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Time Effective Therapy with Couples:

Theory, Research and Practice

Sometimes, couples counseling is not about “fixing” a relationship. Its goal is not

to bring a broken marriage back together. Couples therapy simply brings two people in an

intimate relationship together in the presence of a counselor to discuss the issues that

come up within the dynamic of the unique relationship. Couples counseling is sought by

people looking to help the dynamic between two people rather than problems within

oneself (which is more commonly the focus of individuals in psychotherapy). Brief

Therapy can be an effective approach to treating couples who are looking for help within

their relationship because the therapeutic approach is solution-focused and involves more

action by the therapist. The action and interventions made by a therapist when helping

two people work on their dynamic can be especially helpful since the therapist acts as an

objective third party observer

Sometimes the therapist will help a couple to navigate the difficult process of

separation and divorce, and this is not considered a failure in therapy. Approaching this

complex process with compassion and objectivity can help to facilitate either a more

nourishing connection between partners, or a healthy closure to the dissolution of the

relationship, if this happens to be the most prudent course.

Five-hundred, twenty-five thousand, six hundred minutes

Five hundred, twenty-five thousand moments so dear,
Five hundred, twenty-five thousand, six hundred minutes
How do you measure a year?
In daylight, in sunsets, in midnights, in cups of coffee?
In inches, in miles, in laughter and strife?
–Rent.
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So, the question posed is – how do we, as therapists, decide the length of time we treat

each individual client? How do we measure therapy? In an arbitrary number of 50

minute sessions? In a planned number of sessions? By how many sessions the client’s

insurance allows? By how many new clients we can take on, given our current case load?

Does the client stop coming to treatment one day, and that marks the end of his therapy?

Do we measure success with clients by the alliances formed? In break-throughs? In

therapeutic turning points?

Moreover, how do we measure time effectiveness? Brief therapy does not

necessarily mean a short span of time spent in therapy session, despite its name. Rather it

is a modality with which we treat clients in a Time effective manner. The time effective

therapist values her time spent in session as well as the client’s time. understand time

effective as the effect that time can play in creating a desired outcome in therapy. We

submit that it isn’t the amount of time that a therapist takes that determines a successful

outcome in therapy; but rather it is how the time is used. And, in couple therapy, the time

that we take –and what we do with it- can ultimately be for better or worse.

As we were mulling over the title for this journal article, we happened to be riding

in an elevator up to the 27th floor with a young East Indian couple. Not liking the strange

silence that always befalls folks once the doors close, we made a passing comment that

winter was, at last finally here. The young man looked at us and stated –very proudly so-

“Today is our first anniversary!” while his demure bride smiled. As they departed, we

congratulated them and wished them a good day. There it was! That pride; that joy; that

measure of time marked by anniversaries, that couples take pride and delight in –that is,

when all is going well.

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In her book Uncoupling, Diane Vaughn (1986) relates the story of a woman who

spoke of having a premonition the night before her wedding. She dreamed that she was

dressed all in white but was wearing black shoes, and her interpretation of this was that

going through with the marriage would be a mistake. Despite this, she did not listen to

her inner voice and chose to consummate the marriage. During her honeymoon an

argument ensued with her husband and he took off his wedding ring, threw it across the

room then hit her in the nose. According to this woman’s account, before she left for the

hospital with her husband she searched the floor of the hotel room until she found the

ring and placed it back on her husband’s finger. Over the course of six years this pattern

was repeated several times. The “aha” moment for this woman came when, one snowy

night six years later as she and her husband strolled the streets of Japan, he, once again,

responded to the disagreement with his wife by throwing his ring in the snow. The

distressed wife recalls that she crawled around in the snow for three hours to uncover the

ring.

We tell this story to illustrate two points - (1) that not all marriages are meant to

be saved and (2) the priority that we place on relationships. So important are they, that

according to Vaughn (1986), “we hang on to them though we may not be at all happy [in

them]” (p. 5). Regardless of why we stay in relationships –be it for the children etc. – we

would maintain that couples who are either struggling to keep a marriage or partnership

afloat, or contemplating a separation and / or divorce, need help in navigating this

territory with dignity and grace –for both parties.

Thinking back once more to the young couple in the elevator we were reminded

that partnerships develop over time with transitional stages such as an engagement period
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wherein the couple begin to adjust to the notion of a life together, allowing time for

becoming familiar with each other’s idiosyncrasies. Not so with the endings. More often

than not, they end abruptly, usually leaving one partner feeling abandoned and confused.

Most marriages are honored with ceremonies and celebrations and in community with

loved ones –family and friends. Yet, the parting of ways, on most occasions, is not given

the respect and dignity that it many times deserves.

This article will focus on two models of time- effective (in the best sense of the

word) therapy for couples who are desirous of either resolving their marital /

partnership issues or considering separation and / or divorce. We will lay out

“uncoupling” techniques and rituals which unfold over time; and when integrated into

therapeutic frame-work, results in decreasing time, and increasing effectiveness of

treatment. Ways in which the dissolution of a marriage and or partnership can end, in the

same way that most of them began – in a dignified and respectful manner. Not with

fanfare and flourish, but also not with frustration and failure; hopefully, with dignity and

respect for each other as individuals, the love once shared, children who may have been

born of that love, and the marriage / partnership which developed it’s own identity and

should be afforded the same respect in it’s death as it was in its birth.

“Self-regulatory couples therapy" (SRCT), is a technique whereby the therapist

empowers the couple to change their own relationship (Halford 2001). When the couple

“fixes” their own relationship they are more likely to find greater satisfaction within the

relationship, plus the number of sessions are limited because the couple learns the

techniques in therapy and then broadly applies them to their relationship, thus they are

constantly utilizing the techniques learned in therapy to improve their relationship

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(Halford 2001). It is important for the couple to not have to rely on the interventions of

the therapist in order to see changes or improvements in the relationship, which is why

the SRCT model builds on the behavioral self-control theory and cognitive treatment

models to put the power in the hands of the couple, making the role of the therapist brief,

by design (Halford 2001).

The Model of Structured Separation Therapy: Budman & Gurman’s (1988)

Structured Separation Therapy (SST) can indeed be used as a transitional period in the

life of a couple who are considering uncoupling. Akin to a trial separation, SST is a form

of trial separation but with guidelines and “rules” constructed with the aid of a therapist

and agreed upon by the couple. Structured Separation Therapy is particularly helpful

when working with undecided couples who are also in extreme conflict such as physical

or emotional abuse, intense anger; when there is a controlling partner; when couples are

immobilized by their unhappiness and can not seem to take any steps toward making a

decision in either direction (separate, divorce or work it out); or when either partner’s

transition in midlife triggers feelings of self-doubt and / or disillusionment (p. 176).

Why it Works: There are four identified ways in which SST can facilitate the

couple’s decision-making around the future of the marriage (1) It temporarily calms

down anger and intense feelings of conflict that may be present; (2) it forces couples who

are immobilized by fear and/or deep unhappiness to face the reality of their situation,

both as individuals and as a couple; (3) it allows for the exploration of alternative

relationships and personal pursuits and growth; (4) and it necessitates both partners to

function independently (1988, p. 176).

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How it Works: A three month period of separation seems to be the optimal

duration of time when working within the SST framework. During this time the couple

agrees that neither will make a final decision regarding either dissolution or reconciliation

of the marriage. Both parties also continue their individual therapy sessions in addition to

their conjoint sessions, and negotiate matters such as sexual contact with each other and /

or within the confines of new relationships that they may choose to explore. Concerns

related to children (e.g. which parent’s residence will be considered the child’s primary

home, childcare, and such) are paramount in an arrangement such as Structured

Separation, as are financial and other household issues (1988, p. 177).

Why it is Time-Effective: Structured Separation Therapy is effective because it

“provides a directive intervention and directed format in which both individual and

shared marital development impasses can be confronted (p. 177). However, it derives its

power from the parallel self-reflection which enhances the decision-making process

without placing undue pressure on the couple to make a premature decision, and also by

reinserting the element of choice into the partnership. The therapist who assists the

couple in a manner which is not only helpful, but one that also respects and honors the

partnership itself, as well as the difficult decisions facing both partners, jointly and as

individuals, can be said to have used the therapeutic time effectively.

Ritual Techniques in Time Effective Therapy: Separation is not the only way for

couples to test the marital waters when ambivalence about the future of the marriage

exists. Imber-Black (2003) has written about a variety of rituals which, when introduced

into couple therapy, have proven to be both effective and efficient. Ritual techniques can
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also enhance a couple’s decision-making and deliver an unexpected resolution of marital

conflict.

Open rituals - is one such therapeutic rite of passage proposed by Imber-Black

which is most effectively used anytime differences are being negotiated in therapy

(2003). “odd days / even days” is another technique that can be used as part of “open

rituals”. For example, the couple agrees that on Mondays, Wednesdays and Fridays they

will act married, and on Tuesdays, Thursdays and Saturdays the will act as if they are

unmarried. Rituals, especially repetitive rituals such as the odd/even day’s technique, can

add clarity and deeper understanding, and bring about more empathetic ways of being in

a relationship and/or facilitate new behaviors which can ultimately shift the dynamics in a

relationship.

Reversals - Yet another alternative – reversals- may be used within the

framework of the odd days / even days approach where upon the odd days the couple will

agree that “Today we will think like a man” and conversely, on the even days they tell

themselves, “Today we will think like a woman.” The reversal approach could even

include a “man’s night out” and a “woman’s night out” where the male spouse takes his

wife out to the places and engages in activities that he would ordinarily do with his male

friends and vice versa. This approach is useful in expanding roles and helping each

partner gain a better understanding of what it is like to be in the other’s shoes. More

importantly, this ritual fosters a connection between the pair around their experience of

being a man and being a woman (Imber-Black 2003).

The cognitive dissonance described by Ecker (2008) is a “side by side

juxtaposition experience of two incompatible yet compelling ways of knowing as the

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reason for transformation” (p.46). Similarly Vaughn (1986), commenting on the

dissolution of her own twenty year marriage, described it as having “eroded slowly and

steadily over time in an orderly way” and concluded, “That an experience can be orderly

and disorderly at the same time was counterintuitive” (p.3). Often analyzing the cognitive

dissonance each member of a relationship may be experiencing can be a very effective

intervention, and it is our responsibility as time effective counselors to point out cognitive

dissonance as it inevitably comes up in therapy and to help our clients make meaning of

it.

Each of these techniques can easily be integrated into the “time-effective” and

solution-oriented therapists’ repertoire since the strategy of the brief therapist is to be

highly active in the therapeutic process. By being highly participatory in therapy the

counselor teaches the couples skills they can use and generalize outside of therapy,

making the time spent in therapy time-effective.

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References

Budman, S., & Gurman, A. (1988). Theory and practice of brief therapy. Guilford
Press, New York.

Ecker, B.(2008). Unlocking the emotional brain. Psychotherapy Networker, Sept/Oct,

Vol. 32, (5), 43-47.

Ecker, B. & Hulley, L. (2007). Coherence therapy for couple therapy. Retrieved
December 5, 2009, from http://www.coherencetherapy.org

Fosha, D. (2006). Quantum transformation in trauma and treatment: traversing the crisis
of healing change. Journal of Clinical Psychology: In Session, 62, 569-583.

Halford, W.K. (2001). Brief Therapy for Couples: Helping Partners Help Themselves.
Guilford Press: New York.

Imber-Black, E. et al. (2003). Rituals in families & family therapy. (Rev. Ed.)
W.W. Norton and Co. Inc., New York, N.Y.

Vaughn, D. (1986). Uncoupling: Turning points in intimate relationships. Random

House, Inc., New York.

Therapy technique cuts divorce/separation rate by nearly 50 percent. Retrieved

December 5, 2009, from http://www.medicalnewstoday.com/articles/159655.php

Lankton, S.R. (). Brief Goal-Directed Couples (and Individual) Therapy. 10pgs.
Retreived December 16, 2009 from,
http://www.lankton.com/handouts/briefmaritaltherapy.pdf
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