How Do Couples Therapists Use Cognitive Behavioral Therapy?
Updated January 09, 2020
Reviewer Elizabeth Strong
Cognitive behavioral therapy is a well-known method of creating change in thoughts, feelings and behaviors. While many people are aware of its use in individual therapy, CBT can also be used in couples therapy to help partners change their behavior in ways that are beneficial to the relationship. Couples therapists use this technique in special ways that apply specifically to couples.
What Is Cognitive Behavioral Therapy?
Cognitive behavioral therapy is a specialized treatment used to facilitate change by challenging thoughts we have that may be detrimental to our well-being. We tend to believe what we tell ourselves over and over and if we can change these sometimes unhealthy, untrue, or unproductive thoughts, we can often change the harmful behaviors and feelings that tend to follow.
What Problems Can Be Addressed With CBT?
Cognitive behavioral therapy can be used to deal with a variety of personal and relationship issues. It's often used to treat mood disorders, but it can also be used to help with any issue that is caused or affected by maladaptive thoughts. As long as you aren't in a crisis, such as being in a physically abusive relationship or contemplating suicide, chances are CBT can be used effectively.
CBT As One Part Of An Eclectic Approach
Some therapists use CBT as one of several therapies. In couples' therapy, it's often used alongside communication and assertiveness training. When a thought or behavior that is causing discord in the relationship comes up, the therapist can switch to cognitive behavioral therapy to help the couple make changes designed to set a healthier course for the relationship.
CBT As The Primary Therapy
Cognitive behavioral therapy may be used as the primary or only mode of therapy. The technique is versatile, as it can be used to solve a wide variety of problems. It's suitable for couples' therapy because many couples find they want or need to change their thoughts, behaviors, and feelings in order build a stronger relationship. CBT provides them with a systematic way of achieving that.
How Cognitive Behavioral Therapy Works To Create Change
If you've never experienced CBT before, the notion that it can create positive change may seem a bit like magic. After all, you feel the way you feel. How can a simple technique change those feelings that seem so real and permanent?
The truth is that you can change the way you feel, but you have to do it by changing your thoughts about your situation. Once you change your thoughts, new feelings often follow and new, healthier behaviors can be more easily implemented. Cognitive behavioral therapists use a systematic technique to help you create these changes.
Orientation To CBT
Before your therapist begins CBT, they'll likely spend some time orientating you to the process. You'll learn more about what cognitive behavioral therapy is, how your therapist uses it, and what procedures you'll use during therapy sessions.
Identifying What's Good
CBT starts with identifying current situations and thoughts, feelings, and behaviors related to those situations. Many therapists have found that the best way to create positive expectations of couples' therapy is to begin by identifying what partners appreciate about each other.
What do you like about them? What do they do that helps make the relationship work as well as it does? What are some pleasant memories you have of your partner? These types of questions can also help the therapist understand the basis of your relationship.
Identifying Problem Situations, Thoughts, Feelings, And Behaviors
Before you can change anything, you'll spend some time talking about the situations that are causing stress in the relationship. Some examples might be changes in employment, serious medical conditions, interference in the relationship by family members, or past traumas of one or both partners.
You'll also describe your feelings about these situations as accurately as possible and talk about what seems to trigger those feelings. In the process, you'll get an opportunity to learn more about your partner's perceptions and feelings and notice how they're the same as or different from yours.
Once you cover the problem situations and the uncomfortable feelings surrounding them, your therapist will typically help you pinpoint how your behaviors contributed to or helped alleviate the situation. The goal here is to create an accurate and complete picture of what is happening in your relationship.
When you become more aware of the current state of your relationship and the feelings and behaviors that are a part of it, you can begin to uncover the thoughts that led you to that point. Only then can you use all this information to make plans for change.
Identifying Avoidance And Escape Behaviors
Often, rather than facing problems directly, people use avoidance and escape behaviors that temporarily keep them from having to deal with the situation. The problem is that when you avoid the situation for very long, the problems can mount up without you even realizing it.
While it might seem wonderful to escape problem situations completely, the risk is that by doing so, you reduce your chances of bonding and developing a closer relationship with your spouse. It might be great to avoid or escape a bad situation, but if you leave your partner to deal with it alone, they may have a very hard time surviving it, and they might come to resent you.
Identifying Automatic Thoughts
One of the basic tenets of cognitive behavioral therapy is that everyone has automatic thoughts: the thoughts or images that come up in response to a trigger. You don't actively try to think about them, they come up without prompting. You may or may not even be aware of them.
For an example of an automatic thought, consider a situation in which you think your spouse is angry with you. There could be several feelings that immediately surface in regards to that thought. The thoughts and feelings that arise may then lead you to act a certain way toward him or her. You might not be consciously aware of these thoughts, but there they are influencing how you feel and respond.
Only when you identify automatic thoughts can you discover whether they're accurate or not and decide if you want to change them. When you recognize all the images, thoughts, associations, and assumptions surrounding your feelings, your therapist can guide you in the work of changing them.
Identifying Shared and Different Core Beliefs
Core beliefs go a lot deeper than automatic thoughts. Your core beliefs are beliefs about yourself, the people around you, the way the world works, and what will happen in the future. These core beliefs are so strong that they are typically a part of who you are as a person and usually develop over a long period of time. They're often very rigid and inflexible beliefs that influence much of what we think, feel, and do.
Core beliefs can be changed, but the process is much more difficult and may take much longer than with more transitory thoughts. People commonly look for evidence to support their core beliefs, but in CBT, the goal can be to challenge these beliefs if they're unhelpful.
In couples therapy, you need to be very aware of your and your partner's core beliefs as well as your own. You might spend some time investigating each of your core beliefs and seeing whether they match up, work well with your partner's core beliefs, or cause discord between you. At that point, core beliefs can be addressed in the same way as other thoughts.
Setting Goals For Change
Just as cognitive behavioral therapy is a systematic method, setting goals for CBT is a systematic process. First, you need to settle on broad categories of change you want to work on. Then, you can narrow down to specific behaviors that you want to change.
Goals for CBT need to include three factors; they need to be observable, measurable, and achievable. Ideally, the change is carried out in small increments so that you can enjoy success as early as possible. Then, you can set new, narrowly-defined goals that contribute to your broad overall goals.
After you change your thoughts about a situation, your feelings may begin to change, too. You may also be ready to change your behaviors so that they mesh more closely with your new thoughts about your situation. This will increase your positive feelings, and at the same time, you'll choose behaviors that are more adapted to improving your relationship.
The Importance Of Homework
You're typically only in therapy for a limited amount of time. If you're going to make real changes, you'll need to practice new behaviors more frequently than you can in a therapy session. What's more, you and your partner may be on their best behavior during therapy sessions. For these reasons, your therapist may assign you homework to do alone or with your spouse between sessions.
Your therapist might give you information to read, exercises to do alone or together, and of course, specific behaviors from your list of behavioral goals to practice. It's important to take the time to do these exercises if you want to get the most out of therapy and create the changes you want for your relationship.
The Setup For Cognitive Behavioral Therapy For Couples
Cognitive behavioral therapy for couples is a bit different than for individuals. The setup is based on the fact that you and your partners are both distinct individuals and together make up a couple. This means that these three distinct entities need to be considered throughout the therapeutic process. The therapist facilitates the interactions between the two of you during sessions.
The Couple As Two Distinct Individuals
Even though you're in a relationship, you're still two distinct individuals. You'll need to work together as a couple, but you'll also need to identify your issues that contribute to the problems you face together.
The Couple As A Unique Entity
Many people have trouble wrapping their minds around what it means to consider a couple as a unique entity. What you need to remember is that you and your partner have characteristics and interactions as a couple that you may or may not have as two individuals.
For example, each of you might be very career-minded. On the other hand, when you're functioning as a couple, you might be more fun-oriented. Or, you might work together to advance a shared business. Either way, the couple made up of you and your partner can easily be different in type or degree from each of you as individuals.
You may speak in therapy as a part of a couple, or you might speak regarding your individuality. You might work together to change unhelpful patterns of behavior the two of you have developed. You might also do homework on your own to address your behaviors so that you're not contributing to problems between you. Regardless, each entity will need to put in the work for quantifiable changes to be made.
The Therapist as Facilitator
A CBT couples' therapist has a unique job. They're not there to tell you what to think, do, or feel. Rather than directly leading the sessions, they'll make it easier for you to discover what you want, understand how to set goals, and accomplish the changes you want to make.
You can rely on your therapist to keep the conversation between you flowing in a helpful direction. They can also provide you with information and guidance on certain issues and techniques. However, the two of you are in charge - both separately and together - of making all the decisions involved in your couples cognitive behavioral therapy.
Finding Out What Is Negotiable And What Isn't
If you've never been in therapy before, you might assume that the therapist will tell you what you have to change. Guess what. They won't. While they might help you understand the consequences of changing or not changing, only you will decide what you will change.
In fact, one of the most important parts of setting CBT goals in couples' therapy is to identify what each partner is willing to change. If you or your partner says that a thought or core belief is non-negotiable, then the other has to learn to accept their partner having that thought or core belief as well as the natural consequences of it. Otherwise, you can't make much progress in therapy.
If you and your partner are ready to start therapy, waiting for an appointment can cause you to lose your momentum and commitment to that goal. Fortunately, you can begin online therapy right away with Regain. The therapists are licensed counselors who work with couples to help them achieve their goals for a closer, more satisfying relationship.