What Makes Marriage and Family Therapy Different?
Here are a few of the main differences between MFTs and other mental health practitioners:
1. MFT is systemic, giving much consideration to how a client both affects and is affected by relationships (present and past) and other factors in their lives. These other factors may include, but are certainly not limited to personal relationship history, medical history, spirituality, history of trauma, habits, addictions, etc.
2. How “client” is defined is different than other approaches: MFTs view “the client/the treatment unit” as being all members of the relational system who are participating in treatment. For example, if you and your significant other are coming for therapy, then the couple is considered “the client/treatment unit.” If you and your significant other and/or one or more of your children are coming for therapy, the family unit is considered “the client/treatment unit.” There are myriad combinations but these are two common examples.
3. Another factor that differentiates Marriage and Family Therapists from other mental health practitioners is that, while it is not uncommon to meet with each spouse individually for his or her own intake session, once standard intake sessions are completed, MFTs generally do not meet with spouses separately.
Divide and conquer is not the rule of thumb here!
Bear in mind that your reason for pursuing marital therapy has to do with a desire to strengthen and heal your marriage. When spouses request to meet individually with the therapist, it is always because of a desire, no matter how sincere or innocent, to form an alliance with the therapist in order for the therapist to see it from that spouse’s perspective. This can make the other spouse feel left out, emotionally threatened and also offended. Therefore, if you/your spouse desire, I will be happy to refer you to a one-onone therapist in order that you may address your own personal needs while continuing to meet with me and your spouse for marital therapy.
Confidentiality
- Regarding entities outside of the treatment unit:
There are standard legal requirements placed on practitioners with regard to sharing clients’ personal and treatment info. Therefore, in order for me to speak with anyone (e.g.: other providers, extended family members, clergy, mutual friends, etc.) with regard to your treatment I am required by law to obtain your signature on a release form. When you desire to give me permission to speak with someone else, each member of the client unit will need to sign a release of info form. Since the couple/family is the treatment unit, when possible, and allowable by the law, I will seek the authorization of all legal adult members of the treatment unit before I release confidential information to third parties.
- Within the treatment unit: “No Secrets” Policy for Family Therapy and Couple Therapy
During the course of my work with a couple or a family, I may see a smaller part of the treatment unit (e.g., an individual, parents alone, siblings alone, etc.) for one or more sessions. These sessions are intended to be an important piece of the work that I am doing to help the entire family or the couple. If you are involved in one or more of these sessions please understand that I may need to share information disclosed during one of these sessions with the entire treatment unit in order to effectively serve the entire client unit being treated. I will use my best judgment as to whether, when, and to what extent I will make these types of disclosures to whole the treatment unit, and will also, if appropriate, first give the individual or the smaller part of the treatment unit being seen the opportunity to make the disclosure. This “no secrets” policy is intended to allow me to continue to treat the couple or family unit by preventing, to the extent possible, a conflict of interest to arise where an individual’s interests may not be consistent with the interests of the unit being treated. Often, information learned in the course of an individual/smaller session is relevant or even essential to the proper treatment of the couple or the family. If I am not free to exercise my clinical judgment regarding the need to bring this information to the family or the couple during their therapy, I might be placed in a situation where I will have to terminate treatment of the couple or the family. This policy is intended to prevent the need for such a termination.
Exceptions:
*Parents & children: Not all disclosures made by parents during their own sessions will be appropriate for sharing with their children. Clinical discernment and sensitivity will be exercised when considering the “no secrets” policy.
*Disclosures made by a minor: When a disclosure regarding safety issues is made by a minor to a mandated reporter, in addition to being required to report the disclosure to legal authorities, that mandated reporter is legally bound to share the disclosure with the parent/guardian, unless doing so poses a significant safety risk to the minor. When applicable, this will always be handled with the utmost sensitivity to the minor’s needs and safety.
Any member of the family may feel it is necessary to talk about their own personal matters with a separate therapist. If so, this sentiment is completely understandable. I strongly encourage you to consult with a different therapist who can focus on your individual needs. Pursuing one’s own individual therapy while also in family therapy is often very beneficial so if this option resonates with you, please do not hesitate to ask for a referral.