Evidence-Based 
Couples Therapy

Why Evidence-Based Therapy?

When therapies for couples first emerged in the 1930’s, interventions were based on a multitude of ideas and theories with little or no scientific under-pinning and often unstructured. As a result, there was no way of knowing if they worked, or indeed if they were harmful. Therapies like these are still on offer at couples therapy/counselling practices today.

Since the 1970’s, there have been concerted efforts in the academic community to use scientific methods to learn more about what makes and brakes relationships in order to develop better interventions with clearly defined structure and tools.

The Bath Couples

Therapy Practice

At the Bath Couples Psychology Practice, the latest advances in Couples Therapy will be used and adopted to your needs and situation.

Whenever possible, we will only apply methods and approaches that have been validated and proven to work, including the Gottman Method, Cognitive-Behavioural Couples Therapy, Emotionally Focussed Therapy and others.

I also draw on the wisdom and therapy methods developed for individual needs because there is commonly an intricate interplay between individual and couple needs that requires expertise in many areas of psychology to give you the best care and support.

After a comprehensive assessment, I make use of those approaches and methods to construct a bespoke treatment together with you.

Positive change is enabled by the establishment of a safe talking space, guided discovery of each other's deepest thoughts and affective private worlds, reprocessing and deepening of emotions, and the practice of new ways of interacting both inside and outside the sessions.

What to expect at the BCTP

Guided by the research, I have found that the most successful delivery of therapy involves three distinct stages outlined below.

Stage 1: Assessment

Most people seeking therapy are eager to get started and make gains straight away rather than going through with an assessment. This is completely understandable. So why do most Couples Therapists, including myself, insist on a comprehensive assessment?

Well, consider other situations where an assessment is important, for example unexplained medical symptoms, a broken down car or a blue screen on your computer. Without fully diagnosing the problem, any rash remedy is unlikely to be successful. If you don't know where you are going, you don't get there faster by running. This is equally true for Couples Therapy.

In Couples Therapy, the assessment offers many challenges and complexities. The therapist cannot rely on blood tests, eyeball examination or computer analytic tools to figure out what is going on. In addition, there are two people to understand as well as the intricacies of their interactions and often a long history of issues to consider. For this reason, the assessment is carried out over more than one session to make sure we come as close as possible to the heart of the matter.

The assessment is also a necessary part of the therapy itself, helping you to get a detailed understanding of what is going on in your relationship and how to reach your relationship goals. It is also not uncommon for couples to find the assessment edifying and even fun at times.

The ultimate aim of the assessment stage is to develop a bespoke treatment programme together.

  Intake Interview

In the intake interview you are invited to tell the story that brings you to therapy. You may also be offered the option of a written science-based questionnaire. Depending on your needs, this part of the assessment may be completed in one 50-minute session, or if your prefer, in two sessions.

  Individual Interviews

As part of the assessment you will also be offered an optional individual session each.

The purpose of the individual interviews is to give you both an opportunity to share individual needs, thoughts, feelings, and perceptions, which may be more difficult to express in a three-person situation in the beginning of therapy.

The two individual interviews will last 50 minutes each and can be scheduled back-to-back or on separate days.

  Treatment planning

In the final session, we will review all the gathered information to make sure we have covered all the things you wish to disclose. We will then proceed to develop a therapy plan together with mutually-agreed, specific and measurable goals. This session is either 50 or 90 minutes, depending on your preference.

Stage 2: Main Application

The main application is where all the therapy methods and tools relevant to your goals will be introduced and practised. It includes, if desired, general methods to strengthen and enhance your relationship. They will concern both what we do in the session and what you do between sessions.

The starting point in all our work will always be the recognition and appreciation of your existing knowledge and skills, and relationship strengths.

Home Application

It is likely that you will be invited to carry out therapy activities between sessions. The best way to make Couples Therapy work effectively is to practice at home what you learn and discover in therapy.

Number of Sessions

The number of sessions of the main application is determined by you. Factors that will influence the speed of progress in therapy include the severity and longevity of the presenting issues, and both your motivation and commitment to therapy and each other. The more time and effort you devote, the quicker the progress is likely to be.

There is some general guidance in the research literature to help you decide what would be best for you. For example, for less complex needs, less than six sessions could provide sufficient progress for you to continue and further develop the therapeutic work yourself. For more complex needs, there is some evidence to suggest that weekly sessions up to 12 sessions is required. Some couples need and request more than 12 sessions.

Spacing of Sessions

There is strong research evidence to suggest that sessions need to take place either weekly or fortnightly during the first phase of the main application. Longer gaps between sessions reduce the efficacy of the therapy.

About half into therapy, we will "phase out" our programme by having longer breaks between sessions in order for you to test out what you have learned and discovered, and prepare for the end of therapy.

Duration of Sessions

Sessions last either 50 or 90 minutes depending on what you prefer and the nature of the work we are doing. If there are many or complex issues to address, 90-minute consultations are recommended for the beginning of therapy. Research has found that with 90-minute sessions, more progress is achieved. Indeed, it has been found that the last 40 minutes of a 90-minute consultation can be particularly productive. Also, the consultations need to be long enough for each of you to express yourselves fully.

Stage 3: Follow-up Application

You decide whether or not you want follow-up sessions and how many you want. Research has shown that follow-up sessions support the maintenance of gains made in therapy.

The objectives are to fine-tune what you have learned, to coach you in developing new ways of connecting and dealing with issues as needed, and to receive support and encouragement on your new and more happy relationship journey.

If you wish to take up this offer, there are two types of follow-up services. One follows the Gottman Method evidence-based recommendation, which involves four 60 or 90 minutes sessions at 6, 12, 18 and 24 months after the end of the main application of therapy.

In the second option, you simply choose the number and spacing of the follow-up consultations yourselves.