How do relational therapists approach case conceptualisation and treatment planning when working with consensually non-monogamous clients? And how might dominant assumptions that monogamy is the norm influence that work?
This COSRT Research Learning Session centres on original doctoral research by Caitlyn Burns, a psychotherapist and PhD. The study examined how relational therapy providers make sense of clients’ presenting concerns and plan treatment, and whether their responses change when a relationship is described as consensually non-monogamous rather than monogamous.
Using a qualitative, constructivist grounded theory approach informed by queer theory, Caitlyn gathered short-answer survey responses from 32 relational therapists in the United States. Participants reviewed a clinical vignette and responded to questions about their hypotheses, the further information they would need, and their initial treatment plans. They were also asked whether their responses would change if the couple were monogamous.
The findings suggest that mononormative bias can shape therapists’ case conceptualisation and treatment planning, even when they intend to treat CNM clients “the same as any other client”. The study describes a two-part process: an intention to treat clients similarly, followed by responses that may not reflect that intention. These responses included pathologising CNM relationships and forms of dissonance, such as misconceptions about CNM, scepticism towards clients’ accounts of their relationships, or a mismatch between therapists’ stated intentions and their answers.
During this focused session, Caitlyn will introduce the research, explain its methodology, present the findings and consider their relationship to existing literature. The discussion will explore implications for ethical clinical practice, including the need for therapists to examine their own assumptions, build knowledge of diverse relationship structures, and consider how mononormative discourses may affect their work.
This is a research-focused learning session rather than a traditional skills-based training. Participants will be invited to engage critically with the study, its methodology, its findings and its implications for practice.
By the end of the session, participants will be able to:
• Explain mononormative bias and monogamism, and consider how they may appear in clinical practice.
• Describe the study’s research questions, methodology and emergent theory.
• Identify and critically consider key contributions of the research to the literature on working with CNM clients.
• Reflect on how the findings may inform their own case conceptualisation and treatment planning.
Session outline
Background and purpose of the research
• Why the study was undertaken
• The gap in research on case conceptualisation and treatment planning with CNM clients
• The study’s central research questions
Research methodology
• Qualitative, constructivist grounded theory and queer theory
• Participant sample and recruitment
• Vignette-based survey data collection
• Grounded theory coding and analysis
• Ethical considerations, trustworthiness and study limitations
Key findings
• How mononormative bias appeared in case conceptualisation and treatment planning
• The two-part process of intending to treat CNM clients similarly, followed by responses that may depart from that intention
• Pathologising CNM relationships
• Dissonance, including misconceptions about CNM, dissonance with clients’ accounts and dissonance with therapists’ own responses
Critical discussion
• How the findings support and extend existing research on mononormative bias and monogamism
• What the study suggests about therapists’ stated intentions and clinical responses
• Limitations of the research and questions for future study
Implications for practice
• Considering how assumptions about monogamy may shape clinical judgements and treatment plans
• Exploring therapists’ own biases, knowledge and assumptions
• The role of training and supervision in preparing therapists to work with CNM clients
• Reflecting on how to support ethical and affirmative practice with diverse relationship structures
Questions, critical appraisal, and discussion
Participants will be invited to discuss the emergent theory, consider the study’s contribution to the evidence base and reflect on how its findings may relate to their clinical work.
About the Trainer
Caitlyn (Cait) Burns PhD
Licensed marriage and family therapist
Caitlyn (Cait) Burns, PhD, is a licensed marriage and family therapist in New Jersey and Washington. She holds a master’s degree from Seton Hall University and a doctorate in Couple and Family Therapy from Antioch University of New England.
Cait’s interest in systemic and relational therapy began during her undergraduate fieldwork with autistic clients and their families. She now works in private practice, supervises emerging therapists and teaches at two universities. Her approach integrates narrative and contextual therapies, informed by queer theory and attachment perspectives.
Cait is an out and proud member of the asexuality community. Her areas of focus include sexual and gender identity, neurodivergence, and systemic and relational dynamics. She has also undertaken research and training on consensual non-monogamy. Passionate about social justice, Cait is committed to expanding inclusive and affirming care in the field.in New Jersey and Washington. She holds a master’s degree from Seton Hall University and a doctorate in Couple and Family Therapy from Antioch University of New England.