Cognitive marital therapy

This article reviews recent applications of cognitive therapy to the treatment of marital distress. Three categories of cognitive phenomena that can decrease marital satisfaction and elicit dysfunctional interactions between spouses are described. First, automatic thoughts that comprise an individual's stream-of-consciousness thinking about marital events can be biased by systematic cognitive distortions. Inaccurate attributions about the causes of marital problems are a major form of such automatic thoughts. Second, individuals' behaviors toward their partners are influenced by their expectancies about the probabilities of the partner's subsequent responses, and these expectancies also are susceptible to systematic distortion. Third, an individual's unrealistic or irrational beliefs about the nature of intimate relationships can produce distress and dysfunctional behavioral responses toward the partner. Methods for assessing and modifying these dysfunctional cognitions, particularly in conjoint treatment, are described. Similarities and differences between cognitive therapy and rational-emotive therapy in the treatment of marital problems are noted.     

A rational-emotive theory of marital dysfunction and marital therapy

This article first discusses some rational-emotive perspectives on marital and couples therapy, including what constitutes a good relationship, some important differences between rational-emotive and other couples therapy approaches, and an RET classification of relationship problems. Second, this article also sketches out ways in which social exchange principles can be integrated into rational-emotive couples therapy.This is a revised version of a paper that originally appeared in A. Ellis and M. Bernard's (Eds.) 1985 text,Applications of Rational Emotive Therapy, Plenum Publishing Co., New York.     

Early stages in experiential marital therapy

The treatment of marital issues in symbolic-experiential therapy unfolds in somewhat predictable stages, though some of these may be imposed by tasks required by the therapist. The first stage calls for defining the dominant symbolic theme in the couple's struggle, and for engaging with that symbolic structure from a certain posture. Opening strategies are discussed for dilemmas concerning power, closeness, depth, flexibility, balance, and time. The second major stage requires that the couple take initiative in exposing issues and in changing problematic communication patterns. Covert relationship and family of origin issues are exposed, with insight being a goal. The third stage involves negotiated behavioral change, with the therapist implicitly suggesting a regressive stage. A second paper, Later Stages in Experiential Marital Therapy discusses regressive work with couples, including engagement with the family of origin.     

Cultural tensions in strategic marital therapy

Whether the elements of a good marital relationship are universal is the question addressed in this case study of therapy with a couple who were culturally different from the therapist. The conflicts between the therapeutic strategies, which were based on a strategic therapy model, and the customs of the couple from a foreign culture, made it difficult to evaluate whether the therapist was on target with interventions. On one hand, therapists need to guard against being misled into believing that customs are cultural imperatives which never can be changed. On the other hand, they need to be aware of the impact and possible ramifications of challenging long-held, culturally-based beliefs and behaviors. The following case study details the dilemmas faced by a therapist working with an Asian-Indian couple who presented themselves as being bound by their cultural background and heritage.Grateful acknowledgement is made by the author to Etienne Phipps, PhD, whose comments give direction and substance to all my work.     

Recent developments in family behavioral marital therapy

This paper reviews recent developments in the area of behavioral marital therapy (BMT). New information is summarized regarding the long-term efficacy of BMT and the identification of predictors of positive response to treatment and to relapse. Finally, new applications of BMT techniques are reviewed (e.g., spouse-involved therapies as the sole treatment for presenting problems in which marital distress is not the primary focus such as anxiety and affective disorders).     

Adlerian marital therapy with the passive-aggressive partner

Abstract

This paper describes the passive-aggressive personality and provides an Adlerian formulation of the PAP in couples functioning. It points out the similarities of this formulation to DSM-III-R, cognitive therapy, and transactional analysis. A specific treatment plan incorporating several types of intervention for helping such couples lead more effective marital lives is presented.     

The marital and family therapy examination program

This report is intended to inform the reader—as fully as is compatible with examination security—about the Examination in Marital and Family Therapy used by most of the states licensing marital and family therapists in the United States. The rationale for the examination is given, its development and validation are described, and the knowledge base that it samples is provided. The examination is presented as a necessary and logical component in the development of marital and family therapy and as an essential part of the implicit contract that exists between professionals and the community.Although a great many people labored on the Examination in Marital and Family Therapy, and continue to do so, the National Exam largely was founded and developed under the leadership of Carl F. Johnson of Atlanta, Georgia.     

Psychoanalysis, marital therapy, and object-relations theory

This paper attempts to indicate why psychoanalysts should be interested in marital therapy. It discusses the clinical advantages and disadvantages of marital therapy as compared to psychoanalysis, describes the contributions of the classical psychoanalytic viewpoint to marital therapy, and finally, attempts to complement the classical psychoanalytic viewpoint with an object-relations viewpoint which can illuminate marital dynamics and provide interpretive content during the course of marital therapy.     

Research applications of Shapiro's personal questionnaire in marital therapy

Clinical research raises many problems and is often neglected in clinical settings. In this paper, the contribution of Shapiro's personal questionnaire in marital therapy research is described in the context of these contrasting research designs.     

Research-structured vs clinically flexible versions of social learning-based marital therapy

The purpose of this study was to compare our structured research-based version of marital therapy from a social learning perspective with a clinically flexible version of the same treatment where treatment plans were individually-based and there was no specific number of treatment sessions. Thirty distressed married couples were randomly assigned to one of these two treatments. Assessment of outcome was based on global marital satisfaction, spouse reports of functioning in specific areas, and direct observational measures of communication. At posttest there were no differences in efficacy between structured and flexible treatments, although both treatments led to significant improvements. At a 6-month follow-up couples treated with the structured format were more likely to have deteriorated and flexibly treated couples were more likely to have maintained their treatment gains.     

Developmental perspectives and family therapy: The marital life cycle

Developmental perspectives have been part of family therapy for more than two decades with a primary focus on the family life cycle and individual development. Most efforts at recognizing a marital life cycle have subsumed marital tasks under rubrics based primarily on parental roles. This paper offers a marital life cycle based on marital development with specific tasks for each of four stages-the marital breakup and remarriage phases are not included here-and provides implications for therapy.