Abstract
The integrative model of couples counseling begins with a specific technique called identifying an interactive definition of the problem. This technique involves specific steps that clinicians can use to reduce blame, unite the couple under a common definition of the problem, and develop a reframe to enhance commitment and engender hope. The authors include an illustrative case study.
Mark E. Young and Lynn Long developed the integrative model of couples counseling in the 1990s. It is the basis for their book, Counseling and Therapy for Couples (Long & Young, 2007; Young & Long, 1997) which presents a simple step-by-step method for counseling couples that is easily learned and taught. It is an integrative model because it brings together elements of solution focused, narrative, and brief therapy approaches. The model itself has been the subject of research (Young & Carlson, 2011) and initial data analysis for approximately 200 couples supports the integrative model as an effective treatment when compared with psychoeducational methods (Young & Daire, 2010).
The centerpiece of the integrative model is a technique called identifying an interactive definition of the problem. This technique, which we also call “the big reframe,” is employed in the first or second session and involves persuading the couple to see their individual complaints as one and the same issue. The technique was developed to overcome three persistent and crucial problems in the initial stages of couples work, getting “buy-in,” reducing blame, and eliciting hope. Very often, one partner has a complaint about the other, and the initial session focuses on the airing of grievances. This pushes the complained-about partner away from involvement and casts the complainer as victim. The blame-fest that characterizes many first sessions leads to discouragement and premature termination. The only motivation to continue in counseling, for the blamed partner, is to satisfy the unhappy member of the couple. If the counselor can help the couple agree upon a joint definition of the problem which has something to offer both members of the couple, the estranged partner is more likely to buy in and contribute to the process.
The following simple example illustrates this technique of bringing the couple together on a collaborative definition of the problem. Partner A of the couple complains that the Partner B works too much and that they never spend time together. Partner B complains that Partner A finds fault and nags, making their time together unpleasant. For the beginning counselor, it seems obvious that each member of the couple just needs to be more flexible. Partner A should work less and B should stop nagging; A + B is the obvious solution. In our experience, however, this does not produce buy-in nor stem the tide of blaming. Both partners still feel that they are doing something wrong.
In contrast, the interactive definition bypasses each partner’s complaints and tries to find a common element in each person’s concerns. The interactive definition is a statement, devised by the counselor, which becomes the basis for the initial treatment plan. In the example mentioned previously, the counselor offers the following interactive definition of the problem to the couple: “It sounds like you both want to find a way to get closer.” Note that each member’s complaints have been reframed as something the couple can do together to improve their relationship. Like the miracle question, the interactive definition focuses them on the future rather than the problem-saturated story. To reiterate, this big reframe is supplied by the counselor and not elicited from the couple. The counselor is typically more objective and thus able to assist the couple in finding common ground. Through practice with the technique, counselors eventually learn to find the common goal in the confusing mix of issues that couples throw out.
What if the couple cannot agree to the counselor’s interactive definition? If either member of the couple cannot buy into this definition, the counselor spends more time trying to understand each person’s concerns or conducting further assessment until a mutually acceptable definition of the problem is formulated. Frequently, the counselor must offer several reframes before finding one that produces buy-in for both members. If an interactive definition of the problem still cannot be constructed, then individual counseling may be the answer. This fits with Gottman’s (1979) idea that one of the first tasks of the counselor is to decide who is going to attend the counseling session. The interactive definition of the problem helps counselors make this decision by determining whether the problems are primarily interactive (interpersonal) or individual (intrapsychic).
Steps in Developing an Interactive Definition of the Problem
There are three steps in constructing an interactive definition of the problem: (a) understand each person’s definition of the problem; (b) complete an assessment of individual and couple functioning; and (c) create an interactive definition of the problem through a big reframe. The first step involves asking each person to talk about his or her concerns. Time is given to each member of the couple to describe, without interruption, that person’s perspective on what is going wrong. This may seem obvious, but it is frequently missing in initial couples counseling sessions. Providing time for each person to tell his or her story establishes neutrality, helps each partner feel heard, and allows the counselor to model nonjudgmental listening.
The next step is conducting a thorough assessment of the couple’s background and current functioning. Particularly important in this assessment stage is identifying issues that could undermine success such as (a) dangerous behaviors including suicidal ideation, intimate partner violence, addiction or emergent psychiatric issues; (b) lack of commitment to the couple relationship; and (c) hidden or unresolved resentments from the couple’s history. In essence, the purpose of history taking is to identify obstacles and prevent disasters rather than to establish goals.
The final step in the interactive definition technique is asking the couple to look at their problem through a different lens. The counselor finds the underlying similarities in each member’s version of the problem and provides a big reframe. Although the counselor initially identifies the goal, it is based on the couple’s stated problems and must be accepted by both of them. Moving so quickly to goal setting is based on our experience that many couples arrive demoralized and angry. Therefore, less time should be spent on discovering the roots of the problem and more emphasis placed on bringing them together on a common project. It is not essential that they begin with the right goal but that they begin and that they begin together. In the next section, we describe how this works in practice.
Case Study
Tana (66) and Keith (64) have been married for 40 years and are experiencing some marital strife since Keith’s retirement 5 months ago. Tana retired 3 years ago from her job as a nursing assistant and initially spent much of her time taking care of her aging mother. Tana’s mother died approximately 8 months ago, and although she grieved the loss, she was also excited by the thought of having more free time to spend with her husband. She spent the 4 months before Keith’s retirement planning trips and identifying hobbies and activities they could engage in when they were both retired.
Just before he retired, Keith experienced a health crisis that made him reexamine his life. When he recovered, he was committed to finishing out his final months of work even though he hated his job. He resented, however, that he had spent much of his life in a job which was not his “true calling” and which he had persisted in because of his family obligations. He was sad that his relationships with their sons were not as good as he would have liked. In short, he believed that his life had been wasted.
In the 4 months after his retirement, he went with Tana on various short trips and to community gatherings, but she found him irritable and abrupt. Tana felt hurt and confused by Keith’s behavior and was unsure of what to do, as this is the first time he had behaved like this in their marriage. Keith felt angry at his inability to overcome his feelings of failure and was not sure how counseling would help the situation.
Tana finally convinced Keith that they should come to couples counseling, yet she doubted that he would stick it out. In the first session, she indicated that she appreciated his willingness to come despite his reluctance. Keith indicated that he did not agree with Tana’s concerns but said that he loved Tana and wanted to make her happy, so he was willing to attend counseling. Tana stated that she tried to stay positive and encourage Keith despite his bad attitude, but she was getting tired of being a cheerleader.
The counselor began the session by allowing Keith and then Tana to each explain how they experienced the current situation. Tana identified the problem as not being able to find ways for her and Keith to interact. She felt that she could not be happy in retirement if he were miserable. Keith, on the other hand, said he felt controlled and needed to find his own way through this and to develop some meaningful contribution to the world, not just survive. He felt guilty for making Tana unhappy.
Before formulating an interactive definition, the counselor asked the following questions: (a) “Keith and Tana, how did you imagine your retirement would be?”; (b) “Keith, tell me about the health scare you had and the insights that came after?”; (c) “Tana, how are you coping with Keith’s health scare?”; and (d) “How has it changed your view of how you both should spend time together?” In addition, the counselor assessed for substance abuse, violence in the relationship and also evaluated Keith’s depression.
The assessment and a deeper understanding of the couple’s presenting issues helped the counselor develop an interactive definition. The counselor’s initial reframe of the couple’s problem was as follows: “Your concerns about making the other person happy are interfering with developing a retirement plan you both can live with.” Note that the counselor did not attempt to deal with Keith’s individual existential issue as one of their goals. Instead, the counselor referred Keith to individual counseling. In the week between counseling sessions, the couple was urged to think about the interactive definition of their problem and whether or not this was an important enough issue to try and solve. In the next session, Keith and Tana came to agree on the following refinement of the interactive definition: “We are unsure of how we want to spend this phase of our life and need to develop our relationship as a couple as well as our individual interests so that we can feel closer, and allow the other person to grow and enjoy life.”
Conclusion
According to Doherty (2002), couples work is the most difficult specialty in counseling. Thus, regardless of their clinical experience with individuals, all counselors need a place to start and a way to begin working with couples. The big reframe, an interactive definition technique, offers a way to avoid some initial pitfalls that discourage both counselors and clients. These include lack of “buy-in” by one member, time wasted in blaming, and demoralization that leads to dropout. By reframing their complaints and discovering the underlying joint goal, counselors can help the couple get on the same page from the very beginning of counseling. Although finding an interactive definition of the problem is part of a larger system (the integrative model of couples counseling), it can be used independently as way of forming the initial strategy for brief couples counseling and in conjunction with other approaches.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.