This summer, I reviewed recent research in the field of marriage and family therapy. In this post, I include a brief summary of several articles and one book that I read—all on the topic of romantic relationships and relevant for couple therapy. The articles are from the July 2024 issue of the Journal of Marital and Family Therapy.

Managing Desire and Affection Discrepancies in Romantic Relationships

The researchers investigated, using qualitative methodology, strategies for resolving sexual desire discrepancies in, primarily, LGBTQ+ couples. The following were orienting questions for the study:

1 | What strategies do adults use to address sexual and affectionate desire discrepancies in their romantic relationships?

2 | Do adults think that their strategies are effective?

3 | Do strategies differ based on whether adults perceive their desire discrepancies to be problematic?

The authors found that participants used five main strategies to manage desire discrepancies:

Alternative behaviors

These behaviors include: Participating in alternative sexual/affection behaviors than desired, non-sexual behaviors that met closeness needs, and engaging in sexual and/or affection behaviors with a third party (for participants in open relationships).

Communication

Behaviors in this category include dialogue regarding desire, compromise to find agreed-upon sexual or affection behaviors, and reassurance about attraction and love between partners.

Doing nothing

“Doing nothing” refers to partners not addressing the discrepancy issue within the relationship. However, partners using this strategy mentioned coping with a lack of interest on their own, both in negative and positive ways.

Engaging in physical behavior without desire

Some participants explained this strategy as having an “openness” to their partner’s desire, while others used this strategy out of guilt or obligation.

Giving control to one partner

This strategy varied within the study. Some participants gave control to the lower desire partner, engaging in what was comfortable for that partner. Other participants gave control to the higher desire partner, as long as their limits were respected.

To read this full study, visit: https://onlinelibrary.wiley.com/doi/full/10.1111/jmft.12709

Clark, A. N., Walters, T. L., & Lefkowitz, E. S. (2024). “It's an ongoing discussion about desire”: Adults' strategies for managing sexual and affectionate desire discrepancies in romantic relationships. Journal of Marital and Family Therapy, 50(3), 669-686.

Assessments for multi-heritage couple therapy

“Multi-heritage couples encompass inherent differences in race, ethnicity, religion, gender, sexual orientation, national origin, and culture” (McIntosh & Wang, 2024). Multi-heritage couples face similar challenges to all couples; “however, these challenges are frequently intensified by differences in worldviews, such as collectivistic or individualistic perspectives, as well as racial, ethnic, and religious diversities.”

The researchers conducted a systemic review, utilizing the following guiding questions, with the goal of “shed[ding] light on the efficacy of existing assessment tools and identify[ing] opportunities for the development of culturally attuned assessments for multi-heritage couples:”

1 | What are the existing assessment tools for multi-heritage couples?

2 | What are the strengths and limitations of those existing assessment tools?

The researchers included nine tools in their analysis, and “did not find any standardized assessment tools that were specifically developed for multi-heritage couples” (McIntosh & Wang, 2024). While assessments do exist that gather information on essential couple dynamics, and one assessment is standardized, no existing assessment was designed for multi-heritage couples. The authors call for developing, in the field of MFT, the “evidence base” in the area of mutli-heritage couples.

To read this full study, visit: https://onlinelibrary.wiley.com/doi/10.1111/jmft.12708

McIntosh, D. L., & Wang, G. (2024). Assessments for multi‐heritage couple therapy: A review of existing tools. Journal of Marital and Family Therapy, 50(3), 611-629.

Developmental Couple Therapy for Complex Trauma (DCTCT): A Pilot Study

The researchers conducted a study on the process and outcome of DCTCT, utilizing the modality’s treatment manual with seven couples. The inclusion criteria for trauma was defined as one partner meeting diagnostic criteria for CPTSD according to their results on the International Trauma Questionnaire.

The seven couples completed an average of 30 sessions of DCTCT, each. The couples showed statistically significant improvements in “overall trauma symptoms, emotion regulation capacities, and reductions in attachment-related anxiety”. Only one participant met criteria for CPTSD at termination of the study, as compared to seven participants meeting criteria at intake.

To read the full study, visit: https://onlinelibrary.wiley.com/doi/full/10.1111/jmft.12711

MacIntosh, H. B. (2024). Developmental couple therapy for complex trauma: Results of an implementation pilot study. Journal of Marital and Family Therapy. 50(3), 545-566.

***This is How Your Marriage Ends*, Matthew Fray**

Matthew Fray found himself an accidental relationship coach after blogging about the demise of his marriage. In this book, he explains the cycle and impact of relationship-killing behaviors and beliefs, and how they seem innocuous in the moment of conflict, but build to devastating consequences in long-term relationships. If you’ve received training in couple therapy, many of Fray’s points will be familiar, including: The losing strategy of “being right,” invalidating statements, and ways partners communicate judgment and blame. What resonates most from this book, is the first hand account of a man who realized, seemingly on his own (albeit post divorce), how he contributed to the destruction of his most important relationship.

Fray, M. (2022). This is How Your Marriage Ends: A Hopeful Approach to Saving Relationships. HarperOne.

Let me know, in the comments:

Which resource was most interesting to you, and why.

How to Keep Your Therapy Communications Secure, While Working Remotely: An Interview with iplum CEO Pankaj Gupta

Pankaj Gupta, CEO of iPlum, joins me for this post. I interview him about iPlum’s mission, the services the company offers, as well as why iPlum is the right fit for therapists in private practice.

If you haven’t already read Part 1 of my partnership with iPlum, see the five benefits of using a HIPAA-compliant phone solution.

5 Ways Vicarious Trauma Can Sneak Up on You as a Psychotherapist

Vicarious trauma is a term that is not unfamiliar to most therapists. Many of us were warned about VT in grad school, have attended self-care workshops that promised to resolve the effects of VT, or have simply resigned ourselves to white-knuckling it through each day. But do you really know how to identify vicarious trauma? Can you pick up on sneaky warning signs that VT is already present in your life?

When You Don’t Want To Do Therapy Anymore: Ten Tips for Rekindling Career Energy, for Therapists Who Are Burned Out

Recently, I published two articles on the topic: Reasons why therapists are leaving the mental health field. In them, I covered ten of the most common reasons therapists are choosing to change their career path. (If you’d like to read those posts, here are the links to part one and part two.)

There are many therapists who are living through challenges in their work and career, and yet have not chosen to, or do not want to, leave the field. If this describes you, then keep reading for ten steps that will help you rekindle some career energy.

Five More Reasons Why Therapists Are Leaving The Mental Health Field

In this post, I continue listing reasons why therapists are considering leaving the mental health field, because there are many. And, if you are one of the therapists considering leaving the field, please know: You are not alone. If you missed the first post on this topic, head here, and read that first.

Five Reasons Therapists Are Leaving the Mental Health Field

Each week, I coach at least one therapist who mentions that they are considering leaving the therapy field. This sentiment seems to have increased among psychotherapists in the past two years with challenges related to COVID (for therapists and clients), including a) sickness, b) working from home, c) relational and family transitions, among others.

Of course, each therapist has their own particular reasons for their desire to leave their profession. Also, from my interaction with thousands of therapists each week, I have noticed several common challenges emerge in conversations about leaving the field.

How to Find and Live The Refreshed Therapist Life

As a clinical supervisor and consultant to therapists, I meet many clinicians who find themselves burned out, bored, or numb after years of showing up for their clients, and neglecting, to some degree, to show up for themselves. The reality of our work is that in order to sustain and enjoy it, we must intentionally deal with the nuances of what it means to function as a therapist inside and outside the therapy room.

As therapists, we have the opportunity to be vocal about the ways we live out the intersection of life and work. Our voices generate more expansive and encouraging conversations that can lead to a sense of flow in navigating our personal and therapist selves.

How To Engage In Social Media Self Care: Eight Steps For Therapists

Social media posting is a must if you’re a therapist marketing a private practice. Even if you’re not a business owner, you may find that your social media is taking up more time than you’d prefer (gentle nudge: How’s your screen time report looking this week?).

Hey—like therapy, this is a judgment-free zone. It is also a “let’s be our best selves” zone. And, to show up as our best selves, self care is essential.

Technology-Assisted Clinical Supervision: Benefits, Challenges, and Regulations

If you’re a clinical supervisor navigating the delivery of supervision right now, you may have encountered some challenges, including state, institutional, and technological limitations. The information I present in this post is intended to encourage the legal and ethical use of technology-assisted (distance) supervision in a variety of settings.

Dr. AnnaLynn Schooley and I recently discussed this subject as it relates to our experiences and our development as supervisors. Dr. Schooley is a LMFT and LMHC in the state of Florida, and carries licenses in additional states. She serves as a supervisor for master and doctoral-level MFT students in her role as professor for Capella University.

Start on Time, End on Time: HOW TO MANAGE Your Private Practice THERAPY Sessions

Whether you’re 6 or 60, there’s one thing everyone hates when going to the doctor; and no, it’s not getting pricked with needles. It’s waiting to get pricked with needles. Your appointment is at 2, but as 2, 2:05, 2:10 rolls by, you ruminate “I had an appointment. If the doctor wasn’t going to be available, why schedule at this time? Apparently, my time isn’t valuable.”

As our lives are perhaps more rushed than ever, waiting for any appointment or meeting is a hassle. However, a tardy counseling session is qualitatively worse than other late meetings. Getting started late is a broken promise in a relationship that needs trust in spades.

The Problem With Loving Your Work: The Role Of Expectations, Wages, and Passion

Recently, I’ve been thinking about the role of work in my life, as well as how I relate to work. This train of thought naturally leads to evaluating how well I am doing engaging with people (and myself) as more than a worker.

How much time and mental energy does my work take from me, or give to me?

How much of my drive and motivation does my work inspire?

These are a few of the questions I am asking in order to continue my mission for myself and other therapists: To live and work well.

Three Ways to Be A Leader Who Lasts

What does it take to be a leader? Thousands of words have been written on the topic. Here’s the truth: there’s no magic formula. But I do suggest three important elements to work on over time: Know yourself, know your purpose, and know your people. How to live that out will differ for every leader and every setting.

Mindfulness Tips for Therapists, for Work and Life

Mindfulness is popular.

You likely have worksheets, lessons, techniques, and theories that help your clients understand mindfulness and its benefits.

You understand mindfulness and its benefits.

But, as we therapists know, sometimes understanding doesn’t foster motivation, or change. The fact is, therapists struggle to implement mindfulness, along with a “self-caring” lifestyle (Kissil and Niño, 2017).

10 Therapist (and Child)-Approved Activities to Support Kids with Anxiety

If you’re a mental health professional working with children, you will probably agree that many of the calls you receive from parents have something to do with anxiety or stress. Child therapists have the amazingly important yet challenging task of educating and supporting kids in a therapeutic setting that is both productive and fun. When working with children as young as preschool age, it can be a very daunting task to keep things fresh and exciting week after week! So, how do we help children develop the coping skills they need while keeping them engaged (and not glancing at their watch)? Here are ten therapist (and child!)-approved, fun activities that address anxiety-based disorders and promote relaxation and stress reduction in children:

The Art and Science of Therapy as Craft, Part 2: Crafting Questions

For this week's video chat, Dr. AnnaLynn Schooley returns to discuss therapy questions as an intentional craft, and she covers four basic question types: single answer, open, closed, relational, and circular.

Therapist Self-Disclosure Simplified

Self-disclosure is a touchy subject among therapists. Some therapists never self-disclose, while others feel stifled by having a rigid boundary around self-disclosure. As I consider self-disclosure in therapy, I ask myself, “When is self-disclosure appropriate?” “How does self-disclosure deepen the therapist-client connection?"

Solution Focused Brief Couples Therapy Tips, with Elliott Connie

Elliott Connie is a Solution Focused Brief Therapy (SFBT) practitioner, author, and speaker. He developed an approach to couples work that distills the essence of SFBT into guiding principles for working with couples.

As a therapist who loves working with couples, I am always interested in ways to enhance my couples therapy skills. For this reason, I invited Elliott to explain the reasons why SFBT is his choice for working with clients, as well as how it creates a contrasting experience for couples that have a history in therapy.

Family of Origin Exploration for the Therapist: How to Create Your Genogram

In article three of the Family of Origin for the Therapist series, you learned 3 simple steps for how to begin family of origin (FOO) exploration: 1) read Bowen’s chapter, 2) observe your FOO experience, and 3) reflect on what you learned. Hopefully, your curiosity has led to significant understanding.

Understanding is the foundation of Bowen Family Systems Theory (BFST). Bowen (1985) believed that if clients could understand themselves as members of their FOOs and as created by their histories, they could begin and continue significant change.

In today’s post, I offer the next step in developing understanding: Creating your genogram. I explain how to create a basic genogram that you can expand as you continue your exploration.

5 Tips for Keeping Up with Therapy Paperwork

In my interaction with therapists as a mentor and supervisor, I’ve learned that one of the main struggles therapists face is having too much work and not enough time. Many therapists find themselves overwhelmed by documentation responsibilities, in particular; this includes completing client notes, referrals, billing, treatment plans, etc.

In today’s post, I offer several strategies for keeping up with paperwork, so that you can stay on track and avoid the stress of falling behind.

Solution-Focused Brief Therapy Client Types, and Their Relevance To Every Session

In her 1989 article, Of Visitors, Complainants, and Customers, Insoo Kim Berg details three types of “client-therapist relationships” (p. 21). Her wording is significant, because she is not labeling clients; she is describing them in terms of their relationship to the therapist, the process of therapy, and the problem. These three relationships have undergirded Solution-Focused Brief Therapy theory and interventions over the years, although they are not consistently discussed in newer works. The client relationship types are widely applicable to therapy, regardless of theoretical orientation, making them one of the most useful concepts in marriage and family therapy.

In this post, I present a review of these client types, and I explain their relevance to and usefulness for all therapeutic sessions.

How to Ethically Offer Coaching as a Licensed Therapist: A Step-By-Step Guide

One of the most common professional goals for my clients is expanding their private practice to include life coaching services. As professionals with a depth of knowledge in personal development and goal achievement strategies, therapists are ideal candidates for the coaching profession. Despite this near perfect fit, there are some important ethical consideration for therapists when offering coaching services alongside therapy, or when choosing to become professional coaches. In this post, I focus on offering solutions for these complications, in an effort to help you ethically practice coaching.

5 Step Plan for De-escalating an In-Session couple Argument

Most of us, therapists, have been there: A simple disagreement turns into an all-out screaming match in the middle of a therapy session. This is, thankfully, not a common scenario for most therapists, but it’s also not rare--especially for therapists who specialize in couple therapy.

In this post, I cover steps for disrupting an argument occurring in a couple therapy session. Intervention on the part of the therapist is necessary during some conflicts, because the arguments can cause further damage in the couple relationship. And, if therapists allow arguments to continue for too long, they can affect the couple’s sense of safety when in therapy.

The main goals of intervention in this case are to: