Current Issues in the Practice of Integrative Couple and Family Therapy

This paper provides an overview of current issues in integration in couple and family therapy. It summarizes the evolution of integration in couple and family therapy, the various traditions in integration, the strengths of integrative approach, and the possible pitfalls involved. It highlights the extent to which most couple and family therapy is now integrative practice. It concludes with a consideration of an emerging trend toward methods of practice centered on modules of intervention that have been identified as effective with certain presenting phenomena. The example of therapy for high conflict divorce is utilized to illustrate how various components can be brought together to create a maximally effective intervention.     

The Integrative Revolution in Couple and Family Therapy

A quiet revolution has resulted in significant movement toward integrative practice in couple and family therapy. This article examines the present status of integrative methods, highlighting the factors that have led to their broad acceptance, issues surrounding the definition of integration and the nomenclature used, the content of recent approaches, and specific conceptual developments and directions.     

Psychoanalytic Models of the Mind for Couple and Family Therapy

This paper describes an object relations theory of mind that highlights the interactive origin of psychic function and the beginnings of mental structure in the infant's relationships within the family group. Based on this model, psychoanalytic family and couple therapy employs the interactions between family and therapist to detect and work with developmental failures in holding and containment, skewed family projective identification, and attacks on linking, which characterize pathological and traumatized families. The coming together of transference generated by the family as a group and the therapist's countertransference are the fulcrum on which such therapy turns. An extended vignette of a session is used to illustrate the application of object relations theory to the therapeutic process of family therapy.     

Clinical Supervision of Couple and Family Therapy during COVID-19

This paper addresses the need for a swift transition from in-person clinical supervision to telesupervision during the time of the COVID-19 global pandemic. Five specific areas will be discussed in the effort to enhance the quality of clinical supervision provided to couple and family therapists in training at this time including the following: (1) COVID-19 and the structural changes and technological adaptation of supervision; (2) culturally and contextually sensitive guidelines for clinical supervision during COVID-19; (3) the supervisee’s competence and the clinical supervisory process; (4) the new set of boundaries and the supervisory role; (5) and the supervisory alliance and supervisees’ vulnerabilities in the face of COVID-19.     

Work and Family Conflict: An Often Overlooked Issue in Couple and Family Therapy

Despite the systemic interaction, family-based journals, as well as intake and assessment forms most frequently used by couple and family therapists (CFTs), have given a limited amount of attention to the issue of work and family conflict. Moreover, a review of the literature indicated that many CFTs perceive themselves as inadequately prepared to assist couples and families with work and family conflict. Addressing this apparent limitation, the present study identified various work stressors that contributed to family conflict (WFC), and the family stressors that contributed to work conflict (FWC). Results revealed significant predictors of WFC and FWC. Implications for CFTs and recommendations for changes in academic training and supervision are provided. The authors would like to thank Dr. Gary Bischof, Associate Professor of Counselor Education and Marriage and Family Therapy program Director at Western Michigan University, for editorial comments made on a previous version of this paper.     

Clinical Application of the Advantages of Technology in Couple and Family Therapy

While couples may be holding hands with one another, they are also holding their cell phones in the other hand. Technology is so woven into the fabric of our society that it is hard to separate it from the relationship itself. As such, the role of the marriage and family therapist demands that it attends to technology within the practice of couple therapy. This article describes strategies for couple and family therapists to use in the context of their treatment. The strategies are grounded in both theoretical and empirical knowledge and cover three categories of application: relationship initiation, relationship maintenance, and relationship enhancement.     

Video Game Therapy: Application of the Couple and Family Technology Framework

The couple and family technology framework outlines how technology affects couple and family relationships. This framework has been applied to understanding the impact of technology on infidelity, contributed to our understanding of online gaming issues in couple relationships, and sexting. The purpose of this paper is to outline how to implement video gaming as a disciplinary tool for youth congruent with the couple and family technology framework. Specifically, we identify the elements of video games that can be applied as an intervention in family treatment with youth in a token economy. This proposed technique focuses on utilizing technology (and specifically video games) as a strategy to improve youth’s behavior. Consistent with the couple and family technology framework, this paper outlines how accessibility, affordability, accommodation, and approximation can be used to improve behavior as well as improve parent–child relationships. Implications are included.     

Feedback in Couple and Family Therapy: A Randomized Clinical Trial

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC (“treatment as usual” or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed.     

Beyond the Binary: Trans‐Negotiations in Couple and Family Therapy

Dualistic notions about gender and sexuality have permeated the field of couple and family therapy. These binary constructions have been limiting for everyone, especially those who fall outside the male/female dichotomy. This article examines the impact of these binary notions, especially on transgender and gender‐creative individuals, couples, and families. Current theory and research in the field as they relate to gender identity, sexuality, and gender minority stress in couples and families are presented. Case examples are used to illustrate affirmative approaches to treatment issues such as coming out, safety, grief and loss, redefining relationships, and social/medical transitions that may arise for transgender or gender nonconforming (TGNC) individuals, couples, and families.     

Couple Crises and the Trigenerational Family

ABSTRACT

A trigenerational approach to couple crises is presented. Key ideas are developed from the work of Bowen, Framo and Whitaker on families of origin; Bowen sends partners back to their own families; Framo invites the extended family into the session with the couple; Whitaker enlarges the unit of observation to include more family members, increasing family resources. For the author, the early phase of therapy is diagnostic, so extended family members are invited to provide information as consultants. One couple'S crisis is reviewed m detail. Issues arising from inviting the couple'S parents and siblings, their children, and the value of individual sessions for the partners are examined using the trigenerational framework.