BT12 Clinical Demonstration 10 - Assessing a Couple’s Developmental Stage & Selecting High-Impact Interventions - Ellyn Bader, PhD

Description:

Learn to quickly identify a couple’s developmental stage. Assess each partner’s role in maintaining arrested development and create an effective treatment plan that emphasizes “teamwork”.

Educational Objectives:

1. Demonstrate how to use a couples history and presenting problem to identify their developmental stage.
2. Select stage-specific interventions to target more rapid change.

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

Outline

Introduction and Purpose of the Demonstration

• The session demonstrates a technique used for both diagnosis and intervention in couples therapy.
• The goal is to help therapists think developmentally and intervene with clarity and precision.
• The exercise, called the "paper exercise," was developed by Susan Campbell and later adapted.
• Acknowledgment that demonstrating with non-clients is imperfect but still valuable for learning.

Exercise Setup and Instructions

• Two volunteers, “Kevin” and “Angela,” role-play a couple together for 20 years.
• Presenting issue: Angela’s recurring anger and Kevin’s emotional withdrawal.
• Instructions:
  • Each partner is given a piece of paper to represent something important to them.
  • They must decide who gets the paper—without involving marriage/kids or tearing it.
  • The interaction is observed for communication patterns and emotional responses.

Execution of the Exercise

• Kevin and Angela hold the paper and engage in a non-verbal struggle over it.
• Conflict arises when Angela becomes angry and Kevin retreats emotionally, mirroring their typical dynamic.
• Both are asked to reflect on their internal experience and emotional responses during the interaction.

Feedback and Analysis

• Six core dimensions observed in the exercise:
  1. Self-definition
  2. Boundary management
  3. Awareness of the other
  4. Conflict management
  5. Moving conflict forward
  6. Giving and receiving
• Neither partner clearly defined what the paper meant to them, indicating difficulty with self-definition and assertiveness.
• Analysis focuses on how past relational experiences inform current behaviors and coping strategies.

Role-Play and Guided Feedback

• Therapist engages each partner in a role-play to explore deeper needs and fears.
• Angela identifies a desire to be heard and included in decisions.
• Kevin reveals fear of Angela’s anger and his tendency to withdraw.
• Suggestions for change include:
  • Angela offering loving reassurance
  • Kevin naming and acknowledging his fear
• Emphasis on differentiation and building emotional safety through small, intentional shifts.

Conclusion and Q&A

• Session wraps with additional insights and practical applications of the paper exercise.
• Audience questions address how the technique can be adapted in clinical practice.
• Encouragement to use the exercise to observe core dynamics and initiate change through developmental interventions.