Session Attendees
- Who attended (both partners, one partner, etc.)
- Note if one partner was absent and any information shared about that partner
Presenting Concerns and Reasons for Seeking Therapy
- Primary relationship concerns and difficulties
- Each partner’s perspective on the main problems
- Frequency, duration, and severity of concerns
- Precipitating events or recent changes prompting help-seeking
- Any crisis or urgency elements
Relationship History and Timeline
- How the couple met and what initially attracted them to each other
- Length of relationship and current status (dating, cohabiting, married, etc.)
- Significant milestones (marriage, children, relocations, etc.)
- When things were last good; when problems first emerged
- Pivotal events that significantly impacted the relationship
Current Relationship Structure and Context
- Living arrangements
- Children
- Extended family involvement
- External stressors (financial, occupational, health, cultural/religious factors)
- Social support network
Communication and Conflict Patterns
- Typical conflict triggers
- Each partner’s behaviour during conflict (pursuit, withdrawal, criticism, defensiveness, etc.)
- Patterns of escalation or avoidance
- Capacity for repair after conflict
- Quality of everyday communication outside conflict
Emotional and Physical Connection
- Current state of emotional intimacy and attunement
- Ability to be vulnerable; emotional responsiveness
- Expressions of affection and appreciation
- Physical intimacy and sexual relationship (if discussed)
Individual Partner Backgrounds and Relevant History
Partner A’s Background:
- Family of origin experiences and relationship models
- Previous significant relationships
- Relevant mental health or trauma history
- Cultural or religious background relevant to relationship expectations
Partner B’s Background:
Mental Health, Substance Use, and Medical History
Partner A:
- Current mental health concerns, treatment history, substance use, relevant medical conditions, current medications
Partner B:
Previous Therapy and Treatment History
- Previous couples therapy (when, with whom, outcome)
- Previous individual therapy relevant to relationship issues
- What was helpful or unhelpful; what the couple hopes will be different
Relationship Strengths and Positive Factors
- Positive qualities each partner sees in the other
- Shared values, interests, and what is still working
- Commitment level and motivation to engage in therapy
- Capacity for reflection, empathy, and accountability
Each Partner’s Goals and Expectations for Therapy
Partner A’s Goals:
- Specific goals Partner A articulated for therapy
Partner B’s Goals:
- Specific goals Partner B articulated for therapy
Shared Goals:
- Areas where partners’ goals align or complement each other
Divergent Goals:
- Areas where partners want different things from therapy or have conflicting expectations
Therapist Initial Impressions and Conceptualisation
- Primary relational dynamics observed or described
- Preliminary hypotheses about underlying patterns
- Attachment-related themes (if evident)
- Individual and systemic factors impacting the relationship
- Readiness and motivation for change
Assessment of Suitability for Couples Therapy
- Safety factors and power dynamics
- Both partners’ willingness to participate
- Compatibility of goals with conjoint therapy
- Whether individual therapy is indicated first or concurrently
Safety Assessment and Contraindications
- Intimate partner violence (history, frequency, severity, recency)
- Threats of separation or divorce
- Suicidal or self-harm risk (highlighted in red if current risk present)
- Substance use severity
- Affairs and infidelity
- Contraindications for couples therapy
- Protective factors
Risk Management and Follow-Up Actions
- Immediate risk management steps, safety planning, referrals, crisis resources provided
Therapeutic Approach and Preliminary Treatment Planning
- Framework(s) to be used or integrative approach
- Initial focus areas for treatment
- Session structure (frequency, duration, format)
- Psychoeducation and ground rules discussed
- Each partner’s response to the proposed approach
Homework or Between-Session Tasks
- Tasks, questionnaires, or reflection exercises assigned
- Rationale for assignments; any concerns raised
Next Steps and Treatment Plan
- Whether ongoing couples therapy will proceed or individual sessions are recommended first
- Preliminary goals, session frequency and duration
- Additional assessments or referrals needed
- Date, time, and day of next scheduled appointment
Summary
- Who attended; primary presenting concerns; key relational dynamics; preliminary treatment direction (four sentences maximum)
Session Attendees
Both partners attended: James Bloggs (Partner A) and Sarah Bloggs (Partner B)
Presenting Concerns and Reasons for Seeking Therapy
- Longstanding communication breakdown, emotional disconnection, and escalating conflict, worsening over the past 12 months coinciding with increased work demands and the arrival of their second child
- James described feeling “shut out”; Sarah reported feeling overwhelmed and criticised
- Both agreed the relationship has deteriorated significantly; James expressed concern it may not survive without intervention
Relationship History and Timeline
- Met approximately 10 years ago through mutual friends; married six years ago; two children aged four and 18 months
- Both described the early relationship as close, with a gradual decline following the birth of their first child
- Sarah identified the birth of their second child as a significant turning point after which conflict became more frequent and repair more difficult
Current Relationship Structure and Context
- Living arrangements: Together in the family home
- Children: Two children aged four years and 18 months, both residing in the family home
- External stressors: Both working full-time; financial pressure from mortgage and childcare costs; Sarah reported significant parenting-related fatigue
- Social support: Both described limited social contact; James identified one close friend as a primary support
Communication and Conflict Patterns
- Recurrent demand-withdraw pattern: James initiates discussion of concerns; Sarah withdraws or disengages
- Conflict typically triggered by parenting disagreements and perceived lack of emotional availability
- Limited capacity for repair; periods of distance typically last several days
- Communication outside conflict described as functional but superficial, focused on logistics
Emotional and Physical Connection
- Both partners reported emotional disconnection; James described loneliness within the relationship; Sarah described feeling depleted and unseen
- Physical intimacy has reduced significantly over the past 18 months; neither had raised this directly prior to this session
Individual Partner Backgrounds and Relevant History
Partner A — James Bloggs:
- Grew up in a conflict-avoidant, emotionally reserved household; learned to manage distress privately
- Acknowledged this background may drive his tendency to pursue connection when he feels disconnected
Partner B — Sarah Bloggs:
- Grew up in a high-conflict household; identified withdrawal during conflict as a learned response to avoid escalation
- Disclosed a history of sub-clinical anxiety managed without formal treatment; noted current stress is elevated
Mental Health, Substance Use, and Medical History
Partner A — James:
- No mental health history; social alcohol use; no medications
Partner B — Sarah:
- Sub-clinical anxiety; one prior course of individual counselling (work stress, five years ago, described as helpful); no medications
Previous Therapy and Treatment History
- No previous couples therapy
- Both expressed hope that a neutral, structured space will be more productive than managing concerns independently
Relationship Strengths and Positive Factors
- Both expressed genuine commitment to the relationship and their family
- Each identified valued qualities in the other; moments of warmth and humour were evident during the session
- Both demonstrated capacity for self-reflection and acknowledged their own contributions to current difficulties
Each Partner’s Goals and Expectations for Therapy
James’s Goals:
- Rebuild emotional connection; develop more productive ways of raising concerns; restore intimacy
Sarah’s Goals:
- Feel less criticised during conflict; develop communication strategies around parenting and household responsibilities
Shared Goals:
- Reduce conflict frequency and intensity; improve day-to-day communication
Divergent Goals:
- James prioritised rebuilding intimacy early in treatment; Sarah’s focus was on reducing conflict first
Therapist Initial Impressions and Conceptualisation
- Demand-withdraw pattern well-established, with family-of-origin experiences appearing to reinforce each partner’s position
- Relationship deterioration coincides with significant life transitions, suggesting contextual stressors as contributing factors
- Both partners motivated and reflective; genuine warmth between them noted as a positive prognostic indicator
Assessment of Suitability for Couples Therapy
- Assessed as suitable for conjoint couples therapy; no contraindications identified
- Both partners willing to participate with sufficient reflective capacity for joint sessions
Safety Assessment and Contraindications
- Intimate partner violence: None reported; neither partner expressed fear of the other
- Threats of separation: James had privately considered this; had not been disclosed to Sarah prior to this session
- Suicidal or self-harm risk: Nil
- Affairs and infidelity: None reported
- Protective factors: Mutual commitment, shared parenting values, capacity for self-reflection, warmth and humour between partners
Therapeutic Approach and Preliminary Treatment Planning
- Integrative approach drawing on EFT to address attachment needs and interaction cycles, and Gottman Method principles for communication skill development
- Initial focus: mapping the negative interaction cycle and building a shared understanding of the demand-withdraw pattern
- Fortnightly sessions, conjoint format; no-secrets policy outlined and acknowledged by both partners
Homework or Between-Session Tasks
- Both partners to complete the Gottman Relationship Checkup questionnaire prior to the next session
- Both to notice and record one moment each day of feeling connected or disconnected, without attempting to resolve it
Next Steps and Treatment Plan
- Ongoing conjoint couples therapy to proceed fortnightly
- Next appointment: Tuesday, 4 March 2026 at 5:00 PM
Summary
Both James and Sarah Bloggs attended this intake presenting with communication breakdown, escalating conflict, and emotional and physical disconnection, intensifying over the past 12–18 months in the context of parenting demands and occupational stress. A demand-withdraw interaction pattern was identified as the primary relational dynamic, reinforced by contrasting family-of-origin experiences. The therapist assessed the couple as suitable for conjoint therapy and proposed an integrative EFT and Gottman Method approach.
