One-partner couple therapy & Gender…

1/17/2005
I to was trained within the classical family therapy framework which emphasized the need to involve both parties in the therapeutic process. If possible, I still prefer to go that route. One of the fundamental tenants, however, of systemic thinking is that movement in any part of the system will generate shifts throughout the system. According to this view if one can engage someone who has sufficient resources to make changes in his or her relational stance, systemic work with just one member of a couple can be justified.

In each case, this calls for a careful clinical judgment: If one accepts the challenge of working with one member of the system, will the momentum generated be sufficient to create new opportunities? Or will it, instead, generate additional frustration and perhaps further stress the allegiance issues within a couple? I prefer to discuss the risks involved in committing ourselves to such work upfront with such client at the very beginning of contact. I often recall a question suggested by the late Carl Whitaker: “What would your partner think if he/she was to hear that you are discussing your relationship with him/her with a stranger“? Though at first glance she is questions seemed provocative, it has alerted me to the risks that one faces with working with only part of the couple system. I want to share information on risks and benefits of single partner work with my client as soon as possible so the client can become a partner in making the appropriate choice. Most often, in my experience, the next session is a conjoint one…

On the matter gender, I believe research shows that the quality of the alliance over the longer term is about the same with the same sex as compared to the opposite sex client. The challenge here, I believe, has to do with finding a way of engaging with each client with sensitivity to their own “voice”.

Based on our research, we suspect that in “traditional” heterosexual couples establishing a strong bond with the male partner is often critical in keeping the couple engaged with the therapeutic process: Our sample consisted of heterosexual, largely middle class, white/Anglo persons drawn from communities that tend to vote on the right side of the liberal-conservative continua. It seems likely that in this population the need to “capture” the male client is at least partly a function of the “traditional” male ambivalence or insecurity in entering a counselling situation. Although we have no direct empirical evidence, we think it is likely that unless the male partner feels safe he may quickly exercise his “negative power” and in effect, calls on the partners’ allegiance to protect him from a threatening situation. Since the relationship between partners is already fragile, will she risks “abandoning him” in this threatening environment? If she forms a strong alliance with the therapist, will he feel more threatened in the counselling room and, in turn, distance himself (disaffiliate) at home? It appears that the female partner in these type of relationships is more resilient, has less fear of being abandoned by the therapist thus is more tolerant of split alliance that temporarily favour the male partner.
We have (Bedi & Horvath, 2003) examined the outcome of 3 types of alliance patterns: “Blessed”= a split alliance where the partner feels that his/her alliance with the therapist is stronger than partners; “Cursed”= the opposite, self reporting that partner has better alliance; and “Balanced”= an pattern which indicated that both partners had similar levels of alliance. The results were complex but suggests that a split alliance favoring the male, or a balanced pattern both increase the likelihood good outcome.
(It should be noted however, that the pattern we saw are likely predicated on some culturally rooted gender specific roles and expectations: I.e., ales are more sensitive/frightened in verbal emotionally unfamiliar context; Females feel safer verbal affiliation focused environments. If the clients have a less “traditional” gender expectations, it is our guess that this “hook the male fist” strategy might not work. We do think however that it may by be useful explore the possibility that therapists might benefit from locating the less comfortable, or safe partner and pay attention in the early phases of the work to forming a “good enough” alliance with this partner.)

Couple Therapy
4/5/2005
I work in an NGO with a sliding fee scale. Some clients pay very little. I like to see couples together for the first session, assign a task for the next couple session and then see each person individually. I advise the couple that I will use information from the individual session in the couple sessions. This allows the individuals to edit their comments and I think lets the couple know that I will not maintain secrets. As an aside, our agency does not do therapy where there is physical violence until they have taken treatment for the violence. We are fortunate to have a male and female treatment program in our community to address the violence in relationships.

I often see an individual who does not present as wanting couple therapy. When they then want to move to couple therapy, I request and see the other person for 1 or 2 sessions to get their ideas, motivation and to begin a therapeutic reationship with them. This has been working for me.

Thanks you for the post.
Hi guys, Im a newbie. Nice to join this forum.

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