Q: I notice that many of my couples clients do well in therapy, only to return with the same or similar problems in a few months. What can I do to make the effects of treatment last?
A: This problem is probably a lot more common than most therapists want to admit. Clinicians don't get enough training in how clients can maintain their therapeutic gains. Also, today's mental health landscape promotes short-term symptom removal, not permanent change.
When a couple returns to therapy with the same problems, the first question to answer is whether they really want to resolve the problem. After all, it may serve an important function for them. Asking, "How would your life be different if you did not have this problem?" can give insight into the underlying purpose of the conflict. If the answer reveals that solving their problem is not a couple's primary motive, the therapist needs to address that issue.
But if, in fact, the couple wants to maintain their improvements, review five areas of your original course of treatment:
1. How aligned and actively committed was the couple to the treatment process? Without clear agreement on the goal of therapy and how to reach it, long-term treatment success is not likely. For example, Pedro and Mary had been very positive about therapy and never missed appointments. So I was surprised when, six months after our last session, they came back with the same family…