Why informed consent is the foundation of ethical couples therapy
The Uncomfortable Truth: Not Every Couple Should Be in Therapy Together
Picture this: A couple sits in their first counselling session. The therapist asks about their relationship history. The wife begins describing patterns of control and isolation. Her husband interrupts, correcting her “misperceptions.” She immediately goes quiet, glancing nervously at him before agreeing she “probably remembers it wrong.”
The therapist faces a critical decision: continue with couples counselling, or recognize that this isn’t a safe space for honest communication.
This is why consent in relationship counselling is so much more complex than simply signing a form.
In Canada, domestic violence occurs in approximately 1 in 3 relationships at some point (Statistics Canada, 2024), and couples therapy can actually increase risk for victims when power imbalances aren’t properly assessed (Canadian Association for Marriage and Family Therapy, 2024). Yet many therapists receive minimal training on consent, power dynamics, and when couples therapy is contraindicated.
At VCCT, we teach future relationship counsellors that consent isn’t just a legal requirement—it’s an ongoing ethical practice that protects clients and ensures therapy actually helps rather than harms.
What Consent Actually Means in Relationship Counselling
Beyond the Intake Form
Most people think consent in therapy means:
- Signing paperwork at the first session
- Agreeing to confidentiality terms
- Accepting the therapist’s approach
But informed consent in relationship counselling is far more nuanced.
The Three Levels of Consent
1. Informed Consent to Treatment
- Understanding what couples therapy involves
- Knowing the therapist’s theoretical approach
- Being aware of confidentiality limits
- Understanding fees, cancellation policies, and duration
2. Consent to Participate Freely
- Ability to speak honestly without fear of consequences
- Freedom from coercion by partner to attend therapy
- Option to request individual sessions
- Right to discontinue therapy at any time
3. Ongoing Consent Throughout Treatment
- Agreement to discuss specific topics
- Comfort with therapeutic techniques used
- Consent to involve third parties (children, extended family)
- Acceptance of homework assignments or interventions
The critical question: Can both partners freely give all three levels of consent?
When Couples Therapy Isn’t Appropriate
Red Flags That Require Assessment
Professional relationship counsellors are trained to identify situations where couples therapy may cause harm:
Active Domestic Violence: When one partner fears the other, couples therapy can:
- Provide the abuser with ammunition (“even the therapist agrees you’re too sensitive”)
- Escalate violence after sessions where abuse was discussed
- Create false equivalency between victim and abuser behaviors
- Prevent the victim from speaking honestly
Severe Power Imbalances:
- Financial control preventing one partner from leaving
- Immigration status dependencies
- Threats involving children or custody
- Isolation from support systems
Active Substance Abuse:
- Intoxication preventing meaningful participation
- Using therapy as manipulation tool
- Refusing to address addiction as primary issue
Untreated Serious Mental Illness:
- Psychosis or severe mania
- Active suicidal ideation
- Personality disorders requiring individual treatment first
In these cases, ethical therapists recommend individual therapy first, safety planning, or referral to specialized services (Canadian Counselling and Psychotherapy Association, 2024).
The Assessment Process: How Counsellors Evaluate Consent Capacity
Initial Individual Sessions
Many relationship counsellors conduct separate intake sessions with each partner before beginning couples work. This allows:
Safety Assessment:
- Screening for domestic violence
- Evaluating fear or coercion
- Understanding power dynamics
- Assessing emotional safety
Individual Goals:
- What does each person hope to achieve?
- Are goals compatible or contradictory?
- Is one partner being pressured to “fix” the relationship?
Consent Verification:
- Is each person choosing therapy freely?
- Do they understand what’s involved?
- Can they speak honestly without repercussion?
Ongoing Monitoring
Consent isn’t a one-time checkbox. Ethical relationship counsellors continuously assess:
- Body language during sessions (withdrawing, fear responses)
- Who speaks more and who defers
- Changes after sessions (escalation, punishment)
- Ability to disagree with each other or the therapist
- Willingness to complete homework assignments
Research shows that therapists who don’t continuously monitor consent and safety may inadvertently contribute to relationship harm (Journal of Marital and Family Therapy, 2023).
Confidentiality: The Complex Issue in Couples Counselling
The “No Secrets” Policy Debate
Traditional Approach: Shared Confidentiality Everything discussed (including individual sessions) is considered shared information. If one partner discloses something individually, the therapist may require them to share it in couples sessions or will discontinue therapy.
Pros:
- Prevents triangulation
- Maintains therapist neutrality
- Avoids secret-keeping burden on therapist
Cons:
- May prevent disclosure of abuse, affairs, or safety concerns
- Can deter honest communication
- Puts victims at risk
Modern Approach: Modified Confidentiality Individual sessions remain confidential unless safety is at risk. Therapists help individuals decide what to share in couples sessions.
Most Canadian relationship counsellors now use modified confidentiality policies with clear boundaries established during informed consent (Canadian Association for Marriage and Family Therapy, 2024).
What Gets Disclosed Without Consent
Therapists must break confidentiality when:
- Child abuse or neglect is disclosed
- There’s imminent risk of harm to self or others
- Court orders require testimony
- Client provides written consent for specific disclosure
These limits must be clearly explained during the consent process.
Cultural Considerations in Consent
Beyond Western Individual Autonomy
Consent frameworks in counselling are often based on Western values of individual autonomy. However, many cultures prioritize:
- Collective family decision-making
- Respect for elder authority
- Gender role expectations
- Community harmony over individual expression
Culturally competent relationship counsellors understand that:
- Consent may involve extended family input in some cultures
- Gender dynamics vary across cultural contexts
- Translation isn’t just linguistic—it’s conceptual
- Western therapeutic approaches may conflict with cultural values
This doesn’t mean accepting abuse or coercion, but it does mean understanding context when assessing voluntary participation (Canadian Counselling and Psychotherapy Association, 2024).
Practical Applications: Consent in Action
Scenario 1: The Reluctant Partner
Situation: One partner was given an ultimatum—”go to therapy or I’m leaving.”
Ethical Response:
- Acknowledge the pressure explicitly
- Validate the reluctant partner’s hesitation
- Explore their own reasons for considering therapy
- Offer individual sessions to process feelings about being “forced”
- Reassess whether they’re choosing to engage or just complying
Scenario 2: Mid-Therapy Disclosure
Situation: In an individual check-in, one partner discloses ongoing emotional abuse.
Ethical Response:
- Immediately prioritize safety
- Discontinue couples therapy
- Provide safety planning resources
- Offer individual trauma-focused therapy
- Explain why couples therapy is contraindicated
- Document decision thoroughly
Scenario 3: Cultural Complexity
Situation: A South Asian couple where the husband makes most decisions and the wife defers to his judgment, as expected in their cultural context.
Ethical Response:
- Explore whether deference is cultural norm or fear-based
- Meet individually to assess safety and autonomy
- Understand cultural expectations without pathologizing
- Distinguish between cultural practice and abuse
- Ensure both partners have genuine voice in therapy
Training Requirements: What Counsellors Learn
Essential Competencies
Professional relationship counselling training includes:
Ethical Frameworks:
- Canadian counselling ethics codes
- Consent capacity assessment
- Duty to warn and protect
- Professional boundaries
Assessment Skills:
- Domestic violence screening tools
- Power dynamic evaluation
- Cultural competency assessment
- Mental health and substance use screening
Intervention Decisions:
- When to refer out
- How to transition from couples to individual work
- Safety planning protocols
- Appropriate use of different therapeutic modalities
At VCCT, the Counselling for Intimacy in Relationships Certificate specifically addresses these complex consent and safety issues through courses in couples counselling, conflict resolution, and ethical practice.
The Bottom Line: Consent Protects Everyone
For Clients
Proper consent processes ensure:
- You understand what you’re agreeing to
- You can participate safely and honestly
- Your autonomy is respected
- You can change your mind
For Therapists
Thorough consent practices provide:
- Legal protection
- Ethical clarity
- Framework for difficult decisions
- Professional credibility
For the Profession
Emphasis on consent maintains:
- Public trust
- Professional standards
- Client safety
- Therapeutic effectiveness
Relationship counselling without proper attention to consent can cause significant harm. With it, couples therapy can be transformative.
Frequently Asked Questions
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Can a therapist refuse to work with a couple?
Absolutely. Ethical therapists regularly decline or discontinue couples therapy when they determine it’s not appropriate. Common reasons include:
– Safety concerns (domestic violence, coercion)
– One partner lacks capacity to consent (severe mental illness, substance intoxication)
– Goals are incompatible with couples therapy format
– Therapist lacks specialized training for the presenting issues
– Conflict of interest (knowing one partner outside of therapy)Refusing to provide inappropriate treatment is an ethical obligation, not discrimination (Canadian Counselling and Psychotherapy Association, 2024). Therapists should provide appropriate referrals when declining services.
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What happens if I want to stop couples therapy but my partner doesn’t?
You have the absolute right to discontinue therapy at any time. Consent to treatment is ongoing and can be withdrawn. An ethical therapist will:
– Respect your decision without requiring justification
– Offer individual sessions to you and your partner separately
– Provide referrals if you wish to continue individual work
– Not pressure you to continue couples therapy
– Support your autonomy even if your partner disagreesIf you fear your partner’s reaction to stopping therapy, this itself is crucial information that may indicate safety concerns the therapist should address.
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How do I know if my therapist is properly trained in consent and safety issues?
You can ask potential therapists:
– “What’s your training in domestic violence assessment?”
– “How do you handle power imbalances in couples?”
– “What’s your confidentiality policy for couples therapy?”
– “Under what circumstances would you recommend individual therapy instead?”
– “Do you conduct individual sessions as part of your couples work?”Red flags:
– Dismissing safety concerns
– Refusing to meet individually
– Lack of clear confidentiality policy
– No screening for violence or coercion
– Pressure to continue therapy despite discomfortGreen flags:
– Clear explanation of consent process
– Individual safety assessments
– Willingness to refer when appropriate
– Transparent about theoretical approach
– Cultural humility and sensitivity -
Is it normal to feel uncomfortable in couples therapy?
Some discomfort is expected—you’re discussing difficult topics. However, there’s a difference between productive discomfort and unsafe discomfort:
Productive discomfort:
– Nervousness about being vulnerable
– Uncertainty about expressing needs
– Awkwardness of trying new communication techniques
– Embarrassment about past conflictsUnsafe discomfort:
– Fear of your partner’s reaction
– Inability to speak honestly
– Feeling blamed or attacked
– Physical symptoms of anxiety or panic
– Dread before or after sessionsIf you’re experiencing unsafe discomfort, discuss this with your therapist immediately—ideally in an individual session.
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Where can I learn about ethical relationship counselling practices?
Vancouver College of Counsellor Training (VCCT) offers a Counselling for Intimacy in Relationships Certificate that comprehensively covers consent, ethics, and safe practice in couples therapy.
Program Highlights:
Duration: 21 weeks
Format: On-campus or online (distance education)Comprehensive Curriculum:
– Models of Counselling: Theoretical foundations
– Couples & Marital Counselling: Specialized techniques and approaches
– Listening, Asserting & Resolving Conflict: Essential communication skills
– Introduction to Psychopathology: Understanding mental health in relationships
– Sexual Identity & Gender Counselling: LGBTQ+ affirming practices
– Clinical Counselling Skills: Practical application and ethics
– Case Study Approaches: Real-world problem-solvingWhat Sets VCCT Apart:
– Ethics-first approach: Consent, safety, and boundaries are integrated throughout
– Experienced instructors: Learn from practicing relationship therapists
– Cultural competency: Understanding diverse relationship contexts
– Practical skills: Not just theory—actual counselling techniques
– Flexible learning: Choose what works for your schedule
– Career-focused: Prepares you for professional practiceWho Should Enroll:
– Aspiring relationship counsellors
– Current counsellors seeking specialization
– Social workers expanding their skills
– Anyone passionate about helping couples build healthier relationshipsCareer Pathways: Graduates work in:
– Private practice relationship counselling
– Family service agencies
– Community mental health centers
– Employee assistance programs
– Premarital counselling servicesNext Steps:
Ready to learn ethical, effective relationship counselling?
– Explore the program: vcct.ca
– Speak with an advisor: 604-683-2442 or 1-800-667-3272
– Email inquiries: info@vcct.ca
– Visit us: 503-333 Terminal Avenue, Vancouver, BCWeekly Information Sessions: Wednesdays at 11:00 AM
The couples in your community deserve counsellors who understand that safety and consent aren’t just legal requirements—they’re the foundation of healing.
Remember: The most important intervention a relationship counsellor can make is sometimes recognizing when couples therapy isn’t the right intervention at all. That discernment protects clients and honors the complexity of human relationships.
References
Canadian Association for Marriage and Family Therapy. (2024). Ethics and Standards of Practice. Retrieved from https://camft.ca
Canadian Counselling and Psychotherapy Association. (2024). Code of Ethics. Retrieved from https://www.ccpa-accp.ca/profession/code-of-ethics
Journal of Marital and Family Therapy. (2023). Therapist Awareness of Domestic Violence in Couples Therapy. Retrieved from https://onlinelibrary.wiley.com/journal/17520606
Statistics Canada. (2024). Family Violence in Canada: A Statistical Profile. Retrieved from https://www150.statcan.gc.ca/n1/pub/85-002-x/85-002-x2024001-eng.htm