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If Only I Had Known: Avoiding Common Mistakes In Couples Therapy

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Each chapter addresses common mistakes made in the area that chapter covers and offers suggestions on how to avoid those mistakes. The authors include examples of counseling situations where mistakes were made or avoided to demonstrate what they are talking about. Mistakes may be philosophical/conceptual or applied. Philosophical or conceptual mistakes refer to incorrect assumptions. Applied mistakes refer to a poor use or no use of theory. Mistakes are often hard to recognize.
Mistakes can be made in any one of the following areas:
Structure
If there is no structure, the couple replays the dynamics of their interactions at home in the therapy session.
The therapist must demonstrate that he/she is on the side of the relationship, not the side of one individual.
Confidentiality
Therapists can choose models of confidentiality when seeing couples ranging from sharing everything from individual sessions with both spouses to sharing nothing from individual sessions with the other spouse. The authors recommend a model they call accountability with discretion, in which the therapist maintains information from individual sessions in confidence unless it is detrimental to the goals of the couple. In that case, the therapist asks the individual to share with his/her spouse. If the individual refuses, the therapist tells the couple that he/she is aware of information that makes it impossible to do couple therapy.
Neutrality
Partners often want the therapist to side with them against their partner, whom they see as more emotional, "sick," less articulate, etc. The therapist needs to maintain neutrality and must probe to know if the couple views the therapist as neutral.
Getting a full list of the clients' problems
Past and present must be held in balance.
Listening for a full range of problems
The therapist must be aware of indications of abuse, affairs, addictions, and severe pathology, as couples often try to hide such problems.
Completing the assessment before intervening
Intervening too quickly or too slowly is a problem. Therapists need to be aware of therapist issues that interfere with treatment, such as uncomfortable topics, blind spots, avoiding or minimizing issues, and lack of training.
Attending to the process
Therapists need to teach clients the process of resolving conflicts, as opposed to focusing only on content. Tone of voice, body language, and use of language ("I" vs. "you") are things that couples need to pay attention to. Process can be made explicit in the course of therapy.
Conflict
Conflict can be covert, overt, or a combination. The intensity of conflict may be high or low. The therapist must manage anger and conflict in the session.
Continuum of how couples perceive situations
Some couples can agree on most things, some couples have some disagreements, and some couples disagree on almost everything.
Reframing
A reframe is a statement designed to change the perception or emotional meaning that the client attaches to a behavior or event. Reframes often prepare the client for additional interventions.
Evaluating commitment
Commitment should be discussed when the couple raises the issue or when there are clues that one or both partners are thinking about leaving the relationship.
Spirituality
The therapist should not overlook or impose spirituality.

This book is a valuable resource to anyone who is practicing couples therapy. Of particular interest to me was the list of statements designed to foster closeness and statements designed to create distance, as these could be used as examples in working with clients. The section on dealing with conflict was also helpful, as the following steps for dealing with conflict were explained: normalize, recognizing individual roles, questioning the meaning each partner assigns to the other's behavior, and instilling hope that the couple can learn new ways of coping. Therapists also need to remember that symptoms serve some type of useful function. Reframing can change the focus of therapy from the individual to the couple. Therapists can learn from the mistakes of others by reading this book, as well as learning some things to watch for to know when they have made a mistake and what they should do about it.

I wish I had more time to write a detailed review. This is by far the best book I have ever read on couples therapy. I just came back to Amazon to purchase other books that Gerald Weeks has written. If they are as complete, pleasurable to read, in depth and useful as this one, I will be quite satisfied. This book would have been great to have a novice therapist but even now the writing articulates problems and solutions in such a clear helpful manner. I have hundreds upon hundreds of books on couples and family therapy and I could not put this one down. It was highlighted and weathered the night it received it. A real gem.

Weeks and his collaborators offer help to beginning as well as seasoned therapists regarding avoidance or correction of the most prevalent mistakes made when treating couples. The general categories addressed are:
Failing to acknowledge that mistakes exist
Failing to use theory when intervening
Failing to use a chosen theory or theories correctly
Failing to discard a theory when it is not applicable
Failing to act when action is clearly warranted
Failing to restrain oneself from intervening when it is not time


Weeks is also the co-author of Couples In Treatment: Techniques and Approaches for Effective Practice, a Standard textbook for couples therapy. This volume serves as a complement to that earlier work.

The authors cover the gamut of therapeutic blunders as a listing of chapter titles indicates:
The "Battle for Structure"
Confidentiality Traps
Alliances and Coalitions
Overemphasizing the Past or Present
Lapses in Careful Listening
Inadequate assessments and Mismatched or Mistimed Interventions
Overlooking Proce3ss Considerations
The Pitfalls of anger and Conflict
Mistakes in Dealing with Partners' Different Perceptions
Faulty Interpretations and Reframes
Failing to Foster Commitment
Overlooking or Inadvertently Imposing Spirituality

The topics listed above are explored in depth by using case vignettes, relevant interventions, and useful questions to ask about what is occurring in therapy. Ethical dilemmas are carefully considered. Issues of domestic violence, affairs, addictions, when to see clients individually or as couples, severe psychopathology, secret keeping, managing conflict in session, dealing with level of commitment of the couple, and assessing and dealing with spirituality in couple therapy.

This is another one of those books I wish had been around when I was a young therapist. It provides clear guidance in many situations where couple therapists are often stuck. It also serves as a reminder to all therapists that therapeutic mistakes are common. That is encouraging to both young and older therapists. I intend to recommend this book to all my therapist friends because of its clarity and practicality.

Haven't we all said, "Whew, I certainly did learn from that mistake!" or "I wish I was wise enough to learn from other's mistakes before I have to learn by error myself!"? This book offers you a way to prevent mistakes in couples therapy and provides solutions for working with tough situations in relationship counseling. Ah, it is so much easier to hear someone else talk about their learning experiences. And so refreshing to prevent them in your own practice! Great book!
Gail Olson, PhD, LIMHP
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As a therapist recently returning to the field, this book has been an excellent review of basics and some keen insights regarding the many issues and dynamics of work with couples. I recommend it to anyone finding themselves challenged by current couples issues.