Individual Therapy for Couple Problems: Perspectives and Pitfalls

Abstract

Despite the demonstrated efficacy of conjoint couple therapy, many clients seeking help for couple problems ultimately find themselves in individual therapy for these concerns. Individual therapy for couple problems (ITCP) may evolve from a partner's refusal of conjoint therapy or from the treatment format preferences of either the client or therapist. Having acknowledged the role of partner refusals, we offer some perspectives about the idiosyncratic personal factors and professional background factors that may lead therapists to provide ITCP and discuss the significant pitfalls in its practice. We emphasize five central areas of concern in the ongoing practice of ITCP: structural constraints on change; therapist side-taking and the therapeutic alliance; inaccurate assessments based on individual client reports; therapeutic focus; and ethical issues relevant to both attending and nonattending partners. We conclude by urging that this very important but largely neglected topic be paid greater attention in psychotherapy research, training and continuing education.

Relationship Help‐Seeking in a Danish Population Sample

“…However, previous literature suggests that intervention offered to only one member of a couple, such as individual therapy, is not the most effective treatment to ameliorate severe relationship distress (Atkins, Dimidjian, Bedics, & Christensen, 2009;Emanuels-Zuurveen & Emmelkamp, 1996;Nowlan, Roddy, & Doss, 2017). Traditional individual therapy may hold pitfalls, such as the therapist unknowingly contributing to a further polarization of the couple (Gurman & Burton, 2014). When relationship distress is present in an individual client, engaging a reluctant partner will often be the first priority, except in couples with severe aggression and fear of harm (Halford, Bouma, Kelly, & Young, 1999).…”

Does Relationship Counselling for One Work? An Effectiveness Study of Routine Relationship Counselling Services Where Only One Individual Attends

“…IRC makes use of approaches such as behavioural and cognitive behavioural couple therapy, emotion‐focused couple therapy and Gottman Method couple therapy in an individual counselling format to address couple relationship‐focused therapeutic goals, such as setting realistic relationship expectations, positive communication, and conflict management (Gurman & Burton, 2014), and is thus distinct from individual systemic therapies (e.g., structural and strategic family therapy, narrative therapy, solution‐focused therapy). IRC has its unique advantages, including allowing the client to be more open in sharing their feelings and accepting more responsibility for implementing positive behavioural changes in their relationship (Wilson & Flammang, 1990), especially in cases when the other partner is unable to provide support or commit to reducing relationship stress, as in traditional CCT.…”

“…A number of situations may necessitate the need for IRC. These include but are not limited to a client requesting to be seen alone, a partner’s refusal to be involved in CCT, or a therapist recommending IRC based on the assessment of clients’ circumstances (Gurman & Burton, 2014). Anecdotally, it is common for individuals to attend RC on their own (Bernstein, 2012).…”

Projective Identification in Couples

“…Although this couple did well, Feldman's beaten-down husband, who was seen individually, divorced his wife, presumably because he and his individual therapist felt the situation was unworkable. Clinical experience (Graller et al 2001) and formal research (Gurman and Burton 2014) have found that therapists who have not seen the partner (or consulted with someone who has) may too readily conclude that a marriage is hopeless.…”