Couples Intensives: What They Are, Why They Work, Who They Help
- What is intensive couples therapy?
- Purpose, benefits, and risks of longer-format therapy
- Relational dynamics and clinical issues intensives are helpful for
- Contraindications: interpersonal violence, substance use, mixed agendas, suicidality
- Logistical and ethical considerations
- Limitations of the research and potential risks
Setting Up for Success: Training, Policies, Forms, and Communication
- Training, credentials, and characteristics of an intensive couples therapist
- Pre-session communication: policies, paperwork, expectations
- Consultation calls: How to manage client expectations ahead of the session
- Scheduling and payment considerations based on the client
- Assessment: IPV, SI, substance use; modality-based assessments
- Therapist humility: cultural and person-of-the-therapist knowledge
Intensive Day One: Joining, Information Gathering, Preparing and Providing Feedback
- The first 90 minutes
- How to “join through hope” instill a sense of possibility and security early on
- Early enactment: Observing patterns, communication
- Assessment of readiness to change, familial influence, commitment, and goals
- Individual interviews
- Deeper dive into the history of the problem
- Further assessment: Co-morbidities, family of origin issues, disclosures
- Preparing and presenting feedback
- How to share observations effectively
- Creating a “roadmap” for change
- Case studies:
- Alex and Priya: Chronic Low-Grade Conflict, Existential Drift
- Marcus and Dani: Post-Baby Drift and Resentment
- Linda and Charles: Later-Life Love Under Strain
- Jordan and Ray: Recovery Under Threat
Intensive Day Two: Setting Up and Facilitating Enactments, Pacing Deep Work Across Multiple Hours, and Handling Dysregulation in Real Time
- Therapist preparation
- Clinically-informed review of previous day’s feedback sessions
- Choosing the appropriate interventions and exercises
- Prepare to be unprepared: When things don’t go “to plan”
- How to start session with containment and focus
- Enactments: Bringing relational dynamics into the room in real-time
- Successful enactments: Assessment, facilitation, redirecting, and restructuring.
- Choosing exercises to build enactments: Speaker/Listener, the HARD conversations model, guided imagery, the intimacy wheel, repair, negotiation, and more
- Differentiating between “conflict” and “flooding” (diffuse physiological arousal)
- Intervening in dysfunctional patterns to create a new path
- Emotional regulation tools
- Interventions: Stop the Pattern, Map The Dance, commonly used psychoeducation, cross-tracking, doubling, Physiological Self Soothing, and more
- The final hour of the intensive
- Reflection of the shared experience for the couple
- The Farewell Conversation
- Future planning through couple agreements and plans, referrals, and follow up appointments.
- Case study couples revisited: Enactments, exercises, closing practices


