What should be included in the records of marriage counseling?

If we are to gain further specific knowledge from the rapidly growing and developing work of marriage counseling it is essential that reliable and reasonably comprehensive records should be kept, and that they should be kept in such a manner that any use of them will be for general statistical purposes and with absolute safeguard of the confidential nature of all that is disclosed to any marriage counselor. This safeguarding is generally carried out by distinguishing all records by a number and keeping the corresponding names and addresses on a separate cross-indexed file under lock and key, as of course are the records themselves.

It is important for the value of the records and also for the counselor’s own orderly thinking and learning that he should keep at the back of his mind a fairly comprehensive picture of the main details which need to be recorded. In this way he is less likely to overlook some important aspect of the trouble which the partners may not volunteer to him in the course of the interviews, but which they will readily discuss if he asks a suitable “creative question” at the right time. Much of the necessary material will be discussed later in this book but a brief summary at this point of the main headings under which the records may be made will possibly help the counselor to build up a simple and easily remembered picture of what is valuable in the records.

The basic routine details of names, addresses, ages, religious affiliations, and other similar matters are for each counseling agency to decide upon in its standard record sheet, and these are often recorded at the time of registration by the receptionist, although there is no reason why the counselor should not record them if that seems more workable. But the counselor will help in future research if he sees that clear records are made of some specific matters at least, and these can be divided for convenience into seven groups of data:-Observation of the clients, Clients’ motives for coming, Present situation, Clients’ feelings about the difficulty, Previous history, Counselor’s assessments, and Final Outcome and Follow-up.

a. Observation of the clients. This is a useful beginning of each consecutive record, and it is most often neglected. It may include such characteristics as the following:-
Appearance:-strained, anxious, restless, “on guard,” indifferent, despairing, or hostile.
Dress:-neat or careless, restrained or flamboyant, etc.
Manner and behavior:-weeping, aggressive, withdrawn, clinging, or seductive, able to look counselor in the face, hand movements.
Speech:-voluble or reticent or silent, coherent or rambling, repetitive, restrained or hostile and aggressive.

The change in the records of the clients’ appearance with the progress of counseling may offer a very good indication of what is happening, one which may not be so obvious from the record of what the clients say. Such records also offer an extra dimension by which the client can be pictured in the mind of the counselor in reviewing his case history, and by anyone doing research in the counseling field.

b. The clients’ main motives for coming. Did they come willingly on their own initiative, or in the case of the second client in willing response to a letter of invitation by the counselor? Were they easily persuaded to come by a friend or relative, or referred by a minister, doctor, lawyer, or other person? Did they come rather hesitantly because of an appeal by someone to “give it just one more chance?” Or were they directed to come by a divorce court judge, and if so was it because they hadn’t realized the availability of counselors or in spite of their own indifference or rebellious hostility? These are important details which may easily be omitted from the counselor’s records unless he keeps them specifically in mind and develops good habits of recording. As a corollary to the actual expressed motives for coming the counselor may gain some idea from the statements of the clients of their expectations from the counseling. Did they believe that the counselor would listen to them and ask any questions and then give his judgment and advice? Did they think it would only need one interview? These expectations are better picked up in the actual discussion, especially when the counselor comes to the point of defining the counseling situation and its goals; rather than made the subject of actual questions, at least at the beginning.

c. The present situation, as seen by the clients, and in their own words. Are they living together at the present time, if not how and when did they separate? If together what degree of tension? Can they communicate? How did the
trouble develop and from when? Any events or experiences which seem to have helped to bring it about? How long mar
ried? What children-age, sex, temperament? Illnesses, living conditions, Jobs, Neighborhood, How do they relate in sex,
personally, socially, parentally? What seem to be the main points of discord or vulnerability?

d. The clients’ feelings about their difficulties and about themselves and each other. This is put in a separate heading to emphasize the need for recording of feelings as well as facts. Many records of less experienced counselors are almost entirely limited to the facts of the dispute and give no idea of how either client felt about them. With this account there may be information about each client’s feelings about the “in-laws,” about children, jobs, habits and all kinds of other matters which may stir up feelings. Behind these feelings the counselor will try to evaluate each partner’s “role perceptions” and “role expectations” in marriage and parenthood, and any consequent feelings of “role frustration.” Behind these again he may discern some patterns of habitual attitudes and emotional needs and uncritical assumptions, all of which will be dealt with later. They are essential elements in a good record.

e. Previous history of each partner, as seen, if possible by both separately. Such matters as family background, school and social life, introduction to sex, courtship, previous engagements or marriages and how terminated and with what feelings, and any other relevant matters. By hearing how each client views his partner’s family and other history as well as his own it is possible to gain a two-dimensional appreciation of the background “conditioning” of each of them, as we have seen in the case of John and Mary at the beginning of this book.

f. The counselor’s assessment at the end of each interview, and an evaluation of the apparent development of the clients’ insight and the matters which seem to be still in need of discussion, form a good progress report, and a help in the re-establishment of rapport in the next interview. Such records also give a valuable unfolding picture of the progress of the counselings, from which the counselor can learn much about his own counseling attitudes.

g. Final outcome, and (if possible) follow-up. This is mainly an assessment of the counselor’s general impressions after the apparently final interview, and it gives him and any supervisor a good opportunity to sum up his conduct of the whole case. Some agencies write to their clients at intervals to ask them how their marriage has worked out, and any such information which can be obtained is valuable. It is not certain whether such communications are favored by clients in all
cases, but with some such plan of follow-up inquiries adopted by any agency it is possible to prepare for it during the counseling by asking clients whether they would like such a regular communication. In most cases it would be welcomed when put that way, and in fact many happy clients write spontaneously to their counselor, sometimes at Christmas, telling of
their happiness and harmony and any other homely matters that occur to them. But such communications do not constitute a
reliable sample for research purposes because the unsatisfactory cases are not likely to write in this way.

Another use for such comprehensive records is in cases when after one or two interviews the clients fail to come again. It is of some value to know the reason for this as far as possible, and some ideas may well be gained from the record and from the counselor’s recollection of the kind and degree of rapport. In some cases the client or clients come to investigate the possibilities of getting emotional support or of getting the counselor to judge the situation or condemn the partner. When these and other unfulfillable aims are in clients’ minds they may be so disappointed that they will not return, and the counselor has not time to win their confidence in such a way as to be able to define the normal aims of counseling.

In other cases partners may have found enough insights from the first interview to feel able to work out their relationship for themselves, even though the counselor may not have felt that the situation had advanced to any extent. This has occasionally been communicated to the counselor on a subsequent occasion, and he finds that he has achieved more than he knew.

When any client terminates the counseling in this way without any explanation it is a good thing for the counselor to review his conduct of the interview or interviews, and to recall his own feelings as he faced the client. Many such terminations arise from a feeling of rejection of some kind in the client, which he is unable to express except by staying away. In some such cases he will go to another counselor, and these feelings may then be expressed to the new counselor.
Finally a comprehensive record is of the greatest value in the necessary supervision of the work of less experienced counselors as part of their “in-service” training, and for their accreditation when that is required. It is also of value for case conferences through which again the whole work of counseling is greatly developed and improved, to the benefit of all future clients.

Tags: Counseling