The decision to provide couple or family therapy instead of or in addition to another form of therapy is based on consideration of several factors…
Indications for Couple Therapy
- The presenting problem is related to the couple’s relationship.
- The problem began at the onset of the relationship or near a crisis point in the relationship.
- The development of symptoms in one partner coincided with the onset of relationship conflict.
- The couple is thinking about ending their relationship and wants to resolve issues with the help of a therapist.
- Individual therapy has failed or is unlikely to succeed.
- Relationship conflict is identified as a problem by both partners.
Contraindications for Couple Therapy
- Domestic violence is currently present in the relationship.
- One partner is actively psychotic, severely emotionally disturbed, or in an actively addicted state.
- One partner is having an affair and is unwilling to admit to or give up the affair. Individual work is needed before partners are willing to work together.
- One partner refuses to participate in couple therapy.
- There is evidence that another form of treatment would be preferable.
(Bobes & Rothman, 2002; Sholevar, 2003).
Indications for Family Therapy
- A family member’s symptoms are manifestations of problems in the family system. The family is experiencing an acute family crisis.
- Family members exhibit serious problems in communication and perception (e.g., family members blame each other for the family’s problems).
- Improvement in one family member is likely to cause (or has caused) the development of symptoms in another family member.
- A family member has a disorder that is known to be effectively treated by family therapy (e.g., substance use disorder, anorexia nervosa, bulimia nervosa, conduct disorder).
- Another form of treatment has been unsuccessful in alleviating a family member’s problems.
Contraindications for Family Therapy
- A family member’s presenting problem is not related to family functioning but instead to conflicts at work or other issues outside the home.
- Key family members are unavailable or unwilling to participate in family therapy.
- One family member is so severely disturbed that his or her behavior makes family treatment impossible.
- The family is experiencing severe domestic violence that has not been brought under control.
- A family member requires another form of treatment prior to beginning family therapy (e.g., detoxification, individual therapy to establish trust).
- A family member’s problem involves a “secret” (e.g., infidelity, criminal behavior) that he/she does not want to share with other family members.
(Clarkin, Frances, Moodie, 1979; Glick et al., 2000).
Come back on Friday for a practice question related to this topic!