Premarital counselling

With divorce rates approaching 50% of marriages within the first 15 years, couples preparing for marriage are keenly interested in how to best prepare for marriage (Williams, 2007).  This blog will discuss the core content areas to cover in premarital counseling and the interventions therapists use. Additionally, we must pay attention to how to implement these interventions in an ethical and culturally-sensitive manner.
Core Content Areas in Premarital Counseling

• Couples communication skills: One of the most preferred elements of premarital counseling is to help couples learn how to communicate more respectfully and effectively (Tambling & Glebova, 2013). Individuals learn how to identify their needs and to express them in ways that do not trigger their partner’s defensiveness. They also learn how to empathically respond to their partner’s needs and promote a positive interaction (Williams, 2007).
• Conflict resolution skills: another one of the most preferred elements of premarital counseling is teaching couples how to effectively manage conflicts (Tambling & Glebova, 2013). One technique is the speaker-listener technique, whereby the speaker follows rules about “I” statements and asking for needs while the listener validates and empathizes with the speaker (Williams, 2007).
• Exploring expectations: couples are given questions to answer regarding areas like sexuality, children, spending time together, communication, and decision-making, facilitating a conversation about differences that emerge. These expectations can be discussed using active listening and problem-solving strategies designed to minimize conflict in the future (Williams, 2007).
• Fostering commitment: couples are encouraged to think about their marriage with a long-term focus in order to be more proactive, rather than reactive. Couples may also learn about nurturing the friendship part of their relationship or finding common interests (Williams, 2007).
• Sexuality: couples learn to separate sexuality from sensuality, explore sexual preferences, explore sexual myths, and discuss managing possible jealousy. It should not be assumed that individuals have had adequate sex education or experiences (Williams, 2007).
• Exploration of self: couples examine their personal development and family of origin to become aware of how their past may influence their marriage. This journey can help identify triggers, patterns, and learning from the past. Additionally, it can reduce conflict by decreasing defensiveness and increasing awareness (Williams, 2007).

Interventions for Premarital Counseling

• Premarital inventories: an assessment of a couple’s strength and areas for growth, which are designed to facilitate dialogue between the couple. Three researched inventories are PREPARE, FOCUS, and RELATE (Williams, 2007). I typically use the Gottman assessment, which is done online.
  
• Skills-based programs: these programs both teach communication and conflict resolution skills and help participants practice those skills with coaching (Williams, 2007). The essential element is letting participants attempt to use the new skills while being coached to shape the communication more effectively. Tambling & Glebova (2013) found that 66% of participants in their study considered discussion time with their partner to be an essential part of premarital programs.
• Relationship history: this intervention can help uncover differences in expectations, core beliefs, and triggers, which can be identified as necessary to go through the communication and conflict resolution process. These are the issues that may keep coming up for your clients, and they will need to learn how to manage them ongoing. Gottman and Silver (2013) report that 69% of couple issues are unsolvable.
• Genograms: this intervention can be helpful in identifying family-of-origin issues and triggers that may need to be discussed.
• Solution-focused: this framework for premarital counseling stresses the importance of a shared vision for their future marriage. With this vision, couples then develop strategies that will lead them toward their vision. This intervention attempts to activate the skills and resources couples already have, rather than focusing on the past or teaching new skills (Murray & Murray, 2004).  

Five Questions to Consider for Cultural Sensitivity

1. If a couple identifies as LGBTQ or non-heteronormative, are there additional issues that need to be investigated, like relationship stressors due to social discrimination? And have the interventions been evaluated with non-heteronormative samples? Most traditional interventions have been validated with heterosexual cis-gender participants, so we need to choose your interventions appropriately (Casquarelli & Fallon, 2011).
   
2. Due to LGBTQ bias in society, this population may typically receive less social and community support (Casquarelli & Fallon, 2011). Ask the couple about their social supports and help them connect to local supports if needed.
   
3. Is there a way to can recruit same-sex mentor couples to give new couples an opportunity to discuss issues related to sexual orientation? Casquarelli and Fallon (2011) suggested that this inclusion is necessary given the specific needs of the LGB partners.
   
4. I have a responsibility to my clients to reflect on all biases which can include internalized ones. Are members of a couple carrying thoughts of stigma within themselves, which can turn into shame?
   
5. Do not assume I know which terms the clients are most comfortable with. I need to ask you about the meanings of each word and you should be given an opportunity to choose their preferred terminology.
   

If you are engaged or thinking about getting married, consider a pre-marriage session or two to help get you ready and avoid the common pitfalls that lead to separation.
References
Casquarelli, E. J., & Fallon, K. M. (2011). Nurturing the relationships of all couples: Integrating lesbian, gay, and bisexual concerns into premarital education and counseling programs.  Journal of Humanistic Counseling, 50, 149-160.
Gottman, J., & Silver, N. (2013). What Makes Love Last? New York, NY: Simon & Schuster.
Murray, C. E., & Murray, T. L. (2004). Solution-focused premarital counseling: Helping couples build a vision for their marriage. Journal of Marital & Family Therapy, 30(3), 349-358.
Tambling, R. B., & Glebova, T. (2013). Preferences of individuals in committed relationships about premarital counseling. The American Journal of Family Therapy, 41, 330-340.
Williams, L. (2007). Premarital counseling. Journal of Couple & Relationship Therapy, 6(1-2), 207-217.