Monday, October 28, 2013

Goal-Setting in Marital Counseling (2)

I've already done a little summarizing of Stone's Strategies for Brief Pastoral Counseling.  Here's a summary of chapter 10:

Chapter 10: "The Necessity of Goal Setting and Counselor Flexibility in Efficient and Effective Couples Counseling"

This chapter starts with the assumption that a pastor must be careful with time management in the local church. The assumption is that most pastors will not have more than 10 hours a week to give to counseling. If you have one wedding a month, you might have 4 pre-marital counseling sessions. If you have one funeral a month, you might take up 4 hours that month to care for those who are left behind. If you have some individuals or couples you regularly meet with to counsel, it will be easy to fill up those 10 hours.

In this chapter, Frank Thomas focuses on a strategy in marital counseling that does not focus on past causes of problems but on what is potentially useful in their situation. What experiences, skills, and resources do they have? What can they actually do to alleviate their problems?

Thomas gives several basic principles for a “competency-based” type of counseling for relationships. One assumption is that change is inevitable. Most people engage a marital counselor because they are “stuck”. People tend to describe their situation in a static way, as if something is always happening a certain way or the state of their relationship is always a certain way. Movement can happen if they can identify exceptions—instances when the irritation was not happening or they were not thinking about that “state” of the relationship.

Counselees should set their own goals for counseling. Their motivation will be higher when they are headed in a direction they want to go. They should take a small, positive step as soon as possible.

“In pastoral care and counseling, carefully timed meetings that focus on what is changeable in the present and future are more effective than long-term, continuous counseling focused on the intractable past” (141). Focusing on the past may even make a situation more overwhelming. By contrast, the future can offer hope. “Efficient pastoral intervention seizes the moment of motivation, engages the couple’s resources, and establishes momentum.”

The chapter focuses on three basic principles in short-term marital counseling. The first is that brief counseling is not inferior to long-term counseling. Not only does the research indicate both to be comparable in effectiveness, but most counselors are not going to get a long-term commitment from their counselees anyway. The typical duration of counseling in a local church setting is two or three sessions. In short, no matter what you think the ideal is, you probably will only get time for brief counseling.

The second principle is goal-setting. Thomas considers goal-setting one of the most crucial tasks of a brief counselor’s “to do” list. Such goals must be important to those who are being counseled and should not be compromises. The goals need to be mutual so that both are motivated. So a commonly agreed goal might be to argue less rather than to fix a specific issue about which one or the other spouse tends to argue.

Goals should result in something positive rather than the absence of something negative. A future of “staying sober” is more likely than one of “not drinking”. So if the goal is “fighting less”, what would the couple be doing instead? What are they doing when they are not arguing?

Goals need to be small and focused on the beginning, not on the end or on the long term. It is obvious that goals need to be realistic—and realistic in the minds of everyone involved. “The surest way to continue a couple’s pattern of failure is to set a lofty standard for success that cannot be achieved incrementally” (144). The goal of “handling our disagreements more positively” is far more likely than “never arguing again”.

Goals need to be concrete, specific, and should have to do with behavior. The goals need to be observable to both individuals and the counselor (not in attitudes that you cannot see). It is important for feelings and ways of thinking to change too, but they are much harder to observe.

A final key principle is flexibility on the part of the counselor. Pastors need to be prepared to meet the needs of the people they counsel with a variety of responses. “It is the soul of wisdom to resist enshrining any single model or approach to counseling” (145). Empathy with counselees and showing that you value them is perhaps more important for success than a specific method. The counselor tries to relate to each member of a couple, one at a time, with respect and curiosity.

Flexibility is essential because there is no “normal” counselee, no “one size fits all”. The counselor must not start with pre-conceptions about what should happen but to connect with the couple and draw the necessary information from their conversations. The couple decides when they have achieved enough and whether they will return for more sessions.

This chapter ends with two case studies. The first involved a couple who only could agree that they needed help with their sex life. He wanted everything planned. She wanted everything spontaneous. Beyond the basic problem, they could not agree on any goals. The goal of one worked against the goal of the other. They both identified moments of “exception”, when the problem was not there, but these moments conflicted with each other. An encounter one considered an exception to the problem was the problem for the other.

One week, the counselor asked them not to talk about sex, just to do. That week was worse for both of them. The next week, he asked them not to have sex unless both agreed on every aspect of the encounter. He also had them separately write down “great little moments” so he could get a better feel for what both considered pleasant. He was following adages like, at times, “inaction may be the highest form of action” (148) and “The first rule of holes: When you are in one, stop digging” (149). He asked them only to talk about successful sexual experiences and only to offer ideas if one of them believed the idea could not fail. They found the metaphor of holding hands on a foggy road—he couldn’t see much to analyze and she could enjoy focusing on the next few yards ahead.

The second case study involved a divorced couple that was thinking about getting back together. He had an affair for six months after nine years of marriage, and they had divorced after fourteen years of marriage when she had found out. He had also made some bad business decisions that had hurt the family. The short term goal was to assess the direction and motivation they had to put the marriage back together.

During the second session, the counselor asked the former husband if he would leave the room for a moment and he agreed. The counselor asked her on a scale from one to ten, how motivated she was to get back together. She answered a three.

When he returned, the former husband was surprised to find her motivation so low. They both agreed on a pattern in their relationship. He pushed hard and she usually capitulated to his demands. The counselor met with her for a few more sessions. She was able to pay her bills, be a parent, and even thrive without him. A primary conclusion is that she would need to make significant movement in healing the hurt from the affair before she could even entertain the idea of remarriage.

The couple continued to meet and discuss their differences, but now they did so as equals. She was exhilarated by the thought of a future where she had a voice in the direction of her life—with or without her former husband. One of her most important insights was that she could only change herself. She could not change the past and she could not change her former husband.

The couple at that point continued to move forward on their own and the goal of the counseling session was achieved, namely, to assess the direction and motivation to get back together.

1 comment:

Susan Moore said...

I see myself, at times, as being a counselor of the people I meet on the streets and buses. You know my growing up was chaotic and that I suffered with PTSD for 38 years. The PTSD turned any sense of time into a slurry of past and present with no conception of the future other than knowing that the future wasn’t here yet. But then God healed me of the psychosis, and time took on meaning.
As a nurse I worked a lot through nursing agencies, and also as float or per-diem staff, so I rarely had the same patients for more than one shift. So although I may have gotten to know them and cared for them, but if I was to influence them at all I learned that I had only that one encounter to do so.
Now I meet people on the street and bus I rarely see again. They spill their hearts out sometimes, and wait for me to respond. I know I am a seed planter. So I pray and wait for the Spirit to guide my actions and words. And then we part ways and move on.
I’m taking the undergraduate course in Pastoral Care and Counseling, a class I have been eagerly waiting to take. I see myself doing pastoral counseling in the future but, to be honest, no matter how hard I try, I cannot imagine seeing a person more than one time. I’m not saying I would refuse, just that my mind can’t comprehend what that would be like. I mean, absolutely no perception of what that would be like. I’m not sure what that means in regards to becoming a pastoral counselor, or if that is something that will take care of itself over time. I’ve been healed for almost 5 years.