What Evidence Based Therapy Should I Consider For Couples Counseling?

By: Toni Hoy

Updated April 13, 2021

Medically Reviewed By: Aaron Horn

The field of psychology is quite large and complex. Research continues in many different areas of psychology because there's so much that we still don't know about how our brains work and why we think, feel, and act as we do.

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Studies have brought about many different types of counseling methods. Some of them have been researched more in-depth than others. Research brings some assurance that treatments and protocols are effective. Many therapists prefer to use evidence-based treatments. Others have found specialties within alternative or non-evidence-based treatments. It's also common for therapists to use a combination of evidence-based and non-evidence-based treatments, especially for people who live with complex disorders.

What Is Evidence-Based Therapy?

The American Psychological Association (APA) defines evidence-based therapy as, "Evidence-based practice is the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences."

Any kind of treatment is subjective until it's been through rigorous testing to demonstrate that it works. The scientific method uses real-world testing on new ideas. Therapies that have been backed up scientific evidence have proven to be effective. Therapists are encouraged to use evidence-based treatments because they're safe, and most people will find improvement from them.

The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains a list of all evidence-based programs and practices on the National Registry for Evidence-Based Programs and Practices (NREPP). The registry only lists treatments that have proven to significant net impact on the outcome of mental health disorders, as demonstrated by extensive research.

Types Of Evidence-Based Therapies For Couples Counseling

When trouble is brewing in a relationship, couples will usually find help in couples therapy. In many cases, each partner has some things they need to work on within themselves in addition to working on issues that are tough to deal with as a couple.

There's no right or wrong couples therapy. The only right couples therapy is the one that brings them closer and helps them work through their differences in a mutually respectful and loving manner. The following are four evidence-based couples therapy methods.

Gottman Method

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One of the most popular couples counseling methods is the Gottman Method. It was designed, developed, and researched by Dr. John M. Gottman and his wife, psychologist, Julie Gottman. John Gottman is a long-time researcher who spent 40 years researching how to improve relationships for couples. In particular, Dr. John Gottman has researched the predictors of divorce to assist him in counseling couples in the characteristics that necessary to maintain a happy, loving relationship with their spouse or partner.

The Gottman Method consists of nine components of a program called the Sound Relationship House. The therapeutic process entails each partner making a mental map of each other's world and learning how to break through gridlock.

The Gottmans determined that negative emotions, like being defensive and contemptuous, are more likely to hurt relationships than positive emotions can overcome them to improve couples relationships. The structure of the Gottman Method helps couples develop understanding and skills so that partners can turn towards each other when one of them is hurting rather than turn away. The process helps couples strengthen their fondness and admiration for each other, manage conflicts, and explore each other's dreams together.

Narrative Therapy

Narrative therapy is a type of counseling that helps people isolate their problems from themselves. By giving issues a bit of distance, it's easier for couples to see other ways that the issue is affecting them. The issue may be protecting them in some way, and it may even be helping them. In being able to see the issue from various new perspectives, couples become motivated to make changes in their thoughts and behavior, so they can reframe their life story in a way that reflects who they are as people and their life's purpose. Narrative therapy gives couples a chance to rewrite the narrative of their lives while keeping problems separate.

Emotionally Focused Therapy

Emotionally Focused Therapy (EFT) focuses on the bonding quality of adult relationships. This therapy entails exploring patterns in the relationship and taking steps to create a closer bond and increase trust. EFT is a short-term, evidence-based therapy that helps couples relationships to become stronger and healthier.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a therapeutic method that helps couples communicate better, improve intimacy, develop rewarding relationship behaviors, and explore the negative and harmful dynamics that are hurting the relationship. Research has shown that CBT for couples is effective, about 75% of the time.

Recent advances in couples therapy suggest that CBT, combined with other interventions, can help couples to change problem behavior patterns and learn to accept their partner's behaviors that aren't bound to change. Therapy that focuses on a combination of making changes and acceptance of the other person helps couples deal with conflict and resolve their differences effectively is even more effective than CBT therapy on its own.

Other Types Of Couples Therapy

There's no denying the importance of research. Couples may be able to find therapy that isn't evidence-based yet, that is still helpful to them. It's important to consider that part of evidence-based treatment assumes that couples will make informed decisions about the status of their relationship and what they need to improve it. Cutting-edge therapies that are still in the research phase of science may be helpful to couples that are open to giving them a try. Following are a few non-evidence-based couples therapy treatments that are showing promise.

Religious-Based Counseling

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If one or both of you are a member of a church or religion, you may check with your church leadership to see if they offer to counsel to members. Having faith in a higher power sometimes provides common ground for couples who are going through difficult times in the relationship. Organized religions are typically highly supportive of strong and lasting marriages, and the membership can be a helpful support system.

Imago Therapy

Couples that lack faith in traditional psychotherapy may be more inclined to try Imago Therapy, which looks at each person's weaknesses and how they choose people that have many of the same weaknesses. Some couples aren't up for talking about their feelings out of fear of being criticized or feeling uncomfortable discussing difficult topics. Imago Therapy may be instrumental in helping couples assess their relationship dynamics rather than focusing on individual behavior. Therapists use conversations between partners as a basis for helping them understand each other's needs rather than striving for a particular outcome.

Marriage-Friendly Therapy

Most marriage therapists are trained in an individual model of therapy where the happiness of each individual supersedes the happiness of the couple. The benefits of this type of therapy are that it when it works, it works by resolving problems within each individual, and it tends to work in a fairly quick time frame. This type of therapy doesn't come without risks. One risk is that each partner may give up rather than be willing to do the necessary individual work that's needed to move the relationship forward. Another risk is that individual work comes at the expense of the work that needs to be done on the couple's relationship and the rest of the family.

Customized Couples Therapy

Many types of couples counseling are fixed programs with a specific structure and timeframe that ranges from a weekend to several weeks. These types of programs are helpful for people with healthy or marginal relationships; however, they don't always work well for couples that are dealing with complex problems and harsh feelings. Some couples will only realize success when they commit to long-term counseling that helps them make gradual and lasting changes to themselves and their relationship.

Concluding Thoughts On Couples Counseling

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Couples counseling works best when couples pursue counseling at the first sign of trouble before bad habits like yelling and screaming come into play. If your relationship is already beyond that, it's not too late to get help.

Here is some insight as to how couples therapists work-there are no secrets. What you divulge to the therapist will likely be shared openly between the three of you. This is an important consideration because the therapist has to remain neutral for trust to develop. Your therapist will not take sides.

Be aware that while one of you may have an individual problem such as substance abuse or infidelity, couples counseling will explore individual issues for both partners as well as issues in the relationship.

Couples counseling takes time and work. It will be painful at times. Remember that just as a physical injury takes time to heal and there is a period of pain before healing takes place, emotional hurt will be painful in the beginning and will heal over time.

If you're ready to start tackling the issues that brought you to consider couples counseling, why not reach out to ReGain and ask to be matched with a couples counselor that can get your relationship back on track? To find success with couples counseling, it's important to select a counselor that you both feel comfortable with. It's also important for both parties to commit to working on their issues.

Frequently Asked Questions (FAQs)

 What is meant by evidence based treatment?

Evidence based treatment is exactly what it sounds like. Evidence based treatment refers to treatment that's backed up by research and evidence. If a treatment is evidence based, it's been studied and verified as effective. Most popular forms of mental health treatment, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT) are forms of evidence based therapy. Evidence based practices are sometimes referred to as EVPs in the clinical world, and evidence based therapy is sometimes referred to as EBT. Evidence based medicine, evidence based therapy, and evidence based psychotherapy all help us to give and receive the most beneficial and well-researched care for medical and mental health concerns. Knowing what a specific evidence based therapy can treat or help with is also essential and is part of the process. For example, scientific evidence shows that dialectical behavioral therapy or DBT, an evidence based therapy modality, is helpful for those living with borderline personality disorder. In addition to being helpful to those with borderline personality disorder, we know that dialectical behavioral therapy and mindfulness based care is beneficial for those with anxiety disorders and numerous other conditions.

What are the 5 steps of evidence based practice?

The first of the five steps of evidence based practice is to form a question or hypothesis to research. The second step of evidence based practice is to conduct research and gain information that answers the question or confirms or denies the hypothesis. The third step of evidence based practice is to use a critical lens to look at the findings of the research or information found in the second step of evidence based practice. The fourth step of evidence based practice is to apply professional experience and client experience to the practice, and the fifth step of evidence based practice is to evaluate how the integration of the practice worked out. These five steps ensure the effectiveness of a practice so that professionals and individuals are assured that a practice or approach can be helpful. The five steps of evidence based practice also allow us to see any flaws in a practice and can help us find surprising or unexpected benefits of a particular practice, too. These steps are used in determining forms of evidence based therapy, evidence based psychotherapy, and evidence based medicine as a whole. If a modality succeeds in these five steps, it can be considered evidence based for the specific issue or issues that were looked at throughout the process.

What are evidence based practices in psychology?

Evidence based practices in clinical psychology are methods used in the field of clinical psychology that are backed by evidence and research. Clinical psychology boasts an understanding of the science behind the diagnosis and treatment of mental health issues or mental health conditions. Often, these practices are referred to as evidence based therapy. For example, an evidence based practice or evidence based therapy used to treat a condition like bipolar disorder or eating disorders will have been researched to ensure efficacy. Examples of an evidence based therapy or practice in clinical psychology is FBT or family based treatment, which is used to treat eating disorders in children and adolescents. In addition to helping children and adolescents, studies on FBT are increasing to gauge the treatment of eating disorders in adults. Cognitive behavioral therapy or cognitive therapy is another example of an evidence based therapy or practice used in the world of clinical psychology. CBT is a wildly popular evidence based therapy modality that's been researched extensively, and it helps people with a number of conditions including eating disorders depression, bipolar disorder, anxiety, and more. Subsets of CBT that are also forms of behavior therapy like dialectical behavior therapy are also evidence based practices.

What is evidence based practice in mental health?

An evidence based practice in mental health is a practice used in the mental health field that's proven to be effective by research and practical application. An example of an evidence based practice in mental health is exposure therapy, which has been shown to help many individuals who struggle with phobias and other concerns such as post traumatic stress disorder (PTSD). Cognitive behavioral therapy, also known as cognitive therapy, is another evidence based therapy used in the mental health field that can treat a variety of mental health issues including eating disorders, depression, and bipolar disorder. Cognitive therapy originated in the 1960s. Since its inception, cognitive therapy has been studied extensively and is one of the most prevalent forms of evidence based therapy. Another example of evidence based practice in mental health is CBT-E or enhanced cognitive behavioral therapy, which is a form of behavior therapy that's used to treat eating disorders such as bulimia, anorexia, and binge eating disorder. Before seeking help for mental health conditions such as eating disorders or bipolar disorder, many people want to know that the treatment they receive will be backed by the best evidence, hence why naming practices, paradigms, and modalities that are evidence based is important. Understanding evidence based therapy is vital to ensure the efficacy and safety of treatments and treatment plans provided to clients in mental health care settings.

What are examples of evidence based practices?

Examples of evidence based practices include forms of evidence based therapy such as cognitive therapy or CBT, CBT-E, dialectical behavior therapy or DBT, family based treatment or FBT, and acceptance and commitment therapy or ACT. Mindfulness is a popular topic, and mindfulness based treatment is another form of evidence based therapy or practice. Mindfulness based treatment is proven to help people with a variety of concerns such as anxiety disorders, which is why many people with anxiety pursue treatment plans that include mindfulness based therapy practices. For couples therapy, EFT or emotionally focused therapy is one example of an evidence based therapy modality that helps many couples and is shown to lead to relationship recovery in 70% to 75% of clientele. Evidence based practices are not limited to those used in mental health care by any means. Evidence based practices are also used for the diagnosis and treatment of medical conditions such as chronic pain. When seeking care for medical issues or medical health conditions, the issue of how cost effective or non cost effective something is, is often one of an individual or family's greatest concerns. Affordable options for evidence based therapy are sometimes provided through online therapy companies, insurance coverage, and institutions such as churches or schools.

What are the 3 components of evidence based practice?

When it comes to evidence based therapy, evidence based psychotherapy, and evidence based medicine, there are certain components that must be present. Here are the three components of evidence based practice:

  • Research (evidence)
  • Patient values or preference
  • Clinical knowledge or expertise

The three components of evidence based practice are used to create treatment plans that are effective and backed by research. They are used when looking at different forms of therapy including family therapy, couples therapy, individual therapy, group therapy, and treatments related to medical concerns or even modalities used to help those in specific circumstances that are not necessarily medical or mental health diagnoses.

What are the 7 steps of evidence based practice?

The first step of evidence based practice is to first create a question, hypothesis, or topic of inquiry. The second step is to look at these questions or hypotheses in what’s called a PICOT (Patient population, Interest or Intervention, Comparison, Outcome, Time) format. The third is to actually find the evidence, and the fourth is appraisal or review of what was found. The fifth step of evidence based practice is the integration or usage of the practice in question. The sixth step is to evaluate the integration from the previous step. Finally, the last step is dissemination. Looking at potential practices in depth is essential in the medical and mental health world because we want to ensure that the treatment plans people receive are proven effective. Evidence based therapy, evidence based psychotherapy, and evidence based medicine are vital because they show us what works in the medical and mental health care system. Some research even helps us to understand what the most cost effective and conducive options are for care.

What are the disadvantages of evidence based practice?

Knowledge of evidence based therapy and evidence based practices are essential in the medical and mental health world. The main potential disadvantage of evidence based therapy or evidence based practice is that there isn't a substantial understanding of some lesser-known medical and mental health conditions, meaning that potential for evidence based care is limited for said conditions. When we don't have enough knowledge regarding a medical or mental health condition, it can be hard to establish an evidence based therapy or practice to treat the diagnosis. New research is always emerging, as are new forms of evidence based therapy and evidence based medicine overall. When seeking help for mental health conditions or mental health issues, we all want to make sure that the most effective treatment plans are available to us. If you're looking for cost effective evidence based therapy or another specific form of care, search the web, contact your insurance company, or reach out to a provider near you for a referral.

What is the Gottman Method Couples Therapy?

The Gottman Method couples therapy is a form of marriage and family therapy that focuses on conflict prevention and resolution in a marriage. The main goals of Gottman Method couples therapy is to:

  • Disarm verbal communication that causes conflict through emotional based intervention.
  • Increase intimacy in the marriage to increase relationship satisfaction.
  • Develop and grow fondness and admiration in the marriage.
  • Decrease relationship distress by introducing new tools for dealing with conflict.
  • Increase the problem solving capabilities of both partners in the marriage.
  • Grow respect and affection within the marriage.
  • Remove the barriers that often lead to a stagnant marriage.
  • Create and grow more empathy and understanding in the relationship.
  • Resolve conflicts in a way that both people feel safe and heard.

With these goals in mind, the Gottman Method couples therapy was created by Doctors John and Julie Gottman. It is a form of emotionally focused couples therapy, with many research based techniques and clinical trials that prove its efficacy. Many couples therapists use the Gottman Method couples therapy, even from the early stages of a marriage, such as at premarital counseling.

The Gottman Method couples therapy is an emotionally focused couples therapy technique, which means that the bulk of the treatment will revolve around the couple’s feelings and interaction patterns. By observing the couple as they interact, the couple’s therapist can ascertain what elements of the marriage need to be improved. Then, they can give professional advice, based on their advanced training, to help the couple move towards a more successful marriage. These emotionally based approaches are a great way to improve intimacy and move forward, even if the marriage feels like it’s lost its sparkle.

There are also some special techniques that the Gottman Method couples therapy employs to reach its goals. Couples therapists with advanced training are set up to help couples learn how to build and grow these traits in their marriage and family. The components are as follows:

  • Building love maps: This refers to a deep and intricate knowledge of your partner’s psychological world. It includes their past, their hopes and dreams, and even their fears and worries. This can also help your partner feel safe around you, psychologically. Being able to build your partner’s love map is a way to develop more empathy and intimacy in the marriage.
  • Sharing fondness and admiration: This means focusing on the amount of respect and affection that can be found in the relationship. The goal here is to use marriage and family therapy to strengthen and increase the affection and respect levels in your marriage. It’s also a great way to work past attachment injuries and other problems with adult attachment.
  • Turn towards instead of away: This refers to stating your needs openly and honestly, and responding to shows of affection from your partner. It also encompasses responding to the bids for affection that your partner makes. The idea is that these small moments of affection in your day to day lives are actually crucial to building a healthy family psychology and overcoming attachment injuries.
  • The positive perspective: This means that couples should keep a positive outlook as they go through problem-solving and conflict management together. This is something that can be improved through emotionally focused couples therapy.
  • Manage conflict: This element refers to confronting the conflict that is bound to come up in your relationship, especially during the course of marriage and family therapy. They say “manage conflict” instead of “resolve conflict” because it’s impossible to totally erase all conflict in a relationship. However, with help from couple’s therapists, married couples can establish good family systems to manage and mitigate the conflict in the marriage that can spring up from attachment injuries or just daily life.
  • Make life dreams come true: This means that, through marriage and family therapy, the couple can create a space in the marriage where both partners can talk openly and honestly about their values, convictions, beliefs, and hopes for the future. This safe space is key to achieving the collective and shared goals of both partners in the marriage, and it gives a huge support for each individual to reach their full potential, as well.
  • Create shared meaning: This means that it’s very important for you and your partner to have a shared way to talk about the marriage with each other. This could mean setting up and growing a series of metaphors for your marriage, or relying narratives, visions, and myths to communicate hard-to-express ideas about the marriage.
  • Trust: This is what happens when you’re fully confident that your partner is acting to benefit you, and that you’re acting to benefit your partner. This element of the Gottman Method couples therapy is important, because it signals a key shift in perspective and decision making. It also gives a sense of security to the marriage.
  • Commitment: This refers to the belief that your journey with your partner really will last for a lifetime. It also encompasses cherishing and valuing the positive aspects of the marriage while also being committed to improving the rough patches in the marriage, usually through couple and family therapy when it’s needed.

All in all, these elements of the Gottman Method couples therapy are key aspects of excellence in emotionally focused couples therapy. The Gottman Method couples therapy uses all of these aspects of a marriage to work towards specific goals as well as the overall improvement and strengthening of the marriage.

Is the Gottman method effective?

According to the American Association of Marriage and Family Therapy, the Gottman Method couples therapy is quite effective, as long as both partners seeking the treatment are committed and invested in the process of getting couple and family therapy. The Gottman Method is an emotionally focused couples therapy, and a lot of research based on observing couples undergoing this emotionally focused couples therapy shows vast improvements in their marriage. These evidence based conclusions make it clear that the Gottman Method is an effective emotionally focused couples therapy. A lot of research support emotionally focused couples therapy on the whole, and the Gottman Method specifically.

There are also the glowing testimonies of people whose marriages are evidenced based on showing the efficacy of the Gottman Method and emotionally focused couples therapy. So, between the research based on actual observation and study of these couples, as well as the testimony of the couples themselves, it’s clear that the Gottman method couples therapy is a very effective form of emotionally focused couples therapy.

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