Thursday, January 19, 2012

Couples Therapy: Questions to Ask Before Making that First Appointment

As I've ranted before, my marriage is going through a rough patch.  My husband is frustrated by my crappy employment history as well as my current unemployment.  This makes me feel that he's not taking my illness and disabilities seriously.  And in fact, he once said in counseling that he thinks I use them as "an excuse to not work".

Because it's not bad enough that I have to hear that crap from ignorant neurotypicals on the internet, the breakroom at work (when I work), or even on the bus.  I get to hear it from my partner.

In other words, we got issues.

We also had severe problems with our marriage counselor.  At this point, we're not sure whether we'll go with another Gottman counselor or not.  Whoever we choose, it will need to be someone who knows what they're doing. 

I'm guessing that if you read this blog, you're either mentally ill or you have ADD, which pretty much means that you've also dealt with relationship problems.  ADHD and mental illness can both put an incredible strain on any relationship, and you may need help to negotiate this treacherous terrain.  A competent couples counselor can be the guide you need to save your relationship.

But how can you tell your couples therapist is competent?

Going through the mill has led me to do some research I wish I'd done before seeking couples therapy.  I've learned that there were questions I could have asked our counselor that might have indicated his lack of experience.  I've also learned that during our sessions he gave clear signs that he had no idea what he was doing.  I've decided to share that research with you in the form of a short series on couples therapy.  Part One will be how to choose a counselor.  Part Two will be signs to watch for when you're actually in the therapists office.  Part Three will be about relationships in general, and staying in them when things get hard.  

So let's begin with Part One.  Your relationship has problems -- whether they're big or small doesn't matter -- and you've decided to seek counseling.  You've looked online, talked to friends about recommendations,  and you've made a list of people who seem like they could work with you.  What next?

Dr. William Doherty, a prominent couples psychotherapist, has suggested a list of questions you should ask any potential couples therapist.   After what my partner and I went through with our previous therapist, you can be sure we will be asking all of our potential therapists all of the following:

1.  What percentage of your practice is couples therapy?  Most "relationship counselors" actually have little or no training regarding couples work.  Choose a counselor who sees couples as the majority of their practice.

2.  What's the success rate of the relationships you treat?  How many of their couples break up?  How many see their relationships improve?  How many see no improvement?

Doherty points out that a success rate of 100% is unrealistic, (and therefore a sign to run far, far away from this therapist), but that a success rate of 70% is on the low side.  Saying that a good therapist should achieve a success rate that's between 70% and 100% isn't terrible helpful, but it's better than having no information at all.

3.  In your opinion, what's the importance of preserving a relationship when there are problems?  Most therapists received most of their training, and spend most of their time, treating individuals.  This often leads them to "help both people do what's best for them" instead of, you know, trusting the couple when they come in and say that they need help saving their relationship.

4.  Are you part of a professional organization that accredits relationship counselors?  If the therapist is in an association such as the American Association for Marriage and Family Therapy, it's a sign that they're more likely to be committed to helping you save or improve your relationship.  Dr. Doherty has also created a registry of "marriage-friendly" therapists who support couples' commitments to their relationships.

5.  What is your experience working with couples in my situation?  There are some relationship problems that are more common, like fighting over finances or emotional support, and others that are less common, such as same-sex relationship issues or those that arise from living with a chronic medical condition.  You can damn well expect that I'll be asking our next therapist about their experience with ADD and mental illness.

For the more fleshed out version of the questions and answers, read Dr. Doherty's list here.

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