Saleha Qureshi has a double Master’s in Human Development and Family Studies and graduated from the University of Connecticut. She has been a licensed Marriage and Family Therapist for the last 10 years. Here is her interview about her work as a Marriage and Family Therapist.
Please give us an overview of your role as a Marriage and Family Therapist?
Saleha Qureshi: I am a Marriage and Family Therapist and I have been in this profession for more than 10 years. I have my own private practice and currently I am doing virtual therapy sessions with my clients. My specialty is trauma and couple counseling, but I also see individuals with depression and anxiety related issues. I enjoy working with clients from diverse backgrounds. A good number of my clients are European-American. Many of my clients have reached out to me via my profile on Psychology Today.
American society has evolved into a more individualistic society while marriage has a lot to do with sacrifices. As a Marriage and Family Therapist, how do you deal with this?
SQ: It is true that the mainstream culture today is a little self-centered and materialistic in its approach. The pursuit of personal happiness in order to live the American dream is considered the epitome of success. As someone from a South-East Asian background, I come from a very collectivist culture and have strong moral values. So, I bring my values to the therapy room as well.
There is a term called “therapist assisted marital suicide”which means that when a therapist is affiliated to a very individualistic culture, he/she actually steers the couple in a direction to end the marriage if they are not finding personal happiness with each other. In other words, without saying it directly, they put the burden on the couple. So, this way, they are defeating the purpose of being a therapist that is focused on saving the marriage. Clients are looking for a therapist who understands them and their values and will help them retain the marriage rather than break it. So, this is where my religious values, cultural values, and my training as a Marriage and Family Therapist come together and I try my best to help the couple save the marriage if possible.
How do you evaluate underlying conditions a couple may be suffering from while providing therapy and how do you provide a solution?
SQ: When I see couples, I evaluate them individually to understand their life histories, family of origin experiences and the impact of any negative life experiences and trauma. I also look out for mental health issues that can impact the couple relationship. It has been my observation that early childhood trauma or emotional neglect can cause depression or narcissistic/borderline tendencies in individuals. These issues, unless treated, can impact the couple relationship in negative ways. Of course, there is a genetic component to mental health as well. Once I identify such issues, I try to have an open conversation with the clients about it. I also alert the other partner because they would be the first ones to bear the brunt of it. Mental health problems related to personality disorders are difficult to treat unless individuals are sufficiently motivated to seek help even if it is for the purpose of saving the marriage. I also help the other partner (mostly women) to make the best decision to protect themselves and their children if they are also witnessing domestic violence episodes as well.
These are severe cases, but mostly it doesn’t get to that level. In normal cases, my whole intention is to make the couple focus on having realistic expectations from each other and take ownership for the role they play in the marriage as a spouse and parent, while also exercising the right to pursue individual happiness. From a moral standpoint, the goal is to help them understand that marriage is a commitment that needs to be taken seriously and every effort needs to be made to save it even if it is for the sake of the children. So, I am definitely pro-marriage while also recognizing that some things should not be allowed to continue in a marriage such as physical and emotional abuse, as there cannot be peace where there is injustice.
AN: The American Association of Marriage and Family Therapy doesn’t have the word Morality or any of its derivatives in its code of ethics. Why do you think that’s the case?
SQ: Professor William Doherty, director of Marriage and Family Therapy, has pushed the idea that one of the goals of MFT should be moral responsibility towards clients. However, in my opinion, the reason it is not included in the code of ethics is because everybody has different values and principles of morality. Some moral values could mean one thing for one person and totally different for the other. We have some specific injunctions in our code of ethics governing the professional behavior of therapists. For example, a therapist cannot have dual relationships with his/her clients; a therapist is not supposed to exploit the clients for personal gain and can only treat them if he/she thinks she is competent to do so. So, all these things imply that there is a moral binding in this profession. But it is difficult to define morality in this society, as it can have different meanings based on one’s religion, cultural influences, moral upbringing etc. These days, there are so many societal ills and so many different perspectives as well. For instance, there are several different forms of intimate relationships other than heterosexual. Some of these relationships would be acceptable for one person and totally unacceptable for the other. Thus, it is hard to establish something as morally appropriate or distasteful them as it will generate another controversy.
There are a few things in this profession where the therapist is required by law to protect clients by breaking confidentiality as it relates to certain situations, such as child or sexual abuse, offensive crime, or suicidal behavior. So, there are guidelines on how to behave in such situations that endanger the safety of a person. In the end it depends on the therapists and how they bring up morality in their work. Since issues of social justice often require taking a stand on moral issues, a culturally sensitive therapist will be well equipped and competent in this regard.
In your bio, it is said that you have a very therapeutic style of providing therapy, and it’s warm, compassionate and yet direct. Tell us a little bit more about it.
SQ: The therapeutic relationship is considered the most important factor (about 75%) in achieving overall positive outcomes in therapy. People come to a therapist when they are hurt, wounded, distraught or feeling hopeless. So, I try my best to make my clients feel welcome and supported by giving them a safe confidential space where they are accepted unconditionally.
As human beings, we want to be seen, felt and heard. If I am able to attend to my clients in a way, they feel this connection with me, they begin to trust me. This trusting bond then helps them open up to me even more and gradually they will be receptive to any insight and recommendations I share with them even if it feels uncomfortable at first. This is what I mean when I say that I have a more direct approach.
I feel that my role as a therapist is very rewarding in a spiritual sense as well as ‘Service to humanity is service to God’.
Any message for the budding Marriage and Family Therapists:
For young budding therapists, I would suggest Psychoeducation can be a good start. Similarly, I think if you are considering MFT as your profession, then try to get out of your cultural bubble. It is important to understand the nuances of other cultures and be curious and open minded. There are several books and trainings available that can help increase your knowledge. There is a mandated requirement for licensed therapists to complete a cross-cultural training every year to stay updated. Neutrality over issues of social justice can result in oppression for certain ethnic minorities. Marriage and Family Therapists can be very instrumental in playing a huge part in restoring equality for all if they continue to advocate for the ones whose voices are not being heard.
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