Assessing Couple Distress

In Assessing Couple Distress:The Four-Session Evaluation, Dr. Anthony L. Chambers demonstrates and discusses this approach to working with couples in the initial assessment stage of therapy. Couple problems are complicated: The therapist must understand each individual, the relationship, the environmental contexts in which the individuals and the relationship operate within, and the bidirectional influences of each.

This assessment approach may be used with any theoretical orientation, and may be used with couples from all walks of life. The four-session evaluation consists of an initial conjoint session, two individual sessions with each member of the couple, and in the fourth session the therapist presents feedback to the couple, which is used to develop a treatment plan and a working alliance.

In this video, Dr. Chambers works with a couple who seek to repair their relationship after an instance of infidelity. Host Dr. Adia Gooden conducts an interview with Dr. Chambers about the four-session evaluation process, and this is followed by brief highlights from the initial couple session and the two individual sessions. The program culminates in a full feedback session with the couple and a lively analysis of the session.

This video features a couple portrayed by actors on the basis of a composite of case material.

Couple problems are complicated, as the therapist must understand the individual, the relationship, the environmental contexts in which the individuals and the relationship operate within, as well as the bidirectional influences of each (Stanton & Welsh). In an attempt to embrace and disentangle that complexity, many therapists use a format commonly referred to as the four-session evaluation (Chambers, 2012; Karpel, 1994). It is important to note that this model is transtheoretical and systemic; thus, it can be used with any theoretical orientation.

Basic Format: The four-session couple evaluation includes an initial conjoint session to understand the couple's relationship problems, followed by individual sessions and a feedback session where the therapist provides the couple with feedback and a treatment plan (Chambers, 2012; Karpel, 1994). Throughout the evaluation, questions are asked to identify problem interactions and constraints that prevent the couple from having a healthy connection. Furthermore, a lifecycle, developmental approach to the questions are used to contextualize the couple's problems.

The goals of the conjoint session center around building balanced alliances, garnering basic information about the couple's life, and exploring the presenting problem in detail. The goals of the individual sessions are to strengthen individual alliances with each partner, assess each partner's level of commitment to the relationship, assess for any intimate partner violence, and collect psychiatric and family of origin histories as well as a history of previous romantic relationships.

Anthony Chambers, PhD, ABPP, is the chief academic officer at the Family Institute at Northwestern University (TFI). Dr. Chambers is also the director of Northwestern University's Center for Applied Psychological and Family Studies and is a clinical professor in the Department of Psychology. Dr. Chambers is also the former president of APA's Society for Couple and Family Psychology (Division 43) and is the past president of the American Academy of Couple and Family Psychology (AACFP). He currently serves on the Board of Directors for APA.

Dr. Chambers received his BA in psychology from Hampton University and completed both his MA and PhD in clinical psychology at the University of Virginia. He completed his internship and postdoctoral clinical residency at Harvard Medical School and Massachusetts General Hospital.

Dr. Chambers engages in scholarly writing, teaching, and public speaking aimed at disseminating the latest knowledge about how to have a healthy relationship. Noteworthy academic achievements include coauthoring Integrative System Therapy; coediting the Encyclopedia of Couple and Family Therapy; coediting an APA series on couple and family psychology; and coediting a book series on the application of The Family Institute’s therapy model called Integrative Systemic Therapy.

Dr. Chambers' professional accomplishments have resulted in becoming a fellow of the APA, a fellow of the AACFP, and a diplomat of the American Board of Couple and Family Psychology. He also serves on the editorial board of the journal Family Process and is the past associate editor for the journal Couple and Family Psychology: Research and Practice.

Chambers, A.L. (2012). A systemically infused, integrative model for conceptualizing couples' problems: The four session evaluation. Couple and Family Psychology: Research and Practice, 1(1), 31-47. doi: 10.1037/a0027505.

Chambers, A. L. (2017). The four session evaluation. In J. Lebow, A. L. Chambers, & D. Breunlin (Eds.), The encyclopedia of couple and family therapy. Springer Publishing.

Fishel, A. (2018). A life cycle approach to treating couples: From dating to death. In A. L. Chambers & C. Datchi (Eds.), Couple and family psychology collection. Momentum Press.

Karpel, M. A. (1994). Evaluating couples: A handbook for practitioners. Norton.

Stanton, M., & Welsh, R. (2011). Specialty competencies in couple and family psychology. Oxford University Press.

Pinsof, W. M., Breunlin, D., Russell, W., Lebow, J., Rampage, C., & Chambers, A. L. (2017). Integrative systemic therapy: Metaframeworks for problem solving with individuals, couples, and families. American Psychological Association.

APA Videos

Couples Experiencing Commitment Uncertainty
Jesse Owen and Johanna Strokoff

Integrative Couple Therapy
Ellen F. Wachtel and Paul L. Wachtel

Integrative Family Therapy With Couples
Patricia J. Pitta

Integrative Systemic Therapy With Couples
William M. Pinsof

Restoring Trust After Infidelity
Lawrence Josephs

Therapy With Diverse Couples
Shalonda Kelly

Working With Couples in the Correctional System
Corrine C. Datchi

APA Books

Integrative Systemic Therapy: Metaframeworks for Problem Solving With Individuals, Couples, and Families
William M. Pinsof, Douglas C. Breunlin, William P. Russell, Jay L. Lebow, Cheryl Rampage, and Anthony L. Chambers

Couple Relationships in the Middle and Later Years: Their Nature, Complexity, and Role in Health and Illness
Edited by Jamila Bookwala

The Dynamic of Infidelity: Applying Relationship Science to Psychotherapy Practice
Lawrence Josephs

Integrative Couple and Family Therapies: Treatment Models for Complex Clinical Issues
Edited by Patricia J. Pitta and Corinne C. Datchi

Rupture and Repair in Psychotherapy: A Critical Process for Change
Edited by Catherine F. Eubanks, Lisa Wallner Samstag, and J. Christopher Muran

Treating Contemporary Families: Toward a More Inclusive Clinical Practice
Edited by Scott Browning and Bradley Matheus van Eeden-Moorefield