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Publications
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Session 1 - Introduction
Brief Couples Therapy: Group and Individual Couple Treatment for Addiction and Related Mental Health Concerns
For this session:
Objectives
Couples will:
- understand the purpose, format and content of the Brief Couples Therapy (BCT) treatment
- introduce themselves and begin to engage with the group
- identify some preliminary short- and long-term goals and expectations.
A safe, comfortable environment will be created through building group cohesion and reinforcing common issues among participants.
Checklist
Guidelines for the counsellor with tips on what to do with or say to the client.
- Therapists Introduce Themselves to the Group
Therapists will introduce themselves and describe their role. This can be a general introduction about who they are, their
responsibilities and their role in helping to facilitate the group.
- Reviewing Participation in the Group—Group Norms and Confidentiality
Safety: “This group is a place where you can start talking about and hopefully solving some of the problems you’re facing
in your relationship. Because people are going to be sharing things, it is important that we all agree that what is said in
the group stays in the group. As you feel comfortable with us and with each other, you may be sharing personal information,
and we want to make it safe for everyone to talk about your issues.”
Confidentiality: “Something that is important for us to talk about is confidentiality. What is said in here stays in this
room. We need your permission to talk to or to release information to others outside of the family treatment team. However,
there are some limits to confidentiality. If you are going to harm yourself or others, or if there are concerns about a child
being at risk for harm, or when records are subpoenaed by the courts, then legally we need to break confidentiality. But aside
from those exceptions, your confidentiality is maintained.”
Contact between Sessions: “This city can be a small place, and we’re asking you please not to have contact with other group
members outside the group while the sessions are in progress.”
Respectful Communication: “A group expectation is that we all communicate in a respectful manner (i.e., no put-downs).”
Timekeeper: “An important part of doing any group is trying to keep everyone focused and to keep us all on track. So we will
be watching the clock and may have to interject from time to time.”
- Client Introductions
Introductions Using an Icebreaker: “In today’s session, we are going to be talking a lot and getting to know one another better.
As a way of starting this, we would like you to [introduce icebreaker].”
Icebreaker Example: “Think about the situation in which you first met and identify a funny or happy memory of that time.”
- Stating the Format and the Rules of the Group
Attendance: “This group will be meeting for about an hour and a half once a week for eight weeks. Please attend all sessions
with your partner and arrive alcohol- and drug-free. We’ll start at ___ p.m. Because the functioning of the group as a whole
relies on input from each of the members, it is important that you commit to coming to every group and that you arrive on
time.”
Format: “The framework for today’s group will be similar to each of the remaining sessions. All of you will have the opportunity
to talk about yourselves and your families in turn. Each week, we will use a different exercise to help you with communication,
problem solving, goal setting and other relationship-building and relapse-prevention skills.”
Roles: “This is your group and you are here to help each other out. Therefore what you have to say to each other is very important.
We (the therapists) are here to help provide a safe environment and to encourage you to participate.”
- Stating the Purpose of the Treatment Group
“The purpose of the group is to help couples with substance use concerns to address the impact that their substance use has
had on their relationship and to identify goals for change. It is also to help you focus on the present, and to have you think
about how you would like your relationship to be in the future. An additional purpose of the group is to provide a supportive
context where participants can benefit from others’ experience and feedback. Aspects of supportive feedback are listening
carefully, taking a non-judgmental position and responding in a clear, brief, specific manner, from an ‘I’ position.”
Hand out the Description of Topics sheet or show a flipchart of the topics that will be covered in the eight sessions.
- Exploring Clients’ Expectations and Concerns
Ask all of the participants to state in turn their hopes and expectations for themselves as a couple during this group and
to briefly describe their drug use history, treatment history and drug use goals. Therapists should encourage clients to focus
on couple-related goals.
- Homework (Genogram/Family Tree)
When handing out folders, instruct participants to keep all homework in their folders and bring them each week.
The symbols used in the Family Tree exercise may be changed to suit the needs of different agencies or clientele. (For example,
we use circles to denote females and squares to denote males; these symbols may not be useful for transgendered or transsexual
clients). Similarly, the sample Family Tree is only one example of a possible family tree that might be used.
Note: Therapists who have not done a genogram/family tree before should do one of their own to gain a better understanding of the
exercise.
Describe the genogram as a “family tree,” and explain its purpose: “We are going to do a type of family tree that can be helpful
for understanding family back-ground and different patterns or issues that may be important in your current relationship,
but that date back to your family of origin. Please use this sample to help you to complete a family tree for your family,
going back to your parents or grandparents if you feel this is important.”
Demonstrate the use of a family tree: Prior to the group, therapists will have copied some or all of the Family Tree example,
or a different example that they made up, onto a flipchart sheet (width-wise if possible). Put up the flipchart example, describe
the different components of the chart and explain the linkages. “We will share your family trees with the group next week,
as a way of getting to know each other better and putting your current relationship into a broader context. Please only include
information you are comfortable sharing with the group; you may have other information you want to share later with your spouse.”
Hand out folder packages: “This will be your folder for you to keep your homework and refer to from week to week. Inside you
will find the Family Tree instruction sheets and a blank flipchart page for your family tree.”
- Check-out
Ask each group member to offer one word, thought or feeling as a check-out for the evening. The therapist may begin with “I
feel hopeful” and go around the room.
Materials
- one package per person, including one folder, the Family Tree example, instruction sheet, blank self-adhesive flipchart page
- Family Tree example on a flipchart sheet
- flipchart, markers
- liquid refreshments
Summary
- Therapists Introduce Themselves to the Group
- Reviewing Participation in the Group — Group Norms and Confidentiality
- Safety
- Confidentiality
- Contact between Sessions
- Respectful Communication
- Timekeeper
- Client Introductions
- Stating the Format and the Rules of the Group
- Stating the Purpose of the Treatment and Group
- Exploring Clients’ Expectations and Concerns
- Homework (Genogram/Family Tree)
- Describe the purpose of the Family Tree.
- Demonstrate using the example on the flipchart.
- Hand out folder packages.
- Check-out
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Tips for Individual Couple Session
There is no group orientation. The assessment and introduction sessions are incorporated into one session. This session may
be longer than other sessions.
Read and follow applicable directions from checklists for both the Assessment and Session 1. Cover the following information
from Session 1 (Introduction):
- Give information about participating in the program, topics, format, rules, confidentiality, hopes and expectations.
- In preparation for Session 2, describe the Genogram/Family Tree and the concept of homework.
- Set the next appointment and hand out the Family Tree for completion prior to the next session.
Brief Couples Therapy
Acknowledgments
Introduction
References
Appendix A: The Background of the Integrative Model
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Centre for Addiction
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