Marriage Counseling: Waste of Money or Balm of Gilead?

July 30, 2010
By

I’m going to go out on a limb here and suggest that most of you could use some good marriage counseling. Yes, you.

“…do ye suppose that the Lord will still deliver us, while we sit upon our thrones and do not make use of the means which the Lord has provided for us?” –Alma 60:21

I have run into two groups (although there are more) of couples in the church. One group has tried marriage counseling and found it to be mediocre, a waste of money, and even damaging. Unfortunately, this happens. Another group of couples has not really considered it. They may feel like their relationship is pretty good, or don’t see how therapy would help. For this group I often quote the verse above – Marriage counseling is a means that God has provided for us. We cannot afford to “sit upon our thrones” (i.e. our pride) and not use therapy as an available means of improving THE MOST IMPORTANT PART OF OUR ETERNAL LIVES.

So what’s the problem?

First, some marriage counseling really IS a waste of time and money. Some of it may even make your relationship worse. This is not something you can just walk into. For those who have tried counseling and had bad experiences, consider yourself validated.

Second, as mentioned above, there are many couples who do not believe their relationship warrants marriage counseling. Many of them may indeed have relatively happy marriages, and could live out their lives without any extra help. They don’t see how counseling could make their relationship even better. Some couples may actually be quite distressed, but still don’t see how counseling would help. These are all valid concerns.

In a study on why people don’t go to counseling, the top two reasons were money and lack of belief that counseling will be effective. That old standby, social stigma, is actually not much of an issue anymore (I think it came in at #18). We are more open, for the better, about psychotherapy.

We can’t afford it

I don’t know what to tell you about the financial aspect. If you really can’t afford it, or you have no insurance that will cover it, my heart goes out to you. Family Services is an option, however, and fast offerings will cover at least part of your fees. If you DO have the money, and still think it’s expensive, I urge to you check your priorities. Do you spend money on golf lessons? Are they more important than your marriage? It IS an investment. You do need to make sure you’re getting your money’s worth though.

Will it actually help?

For the second concern – whether it will actually help or not – you need to do your homework. If you have been caught in one of the cycles I mentioned in my post last week, it is a necessity that you find a therapist that can address these cycles. You will be wasting your time talking to a counseling who tries to teach you “communication skills.” Who can do communication skills when they’re standing on the edge of a cliff? You need someone better.

Not all therapists (even at Family Services) are equally effective. Talk to people you trust who have been to a marriage counselor, and ask about their experience. Talk to any friends who are therapists – they often have some good ideas and/or referrals.

While many therapists do not follow a particular model of treatment, marriage counseling requires a carefully planned set of techniques and goals, with a structure that the therapist can follow as he or she begins working with you and your spouse. Find out what kind of training and experience the therapist has had specifically in working with couples. What is their approach? If you hear things like “skills” you may want to be a little skeptical. Marriage counseling that focuses on learning skills may work in the short-term, but has a woeful relapse rate.

Some therapists will adhere more closely to a particular model of treatment. This may or may not mean they are more effective. It all depends on how good they are at the model. Currently, the only two models of marriage counseling that are heavily supported by research are Behavioral Marital Therapy (also referred to as “Integrative Behavioral Couple Therapy,” “Cognitive Behavioral Couple Therapy,” or “Traditional Behavioral Couple Therapy”) and Emotionally Focused Therapy (also referred to as “EFT” or “Emotionally Focused Couple Therapy”).

For particular models, I admit my bias. In my work with couples I mainly use EFT. According to about 20 years of research, 7 out of 10 couples experience “recovery” from distress. 9 out of 10 experience some amount of improvement. These numbers are huge. Most marriage counseling is about 50% effective, with high relapse rates. EFT has very low relapse rates, and many couples continue to experience gains in their relationships years later.

While EFT is effective for couples in general, certain couples seem to experience the most gains. If you fall into one or more the following categories, you may experience the most improvement:

  • couples who are over 35 years of age
  • men who would be viewed by their spouses as “emotionally inexpressive”
  • women who, despite the distressed relationship, still have faith that their husbands care for them.

What is EFT like?
EFT is largely based on attachment theory, which suggests that we all have needs for safety and connection from infancy to the day we die. The ways we go about getting these needs met can sometimes cause problems in our relationships. I highly recommend the books “Hold Me Tight” by Sue Johnson and “Becoming Attached” by Robert Karen if you are interested in learning more about your relationship and attachment. Those books can be especially helpful for couples who are not distressed, but would just like to improve things.

An EFT therapist will help you understand the pattern that you get caught it, and help both of you experience the emotions underlying the pattern (these are discussed in the post last week). After a while, you and your spouse will be able to see the pattern as a common enemy you fight together, and it will still happen but won’t be as intense. You will be able to interrupt it. This is the first big change, but is not enough to last. The therapist will then work almost solely with the more withdrawn partner to help them feel safe and explore their unmet or hidden needs and emotions that drive the pattern. This partner will eventually “re-engage” in the relationship. Next, both the newly re-engaged withdrawer, along with the therapist, will help the pursuing/blaming partner to explore their underlying needs and emotions, which eventually results in a blamer/pursuer softening. I believe that these two events—the withdrawer re-engaging and the pursuer softening—are next to impossible without something like EFT. After this process has been completed, THEN you may work on specific issues, if they are still a problem. Parenting difficulties, in-laws, money, sex, use of time – all these issues become easier to solve when your cycle or pattern is no longer a problem. Naturally, there are bumps along the way. EFT can take anywhere from 12 to 40 sessions (or more) depending on how distressed you are, and if there is any trauma in either you or your spouse’s history.

This is a very brief and simplified explanation of the EFT process. Naturally, it has also been rather cognitive. This is stuff you cannot do in your head, which is why the therapist must guide you through it. There are EFT therapists in many different countries, and in many states in the U.S. If you are interested, go here to find one. Next to each of their names it will show their experience, from just receiving the basic training if EFT, to being a certified EFT therapist or supervisor. Most certified EFT therapists are probably skilled enough to help most couples.

Whether you choose EFT or some other type of therapy or therapist, choose wisely. It is a big decision. At the same time, don’t put it off! Couples wait way too long before they go to therapy. For all those husbands who don’t think they need marriage counseling, all I can say is repent and listen to your wives! Let go of your pride. Going to therapy doesn’t mean you have failed, it means you care.

May we all be proactive in improving our relationships, in whatever way we may choose to do so. May we let go of our pride and fear and anxiety and make use of the means the Lord has provided for us.

Tags: , , , ,

  • http:://annmjohnson.wordpress.com Course Correction

    A sense of humor is a great asset to a therapist. My husband and I still laugh about the counselor who listened to our opposing views and said, “I don’t know how you two ever had five kids together!”

  • AdamF

    Agreed – humor, as well as other personal characteristics of the therapist can be very important.

  • http://mormonheretic.org Mormon Heretic

    adam, I know you are biased toward eft. can you describe the success of the other technique and who it is suitable for?

  • anon

    what’s your thought about couples each seeking individual therapy? i have to say that’s been really helpful in making our marriage stronger. it’s human nature to have issues. we bring our own individual baggage and issues that feed off the other persons issues. working on our own issues has helped us come to the marriage more ready to work and try again and apologize and forgive.

    “Going to therapy doesn’t mean you have failed, it means you care.”

    well said.

  • Paul

    What’s another problem? It is that many therapists, in the nitty gritty of counseling, don’t treat the marriage as if it has intrinsic value. My good friend (not a Mormon) needed to go through 4 marriage therapists in order to find one who said, “O.K., you want to stay married. I will help you do that.”

  • Rachel

    As an excellent individual therapist who works only with adults, sometimes an individual will, during the first session, ask if I would be willing to do couples work. I reply, “I wouldn’t refer anyone to me for marriage therapy. That is really a specialty. I am happy to work with you individually and refer you to several therapists I know who specialize it marital work”. I think sometimes therapists will do couples work because they need the business but don’t necessarily have the training.
    To second Adam’s point, people do wait too long. When both parties have already had appointments with lawyers, it’s daunting to think about where to start. Even when I see people individually at this point, they’ll say, “I just want to prove to myself I’ve done everything I could to save the relationship”. With that attitude what do you really expect the outcome to be?
    Here’s what happens sometimes. People go to therapy, tell their woes, and after the first couple sessions, realize, for whatever reason, the therapist isn’t a good fit. But they’ll stay with the therapist for two reasons–one-they don’t want to hurt the therapist’s feelings (!!!), and two-they don’t want to start over with someone else. So, they eventually drop out, leaving frustrated/discouraged/hopeless that things can be better.

  • Tim Rollins

    IN REPONSE TO MORMON MARRIAGE COUNSELING

    July 31, 2010

    WARNING: May contain dialogue that some may find bothersome, and others may find refreshing. Saddle up and enjoy the read! — The Author

    I have heard this said and that said over the years about marriage counseling and the Church; so, if any intelligent person is going to take a serious look at this issue, let’s go back to Square One and at least try to be a little more objective, shall we? Granted, and in fairness, all of us have 20/20 hindsight, and I freely confess that I have my weak spots over the years to include surviving divorce — with the percentage of men and women enduring this change increasing in number — however, the fact is, that if we look honestly at ourselves, and do so without beating the snot out of ourselves, many of us will realize that each of came to the marriage altar a little underdone; in other words, we had not advanced sufficiently in our character development to appreciate the covenants we were about to make one with another, the Lord, and our future posterity. Suffice it to say—and pardon the pun—when a marriage goes KABOOM!, it is usually only the children who get ‘screwed’, if you know what I mean.

    Part of this originates from our own youth; some of it from parents and others from peers about the same age as returning missionaries, who, with their peers are eager to see the children marry, make grandbabies, and bring them over so they can crap on Grandma and Grandpa’s brand new carpet. Another part of the reason everyone either pushes these newly returned missionaries and/or servicemen to marry so quickly after coming home is so these comparative ‘young adults/’kids’ can get laid without fearing church discipline hanging over them like the Sword of Damocles.

    Keep in mind I am not advocating premarital sex by saying this. What I AM saying is that there must be a sense of balance in all things, and that everything has its time, place and season. How many of us know about the RM who attends BYU as a sophomore four months after his mission, meets a hot babe at Family Home Evening on Labor Day, has his first date with her the next night, takes her (or she takes him) home for Conference weekend, only to have the entire families hoping they will ‘close the deal’ with a ‘Christmas time’ wedding before December 31, so they can enjoy the massive increase in what would be their otherwise paltry tax refund?

    After the wedding, comes the pressure to ‘multiply and replenish the earth’, often at rates faster than faith, finance, prudence, good health and sanity would prefer. All too often, I have seen marriages begin in the temple, have four children in five years, and after seven years — and the guy has FINALLY finished his degree — she divorces him because he is NEVER home because of all the hours he has to work at ‘rookie’ entry level wage in order to feed everyone sufficiently.

    On the other hand, had these engaged couples received some training from their stake leaders in the form of eight two-hour classes taught by spiritually mature and seasoned couples covering eight areas of successful marriage such as communication skills, relatives and family issues, career choices, child raising and rearing, financial, preparing for retirement (count as two), sexuality and intimacy in marriage, and the importance of continuing to date after marriage…along these lines, and signed off the cards of these couples, by the time these couples see the stake president for their temple recommends, then he will KNOW they are both worthy and qualified to marry in the temple.

    I had an Institute teacher at Cal-State Fullerton who taught the Celestial Marriage Class. On the FIRST day of the class, he had EVERYONE in the class place their scriptures under their desks, saying we knew the scriptures well enough that he was not going to discuss with us anything new from there in our particular class.

    Instead, he chose to concentrate on interpersonal skills; how to live with one another without killing one, the other, or both, in the process. He also bragged that the previous semester, he broke up eight engaged couples, reasoning (correctly, I might add), that it was easier to deal with a broken engagement than a broken marriage.

    So, if this provides us all with a great lesson in hindsight, and helps out either a friend, an adult child of ours or those of a friend, then hopefully what I have said here tonight makes a little sense.

    If anyone gets their knickers in a knot, if anyone’s tight whiteys get themselves in a bunch, they might want to take a long hard look in the mirror and see the source of the problem there.

    Thanks for letting me post. ***

  • http://shenpawarrior.wordpress.com AdamF

    #3 – “can you describe the success of the other technique and who it is suitable for?”

    Actually, the other is really two techniques, behavioral marital therapy and integrated behavioral couple therapy. The latter is an attempt to improve on the former, which had about 50% recovery rates and woeful relapse. IBCT is probably a successful treatment as well, and seems to have near 2/3 recovery rate, with less relapse. While I did mention EFT has 7/10 for recovery, you can’t really compare the studies. What matters most is probably that the therapist has a clear map to help a couple, has experience and specific training, and that each partner really buys into the particular process. Here is a site for IBCT: http://ibct.psych.ucla.edu/, and it lists some research as well I think. The creators of this model also have a self-help book called “Reconcilable Differences” (Andrew Christensen & Niel Jacobson). I haven’t read it yet, but have been meaning to. It looks pretty good.

    #4 anon – “what’s your thought about couples each seeking individual therapy?”

    This can be very helpful, in terms of working on individual issues, just as you mentioned. There are some things to be cautious of here though. Many novice (and/or less effective) therapists may suggest individual therapy when couple therapy isn’t going well, or when there is too much negativity, etc. This is a mistake. They just need a better therapist. Sometimes couple therapists will do some individual sessions for specific purposes (e.g. building the relationship or assessing for abuse or affairs or addictions), but the focus should be on the COUPLE and the RELATIONSHIP rather than on the individuals. You can’t treat the relationship specifically without both people in the room. All that being said, I agree with you anon, therapy in general helps, and is effective, and if you change any part of a system (e.g. the individual) the whole (e.g. the couple) is probably going to change. I just generally prefer to work with an audience. :)

    #5 Paul – “many therapists… don’t treat the marriage as if it has intrinsic value.”
    Those are some lame-o “marriage therapists” imho. As I said above, individual therapists will (for good reason) sometimes value their individual client over the relationship (which is why it’s probably not a good idea if one spouse is seeing a counselor, to then later see the same counselor as a couple—too much bias and a strong alliance with only one partner in place, etc.). ALL of the couple therapists that I know work on the RELATIONSHIP more than anything else. The relationship/marriage is treated as the most important factor, and is seen as the “client” rather than each partner. Personally (and I know many who would agree) I would almost never suggest to a couple they should separate, if they indeed wanted to try to work it out. If the relationship was SO bad and we tried in therapy for long enough to no success, I might say “I don’t know how to help you two” but I would probably not say “you should get divorced.” Glad your friend found someone who had their brains working right, haha.

  • http://shenpawarrior.wordpress.com AdamF

    #6 – Rachel – Thanks for the comment, I hadn’t thought of people staying in therapy because they don’t want to hurt the therapist, but I could see how that may be an issue! I agree, many don’t want to start over. Drop out has been a problem for me in the beginning, and I’ve found that often it’s because I don’t instigate enough change fast enough. I think clients need to feel within the first few sessions that this is going to be helpful, and make a difference. I usually tell couples to give it 3 sessions before they decide if they really want to do this therapy or not (when I’m using EFT), and 12 sessions before they decide if they are going to drop out or not. I can’t really ask for more than that, and if something isn’t happening by then I usually take it as MY problem, not theirs.

    #7 – “many of us will realize that each of came to the marriage altar a little underdone”

    Agreed, and some more than others. Some of that personal growth can happen outside of marriage, but sometimes it’s just going to be hard anyway, e.g. for trauma survivors. I have seen those types of situations you described as well, young marriage, multiple kids, graduate school, and a marriage on the rocks. Kids are really hard on marriages, you can’t really explain that one away. 2/3 of wives have a significant drop in marital satisfaction with the birth of the first child. The other 1/3 stays the same or gets better. It’s usually the husband’s fault (I’m not kidding—they usually aren’t on board with having the new baby like the moms more often are, or are forced to be by circumstance).

    “had these engaged couples received some training”

    I think premarital education should be a requirement, or maybe strongly recommended, for a temple sealing. Actually, engagement is the perfect time for prevention-based educational classes or learning about relationships. Prevention really is the best when it comes to relationships. These classes aren’t as effective once the marriage has started slipping… In a perfect world (according to me) ALL engaged couples would A) consider their own and their potential partner’s history and family context, and assess the impact of any trauma could have and how they will deal with it or even heal, B) would receive as an engaged couple some form of in-depth education on relationships (John Gottman has a GREAT weekend seminar for this, it’s been very effective as prevention, specifically), and C) after they’ve been married for 2 years (or whenever the “limerence” is gone (e.g. honeymoon stage and or intense infatuation etc has calmed down to reality, they get some good therapy for 10-20 sessions. Nevermind the “young age” of marriage or “having kids young” or “being in school” or etc. Those are all huge factors, but I think if every young couple in the church did the 3 things above there would be A LOT less divorce, and MANY happier marriages. And good for your Institute teacher. If education causes couples to split, that’s probably a good thing. If education causes them to marry, that’s good too.

  • Rachel

    Adam, what I say on session one is that you are paying for a service and you should expect results/get your money’s worth. We begin goal setting at that session, and I review those every session, or two. Especially helpful on the days when they say not much has been going on, or not sure what they need to be working on.

  • http://ethesis.blogspot.com/ Stephen M (Ethesis)

    On the other hand, ignoring the hype, Gottman’s Seven Principles for Making Marriage Work is really quite good.

  • AdamF

    Rachel – yeah, monitoring things every session is good. I’ll always ask how the session went. Some places I’ve worked even use an assessment every week.

    Stephen – that’s one of my favorite books!

  • http://mormonheretic.org Mormon Heretic

    so it sounds like eft has the best success rate? how many therapists use none of these techniques?

  • AdamF

    Yeah, it appears so, with the caveat that these studies aren’t perfect, and some meta-analyses suggest that ALL methods that are intended to be therapeutic are EQUALLY effective. So there are often two camps in the therapy field, specific techniques vs the “common factors” people who claim that every therapy consists of common factors that make it successful. My guess is that the majority do not follow a specific model like eft or ibct, and that is not necessarily bad, just as an eft therapist is not necessarily effective. It all depends on how effective that particular therapist is at what they do, in this case couples therapy. To be effective in that arena I think a clear roadmap is needed, with a therapist who doesn’t take sides and knows how to direct each session toward specific goals. Something like EFT provides that map/guide, and also gives the therapist a theory (attachment) that really guides things as well. Without a theory of distress and love and relationships, doing couple therapy is, as the EFT founder said, “like moving chairs around on the deck of the Titanic.” a marriage counselor really needs to know what they’re doing, and where they’re trying to help the couple go, and how to get them there. Without a specific model this may be more difficult.

  • http://www.mormonexpression.com George

    In response to #7, Tim Rollins when he states:
    “On the other hand, had these engaged couples received some training from their stake leaders in the form of eight two-hour classes taught by spiritually mature and seasoned couples covering eight areas of successful marriage such as communication skills, relatives and family issues, career choices, child raising and rearing, financial, preparing for retirement (count as two), sexuality and intimacy in marriage, and the importance of continuing to date after marriage…along these lines, and signed off the cards of these couples, by the time these couples see the stake president for their temple recommends, then he will KNOW they are both worthy and qualified to marry in the temple.”

    I must say that I find this answer to be lame and unprofessional. I think it is exactly this sort of thing which causes so many couples to have issues in their marriage. They work with a Bishop or a Stake President (my bishop is a commercial roofing contractor) who have ZERO professional experience counseling couples in relationship issues. Suddenly they get “then mantle” and they think the are God’s gift to marriage counselors. This is just pure bull crap.

    Or, as you suggest, lets bring Brother and Sister OldTimers in and they can share the success of a their marriage and how if they prayed each night, no matter how mad they were, things would work out great. Again, pure bull crap. What works for 1 couple has so little in common with what will work with another couple that the pure idea blows my mind.

    This is exactly what professional counselors learn to do. They take their personal experiences out of the equation and give advice that is rooted in human behavior , not person opinion.

    I’m currently in marriage couples therapy with a counselor that charges approx $100/hour. It is very well worth it and I NEVER come away from a session thinking it wasn’t worth the money.

    My advice: STAY AWAY from untrained church leaders or members who are not professionally trained.
    RUN TOWARDS professionals who can truly make a difference in your life.

  • http://shenpawarrior.wordpress.com AdamF

    “Suddenly they get “then mantle” and they think the are God’s gift to marriage counselors”

    Thanks for the comment George. Glad your therapy is working out. I think you offer some sound advice. For the quote above, I agree, there are some bishops who try to meet with these couples weekly and help the marriage. Some of it may be due to financial motivation – i.e. if they use less of the fast offering funds, they look better, have a tighter budget, etc. When my father was a bishop he learned rather quickly that he was not qualified to do any kind of therapy with couples, and he used family services religiously (no pun intended). Leave the counseling to the professionals, and bishops should know their role.

  • http://mormonheretic.org Mormon Heretic

    george you have some excellent points, especially when it comes to roofing contractor bishops providing marriage counseling.

    I am glad to hear counseling is working for you. as I have said before, not all counselors are created equal. my $100 counselor actually made divorce seem palatable (which was not his intention.) I fired him. I am curious about eft and these other methods, and I hope are as good as adam suggests.

  • http://shenpawarrior.wordpress.com AdamF

    Agreed – they are not equal. Actually, the therapist is A LOT more important than the specific technique they use. A lot. Granted, the difficulty is finding one who is good. A counselor being “certified” in EFT means they have gone through a 4-5 day training, have had 30+ hours of supervision just in the model (usually a lot more), and have submitted tapes of their work to the people in charge who approve and say yay or nay as to whether these people become certified (all of this is on top of the regular licensure requirements, of course). I’ve been working on this process since January of 2009, and am still in the middle of it. Granted, I’ve had school and other stuff as well so it has taken longer, but it definitely takes a lot of work to get it done.

  • Tim Rollins

    Keep in mind that that those who see bishops for marriage counselors, that it’s like a box of chocolates: You never know what you’re gonna get. Unless your bishop does this type of thing for a living — marriage counseling, that is, — it is best that he limit his marriage counsel to sound, practical counsel based on the words of the living prophets and practical experience. The more serious issues NEED a PROFESSIONAL touch. Remember, these issues did not develop overnight, and they certainly will not fix themselves overnight, either. While bishops and stake presidents get refresher training to help recognize and address these issues that DO come up, they are reminded in this training that they have full-time PROS they can call on as needed for the more serious matters.

  • http://www.mormonexpression.com George

    I’m going to bounce back in here with another thought.

    If you go see a Bishop about anything personal like marriage counseling, you also need to remember that this guy has not professional training, but that his term as Bishop is going to be up in the next couple of years. If you and your wife have gone to him with many personal issues, what then? What about seeing this guy at neighborhood pot-lucks for the next 10-15 years, not knowing what he tells his wife about things. Also, you have a bunch of time invested with him and then he gets released, do you just jump to the next Bishop and hope to keep things moving along or do you stay with the same (non-professional) (now ex-bishop) that you’ve been seeing.

    My opinion, having been in ward leadership, having counseled couples because of my ward position, and now going through it with someone who actually has the skills to help, is that people should just generally run away from taking any counseling issues to their ward or stake leadership. These people have no skills and “gut feeling” or “mantle of authority” is not sufficient to advise you about matters related to your relationship. I feel terrible about the times in the past where I’ve actually thought that I had the God Given Authority to advise couples 10-20-30 years my senior as to what they should do to make their relationship stronger. Or how to fix major holes in the marriage that went so many layers deep it would take months of professional help just to uncover the issues.

  • Tim Rollins

    Part of my success in seeing problems within marriages, is doing ALL I can to NOT know of the deeper issues. Like George and others have said, DO NOT TRY THIS (MARRIAGE COUNSELING) AT HOME!! Leave this strictly to the professionals, especially in light of the fact that bishop and even stake presidents come and go.

    Unless President Monson is your personal marriage counselor, I suggest you not use him in that capacity; his schedule does not allow for it, and he’s not in your priesthood line of authority anyway. Your bishop – upon request and by way of referral – can refer you to professionals who actually KNOW what they’re doing…otherwise, do not volunteer any more information than ABSOLUTE MINIMUM to your bishop about marital problems unless it affects the temple worthiness of either you or your spouse. It is NOBODY ELSE’S BUSINESS!!

  • adamf

    I think that’s some sound advice. Beyond the TR issues, volunteer enough information to help your bishop use his authority to act as a go-between to get you to a counselor, if you don’t know how to find one otherwise.