Saturday, February 8, 2014


Learner therapist (41)…… Creating a couples work agenda through shared needs and wants

Torrey Orton
Feb 8, 2014

 

Guidelines for partners (and therapists)

What follows is a self-administered exploration process for couples. The purpose of this paper is to guide them through the process. It may also be used by therapists in session where it is necessary that a therapist direct the process to provide the discipline for focussed work. It is the fifth in a set of couple technique papers under the “Learner therapist” header at www.diarybyamadman.blogspot.com.*

Rationale: couples work is notoriously difficult because the stakes are high and the aggregated injuries, flashpoints and communication incompetences are often close to immovable in the eyes and hearts of couples by the time they show up for therapy. Functionally, a lot of shared ground has been lost or forgotten or lies obscured in the smoking residue of repeated failures to have needs met. The creation of actually shared ground, including the ground of their unmet needs, is an essential anchor for any new efforts to relate more effectively.

Objective: to develop a detailed, specific assessment of the needs and wants the couple has of each other as a basis for starting negotiation of those needs/wants in a manner which models shared ownership and conduct of the exploration process and models a process for developing agendas between them. This technique is particularly useful when the couple cannot start anything without descending into uproar - noisy or silent; hot or cold war!

Principles: that all needs/wants of both persons are included in the initial stage of the process; that respective needs and wants reflect the individuals’ thinking style expressed in their natural language; that engagement of the needs/wants is put off until the most thorough lists possible for the couple are completed; that clarification of meaning only is allowed in the list creation stage; that the agenda has to be chunked down to a workable bit in a context which assures that other bits are kept in view; and, that two levels of management are required – managing the whole process (decisions about what they are doing, how, when, etc.) and doing the work agreed to – exploring understandings, feelings, needs, etc. The first level is the most important, because it is what is missing from their processes: joint management.

1 - Process steps: in rough language that could be used with patients

a) Create a list of your wants and needs of the other and what you imagine he/she needs and wants of you in a format like this – do not consult your partner’s list until you both have finished your own lists.

 
Mine
His/hers
Wants
 
 
 
Needs
 
 
 

 

b) Share your lists, clarifying items as necessary. Do not engage the items yet. Rewrite them if necessary to acknowledge any clarifications. Notice shared knowledge of each other’s needs/wants.

c) Create a shared list out of the two individual lists, without leaving anyone’s items out unless you both agree they are essentially the same. Resolve any dispute by keeping disputed items in the list. Where differences seem merely linguistic keep them in the list because language differences often reveal differences of perspective, value, intensity, etc.

d) Order the list from most important to least, with emphasis on the order of the first 4-5 items. These will provide the starting point for in-session work, preferably one item you both want to start with.

e) Send the joint list to the therapist before the next session.

f) If you cannot do steps b, c, d, or e tell the therapist so and the session will start from step a. In that case, send both lists separately to the therapist and bring copies of your own to the session.

2 - Process management steps in session one – therapist directions

a)      Set out the objectives, principles, and steps of the process and provide background papers (e.g. Needs and Wants here)

 

b)      Check clarity, appropriateness and, then, agreement to this process.

 

c)      Continue checking these aspects of the process as you work through the steps

 

d)     If doing the joint list from nothing live in session, set out the process as above and then take items one at a time from one person and then the other and back again, writing them up on a whiteboard or chart in the language the person uses themselves; do not summarise in your own words without agreement of the speaker.

 
Check that each item is clear to the other as you write them up and stringently do not allow any exploration of the items at this step; this usually requires stopping any counter-assertions or exploratory questions; allow only clarification at this time (Eg - Can you give me an example of…?).

This will often take a whole session. They take away the results for further additions, ordering and selection of the starting point issue for the next session.

 

e)      Before finishing this session point out that they have just experienced a way of handling their continuing development agendas and suggest they use it at home.

 

f)       The next session is the beginning of practicing approaches to managing the systemic communication dysfunction and developing increased communication effectiveness and problem solving by working on live issues of concern to the couple. The need to engage the issues provides the focussed motivation to try new skills and test new attitudes.





My experience is that these short posts are quite readable by patients, so I often offer them as part of their preparation.

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