Why we need to talk about couple therapy

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Couple relationships play an important role in the mental health and wellbeing of families.

Bringing up a family is a hard and it’s completely normal for parents to have difficulties and argue from time to time. However, 1 in 5 couples experience relationship problems which overwhelming and start to affect their mental health, their parenting and, in turn, the wellbeing of their children.

Research on family mental health now clearly shows that conflict between parents, which is frequent, intense and never fully resolved, is very harmful to children’s mental and physical health. That this can impact on how sensitively and appropriately they are able to look after their children is a serious worry.

There are some common trends in families with couple relationship difficulties: babies may become more grizzly or fidgety; toddlers may cry or act up more, and their sleep may be affected; and older children may seem more worried, low in mood, argumentative, and in some cases develop anti-social behaviour problems and their marks can be affected at school. In fact, a recent University College London analysis found ‘family relationship difficulties’ was the most common reason for children using mental health services.

We desperately need to provide more relationship support to prevent these difficulties for parents and their families.

Why aren't people getting the help they need?

Currently, couple therapy is only offered in a small proportion of NHS mental health services and where it is offered through third sector and other organisations – parents do not seek help when they need it.

A recent YouGov poll found that 64% of people in long-term, committed relationships would be unlikely to seek help from a couple counsellor if their relationship was in difficulty. This was despite respondents acknowledging the role they thought relationship support could play in critical issues such as psychological well-being, family life and children’s outcomes. So if the potential is there, why are so many people not aware of the potential positive impact of seeking help from a counsellor or therapist? 

Clearly experiencing relationship problems is still stigmatising and getting help is taboo. We need to do more to talk more openly about couple relationship problems.

Interestingly, the most common answer people gave in the YouGov poll as to why they didn’t seek help was that they were not sure whether couple therapy works (43%).

The truth is that there is evidence from many studies showing that couple therapy can be very effective. This includes evidence from mental health delivery of couple therapy for depression, a mental health intervention shown (where available on the NHS) to be the most effective way of assisting both partners to deal with depression.

At the Mental Health Foundation, we are interested in how we can overcome the barriers that parents experience in getting support for their relationship difficulties. We would like to give them the opportunity to support their families’ wellbeing at the earliest opportunity – from pregnancy through the Becoming a Family programme.

Becoming a Family

Becoming a Family is a couple-focused group programme developed at Berkley University by Professors Carolyn and Phil Cowyn to support couples across the transition to parenthood. It is delivered by two facilitators who are mental health or early years professionals with specific training in the intervention model.

The group starts in pregnancy and couples bring their babies along once they have been born. This provides a ‘living laboratory’ for parent-infant work and partners can discuss issues and solve problems while their babies provide ongoing distractions, both positive and negative.

Parents will discuss their own parents’ couple relationship and how this might have affected them, how they would like to approach being co-parents, understanding and accepting couple differences, and developing techniques to manage conflict and disagreement.

Together with Tavistock Relationships and a number of other academic institutions, we are now leading a piece of work to bring it over to the UK to support couples in the perinatal period. We are also hoping to complete the first-ever randomised controlled trial of a couple-focused perinatal programme in the UK, and increase the evidence base for this kind of programme. Watch this space.

A more extensive report on the findings of the YouGov poll including infographics can be found at www.TavistockRelationships.org