Couple therapy has three stages: assesment, treatment and relapse preventation.
The assessment phase consists of collecting and organizing information about the relationship. It includes conjoint sessions, discussing the history of the relationship, areas of concern, and goals for treatment. It may also include individual sessions with each partner, and written questionnaires to be completed by each partner. The assessment phase concludes with a conjoint session, in which treatment recommendations are discussed, and goals are established.
The treatment phase has three parts, as follows:
Clarification of the partners’ respective positions. Partners come into therapy having already tried everything they can think of to solve their mutual problems. They feel frustrated and stuck. This may have occurred, because individuals have suppressed thoughts and feelings, which get expressed in indirect or distorted ways. Alternately, individuals can be hypercritical in their expressions, provoking the partner’s defensiveness. The first task in therapy, is to help both partners to express clearly and effectively, thoughts and feelings about themselves, their partner, and the relationship.
Increasing understanding of interacting sensitivities and gridlock. Some couples react to efforts to clarify their respective positions, by engaging in the same sort of stalemating interactions that have been frustrating them at home. The therapist acts to break up the gridlock and open dialogue on how the respective positions are mutually depriving and frustrating. The effect is for each partner to become less critical of self and other.
Developing a shared perspective on the sensitivities and maintaining an ongoing dialogue on them. Partners who are discussing their respective positions and interacting sensitivities are talking collaboratively about their problems. Therapy has helped them to establish a two-person observation post, from which they can view their relationship. Once partners are able to view the relationship from a joint perspective, it may be possible for them to have ongoing and developing discussions about it.
Treatment strategies may include conflict conversations that are structured by the therapist in new ways, and debriefing of conflict conversations that have occurred outside of therapy. The therapist may also suggest activities for the partners, outside of therapy, for the purpose of increasing intimacy and other positive feelings.
The relapse prevention phase consists of follow-up sessions spaced widely apart for as long as a year, after the treatment phase has ended. Research has shown that couple therapy is very effective while the treatment is going on, but the likelihood of relapse is very high within six months to a year after treatment. Partners do well, as long as they are trying. If they become complacent about their relationship, they will tend to fall back into old habits. The purpose of follow-up sessions, is to help remind the partners of their goals and the strategies that have been found useful in reaching those goals.