August 31, 2011
Counseling couples: Therapist's new book outlines safe solutions to conflict problems
"Never go to bed angry" is bad advice for some couples, says Sandra M. Stith, a Kansas State University marriage and family therapist who has been studying high-conflict partners for more than 15 years.
"It's OK to decide that you can talk about the problem tomorrow or agree that the disagreement is not going to be resolved easily," said Stith, a professor and director of the marriage and family therapy program, a part of the School of Family Studies and Human Services in K-State's College of Human Ecology.
"Sometimes you need some time and space before resolutions are possible, especially in couples where there is anger and aggressiveness," she said.
Stith, along with Eric E. McCollum and the late Karen H. Rosen, both from Virginia Tech University, wrote "Couples Therapy for Domestic Violence: Finding Safe Solutions," which was published this summer. The book, geared to therapists, outlines an 18-week program for counseling high-conflict partners that the authors developed, researched, tested and evaluated over 15 years.
The National Institute of Mental Health funded development of the solution-focused treatment manual in 1997. The manual was expanded and published by the American Psychological Association.
"We show evidence from research that this program can be effective and can reduce violence," said Stith, who presented the therapy model and the book at the psychological association's recent annual convention in Washington, D.C.
Research shows that 50 to 70 percent of couples who seek counseling have experience with some form of violence in their relationship, Stith said. "They don't consider themselves batterers or battered. They wouldn't consider their relationship violent. They think of violence as the 'burning bed,' trips to the emergency room and seeking shelter," she said.
The professor emphasized that there are different kinds of abuse: physical mental, sexual, psychological and verbal. "The book is not written for extremely violent relationships that involve battering," she said.
Especially when children are involved, if high conflict couples choose to remain together Stith believes that they should work on their relationship. "It pays off in so many ways for children who live in those homes," she said.
Abuse in the form of physical or emotional violence can be as damaging to children as battering, she said.
"We know that if a child grows up with observing abuse at home, than that child is more likely to have abuse in his or her own relationship as an adult -- either because of marrying a violent person or because he or she reacts to problems with violence," she said, emphasizing the overlap between spouse abuse and child abuse.
Key points of the therapy model are:
* Before beginning treatment, each person completes a comprehensive assessment. As part of the assessment both partners are asked about the violence they have used and the violence perpetrated on them by their partner. If the therapists determine that this type of treatment is not appropriate for a particular couple, the couple is given referral to other community resources.
* The first six weeks of the 18-week program involve working with each individual who must take responsibility for his or her own behavior and part of the conflict. Each partner learns anger management skills and how to calm down. Each must agree that he or she wants to try to save the relationship and the only way to do this is to calm the anger and handle conflict better.
* During therapy, substance abuse is addressed. Substance abuse is highly related to domestic violence, Stith said. "If substance abuse is an issue for the couple, both individuals have to control their use for the therapy to be effective and to have a healthy nonviolent relationship," she said.
* Therapy involves either single couple treatment or multi-couple groups. "In our research, group work was more effective because people learn from each other. The influence of the group is useful," she said. However, when a multi-couple group is not available, the treatment can be offered to the couple alone.
During therapy, couples learn to take a time out.
They work together to come up with a signal that means they have to stop what they are doing, Stith said. "They make this decision before an argument that they will separate, the length of time they will be apart, what they will do when they separate and where they will go."
They must do something calming, such as reading or watching television. "Working out with a punching bag is a bad idea. So is driving away," she said.
They sign a contract with each other about the time out. Then they practice it before they need it. "It's hard to call time out in the heat of a conflict," Stith said.
"Our goal is to end all violence in a relationship," she said, noting that even if a couple decides in therapy that they no longer want to save their marriage, they can learn ways to calmly co-parent and provide a safe and healthy relationship for their children.
Sometimes couples realize they don't have the foundation to stay in the relationship. "We consider the program successful if a couple improves their relationship and stays together nonviolently or if they separate nonviolently," Stitch said.
The College of Human Ecology offers a master's and a doctorate program in marriage and family therapy.