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Counseling Couples: The Complexity of Delicate Situations Essay

Abstract
Love is patient and love is kind, according to Corinthians 13:4 yet more and more frequently couples find themselves at impasses not knowing which is better to stay together or to separate. Living in a society of our way right away, right away can present conflicts among couples especially when they each have different views on what is best for their relationship. To add more complexity, family units may be non-traditional or other elements such as substance abuse and infidelity are present, which results in the presence of additional stressors. Through careful intervention, respect for the family unit, and proven methodologies, couples counseling is an avenue that provides hope for preparation for those entering marriage or long-term relationships, while also providing redemption and restoration for those who desire to maintain current relationships.

Introduction and History
For many years psychologist have studied and expounded on the research of pioneers such as John Bowlby and Mary Ainsworth who developed attachment theory, as well as, research conducted by Abraham Maslow, who determined that humans have a “need for belonging.” These pioneers set the foundation for understanding our humanistic desire to have a companion. Prior to these psychologist, the Bible reveals in Genesis 2 that Adam was lonely and for that reason, a “help mate” was created. Furthermore, according to Sandberg, Busby, Johnson, & Yoshida (2012), research has shown that even in adulthood, the presence of a significant other or partner can produce feelings of “security, relief, and other positive affects” whereas the absence of this secure attachment produces avoidant and anxious behaviors. As individuals engage in relationships, spanning from basic acquaintances to commits such as marriage, there are times when communication, confidence, and commitment become difficult.

Some situations lead couples to seek the intervention and expertise of counselors to assist in reconciling. Despite the troubles that couples encounter, Worthington, Lerner, and Sharp (2005) suggest that by utilizing counseling with the purpose of developing strong emotional bonds, couples have the ability to sustain long, healthy marriages. As unique as each individual is, so is each family unit or couple and it is important that therapist work within the systems that are presented, because on some occasions, the couple or family simply interacting within itself produces focus and accessibility of change (Chambless, Miklowitz, and Shoham, 2012). Counseling that promotes hope, forgiveness, better communication, conflict resolution, and build commitments, especially those encompassing Christ, leads to repair and reconciliation, which why most couples initially seek counseling (Worthington, Lerner, & Sharp, 2005).

Major Topics in Couples Counseling

Types of Relationships/ Couples
As times have changed, so have couples. The family unit is often not the traditional mother, father, and 2.5 children, instead families are now composed of stepparents, stepchildren, and same-sex relationships. As Christian counselors, relationships may present that are not condoned, yet respected. Stark, Kirk, and Bruch (2012) offer that even though marriage his recently become a highly idealized commitment, the rates for cohabitation and the number of single parents continues to increase and become more acceptable. Marriage has become a voluntary institution (Stark, Kirk, & Bruch, 2012). In addition, the composition of marriages has changed as reported by the Williams Institute. In 2006, the institute studied same-sex couples reporting status and determined that “nationally, the number of same-sex couples who reported their status to the government increased 437 percent” (Swanson, 2007).

Along with the increase of reporting same-sex couples, the number of blended families has increased as well. Gonzalez (2009) discusses that the couples that blend families often face more challenges, they are more overwhelmed, and they often feel increased pressure to resolve issues quickly. Couples that form blended families are challenged with making the relationship with their partner work, while also with helping to shape and mold two separate entities into one family unit (Gonzalez, 2009). Blended families are also a progressively significant family arrangement that produces complex relationships and distinctive pressures for each of the family members (Shalay & Brownlee, 2007). Accordingly, there is an increasing likelihood that family counselor will encounter blended families more frequent who are seek therapeutic assistance (Shalay & Brownlee, 2007).

Cultural Sensitivity
Counseling couples requires awareness of various cultural belief systems that are important to both individuals, both individually and together. The perceptions of each individual determines their expectations of the relationship, therefore counselors have to be aware of cultures, beliefs, traditions, and even historical references to ensure that elements are being evaluated from the client’s perspective. Couples counseling incorporates cultural intervention that is consistent with the client’s belief system regarding healing and has the potential to effect a specified change (Sperry, 2010). Couples counselors should carefully focusing the treatment process based on the core cultural values of both of the individuals that comprise the couple (Sperry, 2010). Sperry (2010) states that there are three specific steps to cultural sensitivity; recognize the cultural identity, identify the family dynamics, and develop a cultural formation that frames the context of the issue.

Parenthood

One of the most challenging transitions that couples face is the transition to parenthood (PINQUART AND TEUBERT, 2010). During the expectation of a child, parents often become stressed with the required adjustments and often positive communication among couples decrease (Doss, Rhoades, Stanley, & Markman, 2009). For example, as reported by Pinquart and Teubert (2010, in a study conducted by Miller, Pallant & Negri (2006), 80% of first time mothers expressed mild symptoms of depression within the first weeks postpartum, while 10 to 30% of mothers developed clearly diagnosed clinical depression. Emotional and psychological distress of this magnitude may also have a significantly negative effect on parenting behavior, such as sensitivity, investment in the child, overall parenting, and cooperation between parents (Foster, Garber, & Durlak, 2008). Couples experiencing such life changes often seek counseling to better understand each other, the stressors, and methods for making the transition less problematic. Pinquart and Teubert (2010) showed that intervention that were solely couple focused, developed stronger efficacy on couple communication than pure prenatal or postnatal interventions, reminded the couple that they are the foundation of the relationship and conduits of change.

Intimacy

Most couples experience problems that are not understood, therefore couples therapist are often presented complaints that are the results of communication failures and conflicts that are directly related to the couples unfulfilled attachment needs (Solomon, 2009). Couples therapy attends to increase the awareness and recognition between partners of their needs and the relational paths that each partner has encountered (Solomon, 2009). In addition, couples therapy, from an attachment theory approach, attempts to help individual to move beyond what could become an endless cycle of shame and blame, and instead teach and shows them they can choose to stop acting defensively with each other (Solomon, 2009). When couples are experiencing issues, intimacy is most often affected, however through couples therapy, partners are helped to understand their dependence on one another in order to meet their needs for secure attachment through therapeutic process and are encouraged to express emotions when attachment needs are discontented (Solomon, 2009). Solomon (2009) further concludes that “if the couple responds by utilizing and giving examples of the ways their past has played out in their current relationship, it becomes possible to accelerate the healing process”.

Techniques and Interventions

In the past decade, Christian couple therapy has increased and began to develop although slowly (Hook, Ripley, Worthington, & Davis, 2011). Each couple, each situation, and each counselor is unique, so competency of multiple interventions is required to accommodate the needs and goals determined by the couple. Of these techniques, the hope-focused approach (HFA) to couples counseling is encouraged among Christian counselors (Worthington, Ripley, Hook, & Miller, 2007). The HFA is based on the premise that hope is a core Christian value and since Christ ordained marriage, hope is essential among couples (Worthington et al., 2007). The HFA provides couples with strategies for promoting change, offering mutual submission in love, restoration of faith in God and each other (Worthington, et al., 2007).

An alternative counseling technique that is being successful utilized in couples counseling is Marriage Matters (Hook, Worthington, Hook, Miller, & Davis, 2011). Marriage Matters consists of a nine week or 18 hour workshop that is conducted three times per year according to Hook et al (2011). This program is designed to assist couples who desire to invest in their relationship as well as for couples who are experiencing marital difficulties. During each of the nine week workshops, couples learn from trained professionals about topics that are important for couples such as historical background, culture, becoming more empathic during dialogue, conflict resolution, intimacy, forgiveness, and numerous other topics (Hook, et al., 2011).

Ethics Involved in Counseling Couples

A cautiously compiled confidentiality agreement is essential when therapists agree to treat clients conjointly with their spouse or significant other (Bass & Quimby, 2006). Currently although there are not any ethical codes that directly indicate that conjoint counseling is considered unethical, increasing numbers of many organizations caution their members about the ethical disadvantages characteristic in doing so (Bass & Quimby, 2006). Consequently, counselors working with couples are probable, or perhaps even inevitable, to find themselves struggling with the issue and conflicts of one person’s right to privacy versus a partner or spouse’s right to obtain access to information relevant to their personal well-being (Bass & Quimby, 2006). Furthermore, there are additional concerns when the disclosures are related to illegal activities. According to Bass and Quimby (2006), an example of potential conflicts is when adultery has occurred in a relationship. Adultery is considered a crime in some states and as a result of keeping this information confidential, it is possible that a counselor could be accused or even charged with conspiracy or “alienation of affection” (Bass & Quimby, 2006). Researchers further state, that although this charge is highly unlikely, some writers have argued that counselors must not condone illegal activity by keeping secrets. Ignorance of the law is not excusable therefore when engaging in such practice, counselors should be familiar with their state laws and ethical standards (Bass & Quimby, 2006).

Couples counselors have a unique relationship with their clients due to being responsible developing multiple therapeutic relationships. As outlined in the American Association for Marriage and Family Therapy (AAMFT, 2012) code of ethics, counselors are responsible for ensuring that each counselee has been properly informed and consents to services, while also ensuring confidentiality is discussed and is understood by each participate. AAMFT Codes of Ethics, specifically outlines the expectations of counselors in regards to professionalism among couples, present and past. As well as safe handling of information and communication among counselees as well as third parties. The AAMFT and the American Counseling Association are very similar due to the nature of counseling.

Biblical values
Religion can be a significant source of marital and couple conflicts, especially if they do not share the same religious beliefs, however religion also proposes as a source of resolution among couples with common beliefs (Lambert & Dollahite, 2006). Research reveals that couples that participate in congruent religious practices such as public and private prayer as well as religious attendance, couples were more receptive to counseling with less negativity and values that focused on having and maintaining a caring, forgiving relationship (Lambert & Dollahite, 2006). Considering that God’s love abridges all of God’s commands, therefore a fitting appraisal of forgiveness is crucial for one to love in a way that pleases God and to help others in counseling situations (Cheong & DiBlasio, 2007). God’s love and forgiveness are inseparably connected all throughout Scripture and often amidst the pain and conflicts of couples is the need for resolution and forgiveness. The bible clearly defines marriage, the love shared among those married, as well as the sacredness of matrimony, and although as Christians we cannot impose our thoughts and worldviews, according to the American Counseling Association Code of ethics, it is important that the elements are incorporated in counseling, especially with those who consent to Christian integration in sessions.

Personal reflection

I personally believe that couples counseling is important, especially premarital counseling. Although my husband and I dated for six years prior to getting married, we both found that premarital counseling, which is a requirement at our church, brought forth so many subjects that we had not discussed. The opportunity to learn God’s will for marriage and our expectations of each other, provided clarity that we can reflect to even now. Years into our marriage, counseling would definitely be a consideration if we even found ourselves in need of reconciliation and restoration.

Annually, our church hosts sessions during the month of May that focuses on the family. Although this is not considered counseling for us directly, we have found that each year a new prospective, a new method of communicating, and a renewed relationship results from attendance of the sessions. Reflecting on these marriage building workshops and lessons, reassures me that with the desire to stay focused on Christ, our marriage can sustain, and we may even be models for others who are contemplating commitment. I believe that sometimes in the hustle and bustle of life, we can easily slip into routines and struggle to satisfy deadlines, which result in undue stress on relationships. Committing to reconnecting and taking personal time to show appreciation for each other is ideal and provides the support and recognition that although we may be busy, as a couple we are never too busy for each other. Furthermore, the same goes for our relationship with Christ, it is not enough to just be a claim a relationship, instead works, devotion, praise, and worship are due to Him as a priority of our lives.

While researching couples counseling the most interesting aspect that I discovered was the Hope Focused Approach (HFA). The methodology presented in HFA sparked an interest primarily because of the numerous step-by-step interventions that allow the counselor to be the facilitator, yet offering couples the opportunity and supports to reconnect. The opportunity to be a conduit, a vessel, of restoration offers not only the couples hope, it also seems that it would provide counselors with the opportunity to see the magnificent power of Christ and his ability to make people, relationships, homes, families, and even churches whole. Christ offers to make all things new, it is up to us to follow him, forward.

Incorporating the ethical expectations of a counseling professional presents as challenging. It is evident that when working with a couple, the amount of intervention, developing a relationship and rapport with both individuals, however remaining unbiased, and serving them as a couple seems initially difficult. However, it would be my privilege to be a vessel of Christ to assist couples to complete both premarital and martial counseling, as marriage is ordained by God, however staying rooted and grounded in the Word and maintaining the standards as outlined by the AAMFT and ACA subjects one to continued studying, devotion, and increasing competence as well as wisdom to address each couple genuinely.

Conclusion

According to Atkins et al. (2005), there have been numerous randomized clinical trials that confirms the effectiveness of couple therapy as well as the increase in relationship satisfaction after attending therapy. The research further outlines that although there are a number of options, methods, intervention, and treatments greater change in marital satisfaction is expressed among couples who attend direct approach therapy together (Atkins, et al., 2005). Despite these promising findings, there still remains a considerable number of couples that are not responsive to treatment and no correlations have been demonstrated that distinguish between those couples who respond to treatment and those who do not (Atkins et al., 2009). Further evaluations of couples therapy is required to guide treatment revisions that will make techniques more powerful and applicable to increase efficacy among couples according to Atkins et al (2009).

References
American Association of Christian Counselors, AACC Law & Ethics Committee. (2004). AACC Code of ethics: The Y2004 final code. Retrieved from: http://www.aacc.net/about-us/code-ofethics/
American Association for Marriage and Family Therapy, AAMFT Ethics Committee. (2012). AAMFT Code of ethics. Retrieved from: http://www.aamft.org/imis15/content/legal_ethics/code_of_ethics.aspx Atkins, D.C, Berns, S.B., George, W. H., Doss, B.G, Gattis, K., Christensen, A. (2005). Prediction of response to treatment in a randomized clinical trial of marital therapy. Journal of Consulting and Clinical Psychology, 73 (5), 893-903. Bass, B.A & Quimby, J.L. (2006). Addressing secrets in couples counseling: An alternative approach to informed consent. The Family Journal: Counseling and Therapy for Couples and Families, 14, 77-80. Chambless, D.L., Miklowitz, D.J., Shoham, V. (2012) Beyond the patient: Couple and family therapy for individual problems. Journal of Clinical Psychology: In Session, 68 (5) 487-489. Cheong, R. K., & DiBlasio, F. A. (2007). Christ-like love and forgiveness: A biblical foundation for counseling practice. Journal of Psychology and Christianity, 26(1), 14-25. Retrieved from http://search.proquest.com/docview/237250982?accountid=12085 Doss, B. D., Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2009). The effect of the transition to parenthood on relationship quality: An 8-year prospective study. Journal of Personality and Social Psychology, 96, 601–619. Gonzales, J. (2009). Prefamily counseling: Working with blended families. Journal of Divorce & Remarriage, 50 (2), 148-157. Hook, J. N., Ripley, J. S., Worthington, E. L., & Davis, D. E. (2011). Christian approaches for helping couples: Review of empirical research and recommendations for clinicians. Journal of Psychology and Christianity, 30(3), 213-222. Hook, J. N., Worthington, E. L., Hook, J. P., Miller, B. T., & Davis, D. E. (2011). Marriage matters: A description and initial examination of a church-based marital education program. Pastoral Psychology, 60(6), 869-875. Lambert, N. & Dollahite, D. (2006). How religiosity helps couples prevent, resolve, and overcome martial conflict. Family Relations. 55 (4) 439-449

Miller, R. L., Pallant, J. F., & Negri, L. M. (2006). Anxiety and stress in the postpartum: Is there more to postnatal distress than depression? BMC Psychiatry, 6, 12.
Pinquart, M, & Teubert, D. (2010). A meta-analytic study of couple intervention during the transition to parenthood. Family Relations:
Interdisciplinary Journal of Applied Family Studies, 59, 221-231 Sandberg, J.G., Busby, D.M., Johnson, S.M., Yoshida, K. (2012). The brief accessibility, responsiveness, and engagement scale: A tool for measuring attachment behavior in couple relationships. Family Process, 51 (4), 512-526. Shalay, N. & Brownlee, K. (2007). Narrative family therapy with blended families. Journal of Family Psychotherapy, 18 (2), 17-30. Solomon, M.F. (2009). Attachment repair in couples therapy: A prototype of for treatment of intimate relationships. Clinical Social Work Journal. 37, 214-223. Sperry, L. (2010). Culture, personality, health, and family dynamics: Cultural competence in the selection of culturally sensitive treatments. The Family Journal: Counseling and Therapy for Couples and Families. 18(3) 316-320.

Stark, M.D., Kirk, A.M., & Bruhn, R. (2012). Generational differences as a determinant of women’s perspectives on commitment. Adultspan Journal. 11 (2), 112-122. Swanson, P. (2007). Study: More tell U.S. they’re gay partners. The Gazette. Retrieved from http://search.proquest.com/docview/268288139?accountid=12085 Worthington, E.L., Ripley, J.S., Hook, J.N., Miller, A.J. (2007). The hope-focused approach to couple therapy and enrichment. Journal of Psychology and Christianity. 26 (2), 132-139. Worthington, E.L., Lerner, A.J., Sharp, C.B. (2005). Repairing the emotional bond: Marriage research from 1997 through early 2005. Journal of Psychology and Christianity. 24 (3), 259-262.


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