When to Refer an Individual for Couple Therapy?

There are a lot out there for folk who may want to explore couple therapy for themselves, they know what they want and need. What happens when they don’t know what they need? or perhaps they’re in individual therapy and they didn’t even consider couple therapy to be an option. 

As counsellors and mental health professionals, we’re often the first point of contact for individuals seeking support for a myriad of issues. Sometimes they know from the start what they need and how we can help them, for some this evolves.  I’m a big believer in the phrase ”what’s hurt in a relationship is healed in a relationship”, and value having partners or families involved in someone’s care and treatment. 

One of the critical decisions we face is identifying when an individual’s needs may be best met within couple therapy. Sometimes I’ll be working with someone and wonder, if I had their partner here with me would we make more progress? Could have more impact here on their relationship and their mental health?

I often wonder if their concerns might be better addressed within the context of couples therapy. Luckily I can offer this myself, sometimes it’s appropriate to do so and sometimes I need to refer out. 

Recognising the signs that suggest couples therapy could be beneficial is essential for providing the best care and support to our clients.

Here are six key questions to consider asking your client to gauge whether a referral for couples therapy might be appropriate:

Six Questions to Ask Your Client

How does your partner feel about the issue you’re facing?

Understanding the partner’s perspective on the client’s issues can reveal whether both parties recognise the problem similarly or if there’s a significant discrepancy in their views.

Have you discussed your concerns with your partner, and what was their response?

This question helps to assess communication dynamics and whether attempts at resolution have been productive. Do they feel supported? Validated? Safe?

Do you feel your concerns are impacting your relationship?

Identifying the impact of the issue on the relationship can help determine if the problem is confined to the individual or if it’s more relational. Sometimes it could be that one created challenges in the other, relationship struggles can impact mental health and mental ill health can impact the relationship.

Are there changes would you like to see in your relationship? If so what are they?

Understanding if they would like their relationship to look different can be a sign. They may want more closeness, connection or support. Clarifying the desired outcomes can help in understanding whether these goals are achievable through individual efforts or if they necessitate joint work.

Do you often find yourselves stuck in the same arguments without any resolution?

This question can help you understand if they’re experiencing recurring conflicts that seem hard to move past. It’s quite common for couples to get caught in these loops, and having a neutral space to discuss these concerns could provide new insights and ways forward.

Do you think your relationship would benefit from a neutral space to discuss these concerns?

This question can help gauge the client’s openness to couples therapy as a safe space to explore their relationship issues.

Events that may indicate couple therapy would be useful.

Sometimes key life experiences, life events and transitions can significantly stress relationships. Sometimes key life experiences or moments may require the support of a couple therapist. Such as 

  • Job redundancy
  • The birth of a child
  • Health conditions – mental or physical of a child
  • Diagnosis of a terminal illness
  • Illness or death of a parent
  • Miscarriage
  • Fertility issues
  • Diagnosis of a chronic illness or disability

Signs to watch for include shifts in how partners communicate, increased disagreements, or feelings of distance, which suggest these changes might be taking a toll. Understanding the impact of these events is crucial, as they can reveal or amplify underlying issues. Recommending couples therapy becomes essential when couples struggle to adapt, offering them a space to address these challenges together, improve their communication, and strengthen their relationship during these potentially difficult times.

If you decide to refer someone for Couple Therapy.

There are some things you can consider about the therapist you’re referring to.

Do they have a specialisation in Couples Therapy?

It’s vital to refer your clients to a therapist who has training in couples therapy. Look for professionals with certifications or extensive training in recognised models of couples therapy, such as Family Therapy, Emotionally Focused Therapy (EFT), the Gottman Method, or Imago Relationship Therapy. This specialisation ensures that the therapist is well-equipped to handle the unique dynamics present in couple counselling.

What’s their Approach and Philosophy?

Every therapist has their approach and philosophy towards therapy. When referring clients for couples therapy, consider a therapist whose therapeutic philosophy aligns with the needs of your client. For instance, some therapists may focus more on communication strategies, while others might delve into emotional connections and attachment styles. Understanding the therapist’s approach can help in making a suitable referral.

Are they Culturally Competent and Inclusive? 

Ensure that the couple therapist demonstrates cultural competency and inclusivity. It’s important that both partners feel understood and respected, regardless of their cultural background, sexual orientation, or relationship structure. A therapist who is sensitive to diverse relationship dynamics and cultural nuances can provide a more supportive and effective therapeutic experience.

Referring clients to couples therapy is a decision that should not be taken lightly. It requires a nuanced understanding of the individual’s issues, their impact on the relationship, and the willingness of both partners to engage in the therapeutic process. By asking the right questions and knowing what to look for in a couples therapist, we can make informed referrals that support the wellbeing of our clients and their relationships.

by Marie Vakakis

Accredited Mental Health Social Worker, Couple and Family Therapist

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