Couples Therapeutic Assessment FAQs
What is a “Couple’s Therapeutic Assessment”?
Typically, couples seeking some form of treatment are caught in a pattern of relating that feels “stuck.” Despite their best efforts, this pattern keeps repeating. The typical assumption in a Couple’s Therapeutic Assessment (CTA) is that the pattern repeats for an understandable psychological or relational reason; the goal in a CTA is to discover useful information about the existing pattern that might be helpful to the couple in making the changes they seek. In essence, we’re trying to answer the question “Given how person A is built including their history and tendencies, given how person B is built including their history and tendencies, and given the history in the relationship, in what ways does it make sense that they’d be experiencing this challenge or stuck in this pattern?”
What happens in a CTA?
A CTA is typically 7 meetings long, plus about 3 hours of homework.
Session 1 (together): During this initial 90 minute meeting I learn why the couple wants an assessment, their goals for the assessment, and what specific questions they’d like to investigate. I also try to learn as much as possible about the context and history of the problem(s) and the relationship in general. All aspects of the assessment are discussed so clients are well informed about the process. Clients are asked to complete 3-4 hours of psychological testing inventories prior to the next individual sessions.
Sessions 2 through 5 (individual): I meet with each individual twice for 45 minutes at a time to understand what it’s like to be in their shoes in the context of the problem. The goal is to understand why the person’s behavior or reaction to the pattern might make psychological sense, even if their reaction isn’t helpful or perhaps is harmful to others. Results of the psychological inventories are reviewed and used to contribute toward this understanding.
Session 6 (together): In this 90 minute interactive meeting, we test some of our working theories about the pattern being investigated, with time spent experientially exploring other options.
Session 7 (together): In this final 90 minute meeting we review what we’ve learned about three domains: the psychological make-up of each person in the relationship as well as the dynamic they co-create together. We discuss some of the logical reasons why they may have found themselves feeling “stuck”, and the solutions they may have uncovered. These topics are also covered in a written report given to each person. If the couple was referred by a couple’s therapist for an assessment to augment existing couple’s therapy, the fifth session ideally takes place in the referring therapist’s office.
If I’m not being referred by an existing couple’s therapist, how will a CTA without therapy be helpful?
A CTA is not for everyone. However, it may be helpful for people who are seeking a short term intervention designed to give them useful information. Think of it as a psychological tool at the disposal of people who would rather engage in “Do It Yourself” self-improvement. These people may use a CTA to gain insight about existing dynamics and possibilities for change, preferring to do the work of change on their own. People who would prefer to do the work of change in conjunction with therapy may also use a CTA as a thorough start to therapy.
Is there any research to suggest that a CTA is helpful?
There is a growing body of research suggesting that psychological assessment (separate from psychotherapy) can result in significant therapeutic gains, particularly when performed in a client centered manner as described above (see references below). All empirical research pertaining to therapeutic assessments to date has involved individual psychological assessment, though anecdotal evidence [both my personal experience and as documented in Finn (2007)] regarding couples therapeutic assessments is encouraging.
Will this assessment be useful in court if we get a divorce someday?
The purpose of the assessment is to facilitate therapeutic growth, and is qualitatively different than procedures used for forensic (in the court system) purposes. Therefore these therapeutic assessments are not valid in the forensic setting. The document received by each client will specifically state this.
What is the cost of this kind of assessment?
If the assessment doesn’t deviate from the schedule above, the total will not exceed $3900. Clients are always informed and in charge of the extent of the service before it’s provided.
Will my insurance cover the cost?
Most insurance plans cover psychological assessment, often at 80%, though some have limits or require preauthorization. To get an accurate idea of your specific plan, please call your insurance company and inquire about your coverage of mental health services, specifically psychotherapy (service code 90834) and psychological testing (service codes 96130 and 96131). Ultimately it’s the client’s responsibility to know their own coverage.
References
Ackerman, S. J, Hilsenroth, M. J., Baity, M. R., & Blagys, M. D. (2000). Interaction of therapeutic process and alliance during psychological assessment. Journal of Personality Assessment, 75(1), 82-109.
Aschieri, F., & Smith, J. (2012). The effectiveness of therapeutic assessment with an adult client: A single-case study using a time-series design. Journal of Personality Assessment, 94(1), 1-11.
Finn, S. E. (2007). In our client’s shoes: Theory and techniques of therapeutic assessment. Mahwah, NJ: Earlbaum.
Hilsenroth, M. J., Peters, E. J., & Ackerman, S. J. (2004). The development of therapeutic alliance during psychological assessment: Patient and therapist perspectives across treatment. Journal of Personality Assessment, 83, 332-344.
Poston, J. M., & Hanson, W. E. (2010). Meta-analysis of psychological assessment as a therapeutic intervention. Psychological Assessment, 22(2), 203-212.
Typically, couples seeking some form of treatment are caught in a pattern of relating that feels “stuck.” Despite their best efforts, this pattern keeps repeating. The typical assumption in a Couple’s Therapeutic Assessment (CTA) is that the pattern repeats for an understandable psychological or relational reason; the goal in a CTA is to discover useful information about the existing pattern that might be helpful to the couple in making the changes they seek. In essence, we’re trying to answer the question “Given how person A is built including their history and tendencies, given how person B is built including their history and tendencies, and given the history in the relationship, in what ways does it make sense that they’d be experiencing this challenge or stuck in this pattern?”
What happens in a CTA?
A CTA is typically 7 meetings long, plus about 3 hours of homework.
Session 1 (together): During this initial 90 minute meeting I learn why the couple wants an assessment, their goals for the assessment, and what specific questions they’d like to investigate. I also try to learn as much as possible about the context and history of the problem(s) and the relationship in general. All aspects of the assessment are discussed so clients are well informed about the process. Clients are asked to complete 3-4 hours of psychological testing inventories prior to the next individual sessions.
Sessions 2 through 5 (individual): I meet with each individual twice for 45 minutes at a time to understand what it’s like to be in their shoes in the context of the problem. The goal is to understand why the person’s behavior or reaction to the pattern might make psychological sense, even if their reaction isn’t helpful or perhaps is harmful to others. Results of the psychological inventories are reviewed and used to contribute toward this understanding.
Session 6 (together): In this 90 minute interactive meeting, we test some of our working theories about the pattern being investigated, with time spent experientially exploring other options.
Session 7 (together): In this final 90 minute meeting we review what we’ve learned about three domains: the psychological make-up of each person in the relationship as well as the dynamic they co-create together. We discuss some of the logical reasons why they may have found themselves feeling “stuck”, and the solutions they may have uncovered. These topics are also covered in a written report given to each person. If the couple was referred by a couple’s therapist for an assessment to augment existing couple’s therapy, the fifth session ideally takes place in the referring therapist’s office.
If I’m not being referred by an existing couple’s therapist, how will a CTA without therapy be helpful?
A CTA is not for everyone. However, it may be helpful for people who are seeking a short term intervention designed to give them useful information. Think of it as a psychological tool at the disposal of people who would rather engage in “Do It Yourself” self-improvement. These people may use a CTA to gain insight about existing dynamics and possibilities for change, preferring to do the work of change on their own. People who would prefer to do the work of change in conjunction with therapy may also use a CTA as a thorough start to therapy.
Is there any research to suggest that a CTA is helpful?
There is a growing body of research suggesting that psychological assessment (separate from psychotherapy) can result in significant therapeutic gains, particularly when performed in a client centered manner as described above (see references below). All empirical research pertaining to therapeutic assessments to date has involved individual psychological assessment, though anecdotal evidence [both my personal experience and as documented in Finn (2007)] regarding couples therapeutic assessments is encouraging.
Will this assessment be useful in court if we get a divorce someday?
The purpose of the assessment is to facilitate therapeutic growth, and is qualitatively different than procedures used for forensic (in the court system) purposes. Therefore these therapeutic assessments are not valid in the forensic setting. The document received by each client will specifically state this.
What is the cost of this kind of assessment?
If the assessment doesn’t deviate from the schedule above, the total will not exceed $3900. Clients are always informed and in charge of the extent of the service before it’s provided.
Will my insurance cover the cost?
Most insurance plans cover psychological assessment, often at 80%, though some have limits or require preauthorization. To get an accurate idea of your specific plan, please call your insurance company and inquire about your coverage of mental health services, specifically psychotherapy (service code 90834) and psychological testing (service codes 96130 and 96131). Ultimately it’s the client’s responsibility to know their own coverage.
References
Ackerman, S. J, Hilsenroth, M. J., Baity, M. R., & Blagys, M. D. (2000). Interaction of therapeutic process and alliance during psychological assessment. Journal of Personality Assessment, 75(1), 82-109.
Aschieri, F., & Smith, J. (2012). The effectiveness of therapeutic assessment with an adult client: A single-case study using a time-series design. Journal of Personality Assessment, 94(1), 1-11.
Finn, S. E. (2007). In our client’s shoes: Theory and techniques of therapeutic assessment. Mahwah, NJ: Earlbaum.
Hilsenroth, M. J., Peters, E. J., & Ackerman, S. J. (2004). The development of therapeutic alliance during psychological assessment: Patient and therapist perspectives across treatment. Journal of Personality Assessment, 83, 332-344.
Poston, J. M., & Hanson, W. E. (2010). Meta-analysis of psychological assessment as a therapeutic intervention. Psychological Assessment, 22(2), 203-212.
