value, such as status or power. Nature of greed The initial motivation for (or purpose of) greed and a ...
, poor communication/understanding or
problem-solving Problem solving is the process of achieving a goal by overcoming obstacles, a frequent part of most activities. Problems in need of solutions range from simple personal tasks (e.g. how to turn on an appliance) to complex issues in business an ...
, ill health, and third parties. Changes in circumstances, like
financial Finance refers to monetary resources and to the study and Academic discipline, discipline of money, currency, assets and Liability (financial accounting), liabilities. As a subject of study, is a field of Business administration, Business Admin ...
s, physical health, and the influence of other family members can significantly influence 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 involved who exhibit such traits. Relationship influences are reciprocal: each person involved contributes to causing and managing problems. 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 syste ...
s and
emotion Emotions are physical and mental states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavior, behavioral responses, and a degree of pleasure or suffering, displeasure. There is ...
s - how one views 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 and professor emeritus of psychology at the University of Washington. His research focuses on divorce prediction and marital stability through relationship analyses. Gottman ...
. 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 fundamental changes in
thought In their most common sense, the terms thought and thinking refer to cognitive processes that can happen independently of sensory stimulation. Their most paradigmatic forms are judging, reasoning, concept formation, problem solving, and de ...
and
feeling According to the '' APA Dictionary of Psychology'', a feeling is "a self-contained phenomenal experience"; feelings are "subjective, evaluative, and independent of the sensations, thoughts, or images evoking them". The term ''feeling'' is closel ...
. The next step is to adopt
conscious Consciousness, at its simplest, is awareness of a state or object, either internal to oneself or in one's external environment. However, its nature has led to millennia of analyses, explanations, and debate among philosophers, scientists, a ...
, implement 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 emotional or physical closeness between people and may include sexual intimacy and feelings of romance or love. Intimate relationships are interdependent, and the member ...
, and
autonomy In developmental psychology and moral, political, and bioethical philosophy, autonomy is the capacity to make an informed, uncoerced decision. Autonomous organizations or institutions are independent or self-governing. Autonomy can also be ...
, 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. Active listeni ...
, used by the late
Carl Rogers Carl Ransom Rogers (January 8, 1902 – February 4, 1987) was an American psychologist who was one of the founders of humanistic psychology and was known especially for his person-centered psychotherapy. Rogers is widely considered one of the f ...
and
Virginia Satir Virginia Satir (June 26, 1916 – September 10, 1988) was an American author, clinical social worker and psychotherapist, recognized for her approach to family therapy. Her pioneering work in the field of family reconstruction therapy honored h ...
. 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. Farrell initially came to prominence in the 1970s as a supporter of second wave feminism but has ...
. 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 was not 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. Farrell initially came to prominence in the 1970s as a supporter of second wave feminism but has ...
observed that active listening did a better job of 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 people are biologically programmed to respond defensively to criticism, and therefore the listener needed in-depth training 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 and professor emeritus of psychology at the University of Washington. His research focuses on divorce prediction and marital stability through relationship analyses. Gottman ...
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.
Emotionally focused therapy Emotionally focused therapy and emotion-focused therapy (EFT) are related Humanistic psychology, humanistic approaches to psychotherapy that aim to resolve emotional and relationship issues with individuals, couples, and families. These therapies ...
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
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 revis ...
. 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 a 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 2018 review 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. A meta analysis published in 2023, covering 48 studies of non-randomized couples therapies, identified influencing factors on the efficiency. These factors include the age of the partners, the length of the relationship, and the type of institution that provided therapy. Many studies about research on couples therapy can be found in Family Process Journal and
Journal of Marital and Family Therapy The ''Journal of Marital and Family Therapy'' is a quarterly peer-reviewed academic journal published by Wiley-Blackwell on behalf of the American Association for Marriage and Family Therapy. The journal was established in 1975. The current editor ...
, both published by Wiley. Further studies can be found on Research Gate, showing a lot of comparative research activity in Iran in 2024. A biannual newsletter provides short conclusions about actual publications, focusing on practical implications for couples therapy.


Relationship counselor or couple's therapist

Licensed couple therapists may refer to a
psychiatrist A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly ...
, clinical
social work 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 wo ...
ers, 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 role 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: *Providing a confidential
dialogue Dialogue (sometimes spelled dialog in American and British English spelling differences, American English) is a written or spoken conversational exchange between two or more people, and a literature, literary and theatrical form that depicts suc ...
, which normalizes and validates feelings *Enabling each person to be heard and to hear themselves *Providing a mirror with expertise to reflect the relationship's difficulties and the potential and direction for change *Empowering the relationship to take control of its own destiny and make vital decisions *Delivering relevant and appropriate information *Changing the view of the relationship *Improving communication *Setting clear goals and objectives As well as the above, the basic principles for a couples therapist also include: *Identifying 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 l ...
. *Understanding the source of reactive emotions that drive the pattern. *Expanding and re-organizing key emotional responses in the relationship. *Facilitating a shift in partners' interaction to new patterns of interaction. *Creating new and positively bonding emotional events in the relationship *Fostering a secure attachment between partners. *Helping maintain a sense of intimacy. Common core principles of relationship counseling and couples therapy are: *
Respect Respect, also called esteem, is a positive feeling or deferential action shown towards someone or something considered important or held in high esteem or regard. It conveys a sense of admiration for good or valuable qualities. It is also th ...
*
Empathy Empathy is generally described as the ability to take on another person's perspective, to understand, feel, and possibly share and respond to their experience. There are more (sometimes conflicting) definitions of empathy that include but are ...
* Tact *
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 used in such fields as the law, medicine, research, and sexual consent. Consent as understood in ...
*
Confidentiality Confidentiality involves a set of rules or a promise sometimes executed through confidentiality agreements that limits the access to or places restrictions on the distribution of certain types of information. Legal confidentiality By law, la ...
*
Accountability In ethics and governance, accountability is equated with answerability, culpability, liability, and the expectation of account-giving. As in an aspect of governance, it has been central to discussions related to problems in the public secto ...
*
Expert 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 or area of study. Informally, an expert is someone widely recognized ...
ise *
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. It means integrating individual clinical expertise with the best available exte ...
*
Certification Certification is part of testing, inspection and certification and the provision by an independent body of written assurance (a certificate) that the product, service or system in question meets specific requirements. It is the formal attestatio ...
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, there 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 used in such fields as the law, medicine, research, and sexual consent. Consent as understood in ...
, 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 repairing the relationship.


Novel practices

A novel development involves introducing 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 wit ...
and
psychopharmacology Psychopharmacology (from Greek ; ; and ) is the scientific study of the effects drugs have on mood, sensation, thinking, behavior, judgment and evaluation, and memory. It is distinguished from neuropsychopharmacology, which emphasizes ...
into clinical practice.''couples therapy''


Oxytocin

There has been interest in using
oxytocin Oxytocin is a peptide hormone and neuropeptide normally produced in the hypothalamus and released by the posterior pituitary. Present in animals since early stages of evolution, in humans it plays roles in behavior that include Human bonding, ...
during therapy sessions, although this is still largely experimental and somewhat controversial.''love hormone'' 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. Envy can also refer to the wish for another person to lack something one already ...
and ''
Schadenfreude Schadenfreude (; ; "harm-joy") is the experience of pleasure, joy, or self-satisfaction that comes from learning of or witnessing the troubles, failures, pain, suffering, or humiliation of another. It is a loanword from German. Schadenfreude ...
''. Also, oxytocin has the potential for abuse in
confidence trick A scam, or a confidence trick, is an attempt to defraud a person or group after first gaining their trust. Confidence tricks exploit victims using a combination of the victim's credulity, naivety, compassion, vanity, confidence, irrespons ...
s.


Popularized methodologies

Although results are almost certainly significantly better when professional guidance is utilized, numerous attempts to make the methodologies generally available via
self-help Self-help or self-improvement is "a focus on self-guided, in contrast to professionally guided, efforts to cope with life problems" —economically, physically, intellectually, or emotionally—often with a substantial psychological basis. When ...
books and other media are available (see especially
family therapy Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a branch of psychotherapy focused on families and couples in intimate relationships to nurture change and ...
). In recent years,
self-help Self-help or self-improvement is "a focus on self-guided, in contrast to professionally guided, efforts to cope with life problems" —economically, physically, intellectually, or emotionally—often with a substantial psychological basis. When ...
books have become increasingly popularized and published as
e-book An ebook (short for electronic book), also spelled as e-book or eBook, is a book publication made available in electronic form, consisting of text, images, or both, readable on the flat-panel display of computers or other electronic devices. Al ...
s available on the web, or through content articles on blogs and websites. The challenges for individuals utilizing these methods are most commonly associated with those of other
self-help Self-help or self-improvement is "a focus on self-guided, in contrast to professionally guided, efforts to cope with life problems" —economically, physically, intellectually, or emotionally—often with a substantial psychological basis. When ...
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 () was a proprietary telecommunications application operated by Skype Technologies, a division of Microsoft, best known for IP-based videotelephony, videoconferencing and voice calls. It also had instant messaging, file transfer, ...
VoIP conferencing to interact with practitioners is also becoming increasingly popular for the added accessibility as well as discarding any existing geographic barriers. Entrusting the performance and privacy of these technologies may pose concerns despite the convenient structure, especially compared to the comfort of in-person meetings.


With gay and bisexual clients

Differing psychological theories play an important role in determining how effective relationship counseling is, especially when it concerns
gay ''Gay'' is a term that primarily refers to a homosexual person or the trait of being homosexual. The term originally meant 'carefree', 'cheerful', or 'bright and showy'. While scant usage referring to male homosexuality dates to the late ...
and
bisexual Bisexuality is romantic attraction, sexual attraction, or sexual behavior toward both males and females. It may also be defined as the attraction to more than one gender, to people of both the same and different gender, or the attraction t ...
clients. Some experts tout
cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD, and anxiety disorders. Cognitive behavioral therapy focuses on challenging and chang ...
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 mindfu ...
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 ef ...
. 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 personal pattern of romantic attraction 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. Patterns ar ...
, but
LGBT LGBTQ people are individuals who are lesbian, gay, bisexual, transgender, queer, or questioning. Many variants of the initialism are used; LGBTQIA+ people incorporates intersex, asexual, aromantic, agender, and other individuals. The gro ...
clients additionally have to deal with
heteronormativity Heteronormativity is the definition of heterosexuality as the normative human sexuality. It assumes the gender binary (i.e., that there are only two distinct, opposite genders) and that sexual and marital relations are most fitting between peo ...
,
homophobia Homophobia encompasses a range of negative attitudes and feelings toward homosexuality or people who identify or are perceived as being lesbian, Gay men, gay or bisexual. It has been defined as contempt, prejudice, aversion, hatred, or ant ...
,
biphobia Biphobia or monosexism is aversion toward bisexuality or people who are identified or perceived as being bisexual. Similarly to homophobia, it refers to hatred and prejudice specifically against those identified or perceived as being in the ...
, and both socio-cultural and legal
discrimination Discrimination is the process of making unfair or prejudicial distinctions between people based on the groups, classes, or other categories to which they belong or are perceived to belong, such as race, gender, age, class, religion, or sex ...
. Individuals may experience relational ambiguity from being in different stages of the
coming out Coming out of the closet, often shortened to coming out, is a metaphor used to describe LGBTQ people's self-disclosure of their sexual orientation, romantic orientation, or gender identity. This is often framed and debated as a privacy issue, ...
process or 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 im ...
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. Without effective pr ...
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), and cryopreservation of gamet ...
,
adoption Adoption is a process whereby a person assumes the parenting of another, usually a child, from that person's biological or legal parent or parents. Legal adoptions permanently transfer all rights and responsibilities, along with filiation, fro ...
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 t ...
, leaving them
childless ''Childless'' is a 2008 American drama film written and directed by Charlie Levi and starring Barbara Hershey, Joe Mantegna, James Naughton and Diane Venora. The sudden passing of a teenage girl unsettles the four adults in her life. Jarred by ...
, feeling excluded, other, and bereaved. There may be issues with
gender role A gender role, or sex role, is a social norm deemed appropriate or desirable for individuals based on their gender or sex. Gender roles are usually centered on conceptions of masculinity and femininity. The specifics regarding these gendered ...
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 gay identity identity was associated with difficulties in marital satisfaction, viewing same-sex activities as compulsive facilitated commitment to the marriage and to
monogamy Monogamy ( ) is a social relation, relationship of Dyad (sociology), two individuals in which they form a mutual and exclusive intimate Significant other, partnership. Having only one partner at any one time, whether for life or #Serial monogamy ...
.


See also

*
Counseling 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 c ...
*
Counseling psychology Counseling or Counselling psychology is an international discipline. It is practiced in the United States and Canada, the United Kingdom and Ireland, Australia and New Zealand, Hong Kong and Korea, and South Africa. Counseling psychology in th ...
*
Family therapy Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a branch of psychotherapy focused on families and couples in intimate relationships to nurture change and ...
*
Interpersonal psychotherapy Interpersonal psychotherapy (IPT) is a brief, attachment-focused psychotherapy that centers on resolving interpersonal problems and achieving symptomatic recovery. IPT is an empirically supported treatment (EST) that follows a highly structured and ...
* List of basic relationship topics * Relational disorder * Relationship education * Sex therapy * Social work * List of counseling topics


References

37
Conflict to Connection: Importance of Marriage Counselling
by Mcdowall Health, Author: James Arrington, Published on August 2, 2023 {{Authority control Interpersonal relationships Relationship counseling, * Marital problems