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The Therapy Juggling Act

When things are up in the air, marriage and family therapists help you spot what is about to fall. UNLV's Katherine Hertlein on being an agent for social change.

People  |  Apr 18, 2017  |  By Katherine Hertlein

Katherine Hertlein is program director the marriage and family therapy program at UNLV. (Josh Hawkins/UNLV Creative Services)

Editor's Note: 

Katherine Hertlein is a professor and program director of the marriage and family therapy program at the UNLV Greenspun College of Urban Affairs. She was recently selected as the incoming editor-in-chief of the Journal of Couple and Relationship Therapy. The marriage and family therapy program operates The Center for Individual, Couple and Family Counseling. Services are available for anyone in Southern Nevada and are offered at low-cost fees. Here she offers perspective on her profession. 


It seems that I have always tried to keep things from falling.

As a young adult, I was a competitive baton twirler. And whether I was twirling during a football game halftime show or competing in the finals for a national title, it was my job to keep my eye on the baton while so many things moving around it were demanding my attention.

Though it no longer involves trophies or a sash proclaiming me “Miss Winterfest Solo Champ 1990,” my job now as a couples therapist and relationship scholar is not wholly different: I help couples and families balance the important aspects of their lives by keeping focused on the factors that may interfere with their progress. In both cases, it’s a matter of learning to catch what is up in the air before it falls.

There are many areas in life where couples fear that everything they have worked toward together is about to fall. Infidelity, communication deficiencies, incompatibility, unmet expectations, perceived neglect, and power problems obfuscate partners’ recognitions of their own relationships or themselves independently. Despite a couple’s best effort, the baton invariably drops.

Social Agents of Change

Good therapy emphasizes making broad changes across one’s entire routine to prevent what is up in the air from falling altogether. Couple therapists help clients understand what went wrong and how to rebuild the relationship into something new and more sustainable. We listen. We validate. We normalize. We create safe spaces for vulnerability. We seek to understand the etiology of what has failed such that we may clear the floor from falling pieces and strive to prevent the problem that brought the clients to seek out therapy in the first place.

Therapists accomplish this through embracing our role as social agents of change. As social change agents, we evaluate the system, identify vulnerabilities, and advocate for personal and relational health. We advance knowledge on what works best in families in promoting change within the current sociopolitical climate and help clients develop a sense of moral responsibility where they can live authentically and with integrity. We encourage emotional balance and engagement in activities that foster relationships among family and community, and have a responsibility to alter the actions and cognitions of those clients whose values concern us.

Routines Change with Technology

Positioning myself as a therapist and social change agent in today’s digital age means that I work with couples and families to understand how the Internet changes the roles and rules they have in their families and muddies up boundaries that were once crystal clear. My primary research focus is understanding how cellphones, the internet, and software contribute or alter the issues couples and families face. The model I developed, known as the Couple and Family Technology Framework, identifies ways in which technology contributes to changes in our family structures and the way we interact with one another. In this model, I advocate for the usage of technology in a way that will be advantageous to relationship initiation and maintenance strategies. I also research how problems related to technology and the internet can be effectively treated. I work with couples to take control over their devices before their devices distract them from what is about to drop.

Picking up the Baton Where it Fell

Another area where I adopt the position of social change agent is in my scholarship and clinical work with couples recovering from crises. There is no question that couples struggle in our community. Nevada has one of the highest rates of divorce nationally. We live in a place that honors the quickie marriage, and with the shortest residency requirements prior to divorce, why not the quickie divorce, too? Our region for many is considered a place primed for addictions, affairs, and even shift work where the time couples spend together is compromised.

I attend to this in researching and treating cases where the couple has experienced sexual difficulties, infidelity, and/or are entertaining the decision to divorce. I work with couples in reconstructing the play-by-play of the relationship following key areas identified in our text, Systemic Sex Therapy. We then work together on reducing the vulnerabilities for a future fall, pick up the baton, and create something more feasible and sustainable for the couple. For example, in the case of divorce recovery, our research has found that the routine will go on in positive ways for families when their therapists advocate engaging in open and productive communication with any children during a divorce process, hopefully shaping the way these conversations happen in those families outside of therapy rooms.

Adding an Egalitarian Perspective to Achieve Balance

Finally, I put my practice balancing what’s spinning to good use through incorporating gender into my research. Examples involve my research with fellow colleagues in the Greenspun College of Urban Affairs on high-risk sexual behavior in post-menopausal women and, in my own discipline, researching the experience of female professors in family therapy programs. In both areas of inquiry, I am advocating for equality and promoting egalitarian relationships, a position that transcends into my clinical work with couples. This perspective influences my interactions with those clients and, I hope, also is reflected into their relationships with others.

Change isn’t easy. Therapists who operate from a position of understanding their own value system and that of the client can see more coherently what true change will entail. From this vantage point, they will be able to advocate for their client as well as engender changes to the system outside of the client, thus providing more holistic (and realistic) support to maintain one’s relationships before these relationships spin out of control.