On the Road to a Healthy Relationship Using Brief Strategic Couples Therapy

Kimberley Cochrane, MA, RP, dipTIRP, CEC, CAPT

Kimberley Cochrane

Registered Psychotherapist (RP) - Individual & Couples Therapist, Embodied Mindfulness Therapist

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Healthy relationships include the following characteristics: mutual respect, trust, honesty, support, fairness/equality, separate identities, and good communication. As participants in relationships, it’s also important that we have the necessary important skills including: listening, expressing feelings and scripting needs, communication, negotiation, problem solving, and anger and conflict management, to ensure that our relationships are successful. (McKay, Fanning & Paleg, 2006, p.iv)

Being in a healthy, intimate relationship can be one of the greatest joys in life and also one of the greatest sources of pain. Relationships begin with so much hope; the dream of one day feeling known, accepted to the core; the dream of belonging, of protecting and being safe; and the dream of a lasting bond. Hope can collide with the realities of love: needs change, anger divides, judgments erode the once easy acceptance, and loneliness fills parallel but distant lives. (McKay, Fanning & Paleg, 2006, p.1)

In a healthy relationship, mutual respect means that each person values each other and understands the other person's boundaries. Having trust in a relationship means feeling safe with the other person, and not worrying about their behavior when they are not with you. Honesty goes hand-in-hand with trust because it's tough to trust someone when one of you isn't being honest. In supportive relationships, partners are there for each other in bad times and when things are going right. Fairness and equality means that you have give-and-take in your relationship too. Things can become difficult in a relationship when it turns into a power struggle, with one person fighting to get his or her way all the time. In a healthy relationship, everyone needs to make compromises, but that doesn't mean each person should feel like they're not able to be themselves and have a separate identity. When two people first got together, each person had their own lives (families, friends, interests, hobbies, etc.) and that shouldn't change. Each person shouldn’t have to pretend to like something they don't, give up seeing friends, or drop out of activities they love. Each person should also feel free to continue to develop new talents or interests, make new friends, and move forward. Good communication means the ability to speak honestly and openly so that miscommunication is avoided in the first place. It’s important to be able to speak freely about your feelings and not to be afraid of what your significant other might say about it.

As Kingma (2000) says, we are all looking toward relationships to create ourselves. (p.14) As we proceed through life, we are all trying to get a sense of our own identity and we create a series of life experiences to help us discover who we are. (Kingma, p.15) This process of self-definition and self-discovery occurs through ‘developmental tasks,’ and it is through the accomplishment of developmental tasks that we define ourselves. (Kingma, p.15) That’s why we choose the people we do, and why they choose us, and it’s also why relationships begin and end. (Kingma, p.15)

Developmental tasks are stepping stones throughout the developmental process. (Kingma, 2000, p.15) Whether we are consciously aware of this or not, we are all, at any given moment of lives, engaged in this developmental process; going through the process of becoming or trying to become, ourselves. (Kingma, p.15) For every person, married, single or living with a partner, the paramount task of living is the creation of the self. (Kingma, p.28) The reason relationships are so important to us, and the reason their endings are so painful, isn’t just that when they are over we miss the company; it is because through them we undertake the process of bringing ourselves into being. (Kingma, p.29)

As an extension of Brief Problem-Focused Therapy, Brief Strategic Couple Therapy is based on interrupting ironic processes and is a pragmatic embodiment of an “interactional view” that explains behaviour in terms of what happens between people rather than within them. (Gurman, 2008, p.300)

Couple therapy, traditionally referred to as “marital therapy,” is generally viewed as a subtype of family therapy. Indeed, a major national survey of the practices of “family” therapists (Rait, 1988) showed that whole families constituted only about a third of “family” clinicians’ work, and that marital problems constituted the presenting problem in almost two thirds of their cases. (Gurman, 2001, p.52) Interestingly, the majority of influential clinical theoreticians in the family realm have rarely focused on the treatment of conflicted couples and marriages, and a relatively autonomous couple therapy literature has emerged in the last decade (Gurman & Fraenkel, in press; Gurman & Jacobson, in press; Jacobson & Gurman, 1995). (Gurman, p.52)

Strategic family therapy was originally developed in the 1950s by Don Jackson and others belonging to the Palo Alto research group headed by Gregory Bateson. (Gardner, Burr & Wiedower, 2006, p. 340) Strategic therapy was characterized by therapists’ dogged focus on altering family interactions, eliminating client-identified problems, and using sometimes unorthodox or paradoxical directives and homework assignments. (Gardner, Burr & Wiedower, p. 340)

During the latter part of the twentieth century, there has been a dramatic increase in dual-career families and a decrease in peoples’ discretionary time, have made many people less available for long-term therapy. (Messer, 2001, p.1) The rapid rise in both medical and mental health costs is an economic factor that leads to the promotion of brief therapy. In addition, as the stigma attached to therapy has decreased, its popularity has increased, leading to greater demand for and rationing of therapeutic services. (Messer, p.1)

The key assumptions and beliefs for Brief Strategic Couple Therapy are the emphasis on the interruption of couple interaction patterns know as ‘ironic problem-solution loops.’ (Gurman, 2008, p.307) Personal growth, emotional issues and communication skills are not important in this model and the technique itself is more important than the therapeutic relationship. (Gurman, p.307) The model makes no assumptions about healthy or pathological couple functioning, and the couple’s complaint, what has brought them there, is the focus of the treatment. (Gurman, p.307)Couple therapy can also be conducted with one individual, if one person has decided not to participate for some portion of the therapy. (Gurman, p.307)

The key concepts and basic template for Brief Strategic Couple Therapy include:1) interrupt ironic problem-solution loops; 2) set minimum goals for change; 3) investigate solutions for complaint; 4) formulate ironic problem-solution loops (how ‘more of the same’ solution leads to more of the complaint); 5) specify what ‘less of the same’ will look like in particular situations; 6) understand clients’ preferred views of themselves, the problem and each other; 7) use these views to frame suggestions for less-of-the-same solution behaviour; 8) nurture and solidify incipient change. (Gurman, 2008, p. 302)

The role of the therapist is to persuade at least one participant in the couple, or most relevant interactional system, to do ‘less of the same,’ as a solution to resolving the complaint. (Gurman, 2008, p.304) This role does not require the therapist to educate clients, or help them resolve emotional issues, or even working with both members of the couple. (Gurman, p.304) It does require that the therapist works with the person or persons most concerned about the problem. (Gurman, p.304) The therapist treating a marital complaint would not require or even encourage the participation of reluctant spouse, especially if the therapist aims to maximize possibilities for therapeutic influence, which in this model is his or her main responsibility. (Gurman, p. 304) The therapist’s first task is to get a very specific, behaviorial picture of the complaint and assess who sees it as a problem, and why it is a problem now. Then, you begin to think about what the minimum change goal is for the clients. For example, asking clients, “What would he (or she, or the two of you) be doing differently that will let you know this problem is taking a turn for the better?” (Gurman, p. 305)

The brief strategic therapist provides opportunities for change in a variety of ways including encouraging, discussion, examination of motives, and expression. (Gardner, Burr & Wiedower, 2006, p. 341) Strategic therapy is used to produce rapid change in families without spending any time trying to promote insight or psychological awareness of the ‘‘deeper meanings’’ that might be associated with the problem. (Gardner, Burr & Wiedower, p. 341) The expectation is that with the changes effected in therapy the family will continue to change in other areas after therapy has ended. (Gardner, Burr & Wiedower, p. 341)

The main goals of the assessment process are to: (1) define a resolvable complaint; (2) identify solution patterns (problem-solution loops) that maintain the complaint; (3) understand clients’ unique language and preferred views of the problem, themselves and each other. The first two goals provide a template for where to intervene, whereas the third goal is relevant to how to intervene. (Gurman, 2008, p.305)

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