CC24 Workshop 07 - What Not To Say In Couple Therapy - William Doherty, PhD

Although nowadays we have great models of couple therapy, therapists can become pessimistic in working with difficult couples—and inadvertently send messages that undermine their relationships. Based on a new research study with clients who have been in couple therapy, this presentation will describe things to generally avoid saying to couples about their relationship and its prospects for repair. The workshop will offer a mindset for staying positive with couples and a set of skills for handling therapeutic impasses without resorting to making comments that undermine the therapy and the couple relationship.

Learning Objectives:

1. Identify therapist comments in couple therapy that are associated with poorer outcomes.
2. Discuss why these comments are generally not productive and an be harmful.
3. Describe ways to maintain a positive mindset with challenging couples and deal with therapeutic impasses in a constructive way.

Outline:

• Workshop Overview

  • Interactive workshop, focused on mistakes therapists make in couples therapy.

  • Compares harm in therapy to harm from medical errors.

  • Audience included both seasoned professionals and newer therapists.

• Challenges in Couples Therapy

  • Difficulties: balancing two clients, navigating dishonesty, and managing power dynamics.

  • Establishing alliance with both partners is complex.

  • Risk of therapist frustration leading to harmful comments.

• Unhelpful Therapist Statements

  • Common examples: “You don’t belong together,” “You should do individual therapy,” or blaming one partner.

  • These statements can damage trust, derail therapy, and increase divorce rates.

• Research on Harmful Comments

  • 10–21% of clients report hearing relationship-undermining comments.

  • Suggesting individual therapy instead of couples therapy was most common (40%).

  • Associated with lower satisfaction and higher breakup rates.

• Managing Therapist Frustration

  • Causes: countertransference, lack of training, and difficult dynamics.

  • Solutions: stay client-centered, address issues early, and maintain neutrality.

  • Use supportive language even when safety or boundaries require referral.

• Errors of Omission

  • Allowing lies (e.g., affairs) to persist in therapy undermines integrity.

  • Encourage honesty while staying nonjudgmental.

  • Use gentle confrontation techniques like “one down” positioning.

• Problems with Individual-Only Focus

  • Critiques therapists who avoid tough couples work by suggesting breakups.

  • Recommends both individual and couples work, rather than either/or thinking.

• Systemic Framing in Therapy

  • Therapists should validate both partners’ narratives without blame.

  • Importance of thinking relationally, not individually.

  • Therapists should refer cases if they can't maintain a systemic lens.

• Training and Self-Care

  • Not all therapists are suited for couples work—honesty about limits is essential.

  • Training should caution against premature pessimism.

  • Case consults help preserve hope and prevent burnout.

• Final Reflections

  • Audience shared surprise at how often therapists undermine couples.

  • Clients fear being told to separate—therapists must use caution with such messages.

  • Misuse of research (e.g., on contempt) can lead to poor guidance.

  • Participants emphasized supporting couples through challenges and maintaining hope.

• Key Takeaways

  • Avoid unhelpful or overly pessimistic comments.

  • Think systemically, not individually.

  • Prioritize professional growth, supervision, and thoughtful client referrals.

  • Maintain active engagement and respectful, hopeful communication.