Couples Counseling and Social Work

.....therapy can exist within a framework that is similar to individual therapy, but deviates to fulfill specific objectives. These objectives often consist of helping couples open lines of communication and promote feelings of intimacy. The first step of this framework can be understanding family of origin. This usually means understanding the root of the problem, typically stemming from childhood experiences. The next step are personal problems. People can have a myriad of character defects of personal pathologies that can impede the progress of therapy. Then there is the couple system where the search for the pattern or root problem of the couple is made. This is followed by understanding the unconscious purpose, poor boundaries, hidden wishes, and fears, hidden shame, power imbalance, and finally psychoeducation. This research proposal aims to provide an outline of what framework exists for effective couple's therapy so a social worker would be able to make the appropriate recommendations for therapy.

There are three common types of couple's therapy available. The first is Emotionally Focused Couple Therapy (EFT). EFT is research supported and driven, allowing recognition of unhealthy relationship behaviors. Such behaviors may lead to attachment injuries and it is important to recognize the kind of patterns couples exhibit to properly refer them for therapy (Fitzgerald, 2017).

The second common type of couple therapy is the Gottman Method. This method offers insight into dysfunctional behaviors through two continuums: boundaries and self-esteem (Fitzgerald, 2017). Childhood experiences can mold how a person meets his or her needs and such mechanisms can lead to dysfunctional behaviors, especially within the couple context. Social work typically uses the person-in-environment (PIE) theory to understand the person and the personal behavior in light of environmental settings in which that individual acts and lives (Hutchinson, 2014). By using the PIE theory in conjunction with the Gottman Method, the social worker may be able to provide a deeper level of assessment that can lead to breakthroughs for the couple.

Relational Life Therapy (RLT) is a framework developed by Terry Real and is driven mainly via emotional experience. RLT focuses on the development of insight into existing, dysfunctional behaviors and thought patterns, replacing them with relationally-effective ones (Fitzgerald, 2017). RLT allows for enhanced communication for couples and is a great way to allow couples a chance to voice their desires and needs directly. These are the therapeutic frameworks that will be reviewed along with PIE theory for the best means of assisting couples in the social worker setting.

This literature review will cover EFT, the Gottman Method, PIE theory, and RLT. The articles and studies will highlight the frameworks of these concepts as well as potential success of these frameworks when applied in real-world settings. The objective is to understand and highlight theoretical frameworks that may be best suited for couples counseling as a social worker. Although social work does not always involve counseling, it can be part of the job duties and can provide relief to affected couples.

EFT has been used for years to help couples understand the emotional drives of their dysfunctional behaviors. By using research and evidence collected from studies and actual sessions, those using EFT aim to provide couples with the help they need from an evidence-based perspective. "Emotionally Focused Couple Therapy (EFT), an evidence-based couple therapy, strives to foster lasting change through the creation of secure attachment bonds in distressed couples" (Wiebe, Johnson, Burgess Moser, Dalgleish, & Tasca, 2016, p. 213). This perspective allows for examination of problems from an established and proven method. The 2016 article on EFT shows what can be used to predict long-term outcomes. "Decreases in attachment avoidance were most predictive of higher relationship satisfaction across follow-up" (Wiebe, Johnson, Burgess Moser, Dalgleish, & Tasca, 2016, p. 213). When couples do not avoid attachment, and facilitate secure attachment bonds, the long-term outcomes are positive.

Evidence-based practice has long been seen in the healthcare industry to enable better results for patients and improve patient satisfaction. By helping guide clients through proven methods, social workers can enable growth in their clients and then collect that information to further improve methodology. This can be a great way to reinforce or remove aspects of counseling that have been utilized in the past. Without constant assessment, the social worker would have a difficult time gauging what works and what does not.

Julie and John Gottman developed the Gottman Method and illustrate in one of their recent journal publications, the importance of cultivating insight through research and clinical work. In the article, the explain the three phases of love, constructive blueprints for the management of conflict, and how clinical work and the data collected led to a deeper understanding of relationship happiness and stability. One aspect of management of conflict that can help couples is recognizing the biological processes that sometimes occurs with being in love and existing within a couple.

One such biological process is a person's cortisol level. "Cortisol is a stress hormone that has been related to sadness, depression, excessive rumination, separation panic in babies, resignation, giving up, and helplessness. In the newlywed women, ACTH was twice as high in those women who eventually wound up in troubled marriages" (Gottman & Gottman, 2017, p. 12). If a person's cortisol level can affect how a person feels about his or her relationship, this can be incentive for a social worker, to refer a couple to a doctor to check hormone levels. Sometimes social workers must collaborate with other professionals to get help for their client or clients.

For example, if a client has a long history with depression, the social worker can refer the client to a psychiatrist who can then provide a treatment option that may help alleviate symptoms. Humans operate on many levels from emotional, mental, spiritual, and physical. As a counselor, these levels must be addressed to improve client outcomes.

PIE theory has long been used in social work to help social workers identify the potential problems affecting his or her client and act accordingly. Spirituality can play a role in how a social worker uses the PIE theory concerning clients.

The field of social work includes various levels of licensed social workers. Across both fields, spirituality is viewed as a resource that is essential to physical and/or emotional healing and well-being. Social workers include spirituality as an essential component of practice in its person-in-environment guiding framework (James, 2016, p. 191).

When addressing the potential problems of a client, it can help to view certain things using spirituality as a means of incorporating various emotions involved in the assessment into a helpful and multifaceted approach to improvement.

The final framework to explore is RLT. Although RLT does not have much in the way of empirical evidence for its use, it is based off of the Relational Systems Model (RSM) that does have empirical evidence to support it. RSM is a " . . . multisystemic approach that identifies the universal dynamics that dominate human functioning" (Munson, 2015, p. 240). RSM places emphasis on a therapists' personal paradigm and the therapist's capacity to respect client boundaries as well as enabling growth. RLT works with these principles and can be a new means of helping couples as a social worker by understanding boundaries and providing objectives and targets for the couple's personal growth.

So often social workers must aim to provide services to clients all while remaining objective and professional. RLT helps social workers help their clients, but also maintain the professional distance that must be implemented to avoid additional problems. Although social workers can act as a therapist, they are not specifically trained for counseling as a main job duty. Therefore, receiving further insight can help promote effective couples counseling without crossing any boundaries.

In conclusion, couples counseling consists of a complex and multi-faceted approach that involves looking at things from many angles. EFT allows exploration of emotions tied to childhood experiences that allow couples to understand root problems and how to cope with them. It also enables the social worker to use evidence and put that evidence into formulation of effective practice that provides clients with a better experience. The Gottman Method takes clinical experience and evidence-based practice and transforms it into a highly effective mode of understanding what constitutes the basic drives in couple interactions and how this can be used for couple's counseling.

PIE theory shows how spirituality may be a necessary component of treatment. RLT asks social workers to see things from a different perspective. These frameworks are important to understand and analyze to provide a strong foundation from which the social worker can grow and develop to help meet the needs of his or her clients. The field of Social Work is emerging as a field that involves therapy and a focused understanding of client needs. These frameworks offer social workers the tools and theories that will promote a better cultivation of skills and information for continued assessment and improvement of strategies. Such frameworks would be further explored to see which one is most useful for the case study.

References

Fitzgerald, J. (2017). Foundations for Couples' Therapy: Research for the Real World. Routledge.

Gottman, J., & Gottman, J. (2017). The Natural Principles of Love. Journal of Family Theory & Review, 9(1), 7-26. doi:10.1111/jftr.12182

Hutchinson, E. D. (2014). Dimensions of Human Behavior: Person and Environment. SAGE Publications.

James, A. (2016). Spirituality and Practice in Social Work, Youth and Family Studies. Spirituality across Disciplines: Research and Practice:, 191-202. doi:10.1007/978-3-319-31380-1_15

Munson, C. (2015). Relational Systems Model for Family Therapy. Taylor and Francis.

Wiebe, S. A., Johnson, S. M., Burgess Moser, M., Dalgleish, T. L., & Tasca, G. A. (2016). Predicting Follow-up Outcomes in Emotionally Focused Couple Therapy: The Role of Change in Trust, Relationship-Specific Attachment, and Emotional Engagement. Journal of Marital and Family Therapy, 43(2), 213-226. doi:10.1111/jmft.12199