What Couples Who Enter My Practice Can Expect

Assessment and Conceptualization: What is Actually Wrong?

• I typically conduct a psychodiagnostic evaluation of the couple that consists of four sessions. In the first session, we all meet together so that I can hear about the concerns each partner has and get a sense of the interpersonal “vibe” between them.
• In the second and third sessions, I meet individually with each partner to learn about their personal histories, relational tendencies, and perceptions of the relationship.
• In the fourth session, I present my diagnostic impressions, understanding of the origins and persistence of the couple’s distress, and treatment recommendations.

Treatment Planning and Appraisal: Where Are We Going?

• Following the assessment process, if couples therapy is warranted I organize a treatment plan that sets forth an outline of topics and issues that will be addressed. A phased approach works best for most couples, i.e., an anticipated number of sessions are organized to address specific goals that are arranged in a graded and sequential fashion. Once the goals encompassing one phase have been addressed, we move to the next phase. This affords the couple a sense of accomplishment and momentum, with each successive phase capitalizing on the achievement of the goals of the prior phase.
• At junctures between phases, I invite a frank, open discussion with the couple about their treatment experience, i.e., what is working and what is not working. The views of each partner are used as a form of supervision for me, clarifying what therapeutic interventions and strategies seem to be producing the best results.
• I also strongly advise against ongoing couples therapy sessions that continue endlessly, often with little positive results. If, for whatever reason, treatment is not working, alternative courses of action must be considered including consultations with other clinicians to resolve an impasse, a period of individual therapy for one or both partners that will ultimately make couples sessions more effective, or the termination of couples therapy.

The Therapist Gives the Couple Feedback: How Well Are We Moving Toward Our Destination?

• Research of couples therapy shows that traditional notions of the therapist’s need to maintain a neutral stance and avoid candidly observing and commenting on his/her subject experience of the couple have actually not led to successful couples therapy outcomes.
• It seems that couples need, and benefit from, the direct and spirited contribution of the couples therapist. In my practice, I have learned that couples want to know what I think about what’s going on and appreciate my direct, albeit respectful, feedback regarding who is responsible for what issue and how the dynamics between them are getting in the way of their relational goals. The partners of a couple need to learn what they are not doing well, as they often do not see it, and are helped by honest and direct feedback that identifies alternative, and more beneficial, attitudes and behaviors.

Empirical Tools: What Can We Use from Science?

• Scientific research has produced an array of empirical tools and measures that are invaluable in clinical work with couples. I frequently draw from the scientific literature numerous well-validated measure to assist my work with couples. Learning how one’s particular scores on a relevant measure compare with his/her partner’s, and with a representative sample of thousands of couples, is — in and of itself — instructive and revealing.

Skill Development and Pragmatic Change: Practice Outside of the Sessions

• Successful couples therapies do not rely on whatever insights may emerge in any particular session.
• Rather, the couple must work on their relationship outside of the sessions with clear guidance by the couples therapist through suggested exercises, prompts, and directed activities. I emphasize how skill development through practice is the primary means by which pragmatic change is ultimately achieved.

The Educational Component of Couples Therapy: So There’s a Term for That?

• While psychological jargon and complex theoretical ideas are generally not all that useful for couples, and certainly do not aid the progress of therapy, I have learned over the years that couples appreciate learning about their own psychologies and about relationships.
• On more than several occasions, when I have mentioned a term or idea from the couple therapy literature that is applicable to their own situation, couples have been intrigued and even comforted by the fact that whatever they are going through has been experienced by other couples and identified as a “thing” for important reasons.
• Lost in a confusing, chaotic stream of actions and reactions, couples benefit from having elements of their conflictual discourse defined and labeled. As with any other discipline, concretizing a problem through the naming of it is an essential element of couples therapy.

Visit Dr. Tobin's Office

15615 Alton Parkway
Suite 450
Irvine, CA 92618

Hours
Monday: 8am - 8pm
Tuesday: 8am - 8pm
Wednesday: 8am - 8pm
Thursday: 8am - 8pm
Friday: 8am - 8pm
Saturday: Closed
Sunday: Closed