Although the purpose of couples therapy is to address issues within the couple dyad, incorporating individual sessions with the group sessions can be beneficial. Partners are likely to talk more freely without the other partner present, therefore making the information gathering phase of couples therapy much more efficient and effective. In addition, during the therapy process issues within each person may be uncovered, making individual therapy a more appropriate venue for that particular issue.
However, if individual sessions are to be done by the same therapist that is doing the couples therapy, special consideration must be given to confidentiality. Specifically, how should a couples therapist handle a secret? What if one partner tells the therapist something in confidence during the individual session? Does the therapist hold the secret or must it be revealed to the partner? Every couples therapist has to decide what his or her policy is and communicate it from the very beginning of therapy.
The therapist has four basic choices. They can opt for full, partial, or no confidentiality for the individual sessions, or they can opt not to do individual sessions.
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Full confidentiality. Some couples therapists believe in full confidentiality for the individual sessions. There are both benefits and drawbacks to this position. Some therapists believe that the only way clients will be completely honest with you is if they are guaranteed full privacy. And the more useful information the client is able to provide, the easier it is to help them.
On the other hand, if people know they aren’t going to be held accountable for what they say in their individual sessions, doesn’t that create a situation in which they would be more tempted to attempt to manipulate the therapist? On the other hand, by telling both partners up front that anything they share in an individual session that affects the relationship is fodder for future couples sessions, they know they will be held accountable. So, perhaps the benefit is not really a benefit after all.
The drawbacks? With the assurance of complete confidentiality, a client may reveal something he or she doesn’t want is partner to know. If this occurs, then of course the therapist must keep this information secret. Which now means the therapist is keeping a secret to benefit one partner but possibly to the detriment of the other. Power is also unbalanced, because now both the therapist and one partner know this information, but the other partner does not. It is very possible that the partner left in the dark will perceive an alliance between the therapist and the other partner, which is very detrimental for couples therapy. Couples therapists have allegiance to the couple. Not any individual. It is the couple that has sought help, not the individual.
- Partial confidentiality. The therapist may choose to keep some secrets, but reveal others. Usually, things that don’t directly affect the couples’ relationship, or that would serve no benefit to the partner, are not revealed. Things that affect he couples’ relationship, or could influence the partner on whether to stay or go, are revealed. An example of a confidential item would be details of past sexual abuse. An example of an non-confidential item would be an affair. This position allows for some of the benefits of confidentiality without most of the drawbacks.
- No confidentiality. With this position, the therapist does individual sessions but does not guarantee any confidentiality. The risk of this position is that the partner may be unwilling to share certain details, such as an affair, so the individual session may not be as effective and informative as it should. The partner may also be unwilling to discuss a personal issue in depth if they think all of the details will be revealed to their partner. The other problem is if a partner does reveal a secret (despite you making your policy very clear up front) that they want you to keep. Your choice then is to either break confidentiality or end the couples therapy. Neither option is optimum. The benefit, however, is that the therapist does not risk alienating a partner by keeping a secret.
- No individual sessions. Here, the therapist never has to worry about what to keep secret, since all meetings are done with the couple. However, since no space is created separate from the partner there is the risk that the therapist will not get all of the information he or she needs. A good example of this is when there is domestic violence. In the presence of the abusing partner, the abused may not feel safe telling the therapist about the abuse. Yet, this is vital information for the therapist.
Yours in the Joy of Knowledge,
Barbara LoFrisco
