BT06 Topical Panel 01 - Brief Therapy with Couples - Ellyn Bader, PhD; Frank Dattilio, PhD; Pat Love, EdD; Monica McGoldrick, MSW

Description:

Educational Objectives:

1. To describe the use of brief therapy techniques in specific clinical situations.

*Sessions may be edited for content and to preserve confidentiality*

Outline

Introduction and Initial Remarks

• Panel topic introduced: brief therapy with couples.
• Panel format explained: short remarks from each panelist followed by audience discussion.
• Opening reflections include personal anecdotes and professional experience.

Defining Brief Therapy

• Discussion on the meaning of "brief" in therapy and its relevance for couples work.
• Some practitioners report that most couples only attend a few sessions.
• Others express interest in longer-term work while still exploring brief therapy models.
• Brief therapy is noted as especially relevant for practices focused exclusively on couples.

Challenges and Approaches in Brief Therapy

• Couples often stay in therapy for a limited time, creating urgency for impactful sessions.
• Emphasis on structured, focused therapy rather than drawn-out treatment.
• One approach involves seeing couples for a few intensive sessions with breaks in between.
• Key elements include goal-setting, homework, and skill-building.

Intensive Therapy Models

• Intensive formats include long sessions (e.g., 10 hours over two days) rather than weekly meetings.
• Benefits include deeper work and increased engagement in a shorter time frame.
• Honest, straightforward dialogue is encouraged, often outside of insurance constraints.
• Therapy aims to build positive experiences rather than just eliminate negative patterns.
• Focus placed on moments of deep emotional connection.

Marriage, Culture, and Context

• Marriage viewed as an optional yet often lifelong and complex commitment.
• Cultural, economic, and social influences play a key role in shaping relationship dynamics.
• Long-lasting marriages may involve navigating significant cultural differences.
• Understanding gender roles through a cultural lens is critical in therapy with couples.

Structuring Therapy and Differentiation

• Therapists benefit from taking a strong, clear leadership role in couples work.
• Intensive workshops are used to target specific areas of change.
• Differentiation is explored as a core concept—often misinterpreted as rejection.
• Tools like the "Stepping Stones to Intimacy" pamphlet help normalize relationship stages.

Addressing Sexual Abuse in Therapy

• Creating a safe environment is essential when working with survivors of sexual abuse.
• Post-traumatic stress responses must be handled with sensitivity and care.
• Rebuilding trust and intimacy is a gradual, layered process.
• Physiological and relational dimensions of sexual desire are both considered important.

Cognitive Behavioral Techniques in Couples Therapy

• CBT can be integrated into couples work in practical, accessible ways.
• A systemic lens is key—avoiding overly intellectual or authoritarian styles.
• Homework, reading materials, and structured exercises are recommended.
• Workshops provide deeper training on these interventions.

Working with Children and Parental Issues

• Parental dynamics often surface when initially working with children.
• Building a strong relationship with the parents is foundational.
• Therapists must be honest about how parental conflict impacts children.
• Sometimes the initial focus remains on the child before shifting to couple work.

Handling Emotional Unavailability in Relationships

• Emotional unavailability is often a protective adaptation, not a character flaw.
• Creating a safe environment can reduce the need for emotional withdrawal.
• Humor and self-awareness are valuable tools in recognizing common relational patterns—including among therapists.