Innovative couples therapy model developed at U of L

By Alejandra Pulido-Guzman - Lethbridge Herald on January 21, 2023.

Herald photo by Alejandra Pulido-Guzman University of Lethbridge professor Bonnie Lee has developed a innovative treatment for addictions called Congruence Couple Therapy.

LETHBRIDGE HERALDapulido@lethbridgeherald.com

A University of Lethbridge professor in the Faculty of Health Sciences’ Addictions Counselling Program has developed an innovative therapy model focusing on improving couple relationships.

Bonnie Lee said she focuses on clinical and interventional research. She studies people who are struggling with problems related to gambling or alcohol use and tries to find treatment and interventions that would help them improve their condition. Which led to the development of her innovative treatment called Congruence Couple Therapy (CCT).

“I started working with couples, because I noticed very early on in my career as a marriage and family therapist, and later on as a social worker, that problems don’t just exist within the individual, they exist within the context of family, society, and culture,” said Lee.

She said in North America we tend to look at the problem as residing within the individual, as a person having the disease, while in Europe and Asia there is more interest in the family and their influence on the problem and how families can be helpful in resolving the problem.

“Early in my career I found that in these addiction treatment centres there is a lack of services for couples and families, as well as a training gap for counsellors to work with more than one person in the room,” said Lee.

She said it is important to have the proper set of skills to deal with more than one person in the room as it could be rather daunting, especially in cases of addiction because the situation can be volatile with people pointing fingers at each other, or one person shutting down.

“In addiction treatment, the tradition has been to separate out the person with the addiction from the family member and that has been the structure of 12 step programs,” said Lee.

But she pointed out that the difficulty of that is others in the family, especially significant others, are unaware of the information the person with the addiction is acquiring and therefore are unable to help them through it.

“It’s much easier to make change when you have two people in the room and if A says something, you can help B to respond in a way that they would feel heard and vice versa, and you can validate both perspectives,” said Lee.

Lee said she called her treatment Congruence Couple Therapy because congruence is an important word in psychotherapy.

“I would simplify it as two important things. Congruence is awareness of yourself and other people, and it also means alignment, so alignment between yourself and other people. But alignment between what you’re thinking and feeling inside with what you say, so they’re kind of different dimensions to congruence,” said Lee.

She said her therapy model has four dimensions that she calls a house with four doors because she can focus on more than one subject at a time.

“The CCT model is an integrative systemic model, and everything is linked together. With the four doors you are being aware of yourself, of how you interact and communicate with other people, aware of your past, your family history and how it shaped you,” said Lee.

She said she also calls it a house with four doors because you can enter into the client system through any one of those doors.

“Generally, if you have two people in the room the door that is more open is the interpersonal communication, because you can see how a couple talk to each other,” said Lee.

She said she works with couples for 12 sessions.

“With 12 sessions we can actually see significant clinical outcomes with changes in reducing addiction symptoms,” said Lee.

Lee focuses in gambling and alcohol addiction and she explained that not everybody who gambles has a gambling disorder and not everybody who drinks alcohol is an alcoholic.

She said there is a way people can determine if they, or someone they know, have crossed the threshold from being a recreational alcohol user or gambler, to being a problem drinker or gambler by applying what she calls the three C’s.

“The first C is for the Craving for that activity, the second is loss of Control, when you want to stop but you can’t and you keep going back to it, and the third is negative Consequences, when the question arises: does it affect your life negatively?” said Lee.

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