The characteristics of, and practitioner training for, couple therapy Couple therapy' is an enterprise that is subject to pressures analogous to those affecting couple relationships themselves. The needs of the partners as individuals, of children and kinfolk, and of the larger community, all press for attention. The couple relationship being the client, the therapist's task is to manage the tension between competing voices, focusing on others only to the extent that is necessary to assist the partners to evaluate, and perhaps seek to change, influences that affect their capacity to make choices about the nature of their relationship. In England and Wales, therapeutic work with couples was the earliest manifestation of initiatives that have resulted in a wide variety of forms of counselling and psychotherapy being available to the general public today. It remains largely the province of the voluntary agencies which were responsible for introducing and developing it over the past 60 or more years (Lewis et al. 1992). Today, services are offered to those in common law relationships and in lesbian or gay relationships, as well as to married couples and those forming or ending relationships. Work with second and subsequent relationships, and the problems arising in 'blended' families, are a growing part of couple therapists' work. Some couple therapists also offer psychosexual therapy and others staff schemes specifically designed to address domestic violence. Educational programmes preparing people for adult relationships and for parenting have been provided by the 'marital' agencies since their earliest days, often using
ETHICAL THINKING I N COUPLE COUNSELLING AND THERAPY
the skills and insights of couple therapists in their design and delivery. Couple therapy is available in a variety of forms. Brief, solutionfocused couple therapy may involve no more than a single session. Much of the work undertaken by the voluntary agencies is accomplished in about six sessions. More extended work lasting a year or more and based on weekly sessions is provided by some practitioners and is able to address some more intractable relationship problems, the needs of couples coping with mental health issues or a partner's serious illness, or the needs of couples engaged in major life transitions (Carter and McGoldrick 1989). Many couple therapists are willing to work with only one partner, although most casework is conducted with both partners present. The theoretical approaches employed are diverse, as is illustrated by contemporary texts on couple therapy (Jacobson and Margolin 1979; Freeman 1982; Willi 1982,1984; Gurman 1985; Bornstein and Bornstein 1986; James and Wilson 1986; Chasin et al. 1990; Scharff and Scharff 1991; Bockus, 1993; Bubenzer and West 1993; Johnson and Greenberg 1994; Weeks and Hof 1994; Crane 1996; Gilbert and Schmukler 1996;Jacobson and Christensen 1996; Rabin 1996; Butler and Joyce 1998; Brown 1999). While the earliest forms of training in couple work were designed for laypersons with no previous experience of the role of counsellor (Lewis et al. 1992), today's training programmes are increasingly designed for those with some experience of casework. Though no longer limited to the offerings of the major 'marital' agencies (Relate, Marriage Care, Couple Counselling Scotland, Tavistock Marital Studies Institute), such training programmes are many fewer in number than those devoted to the preparation of the various kinds of individual therapist. However, courses currently range from 20-week part-time introductions to marital and couple therapy (London Marriage Guidance) to three-year part-time postgraduate studies leading to masters degrees (Relate). The preponderant theoretical model in the UK is psychodynamic although some agencies have evolved programmes leading to the development of couples practice with an integrative...