CC22 Keynote 01 - Common Factors and Best Practice that Characterize Effective Couples Therapy - William Doherty, PhD

In this golden age for models of couples therapy, therapists may wonder if they should be practicing the “one best model.” The research is clear that couples therapy models that have been tested are about equally effective, and that there are a number of key ingredients in any effective way to practice couples therapy. The presenter will describe these key ingredients that cut across models and some skills necessary to practice any model. He will argue that since this therapy is about improving relationships, the relationships we establish with our couple clients—balanced, caring, and sometimes challenging—are the heart of what we have to do well.

Learning Objectives:

1. Participants identify what outcome research says about the effectiveness of different models of couples therapy.

2. They describe research-based common elements in successful couples therapy approaches.

3. They discuss several basic skills that cut across successful approaches to couples therapy.

4. They describe the challenges of creating clinical relationships in couples therapy and ways to address those challenges.

Outline:

Introduction to Keynote

• Jeff Zigg introduces Bill Doherty and the topic of common factors and best practices in couples therapy.

• Goal: Review outcome research, highlight common elements across models, and identify core therapeutic skills.

Keynote Goals and Approach

• Bill Doherty emphasizes practical strategies and micro-techniques not often taught in graduate school.

• Focus on managing early sessions and creating strong therapeutic structure.

• Includes time for Q&A.

Effective Models and Shared Principles

• Many therapy models are effective—including those outside academia.

• Common principles:

  • Avoid one-sided blame

  • Modify dysfunctional interactions

  • Encourage expression of avoided feelings

  • Improve communication

  • Leverage client strengths

The “Big Three” Core Strategies

1. Empathic connection with both partners—treat the relationship as the client.

2. Active session structuring to prevent reenacting dysfunction.

3. Shared understanding of the couple’s issues and therapy goals early on.

Best Practices in Session Management

• Ensure equal airtime for both partners.

• Stop interruptions and prevent high-conflict exchanges.

• Clarify relationship commitment if goals are vague.

• Promote hope and a forward-looking tone.

Handling Confrontation and Interruptions

• Intervene immediately when one partner interrupts.

• Maintain control to prevent emotional escalation.

• Reinforce respectful turn-taking.

Filtering Negatives and Challenging Mind Reading

• Route negative feedback through the therapist, not directly between partners.

• Challenge assumptions and labels like “you always” or “you’re just like...”

• Maintain psychological boundaries and discourage psychic mind reading.

Creating a Safe, Structured Environment

• Enforce ground rules to foster intimacy and emotional safety.

• Model healthy dialogue and consistency in conflict management.

• Help clients internalize these guardrails for use outside therapy.

Conclusion and Therapist Mindset

• Structure is more important than being “right.”

• Q&A covers handling interruptions, filtering negativity, and managing conflict.

• Session ends with appreciation and transition to workshops.