The Secret Of Couples Therapy That Works…


“The Dodo Bird Conjecture – Psychotherapy works… But no psychotherapy works better than any other.” – Richard Bentall

The Dodo Bird Conjecture is a controversial topic in psychotherapy.

If it’s true (and I believe it is) then the difference between therapy that works and therapy that doesn’t…

…Isn’t how many years experience your therapist has.

Though it’s good that they have some.

And it isn’t what school of couples therapy theory they’re trained in.

Though it’s good that they are trained.

All of this is important.

But there is a convincing argument that the difference that makes the difference between therapy that works and therapy that doesn’t are the variables effecting the relationship between the client and the counsellor. Also known as “The Therapeutic Alliance”.

Wampold et al. 2002, found that 70% of the variability in treatment outcome was due to the therapeutic alliance whereas 10% of the variability was due to a specific treatment.[2][3][4][5]

A 1992 paper by Lambert showed that nearly 40 percent of the improvement in psychotherapy is from these client–therapist variables[6].

Now then…

…Does this apply to Couples Therapy?

The literature I’ve reviewed doesn’t answer this question.

But as a counsellor working only with couples I’ve certainly had my own experience of this.

When I first started practicing as a couples only counsellor, I’d work with any couple. Even couples I knew I didn’t get on with.

But I persevered.

Thinking that as the therapy went on, I’d get to understand them better, warm to them better and the therapy would go better.

You know what?

It never did.

Yes, I’m a professional.

And yes, I’ve got thick skin and don’t take it personally.

But I’m a human being too.

And I know, the results of our work together will be much better (for both of us) if we get on.

That’s why I like to think of the first assessment session as an informal interview.

I’m not everybody’s cup of tea.

Neither are you.

And at the end of the first session, I’ll tell you if I’m happy to continue working with you, or whether we’re not a good fit.

And I’ll ask you to discuss with your partner on the journey home whether you think we’re a good fit.

If you do…

…Great, I look forward to session 2.

And if you don’t?

Great, I wish you both well.

Helping you to decide if we’re going to be a good fit is also why I write these blog posts the way I do.

I write the way I talk.

Couples frequently comment on how there’s a total match between what they’ve read and how I am in the sessions.

That’s deliberate.

So…

…If you think we might be a good fit, let’s meet up and start work on improving your relationship with your partner.

Go here next

Side Note: I once met with a couple. It took 7 minutes from them sitting down and me saying: “Hello” to saying: “I’m bringing this session to an end. We’re not a good fit.”

True story.

Though to be fair the wife really did not want to be there. She’d clearly been forced to attend and took her frustration and resentment at the situation out on me.

Like I said…

…I’m thick skinned.

But if someone doesn’t want to be in a room with me, couples therapy isn’t going to work.

If you and your partner both want to improve your relationship with couples only therapy…

…go here next

References:
[2] Wampold, Bruce E; Minami, T; Baskin, TW; Tierney, SC (2002), “A meta-(re)analysis of the effects of cognitive therapy versus ‘other therapies’ for depression”, Journal of Affective Disorders, 68 (2–3): 159–65
[3] Wampold, Bruce E; Mondin, GW; Moody, M; Ahn, H (1997), “The flat earth as a metaphor for the evidence for uniform efficacy of bona fide psychotherapies: reply to Crits-Christoph (1997) and Howard et al. (1997)”, Psychological Bulletin, 122 (3): 226–30
[4] Wampold, Bruce E; Mondin, GW; Moody, M; Stich, F; Benson, K; Ahn, H (1997), “A meta-analysis of outcome studies comparing bona fide psychotherapies: empirically, ‘All must have prizes'”, Psychological Bulletin, 122 (3): 203–15
[5] Wampold, Bruce E; Serlin, RC (2000), “The consequences of ignoring a nested factor on measures of effect size in analysis of variance”, Psychological Methods, 5 (4): 425–33
[6] Lambert, M (1992), “Implications for outcome research for psychotherapy integration”, in Norcross, JC; Goldstein, MR (eds.), Handbook of psychotherapy integration, New York: Basic Books, pp. 94–129.