Choosing Marriage Counselors & Therapists

July, 2003

I was shocked to learn (Psychotherapy Newtworker, November/December, 2003--you can subscribe at http://www.psychotherapynetworker.com) that most marriage counselors or therapists who counsel couples do not have formal training in couples counseling! As Dr. William Doherty, a nationally known psychologist, professor, and writer says in that article: "A dirty little secret in the therapy field is that couples therapy may be the hardest form of therapy, and most therapists aren't good at it. Of course, this wouldn't be a public health problem if most therapists stayed away from couples work, but they don't. Surveys indicate that about 80% of therapists in private practice do couples therapy. Where they got their training is a mystery, because most therapists practicing today never took a course in couples therapy."

If you're on this site, chances are you are in a relationship, have been in a relationship, or want to be in one. Therefore, the absolute first requirement for your marriage counselor or therapist is good, solid training in how to think systemically. If they don't have, it, don't bother.

As Doherty says, "Most therapists today trained as psychologists, social workers, professional counselors, or psychiatrists. None of these professions requires a course in marital therapy." Apparently, Marriage and Family Therapists--marriage counselors--constitute only 12% of psychotherapists in the US. Well trained marriage counselors are like diamonds--rare and precious. So check out the training of your prospective therapist.

How much training? Well, my own Master's Degree had zero courses or practicums in marriage counseling. But, at that time, my Doctorate at Nova Southeastern had two years of classroom courses on the philosophy and techniques of couples and family counseling combined with six semesters--yup, we worked through the broiling Florida summers--of clinical experience with LIVE supervision by full professors not shy to phone into the therapy room with ongoing feedback!

And that wasn't enough. We had to constantly hand in papers in which we took a good look at ourselves as people/therapists including our strengths, our weaknesses, our hopes, dreams, goals, plans to arrive at those goals, and what to do about our weak points. Now, that's good training. Go click the website above; I think it got even harder! And that's all besides the intellectual stuff of reading books, taking tests, writing papers, attending conferences, and, of course, the mother of all research papers--the dissertation--which took me ten years. (Well, I'm a bit of a perfectionist in my work, but that's not a bad therapist trait for prospective clients, is it?)

So, step one has got to be checking whether your prospective therapist has had a lot of formal classroom and clinical training in doing marriage & family counseling. Obviously, someone with a Ph.D. will have more than someone with a Master's Degree because the Master's is your first course out of college and you need the Master's to enter most Doctoral programs. One semester?--forget it. One year--probably not enough.

And there's another piece to formal training. Let's say you've found someone with a Marriage & Family Therapy education, in fact, a Clinical Member of the American Association for Marriage & Family Therapy (the national credentialing body for marriage counselors). That's good, but maybe not good enough. You're on this website because there may have been some abuse or addiction in your or your partner's history. Then, obviously, you need someone with abuse and trauma training. (Check my credentials so you can compare to the face-to-face therapist you want to see.)

Then there's the legal thing. Many states require a license. Licensing means you have acquired minimal education and clinical experience to be a marriage counselor or therapist. Unless your best friend was a hair colorist or you were a great handy-person, you wouldn't get your hair colored or your plumbing fixed by an unlicensed person, why would you put your life, your heart, your soul in the hands of an unlicensed person? True, licensing does not mean they are smart, talented, or kind. But it does mean they've jumped through the first set of hoops and that someone is keeping an eye on them--and that's a good thing.

All that--by itself--doesn't cut it. Formal training and a license is not enough. As they say, it's necessary, but it's not sufficient. You want to know how many years that individual has been a marriage counselor and what his or her accomplishments in it are. You have the right to ask any questions you want about methods, diagnosis, values, attitude. For example, does your prospective therapist believe--in her heart of hearts--that borderlines just don't get better? If so, run the other way.

How does he feel about verbal abuse? Does he think it is less serious than physical abuse? Run the other way. How about marriage? Does she think it's small potatoes, soemthing you can toss out with the garbage, or would she work like he-l to help you folks save yours? Does she know when to quit? Can she explain to you her rationale? Does this individual seem wise? Has he "been there"? What life experience has he got? Does he seem to understand? Is he respectful of your time? Your feelings? Or does he take an I-am-the-expert position? If so, again, you're outa there.

Sigmund Freud was the originator of psychoanalysis, but he did not put much thought into what it takes for a therapist and client to have a relationship. Maybe his clients just liked him and he sort of took that for granted. I don't know. But all modern research says that that is the core of the treatment. With it, you've got a foundation. Without it, there's no therapy. The grandfather of modern "talk therapy," Carl Rogers, understood this. All his research and all his clinical work focused on the therapist-client relationship and all current research for the last 20 years backs up the notion that no matter how brilliant the therapist or creative the technique, it's the relationship that counts. One of his concepts was that counselors should be "transparent." That means you can read them; they are not full of surprises; they are honest; they're human.

Here's another thought: Sometimes you're stuck using your insurance because you couldn't afford the therapy otherwise. However, many insurances only offer a small number of visits. It may be more planful to shop around for an out-of-pocket person meeting the above criteria who will offer a sliding fee scale. Many very expensive counselors offer a limited number of pro bono or sliding scale slots as a community service. See more about avoiding some of the common pitfalls of insurance on this site.

Putting all that together requires the most important variable of all: you. When faced with such an important decision, you gather the information and then become the evaluator. In this process, trust your gut! Never, ever, ignore gut feelings no matter how brilliant your brain argues against them. (That's true in your more intimate relationships too, of course.) Your gut feeling is really coming from the core of yourself, perhaps your soul. Listen to it.

Good luck in your search.