I had dinner with a group of friends and acquaintances recently. The woman of one of the couples described her experience with her EAP (Employee Assistance Program) counselor, which was not good. Typically, an employer will approve an employee for up to six visits, from within their selected pool, with a licensed clinician. It’s a wise move on the employer’s part: unhappy people make for unproductive employees. But there are limitations.
The woman told me that this therapist fell asleep on her. This therapist makes frequent mention of other clients, though not directly by name (yet since her workplace is small, this woman was able to discern who her fellow clients were). She mentioned a number of things her therapist said that spoke of poor boundaries. Being new to therapy, she wondered if this was normal behavior from a therapist.
As much as I like to allow people to make their own informed, empowered decisions, I was struggling to remain in my seat. This therapist’s behavior was unprofessional, inappropriate, and unethical, for starters. I was sorry this had been her introduction to therapy, and promised her it could, and should, be something entirely different.
The conversation led to this couple considering couples therapy. I explained that many therapists provide couples counseling, though most therapists have not had adequate training working with couples. As a consequence, the therapy does not work. I explained what good couples therapy looked like, then gave them some referrals to people I work with, trust, and admire.
The next day I got an email from them with a list of therapists covered by his wife’s insurance; did I know any of them? They still wanted to cut corners and save money. This is normal, and I liked that they were open to exploring options. But they were also planning a month-long trip to Australia and New Zealand. Why wouldn't they invest in the health of their relationship? Where was the disconnect? Why would they, and so many others, leave the care of their relationship to chance?
Psychotherapy was built on a medical model. It can be expensive. The insurance industry suggests to us that if it isn't covered, it isn't important. Yet couples therapy is a very subjective discipline, with skill levels of therapists varying widely.
The best way to connect with a good couples therapist is through a direct referral, not through a list. And the best way to know if a therapist will work for the both of you is to go for a session or two and assess how you feel, both individually and as a couple, about the therapy. If the therapist is competent, s/he will openly and honestly help guide your decision.
Ask the prospective therapist if s/he has had had specific training for couples work. How much? How is the therapists work with couples different than with individuals (there is a big difference)?
Couples therapy can be a sound investment, and it’s going to cost money. However, the money you spend on a good couples therapist could offset the draining cost of maintaining a stale, conflict-ridden, emotionally taxing relationship. Why wouldn’t you want to get back on track with your partner, increase the quality of your connection to each other, improve your sex life, and trust each other more?
Try a trusted referral, or someone who you know places an emphasis on couples therapy, and if you feel chemistry with the therapist, give the therapy at least three month evaluation period. I find it sometimes takes this long just to discover what the questions are, let alone how to begin answering them.
Within this time, you should look for a reduction in harmful conflict; be learning new ways to express needs; reduce blaming; and increase connectedness. The therapist should be empathic and directive, a confidante and a coach, come from a place of authority, yet remain flexible and open. From there it is up to you to decide how deep you want to go. Your intimate relationship can be a spiritual journey, and a practice. Treat it with care, respect, and sensitivity, make it a priority, and let each other back in.
Derron Santin, M.F.T.
2471 Washington Street
San Francisco, CA 94115
The office is located in the Pacific Heights neighborhood of San Francisco, near Fillmore street.
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