Quick Questions to Help Increase Momentum When Couples Therapy is Bogged Down

Therapists often tell us that they're quite skilled at getting started with a couple, but they eventually arrive at a point where it seems like the couple is making little or no progress. They'd like to develop some momentum in couples therapy.

This month let's look at some questions to ask yourself in the middle stages of couples therapy. This can be helpful even if you and the couple aren't stuck at a plateau, just to keep your work together focused and effective.

When progress has slowed, ask yourself:
1. Has sufficient progress been made for now? Is it time to terminate?
2. Am I lost and wandering and really not sure what to do next?
3. Is the couple working productively and is therapy just going slower than I would like?
4. Are there too many different agendas and is each partner working in opposite directions?
5. Is individual therapy or group therapy indicated for either partner?
6. Am I dealing with an Axis II problem in one partner?
7. Am I providing adequate structure and support for partners who are chaotic and disorganized?

You might also want to ask each partner some questions. Ask them:
1. Do you feel like our sessions are productive?
2. Are you getting the results you want?
3. What do you find most helpful?
4. What is not working for you?
5. Are you experimenting between sessions with new behaviors?
6. Will you help design a homework assignment for yourself that will push you in ways that may create anxiety for you, but will also be valuable risks?

It takes nerve to ask some of these questions, especially when you think your sessions could be more productive! Who wants to ask what's not working? Only the most skilled, confident therapist is willing to repeatedly assess their own work and ask their couples these tough questions. But it helps your work as much as it promotes their progess.

Another possibility is for you to share with couples your conceptual explanation of their problem, their goal and what it is about each partner that is preventing them from realizing their goals. Be very explicit. Then ask if your conceptualization is aligned with theirs. Getting all of you on the same page will re-invigorate the therapy process.

We hope this will help you get back on track. Next month we will look at other ideas for what to do if you are lost and wandering.