Online counseling has a lot of research demonstrating that it is equally effective as face-to-face counseling in the hands of a skilled psychotherapist, trained in online work. We also get great results in online counseling for married couples.
We still prefer face-to-face marriage counseling for very specific reasons: You watch faces and breathing when you're a couples therapist, and sometimes things get lost online. We sometimes have to ask whether someone's eyes are getting moist (and how awkward is that!)
In person, we just feel the tension more easily or a heavy breathe is seen or heard instantly. Sometimes that's just not possible in online work. But we do our best.
However, there are also a variety of reasons why the choice is between Online Counseling for married couples, or no couples counseling at all.
• You live in a remote location, and it takes a long time to get anywhere.
• You live in a country that speaks a different language than you do, or the culture is dramatically different from your own.
• You have care-taking responsibilities for children or the elderly that makes weekly sessions very tough.
• You have a chronic illness that exhausts you, and just getting to a therapist takes all the energy you can muster.
• You or your spouse travel a great deal, so scheduling a reliable appointment in advance is very tricky.
• You are well-known in your community (or the world!) and you want confidentiality in the waiting room, as well as in the office. When your "waiting room" is your living room, that's easy to accomplish. All therapists are required, by law, to keep your confidence when you see them. No therapist can make sure no one sees you on the way in or out.
• You, yourself, have trouble with mobility, making travel difficult.
...and the list goes on.
But we would like to caution you that couples counseling, even in an online format, isn't the same as individual online counseling.
First, the therapists themselves may not be equally trained. As we've repeatedly emphasized, couples therapy isn't just "individual therapy with two people..." no more than espresso is "strong coffee." Like that dark brew, the "beans" (therapist training) is different, in order to withstand the type of treatment it's going to undertake.
While there are many "online therapists," working for smart business-savvy IT start-ups, few are trained in couples therapy. Even fewer are trained at the doctoral level, as we are at Couples Therapy Inc.
And we're professionals who have set our own standards of care that go far beyond what someone running an "internet platform" might require.
To work as an independent senior couples therapists at Couples Therapy Inc, you must be trained in at least one evidence-based training modality for couples. As we've taken great pains to explain, there are reliable ways you can tell if your therapist is truly a couples counselor, or an individual counselor who sees an occasional couple.
Secondly, we expect our professional couples therapists to demonstrate that couples therapy is a passion for them, not just a passing whim. We hire therapists who have devoted their professional careers to marriage counseling and sex therapy. Just possessing a license and malpractice insurance isn't enough to join as one of our Distributed Team.
And we pay them well for that training. And our fees reflect that expertise.
We're not elitist. We just know from clinical experience and common sense that online work isn't the best way to work with some couples.
We know some psychotherapists jump right in and start working, even online, but that's not us. We want to know where you have problems, and the exact nature of those problems, beyond general descriptions such as: "We fight a lot."
• Which of the Four Horsemen are you exhibiting?
• What specific social skills to each of you need to acquire?
• How fast do things escalate, and do you have the "repair tools" to de-escalate?
...and much, much, more.
If it was all as simple as "We fight too much," John Gottman wouldn't have needed 42 years of studying couples extensively. And even as senior clinicians, we wouldn't need supervision to learn and practice his techniques.
Having trained graduate students as marriage and family therapists, you can tell the rookies:
They have the couple talk to the therapist, not to each other.
...and there's a very good reason why: They're not sure what to do if a couple's fight starts to escalate.
When you choose online counseling for your marital problems, make sure you spend a great deal of each session (after the evaluation) talking to each other, not the therapist, about what's wrong and how to fix it.
After all, the therapist's job is to put themselves out of a job. If they make themselves central to each discussion, in order to enable it to go well, they're making themselves indispensable. And that's a big, big, mistake.
This is short-term work, not a long-term commitment. We have to get in there, make an impact, watch how the two of you run with it, and refine. Then have you try it again. After a few short months, (12-18 sessions usually) we're finished. And a good portion of those sessions will be in the "after therapy" time frame.
After Therapy is much as 6 months between each session, over a two-year period.
Four Relapse Prevention sessions in total.
• Assess, Assess, Assess.
• Watch the Results.
• Have the Couple Refine.
• Watch the Results.
• Terminate the Treatment
• Continue in Relapse Prevention
Then go on to the next couple needing our help.
We don't need to keep you in treatment. And we don't want you to work only when you're in front of us. The work happens when you are living your daily life. We're the ones you see for a "tune up." We're not the "engine" of your marriage.
It's easy to set up your first appointment.
And after your first appointment, you can schedule the rest of them using our Online Scheduler.
So it becomes even easier for you to join this growing phenomenon.
See you online!
Dr. K is the President and CEO of Couples Therapy Inc. She maintains her Intensive Couples Therapy practice over the winter in Miami, Fl and the rest of the year in Boston and on the edge of the Berkshires in Western Massachusetts. She is a Gottman Certified Couples Therapist, has advanced training in Emotionally Focused Couples Therapy, and has been a AASECT board-certified sex therapist from 1982-2017. She continues her work in sex therapy.