Home
Doc LobeTeaching, Learning & Research Firm
Lesson · Counseling practice

Couples and Family Counseling

A family is more than the people in it. Systems thinking asks how each person's behavior fits a pattern the whole family keeps going, and how changing the pattern helps everyone. This lesson covers core systems concepts, the major schools of family therapy from Bowen to narrative, couples approaches such as Emotionally Focused Therapy and the Gottman Method, genograms, safety and ethics with more than one client in the room, and culturally responsive work with families.

Systems conceptsSeven schools of family therapyGenogram plannerCouples approachesLesson plan20-question check
Start here

Thinking in systems

Family systems theory grew from general systems theory and cybernetics. Instead of asking "who caused this?", the counselor asks "what pattern keeps this going?" Tap each card.

Know the approaches

Schools of family therapy

Each school has its own founders, key ideas and techniques. On the exams, match the term to the school.

See also the Theorists: therapies and interventions section and the life-span ecology section.

Practice

Which approach is the counselor using?

Read each moment from a session and pick the school of family therapy it comes from.

Working with couples

Couples counseling

Couple therapy helps with relationship distress and with individual problems such as depression and alcohol use (Carr, 2019; Lebow and Snyder, 2022).

Emotionally Focused Therapy (EFT)

  • Sue Johnson; built on attachment theory.
  • Conflict is a protest against lost connection: a negative cycle, often pursue and withdraw.
  • Three stages: de-escalate the cycle, restructure bonds (withdrawer re-engagement and blamer softening), consolidate.
  • One of the best-researched couple therapies (Wiebe and Johnson, 2016).

The Gottman Method

  • John and Julie Gottman; built on observational research with couples.
  • The "Four Horsemen" predict breakup: criticism, contempt, defensiveness and stonewalling. Contempt is the strongest predictor.
  • Antidotes: gentle start-up, building appreciation, taking responsibility and physiological self-soothing.
  • Stable couples keep about five positive interactions for every negative one during conflict.

Other approaches

  • Integrative Behavioral Couple Therapy (Jacobson and Christensen): acceptance plus change.
  • Imago Relationship Therapy (Hendrix): structured dialogue.
  • Discernment counseling: for couples where one partner is leaning out.
  • Prevention programs such as PREP teach communication skills.
Build it

Genogram planner

A genogram is a family tree that shows relationships and patterns across at least three generations (McGoldrick, Gerson and Petry). Plan one for a fictional or case family. Do not use real client information here. In class, sharing your own family history is optional.

Standard symbols

Squares for males, circles for females, a circle inside a square or another chosen symbol for nonbinary people, an X for death, a horizontal line for marriage or partnership, slashes for separation and divorce.

Relationship lines

Close, fused, distant, conflictual and cut off. Show triangles, alliances and who lives together.

Patterns to look for

Repeating roles, losses, migrations, illness, substance use, strengths and resilience across generations.

More than one client

Ethics and safety

Who is the client?

  • The ACA Code (A.8, B.4.b) asks counselors to clarify at the start who the client is, the counselor's relationship with each person, and the limits of confidentiality.
  • Agree on these in writing at informed consent.
  • The IAMFC ethical code gives added guidance for couple and family counselors.

Secrets policy

  • No-secrets policy: what one person tells the counselor alone may be shared in joint sessions.
  • Limited-secrets policy: the counselor keeps individual disclosures private but may help the person share them.
  • Explain the policy before any individual session.

Screen for violence

  • Screen each partner for intimate partner violence alone, not in front of the other partner.
  • Joint sessions are not recommended when there is ongoing violence, coercive control or fear of a partner.
  • Put safety first: safety planning, referrals and individual work. National Domestic Violence Hotline: 1-800-799-7233.
Culturally responsive practice

Every family has a culture

Who counts as family, who makes decisions and how feelings are shared differ across cultures. Systems ideas were developed mostly with white, middle-class families, so test them against each family's reality.

Extended and chosen family

Many Black, Latino, Asian, Indigenous and immigrant families include grandparents, aunts, godparents, church family and fictive kin. LGBTQ+ clients may center chosen family. Ask "who is in your family?" instead of assuming.

The multisystems model

Nancy Boyd-Franklin's work with Black families looks at the family together with church, school, courts and agencies, and builds on strengths such as kinship networks and spirituality.

Acculturation gaps

Children often adapt to a new culture faster than parents, which can shift roles and spark conflict. Link this to Berry's acculturation model.

Name racism and oppression

Kelly and colleagues (2020) call on couple and family therapists to address racism and racial trauma directly as forces that shape family life.

Watch and read

Videos and recent research

Videos and peer-reviewed articles published in 2016 or later. Links need an internet connection.

Videos

The secret to desire in a long-term relationshipEsther Perel · TEDSalon NY2013

A couples therapist on balancing security and closeness with freedom and desire.
Love, no matter whatAndrew Solomon · TEDMED 2013

How families adapt to children who are very different from their parents.

Peer-reviewed articles

  • Carr, A. (2019). Couple therapy, family therapy and systemic interventions for adult-focused problems: The current evidence base. Journal of Family Therapy, 41(4), 492–536.What the research shows for relationship distress, depression, alcohol use, psychosis and more.https://doi.org/10.1111/1467-6427.12225
  • Carr, A. (2019). Family therapy and systemic interventions for child-focused problems: The current evidence base. Journal of Family Therapy, 41(2), 153–213.The evidence for family approaches to children's and teens' problems.https://doi.org/10.1111/1467-6427.12226
  • Wiebe, S. A., & Johnson, S. M. (2016). A review of the research in emotionally focused therapy for couples. Family Process, 55(3), 390–407.Outcome and change-process research on EFT.https://doi.org/10.1111/famp.12229
  • Lebow, J., & Snyder, D. K. (2022). Couple therapy in the 2020s: Current status and emerging developments. Family Process, 61(4), 1359–1385.Where couple therapy is today, including diversity and telehealth.https://doi.org/10.1111/famp.12824
  • Kelly, S., Jérémie-Brink, G., Chambers, A. L., & Smith-Bynum, M. A. (2020). The Black Lives Matter movement: A call to action for couple and family therapists. Family Process, 59(4), 1374–1388.Addressing racism and racial trauma in work with Black couples and families.https://doi.org/10.1111/famp.12614
For instructors

Lesson plan preview: The family as the client

A ready-to-teach lesson where students build a genogram, practice approaches in family role-plays and plan for ethics and safety.

Quick check

Test your understanding

Twenty questions. More in Counselor Exam Prep.

Sources

References

  1. American Counseling Association. (2014). ACA code of ethics. (Check counseling.org for any newer edition.)
  2. Boyd-Franklin, N. (2003). Black families in therapy: Understanding the African American experience (2nd ed.). Guilford Press.
  3. Carr, A. (2019). Couple therapy, family therapy and systemic interventions for adult-focused problems. Journal of Family Therapy, 41(4), 492–536.
  4. Carr, A. (2019). Family therapy and systemic interventions for child-focused problems. Journal of Family Therapy, 41(2), 153–213.
  5. Gottman, J. M., & Silver, N. (2015). The seven principles for making marriage work (Rev. ed.). Harmony.
  6. Johnson, S. M. (2019). Attachment theory in practice: Emotionally focused therapy (EFT) with individuals, couples, and families. Guilford Press.
  7. Kelly, S., et al. (2020). The Black Lives Matter movement: A call to action for couple and family therapists. Family Process, 59(4), 1374–1388.
  8. Lebow, J., & Snyder, D. K. (2022). Couple therapy in the 2020s. Family Process, 61(4), 1359–1385.
  9. McGoldrick, M., Gerson, R., & Petry, S. (2020). Genograms: Assessment and treatment (4th ed.). W. W. Norton.
  10. McGoldrick, M., Giordano, J., & Garcia-Preto, N. (Eds.). (2005). Ethnicity and family therapy (3rd ed.). Guilford Press.
  11. Wiebe, S. A., & Johnson, S. M. (2016). A review of the research in emotionally focused therapy for couples. Family Process, 55(3), 390–407.