Relationship Academy No. 1: Why Your Individual Therapist Can’t Just Become Your Couples Therapist
Relationship Academy is my series of blog posts sharing and pondering what I am learning as I teach myself and receive training in the art and craft of couples counseling.
Too Many Therapists and Wondering Who Does What
I often get asked about the difference between an individual therapist’s role vs a couples therapist’s role. These questions often come from friends, family, and acquaintances who need some aspects of Therapy Land demystified. I mean, who doesn’t? Navigating mental healthcare and services in the US is an abyss to begin with because so much depends on whether or not you use insurance (always easier to not) and the kind of service or provider you’re looking for. But when we add to that the lack of information about what the ethical boundaries are between couples and individual therapy, navigating this world can feel even more daunting.
What’s also interesting is that sometimes I encounter therapists and coaches themselves who are not aware of ethical issues surrounding the blurred boundaries between couples and individual work. So maybe these issues need to be clarified for everyone and there are not enough authorities clarifying it out there!
“I Want You to See Me and My Partner Together”
When I encourage my individual clients to consider couples counseling, sometimes I’m asked if the partner can join the client’s therapy session. To a certain extent, this can be appropriate and helpful but the purpose and goals of these joining sessions need to be clarified with all parties beforehand. In most circumstances, it would not be appropriate for me to shift into being a couples therapist to this couple if I have a history with the client as their individual therapist. As one can imagine, I would naturally have some biases because of the work I have done with the individual client. While I can stay reasonably balanced for a session or two, my objectivity is not reliable for longer than a few sessions.
Here are examples of how a joining session like this can be used by a client.
The individual client in therapy with me is starting to understand themselves better with a new diagnosis (e.g., Autism, CPTSD, Bipolar, etc.) and an important way to support a client with navigating this is to do one or a couple of sessions with a spouse or family member in order to provide education, validation, and encouragement. Supporting a client in getting on the same page with a loved one who is a vital support to them can be a great investment of time and energy in individual therapy.
There is a specific and highly important conversation that a client would like to have with their spouse and due to extenuating circumstances and/or severe mental health symptoms, they are unable to do so outside of therapy. Only with the spouse’s agreement beforehand, I would then facilitate the client’s conversation with their spouse.
Therapists generally don’t occupy both the individual and couples therapist roles for a person because the risk of breaching confidentiality of material from the individual therapy space while working in the couples therapy space becomes higher. Can any of us reliably keep track, every single time, of what was said in which room?Likely not. That’s a crucial limitation we have to acknowledge because when we get it wrong, we can potentially cause harm to a couple or an individual.
Human fallibility aside, psychologists’ Ethics Code Standard 10.02 related to couples and family counseling mandates that when a psychologist may find themselves in conflicting roles with the members of a couple, they take reasonable steps to clarify the roles even if that means withdrawing from the role. I (and many of my colleagues) interpret that to mean “better safe than sorry” in many scenarios and from the outset will actively prevent any potential blurring of boundaries.
“Since I’m already seeing you for couples counseling, can I see you for individual too?”
So the vice versa is worth outlining here too, as that is a frequent question that comes up in my practice. It is a valid and understandable request to do individual counseling with one’s couples therapist because of convenience, safety/comfort, familiarity, etc. However, because confidentiality becomes a huge sticking point in the work we do, it’s generally not possible for a provider to simultaneously be one’s couples and individual therapist. The ideal scenario in which a couples therapist becomes someone’s individual therapist is as follows:
A couple starts work with a couples therapist. Their work with that therapist concludes and one member of the couple has decided that they would like to work with the same therapist for ongoing individual counseling. Both members of the couple agree that if the therapist transitions into the role of one partner’s individual therapist, the couple can no longer see the therapist for couples work in the future.
As you can see, this is a clean, and therefore safer, change in boundaries.
Your Confidentiality is Paramount
The way psychologists practice is guided by an ethical code that prioritizes the rights and well-being of clients who use psychological services. Even when clients believe that they are comfortable with changing and blurring roles and boundaries with their therapist, it may not be ethical or professional for a psychologist to engage in roles that risk compromising an individual’s confidentiality. For this reason, an individual therapist becomes a couples therapist (or vice versa) for the same people only in specific, carefully defined situations. If you want both, ask your therapist for a referral. A good therapist will be glad you asked.