Narrative Process Coding System in Marital and Family Therapy: An Intensive Case Analysis of the Formation of a Therapeutic System

The aim of this study is to investigate whether the method (Narrative Processes Coding System) for studying the narrative sequences of individual psychotherapy developed by Angus and Hardtke (1994) can be applied in a family therapeutic process. According to the results narrative process coding system adds new dimensions and gives new depth in the narrative understanding of family therapeutic process. In micro-analytic interactional level it shows the complicated interactions between narration, plot, and narrative process type.     

Gender, Power, and Relationship Ethics In Family Therapy Education

Awareness and sensitivity about gender issues have central positions in family therapy education. Traditionally gender relationships have been treated as either a reflection of cultural values and norms or as a dynamic of the way that men and women deal with the other sex. This paper presents the findings of a qualitative study that examines the meaning and enactment of gender issues in the supervisory process in family therapy. Based on that study, the authors developed a strategy for raising issues of gender equity in clinical training and describe the effects of that strategy on one practicum.Professor of Family and Child Sciences and the director of the Interdivisional Program in Marriage and Family Therapy at Florida State UniversityAn associate professor of Family and Child Sciences and the co-director of the Family Policy and Research Unit in the Family Institute at Florida State University     

Increasing Marital Intimacy: Lessons from Marital Enrichment

Both marriage and family therapists and family life educators work to increase marital intimacy. In this study the effectiveness of two marriage enrichment programs was assessed with implications for practicing therapists. Participants were randomly assigned to an Adventure or ACME (Association for Couples in Marriage Enrichment) treatment group or to a control group. Marital intimacy was assessed before and after treatment. Findings demonstrated that both enrichment groups had a statistically significant increase in marital enrichment. Suggestions for adopting adventure-based interventions for traditional therapy are discussed.     

Object Relations Theory and Technique Applied to Sex and Marital Therapy

This paper demonstrates integrating psychoanalysis and behavioral techniques in sexual and marital therapy. It particularly illustrates how Fairbairn's (1943) concept of the return of the repressed can help a couple reclaim lost unconscious parts of themselves, and extensive use of countertransference during sex and marital therapy.     

Understanding Forgiveness as Discovery: Implications for Marital and Family Therapy

This article explores the concept of forgiveness in relationship systems and examines various conceptualizations and definitions found in the literature. Forgiveness is described as a complex psychological and relational process that is more a discovery than an act of will. A rationale for viewing forgiveness in a contextual, historical, and relational attachment paradigm is presented, and the association of forgiveness with empathy and emotional intelligence is discussed. Marital and family therapists are encouraged to attend to contextual family of origin issues and to facilitate an empathic relational environment where ambivalence is expected and tolerated for enhancing the process of forgiveness. Relevant clinical cases are shared to illustrate the process of forgiveness as discovery.     

Problem Definition in Marital and Family Therapy: A Qualitative Study

This paper describes findings from a grounded theory study on the process of constructing problem definitions by marital and family therapists. Coding of the observations and interviews resulted in two meta-problem definition processes. In the first meta-process clinicians kept their definitions internal to themselves during the therapy session. In contrast, the second meta-definition process involved clinicians bringing forth their internal problem definitions and incorporating them into the therapeutic conversation. Implications for existing conceptualizations and marital and family therapy practice and supervision are discussed, as well as suggestions for further consideration.     

Maintaining Men's Dominance: Negotiating Identity and Power When She Earns More

This article examines the power dynamics in marriages where wives earn substantially more than their husbands based on in-depth interviews with husbands and wives in 30 couples. The results demonstrate how normative gender expectations constrain interactions between spouses and how spouses in these unconventional marriages struggle to construct appropriate gender identities that are more or less consistent with the conventional expectations that men should be breadwinners and women should be homemakers. These data represent an important counterpoint to the growing body of quantitative work that demonstrates that a woman's power diminishes as her income exceeds her husband's by illuminating how men's power is preserved within marriage, even in the absence of their traditional economic dominance.     

Developing the Working Alliance in Marital Therapy; A Psychodynamic Perspective

A good working alliance in marital therapy is one in which the partners are actively collaborating with their therapist to work through conflicts. The therapist begins to develop the alliance by setting the frame of therapy and helping the couple understand the guidelines of treatment. The partners gradually identify with and emulate the therapist's working style and use of self as a reflective instrument. The working alliance can be weakened by empathic failures and strengthened by increased feelings of trust in the therapist and the process of treatment This paper looks at the development of the working alliance in marital therapy from a psychodynamic perspective. A clinical illustration is included.     

Marital Conflict Among Parents: Implications for Family Therapy with Adolescent Conduct Disorder

Conduct disorder is associated with several causative and maintaining factors, with family functioning being an important one. This is especially true in the Indian context, where a lot of the problem behaviors manifested by adolescents with conduct disorders are in the family context. Marital relationship of the parents is a key aspect of family functioning, affecting a number of other dimensions of family functioning, including adolescent adjustment. The paper highlights the role of parents’ marital conflict in the emergence and maintenance of adolescent conduct problems. The importance of family therapy in managing adolescent conduct disorder is discussed through case examples from India. Shalini Anant, MPhil, PhD Scholar, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore 560029, India. Ahalya Raguram, PhD, Additional Professor, Department of Clinical Psychology, NIMHANS, Bangalore 560029, India. Address correspondence to Shalini Anant (shalinianant@gmail.com).     

The Application of Facilitated Imagery to Marital Counseling

SUMMARY

The purpose of this study was to assess whether facilitated imagery is a successful technique for improving both marital satisfaction and individual psychological functioning. Twenty marital couples were randomly assigned to two experimental groups: Both received three sessions of structured marital enrichment and one also received three facilitated imagery sessions. Posttests were given at one month and four months following treatment. Subjects exposed to facilitated imagery showed significantly greater improvement on some scales of marital satisfaction and individual psychological functioning, and these improvements persisted at the four-month posttest. In posttest interviews, subjects reported the primary benefit was insight into themselves and their spouses.

A series of 2x(3) repeated measure analyses of variance were used to detect changes for husbands and wives. Subjects exposed to facilitated imagery reported significantly greater improvement than enrichment-only subjects on some scales of marital satisfaction and individual psychological functioning. In addition, improvements persisted at the four-month posttest for the enrichment-plus-imagery subjects, but declined for the enrichment-only subjects. In interviews, the majority of imagery subjects reported that the process had been helpful to them both personally and relationally. Subjectively they reported gaining insight into themselves or their spouse as the primary benefit obtained from the imagery work.     

Influence of Therapist and Client Behaviors on Therapy Alliance

This study considers the combined effect of therapist behaviors and couples interaction dynamics on therapeutic alliance because it seems to be a significant predictor of successful therapy outcomes. We measured therapeutic alliance using the Working Alliance Inventory, Observer Version (WAI-O), which includes three subscales: goals, tasks, and bond. We investigated the combined effect of therapist behaviors and couples interactions on therapeutic alliance. There were three significant findings: (1) the models better predicted therapeutic alliance for men clients than women clients; (2) combined consideration of partner behaviors and therapist behaviors provided the stronger prediction of therapeutic alliance; and (3) different variables predicted alliance for women clients versus men clients.     

Toward a More Comprehensive Understanding of Peer Maltreatment: Studies of Relational Victimization

Although many past studies of peer maltreatment have focused on physical victimization, the importance of an empirical focus on relational victimization has only recently been recognized. In relational victimization, the perpetrator attempts to harm the target through the manipulation of relationships, threat of damage to them, or both. We review what is currently known about relational victimization with three issues in mind: (a) developmental changes in the manifestation of relational victimization, (b) gender differences in the likelihood of being victimized, and (c) evidence that relational victimization is harmful.     

Changes in Cognitions, Emotions, and Behaviors in Depressed Patients and Their Spouses Following Marital Cognitive Therapy, Traditional Cognitive Therapy, Pharmacotherapy, and No Intervention

This study evaluated specific influences of a cognitive marital treatment (CMT) for depression based on an integration of cognitive theory of depression and systems theory. The effects of CMT on variables representing cognitions, emotions, and behaviors were compared with the effects of traditional cognitive therapy (CT), pharmacotherapy (PT), and no treatment (NT). Subjects were Major Depression Disorder and Dysthymic outpatients and their spouses. The changes considered were for pre–post treatment and pre-treatment–follow-up. CMT affected a wider range of variables than other treatments. In most instances it was also superior to the NT condition. Most of the gains were manifested at termination and lasted through follow-up. The variables affected by CMT were patients' and spouses' cognitions and emotions. PT had best effects on patients' emotions. CT affected patients' cognitions, but did not achieve superiority on any of the compared variables. None of the treatments produced significant changes in behaviors.     

Relational Couple Therapy with Post-Traumatic Survivors: Links Between Post-Traumatic Self and Contemporary Intimate Relationships

The present article describes a clinical case study of relational couple therapy with post-traumatic spouses. Survivors, who were infants and toddlers during the Holocaust, disclose tremendous difficulties in their intimate relationships. The early loss of parental figures, and cumulative traumatic experiences throughout survivors' lives in the post war era hampered their capacity for intimate partnership despite its ultimate necessity. Relational couple therapy creates an unfamiliar experiential space with the couple's bond. This experiential space enables each partner to change destructive emotional patterns within one's inner psychic reality as well as the couple's emotional system. In addition, the therapeutic triangle creates partial transformational boundaries between past traumas and the couple traumatic bonds.     

Feminist Issues in Couple Therapy

Abstract

The authors reviewed the feminist couple therapy literature from 1995 to 2006. They summarized this large body of work into several key themes. The first revealed that feminist couples therapists are continuing to discuss and deconstruct gender issues in couple therapy. The second showed that feminists believe that therapists should be educated both academically and personally about culture and diversity so as to support couples in their therapy around their own issues of diversity as well as learning to deal with issues of social justice as a couple. In the third theme, the authors introduced readers to feminists' emphasis on connection and empathy within couple and sex therapy. And, in the fourth, the authors explored feminists' work with power in couple therapy as they applied to couple therapy in general as well as around the specific topics of: balancing family and work and therapy for familial violence.     

Dysfunctional Beliefs and Marital Conflict in Distressed and Non-Distressed Married Individuals

To test the hypothesis that the irrational evaluative beliefs, postulated by Rational-emotive behavior therapy, are related to marital conflict, 17 individuals from distressed marriages and 20 from non-distressed marriages participated in the Articulated Thoughts during Simulated Situations procedure. Four scenes, representing different dimensions of marital conflict (power/control, boundaries, expressive investment and instrumental investment), were used. On all the scenes, the distressed group showed significantly more irrational cognitions than the non-distressed group, while the scenes elicited significantly more positive thoughts with the non-distressed individuals compared to the distressed group. The results also showed that the non-distressed group displayed significantly more positive than negative thoughts for all the conflict scenes combined. However, no significant difference between positive and negative thoughts was found for the distressed group.     

Couple Therapy and Spirituality and Religion

Abstract

The current state of the art of the integration of couple therapy with spirituality and religion is presented. Each of three waves of this integration identified in this article have seen an increase in the literature in this area, although only a limited amount in each wave has addressed couple therapy specifically. In the first wave, from 1990–1994, articles set forth arguments for why spirituality should be integrated in therapy. During the second wave, 1995–1999, publications focused on the ways that including spirituality in therapy can enhance as well as harm the therapeutic process. In the third wave, 2000-present, attention has shifted away from whether to include spirituality to how it should be included, and the literature of this period features many practical interventions and suggested guidelines for integrating spirituality and religion into therapy and training. The article concludes with recommendations for further developing the integration of spirituality and religion into couple therapy models, research, and training.     

A Cross-Cultural Comparison of Gender Factors Contributing to Long-Term Marital Satisfaction

Abstract

This article reports on the major findings of a cross-cultural study comparing long-term marital satisfaction between Caucasian couples and Chinese couples in Canada. The Dyadic Adjustment Scale was used to screen couples' marital satisfaction. In-depth qualitative interviews were conducted individually and jointly with the screened couples to explore their meanings and experiences of marital satisfaction. With the use of narrative analysis, the study illuminates how couples constructed their gender relationships to achieve marital satisfaction over a long course of thirty to thirty-six years according to their sociocultural contexts. The similarities and differences in how the two cultural groups' respondents constructed their long-term marital satisfaction are discussed in terms of: (1) household division of labour, (2) decision-making, (3) conflict and compromise, and (4) mutuality.     

The Efficacy of Behavioral Couples Therapy and Emotionally Focused Therapy for Couple Distress

Twenty treatment outcome studies, 13 of which evaluated behavioral couples therapy (BCT) and seven of which evaluated emotionally focused therapy (EFT) were reviewed, leading to the following conclusions. BCT leads to short and long-term gains for moderate to severe couple distress. In the long term BCT probably leads to no better outcomes than its constituent components—behavioral exchange training and communication and problem solving skills training. Addition of a cognitive therapy component to BCT or the use of a variety of treatment formats does not improve the efficacy of BCT. Integrative couples therapy and insight-oriented marital therapy may be more effective than BCT, but studies supporting this conclusion require replication. EFT leads to short and long-term gains for mild to moderate couple distress. Addition of a cognitive therapy component to EFT does not enhance its efficacy. EFT may be more effective than problem solving therapy and less effective than integrated systemic therapy, but the two studies supporting this conclusion require replication.Michael Byrne, PhD, is a Clinical Psychologist, Midland Health Board, Ireland; Alan Carr, PhD, is Director of the Clinical Psychology Training Programme, Department of Psychology, Arts Building, University College Dublin, Belfield, Dublin 4, Ireland (alan.carr@ucd.ie). Marie Clark, PhD, is Lecturer, Department of Psychology, University of Surrey, United Kingdom.