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How to Choose a Marriage Counselor

QUESTION: My husband and I have been married for eight years. Over the past few years, we have been spending more and more time watching TV and less time doing things together. The TV seems to have zapped our ability to communicate. We have started arguing over petty things. I suggested that we get marriage counseling; we both know we have issues that need to be dealt with. My husband agreed to go to counseling, but left it up to me to find the counselor/therapist. How do I know if they are qualified? What kind of credentials should I look for, and can I interview them to see if their style will work for us?

Your marriage is an important investment! Like any investment, your choice of a marriage counselor should be made carefully to ensure the greatest potential for a healthy return.

Training, credentials, experience and personality style are all important to consider when hiring a counselor to assist in repairing or strengthening your marriage. Whether you hire a psychiatrist, psychologist, clinical social worker or marriage and family counselor, it is important that the consultant you choose has sufficient training and experience in marriage and family therapy.

Credentials can be misleading. For example, up until several years ago, marriage and family counselors in California often received licensure with this title without any requirement that they be trained or experienced in marital and family venues. Many who chose to specialize in individual development became well qualified for individual counseling but relatively weak in addressing the marital system. Therefore, no matter what credentials you choose, it is necessary that you ask the consulting professional if she or he has formal and extensive training in marital counseling and what percentage of his or her present work is with couples.

Psychiatrists are the least likely to be trained in marital and family counseling, while social workers are more likely to receive training in family systems. Though not always true, the focus of psychiatry on pharmacological and more traditional analytic methodology leaves less time for devoting significant study to family and marital study. Social workers are traditionally trained to work as "change agents" in systems and work within parameters for change within the family or larger social structure. Therefore, more course study in family systems and marital issues is often part of the curriculum. Psychologists training varies with respect to focus on individual or family but includes psychological testing which may be useful when considering custody evaluations as a part of family counseling.

Recommendations from the National Association for Marriage and Family Therapy in Washington, DC is an excellent resource for trained and experienced marital therapists with a variety of credentials. You can call and ask for a referral in your area from their list of clinical membership. Clinical membership requires that the therapist is trained and experienced in marital and family therapy. Still, ask the therapist what percentage of couples' counseling they do, how long they have been in practice and what kind of formal training they have in marriage counseling. You may also ask how they generally approach couples' therapy and what duration of therapy they are comfortable with. For example, if you have the ability to financially afford short-term therapy of 8 to 12 weeks, but no more, ask the therapist whether he does short-term counseling as well as long-term.

Avenues for referral may include friends or relatives who have had a positive experience, however, it will still be up to you to ask your own questions of the therapist. Avenues of referral that may not be appropriate may include health insurance with preferred providers organizations that select inexpensive, but relatively inexperienced professionals (who may not have adequate specialty training) to stock their provider panel. Again, ask questions and consider that 10 years or more of experience, appropriate training and an ongoing client load of about 40 to 50 percent marital counseling is a good start. Be prepared to pay a higher fee for a more experienced therapist. Do not let fee alone be your deciding factor when it comes to your marriage. Limited but focused treatment is often better than more sessions resulting in vague outcome.

Insight oriented couples' therapy has been found to result in greater success rates over a longer period of time. But behavioral or multi-modality models may also be of benefit. In other words, when one of your therapy goals is to understand your patterns of interaction and where they come from, you will be more likely to be able to solve problems in the future without returning to coupes' therapy.

Finally, and very importantly, consider your rapport and connection with the therapist. If either you or your husband is unable to make an emotional connection or gain at least some insight from the session, it may be the chemistry! Like anything personality counts. Training and experience is important, but it must be matched with your feeling that this person can help you. One therapist will not be right for all couples. Some part of your decision should include your "gut" response to this person's style and personality, along with the information to your other questions.

Because it is a significant investment in your future, do not shy away from interviewing several therapists. It is acceptable to let a therapist know that you are making two or three appointments for an initial session with different therapists, and that you will make a choice before a follow-up session is scheduled. This will allow you to judge the chemistry of your interaction.

If you are well satisfied with your first pick, it is fine to simply continue what you have begun. But if the first session leaves you unsettled in a way that does not seem productive, consider another consult.

You and your husband have fallen into an alternating pattern of withdrawal and bickering early in your marriage. There are other ways of connecting besides bickering. Consider reading books on marriage that might also help you begin to see a bigger picture and vision of what you want in a marriage. Any work you do to get your marriage on track will benefit your counseling.

Do your best to express yourself honestly and directly during your marital session so that the therapist can best help you. If you keep secrets or find yourself protecting your spouse by hedging what you say, you will be less likely to get the help you need. Like going to a physician for a physical problem, be sure to show your therapist where it hurts!

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Gayle Peterson, MSSW, LCSW, PhD is a family therapist specializing in prenatal and family development. She trains professionals in her prenatal counseling model and is the author of An Easier Childbirth, Birthing Normally and her latest book, Making Healthy Families. Her articles on family relationships appear in professional journals and she is an oft-quoted expert in popular magazines such as Woman's Day, Mothering and Parenting. . She also serves on the advisory board for Fit Pregnancy Magazine.

Dr. Gayle Peterson has written family columns for ParentsPlace.com, igrandparents.com, the Bay Area's Parents Press newspaper and the Sierra Foothill's Family Post. She has also hosted a live radio show, "Ask Dr. Gayle" on www.ivillage.com, answering questions on family relationships and parenting. Dr. Peterson has appeared on numerous radio and television interviews including Canadian broadcast as a family and communications expert in the twelve part documentary "Baby's Best Chance". She is former clinical director of the Holistic Health Program at John F. Kennedy University in Northern California and adjunct faculty at the California Institute for Integral Studies in San Francisco. A national public speaker on women's issues and family development, Gayle Peterson practices psychotherapy in Oakland, California and Nevada City, California. She also offers an online certification training program in Prenatal Counseling and Birth Hypnosis. Gayle and is a wife, mother of two adult children and a proud grandmother of three lively boys and one sparkling granddaughter.

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