Cognitive Behaviour Therapy to help with life’s challenges Psychology For Better Living Dr Paul Sigel, Clinical Psychologist, Central London W1 & EC2

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Couples Therapy

People are usually drawn to intimate relationships because it feels good to have closeness, understanding and a person to share important aspects of life with. When couples experience distress, particularly if it occurs repeatedly and on an ongoing basis, this can be painful and potentially destructive.

I provide Integrative Behavioural Couple Therapy (IBCT), a variant of Behavioural Couples Therapy. This form of couples’ therapy is the result of intensive research and development over the past 25 years and is well recognised in the UK and US. Behavioural Couples Therapy is recommended by the National Institute for Clinical Excellence [NICE] and has a well-developed evidence base for a range of client groups.

What to Expect in Therapy

During the initial phase, therapy focuses on evaluation of the couple’s concerns. In the first session, the therapist usually sees both partners together, learns what brings the couple to therapy, and obtains a brief history of their relationship. Both partners are also given questionnaires to complete and bring to their individual sessions. These individual sessions are important for understanding what each partner brings to the relationship, although for the most part, all remaining sessions are conducted with both partners present.

At the end of these sessions, the therapist typically provide feedback to the couple in terms of:

• the major themes in the couple's problems,
• the—usually very understandable—reasons why the couple has these problems,
• how and why their existing efforts to resolve conflicts have not been effective, and
• how therapy can provide new approaches for addressing the difficulties

The couple actively participates in this feedback, adding information, and modifying therapist's impressions to create a conceptualisation of their difficulties that feels accurate and authentic. Couples often find that developing a shared understanding of their difficulties and ways to resolve them is, in itself, a significant step in reducing their distress and the intensity of their conflicts.

The primary focus of subsequent sessions is active facilitation of change in how couples interact in the present moment. IBCT works to foster changes in behaviour and in how partners respond to their differences emotionally and cognitively: During the course of the sessions, couples usually make changes to accommodate each other’s needs but importantly, they also develop ways to be more emotionally accepting of differences between them. Weekly sessions usually focus on problems that have come up recently, are recurrent or are anticipated [often in association with upcoming events]. As in other forms of cognitive behaviour therapy [CBT], couples are encouraged to work on some of the strategies or issues between sessions.

Practical Aspects

Couples sessions tend to be longer than one-to-one therapy sessions, because more time is needed to explore and work through issues and difficulties between two people than with an individual client. Because couples often come with problems that have existed for a while, weekly sessions are generally required during the initial stages of therapy.

For more information about this approach, see Reconcilable Differences by Andrew Christensen and Neil S. Jacobson (click here to view) .

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