I was driving from the beautiful and luxurious Beverly Hills to quiet and quaint Valencia as the iPhone rang my favorite tune, alerting me of a call. It was a potential client. The client was interested in coming in for marriage counseling and wanted to better understand what marriage counseling and couples counseling entail. I had to shift gears from a leisurely cruising on California highway to my alert and focused psychotherapist mode.
Being a psychologist and a psychotherapist specializing in couples counseling and marriage counseling is something I truly love. Answering client’s question required me to put all the richness of couples counseling process into few simple words. I was up for this challenge. Psychotherapy always comes with some degree of explaining and helping the client become more aware. After providing a brief explanation of what couples counseling and marriage counseling is and scheduling an appointment, I realized that this question must be shared by many others. It is common to have an air of mystery and vagueness around the question of what a psychologist or a psychotherapist does, and how psychotherapy works.
Since my specialty is couples counseling I decided to explain the general process for the broad public. As a consumer I would like to know what service to get and how a service I am getting will benefit me and my life. Psychotherapy is a service like any other, and it is my job as a psychologist to explain the service, the process, and the benefits. In my practice in Beverly Hills and Valencia this is usually the topic of the very first conversation with my clients. I am doing my best to explain what to expect in marriage counseling and how it works. Here I will do the same for all of us to demystify and outline the general stages of psychotherapy in general, and couples counseling specifically.
1. Presenting Problem.
First step of counseling frequently occurs even before the clients see the psychotherapist. In an initial phone conversation to schedule an appointment many times the general issue that brings the clients into therapy is discussed. This initial step is important for the clients to assure that this particular psychotherapist is well equipped to deal with the issue at hand. It is important for me as a psychologist, since this is when I am deciding whether it would be appropriate for me to see these clients based on my specialty, expertise, and experience.
2. Before The Initial Appointment
Federal and State Law outline several requirements for counselors and therapists to follow. In order to comply with these legal requirements and provide clients with high quality service therapist and counselors usually will ask their clients to sign documents that confirm clients’ understanding of their rights and their voluntary decision to seek counseling services. States differ in their legal requirements and the paperwork that clients have to complete might differ slightly from state to state.
3. Initial Appointments
When we see our clients for the first time the objective is to obtain the relevant history that brought the clients all the way up to now and their current situation. This is a crucial part of the process. The information obtained during this step is used to fully understand and flesh out the presenting problem. It is very important to define the problem correctly since the next steps in the therapeutic process will be building upon this step. We can think of a diagnosis in a medical field being an equivalent to defining a problem. A medical treatment will only be effective if we are treating the right thing! It works similarly in psychotherapy. I emphasize the importance of this information-gathering phase with my Beverly Hills and Valencia clients to help them understand this point. This step might take up to 3 hours with a single individual and up to 4-5 hours with a couple. This is usually the reason for initial appointment, aka intake, being a longer appointment.
4. Redefining The Presenting Problem And Setting Goals.
Once all of the relevant historic information as well as the information regarding currently experienced difficulties have been discussed, we will sharpen our defined presenting problem. Psychotherapist may choose to share his specific understanding of the root of the problem with the clients and arrive to an agreement. Once the presenting problem is clear, it is a good time to set goals and describe what would it look like when the clients successfully completed the therapy. This is very important since defining the desirable outcome sets direction to the therapy, and also provides a measurement tool for clients to know when they reached their destination. Psychotherapy is NOT an indefinite process. There is a beginning, and an end. Setting clearly defined sound goals helps both the psychologist and the clients to know when they have completed the necessary work. It is unnecessary to set a separate time frame for this step, since many times it is the logical outcome of step 2.
This is the step where the actual intervention to resolve the presenting problem and bring clients to their desired outcome takes place. This step differs vastly between different schools of thought and psychotherapy approaches. The specific approach I use with my clients in the Beverly Hills and Valencia Relationship Empowerment clinics is different from most traditional couples counseling approaches. The goal of this step is for the clients to confirm that they have reached their predefined destination and achieved the goals they defined in the beginning of counseling. The time frame for this step will largely depend on the approach used by the psychotherapist. Some approaches are rather brief, and some require years of commitment on the part of the clients. Relationship empowerment clinics in Beverly Hills and Valencia apply the latest methodology and advanced approach allowing for individual counseling to be successfully completed within 4-5 two hour sessions, and couples counseling to be successfully completed within 7-9 two hour sessions.
This is a fun part since both the clients and the therapist get to enjoy the fruits of their labor. The clients got what they wanted out of the counseling and currently enjoy a high quality of life, relationships, and wellbeing. The therapist feels good about the work that has been done well and enjoys seeing happy faces in the office. The goal of this stage, which usually takes 1-2 hours, is to summarize and solidify the work and the progress clients made, and to set future direction for further improvement and growth. During this time the therapist may choose to set a timeframe for clients to call in and report on their further progress and successes. These follow-up contacts serve to soften the completion of the counseling and to provide clients with additional support during this time.
These are the major stages in the counseling process and these stages are true for individuals and for couples seeking help. Knowing what to expect makes it easier to take the first step toward the bigger and better you. Good luck and much success.