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Couples counseling can come down to one partner

When Courtney Ezzo was engaged to her now-husband -- Jamal Smith, whom she married on Jan. 21 -- she told him that premarital counseling was mandatory.

As a substance-abuse counselor herself, Ezzo, 27, wanted to make sure her relationship was as healthy as it could be. Smith, she says, at first felt was reluctant to attend, and said it wasn't necessary. But after a few sessions, Ezzo's fiance got into it.

"He saw it was more than just going and complaining about each other and talking about our problems," says Ezzo of Wilkinsburg. "We were brainstorming and talking about anything."

If Smith had not agreed to counseling, Ezzo says, she would not have married him yet. "Our communication is absolutely better, 100 percent."

Ezzo's situation presents the best prognosis for a healthy, lasting marriage, according to mental-health therapists who work with couples. However, many people -- most often, women -- get couples counseling without the other half of the couple. Is couples therapy for one a contradiction in terms• Maybe, therapists say. Yet people struggling with relationship issues benefit from solo counseling: They can focus on getting themselves healthy.

"The most effective treatment is when they can both come in together," says DeMarquis Clarke, director of the marriage and family-therapy program at Seton Hill University in Greensburg. "However, we do know that if one partner changes in the couple, the whole couple dynamic shifts. The thought is, regardless of what is going on in the relationship, both parties have some responsibility in it. .... Counseling makes them more accountable for their piece."

One example: A wife who is enabling harmful behavior from her husband can learn to stop, and the dynamics of the relationship will shift with the new boundaries. Chances are, that woman also enables friends and family members and can benefit from counseling, Clarke says. Once an enabling partner starts to change, the other spouse knows the situation is serious and agrees to come to counseling.

Clarke estimates that 75 percent of people seeking couples therapy from him come with their partner -- but of those, maybe 15 percent of spouses will quit the counseling, leaving their mates to go it alone.

According to an article in the Wall Street Journal, unpublished results from a study of 300 couples at the University of Denver found that after a month or so of solo relationship training, people saw as much improvement as those who sought help as a couple. A year and a half after the training, the women who attended sessions alone reported feeling happier than men who attended alone.

John E. Keil, a New Kensington licensed clinical social worker who counsels many couples, says that as many as half of the spouses of his clients will not come to counseling in the early stages. Yet, the reluctant partners -- more often men -- sometimes change their tune and join their wives later.

"If people see that this is not like 'The Bob Newhart Show,' they'll say 'Hey, this wasn't bad.' "

The people who don't want to attend counseling "like to believe that they can handle things on their own. They believe that things will just go away and get better."

Still, Keil says, a person can make some relationship improvements from solo counseling.

Many couples in stressed relationships wait so long to seek help that the relationship is about to fracture by the time they begin counseling, says Megan Norris, a licensed marriage and family therapist, and the owner of Relationship Resolutions, a counseling clinic with offices in Shadyside, Green Tree and North Strabane.

About 75 percent of new referrals are seeking couples therapy, but only about 40 percent of the clinic's caseload involves pairs. Sometimes, a couples-therapy session will end with one person storming out, Norris says.

Also, someone will begin individual therapy for problems such as depression, and the therapist will discover that the marriage contributes to the problem, she says. Then, the spouse gets involved with therapy, too.

"You have a much fuller picture in that scenario," Norris says. "You see how much they change in the presence of the other."

In some cases, such as infidelity, a spouse should insist on counseling as a condition for continuing the marriage, Norris and Clarke say. However, the partner has to want to change, the professionals say.

If someone's partner isn't willing to work on problems in the relationship, is there really much of a good relationship there• Indeed, Norris says, when people go for counseling alone, the focus of the therapy may be preparing to leave the relationship. As the person gets healthy, he or she may realize that the marriage is not healthy and unlikely to improve.

Solo therapy can work out two ways, Norris says. A person may come to the decision to end the relationship, or change enough that their spouse is willing to start changing. Eventually, in most cases, the spouse will need to join the counseling if the relationship is to work.

"It's rare that you can change the relationship for the better on your own," Norris says.

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