"We saw two counselors before you. We'd get angry and start fighting, right in the office, and they'd just sit there. It got ugly fast."
"After one joint session, she asked to meet with me alone. She told me he was just like her ex-husband and I should divorce him..."
"Intimacy? No, that never came up. I wish that it did, because we have real problems in that area. We haven't been close in a while."
Direct clinical experience with couples is not required anywhere for licensure as a mental health professional, even for licensure as a marriage and family therapist.
Insurance companies don't pay for couples therapy, so public agencies can't bill for it. Without financial support, trainees just can't get the experience they need to become skilled couples therapists.
Insurance pays therapists to treat individuals with mental illness for 45- minute sessions. While these insurance corporations don't reimburse for couples therapy, if a therapist does see couples, it is within that limited time frame.
1 person in session = 45 minute sessions.
2 people in session = ___ ?
Research says 80-90 minutes.
Author, Discernment Counseling
Most therapists learn couples therapy after they get licensed, through workshops and by trial and error. Most have never had anyone observe or critique their couples work. ~Putting Family First, 2002, p. 26
Psychologist, Pres. of Couples Therapy Inc.
I go through hundreds of websites and resumes on an ongoing basis looking for qualified couples therapists. Most of them believe they are skilled enough to do it. A thimble-full actually are. 'Certified' means that someone actually watched you do it and said: 'They know what they are doing...'"
The effectiveness of marriage counseling is directly related to how skilled your couples therapist is, how familiar they are with evidence-based couples therapy, and how long your sessions are. Longer sessions -80-90 minutes- gives both of you the time to discuss issues in depth. Science based couples therapy is effective according to some studies at a level of 70-90%. Given the fact that most couples live in distress typically 6 years or more, those are pretty encouraging numbers.
I say I look through a 1000 resumes a year, but that's probably an understatement. It's not a problem finding applicants. Many apply and some have decades of clinical experience. It's just not demonstrated experience in couples therapy or a passion to grow to become the best at this challenging field.
Few have any objective credentials (supervised experience or academic training...) to do couples therapy. And simply having a degree in Marriage and Family Therapy is not enough (although some believe that it is...). That academic training seldom gives you more than one course devoted exclusively to couples. And the internships these students find are rarely "couples therapy" focused. They often work through in-home therapy settings with families in crisis, teenage residential settings and other individual and family therapy work.
Few are fortunate enough to have couples in their training caseload, and most of those cases involve parent guidance issues. And because health insurance doesn't cover couples therapy, they (wrongly) believe that they should build up their private practice talents in other areas once they begin to work on their own.
We believe that things will change not only as therapist train, but also as our clients become educated about the needed skills and qualifications for effective couples treatment. As consumers, when you begin to insist on advanced level of training, our colleagues will comply.
The problems are complex. You can learn more about the current state of our field HERE.
Thank you in advance for taking the time to learn more about us and our approach. And for taking the time to learn about our remarkable Team.