Exploration of a Marital Typology: Implications for Marital Functioning in a Multi-Ethnic Sample

Marital conflict is associated with multiple negative outcomes for couples, including marital dissatisfaction and divorce. Little research, however, has examined conflict in Hispanic/Latino couples or its association with marital satisfaction, which creates an unfortunate knowledge gap for clinicians working with diverse client groups. The present study sought to examine both marital conflict and satisfaction using a sample of 231 European American (EA; n = 108) and Hispanic/Latino (H/L; n = 123) couples. Through observational coding, couples were placed into four groups based on their type of conflict management strategies: Harmonious, Withdrawn, Conflictual-Expressive, or Conflictual-Hostile. For both ethnic groups, couples in the Harmonious group were nondistressed and couples in the Conflictual-Hostile group were in the distressed range of marital satisfaction. Cross-ethnic differences emerged. EA couples experienced distress when both hostile (Conflictual-Hostile) and nonhostile conflict (Conflictual-Expressive) communication types were observed, while only hostile conflict was associated with distress for the H/L group. H/L couples reported similar levels of satisfaction in both the Harmonious and Conflictual-Expressive groups. H/L couples also fell within the distressed range when withdrawn communication patterns were observed; however, this was not the case for EA couples. These differences suggest that both types of conflict are associated with marital distress for EA couples, whereas hostile conflict and withdrawn behavior appear to be more negatively associated with marital satisfaction in H/L couples. Results provide support for the use of an observational coding system with H/L and EA couples and also suggest the importance of understanding how differences in expressions of conflict across ethnicities may relate to marital satisfaction.     

Selection of Patients for Group Psychotherapy

The concept of projective identification is reviewed, and its application to family and group systems is noted. Projective identification is then applied as a construct central to couples' groups, particularly useful in sorting out dynamics within couples, between couples, and toward the group-as-a-whole and its leader(s). Clinical examples are provided from a couples group co-led by the author, with indications of how this perspective on disavowal, interaction, and containment can be utilized therapeutically to provide a stimulus for intrapsychic and interpersonal change. The couples group offers a unique forum for working with projective identification, where this process presents a challenge to the therapist regarding the multiple levels from which to select appropriately and to “contain” skillfully.     

Conflict management: A premarital training program in mutual problem solving

Abstract

The purpose of this study was to evaluate the effectiveness of a structured educational program designed to train premarital couples in communication and mutual problem-solving skills. Twenty-six couples participated in an eight-week, 24-hour problem-solving training program, while 28 similar couples participated in an eight-week, 24-hour relationship discussion group. Results indicated that the problem-solving group, as compared to the relationship-discussion group, showed a significant increase in communication and mutual problem-solving skills. Discussion focused on the benefits for premarital couples of learning effective problemsolving procedures as well as the need for follow-up assessments of both behavioral skill level and relationship satisfaction and adjustment.     

Treatment of alcoholic couples in outpatient group therapy

This paper summarizes special issues that group leaders are likely to encounter when adapting their skills to outpatient group therapy with alcoholic couples. More specifically, the paper: (a) discusses the advantages of treating alcoholic couples in a group as opposed to individual couple's therapy; (b) outlines the parameters of a couples group with alcoholic members that differentiate it from working with other kinds of couples in group; and (c) provides guidelines and techniques for tackling some of the specific kinds of problems and situations that arise.This paper was presented at the Annual Meeting of the American Group Psychotherapy Association, New York City, February, 1985.The author wishes to acknowledge the contribution of Geraldine Alpert, Ph.D., whose thoughtful comments and discussion helped to crystallize the concepts presented.     

Marital commitment,money and marriage preparation: What changes after the wedding?

This paper explores conceptions of commitment and styles of money management in heterosexual couples at two points in time: Just before the wedding (T1) and about a year later (T2). It also examines the potential effects of using FOCCUS as a form of marriage preparation (MP). Forty‐two couples were recruited at T1 and randomly allocated to either A MP group and a group that would not be offered any marriage preparation ‐ the Non‐Marriage Preparation group (NMP). Individual, in‐depth, semi‐structured interviews were carried out at T1 and T2, recorded and fully transcribed. A thematic analysis (TA) yielded three themes or levels of commitment which were used to categorize couples at T1 and T2. Their money management styles were defined based on Pahl's ( 1989 ) typology. The results showed that conceptions of commitment had developed slightly overall by T2, and had been enhanced in the MP group. At T2, a more elaborated conception of commitment was associated with a greater tendency to treat money as a collective resource. Copyright © 2010 John Wiley & Sons, Ltd.     

Initiating a Couples Group

Couples-group therapy is thought of as a helpful treatment for most couples, and as a primary treatment for married couples who have longstanding problems of a rigid and chronic nature. It is most useful for couples for whom blaming, power plays, and suppression of anger are prominent modes of interaction. Couples-group therapy is helpful to these couples because the group is a microcosm of society, provides a wide variety of coping styles, and offers observable alternatives to dysfunctional behaviors. A group dynamic also decreases the couple's sense of isolation. Issues relevant to starting a couples group--indications, contraindications, policies and balancing a group--are discussed. Clinical vignettes from ongoing open-ended couples groups are presented to illustrate the points made.     

Effectiveness of the ‘Hold me Tight’ Relationship Enhancement Program in a Self‐referred and a Clinician‐referred Sample: An Emotionally Focused Couples Therapy‐Based Approach

While evidence‐based couple therapies are available, only a minority of troubled couples seek help and they often do this too late. To reach more couples earlier, the couple relationship education (CRE) group program “Hold me Tight” (HmT) based on Emotionally Focused Couples Therapy (EFCT) was developed. This study is the first to examine the effectiveness of HmT. Using a three‐wave (waiting period, treatment, and follow‐up) within‐subject design, HmT was delivered to 79 self‐referred couples and 50 clinician‐referred couples. We applied a comprehensive outcome measure battery. Our main findings were that (1) self‐referred couples significantly improved during HmT on all measures, that is relationship satisfaction, security of partner‐bond, forgiveness, daily coordination, maintenance behavior, and psychological complaints, with a moderate‐to‐large mean effect size (d = .63), which was maintained (d = .57) during the 3.5 month follow‐up; (2) in clinician‐referred couples, who were vulnerable in terms of insecure attachment status and psychopathology, the improvement during HmT was moderate (d = .42), but this was reduced during the 3.5‐month follow‐up to a small effect (d = .22); (3) emotional functioning (typical HmT target) as well as behavioral functioning (typical Behavioral Couples Therapy‐based CRE target) improved during HmT; and (4) individual psychological complaints, although not specifically targeted, were reduced during HmT. These findings suggest that HmT is a promising intervention for enhancement of relationship functioning. Clinical implications are discussed.     

Basic Considerations in the Application of Therapy and Education to Parent Groups

This article presents a couples group therapy treatment approach that uses analytic object relations concepts such as transference/countertransference, projective identification, containment, and the holding environment. Object relations theory is seen as the most useful theory with which to view couple interaction because it is based on a two-person psychology and focuses on the impact of relational systems on the development of the person. This includes the idea that the person grows within the attachment to another person. Group therapy is seen as a more effective treatment approach because the group is a resilient holding environment that provides an avenue in which projective identifications can be understood and contained, power can be redefined, isolation of the couple can be decreased, and the couple's responses can become more versatile. The model described is illustrated with clinical vignettes from an open-ended couples group.     

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.     

Recruitment and Retention of Low‐SES Ethnic Minority Couples in Intervention Research at the Transition to Parenthood

Low‐SES couples have limited resources to manage the chronic and acute stressors with which they are disproportionately faced. Although these couples are at greater risk for negative individual and relationship outcomes, evaluations of the impact of couple relationship education (CRE) in low‐SES couples have been plagued by methodological problems, most notably challenges associated with recruitment and retention. We review the literature on challenges couples face associated with low‐SES, as well as on recruitment, retention, and CRE in low‐SES, ethnic minority populations. We illustrate some of these challenges in a case study of CRE for low‐SES couples transitioning to parenthood. In this pilot study, 21 couples were recruited from a community health clinic and randomized to either an experimental treatment condition (EXP; N = 11) or a treatment‐as‐usual control condition (TAU; N = 10). This study sought to mitigate documented challenges with recruitment and retention: We leveraged community partnerships, attempted to build and maintain strong relationships with study participants, provided incentives for assessments as well as intervention meetings, and attempted to reduce potential barriers to enrollment and retention. Nonetheless, we had low rates of recruitment and retention. We integrate these findings and experiences with our review of previous work in this area. We make recommendations for future CRE research and practice that have potential implications for public policy in this area.     

Does covenant marriage predict latent trajectory groups of newlywed couples?

Covenant marriage is a legally distinct marriage license available in Arizona, Louisiana, and Arkansas in the United States. This study revisited one of the largest longitudinal dyadic studies on covenant versus standard newlywed couples. Using this dataset of 677 different-sex couples, we explored whether being in a covenant marriage could predict how marital satisfaction developed over the first five marital years. We applied the Growth Mixture Modeling (GMM) method to identify groups that differed in their initial marital satisfaction and trajectory. The results revealed three different trajectory groups—one group showing high and stable marital satisfaction, which we named High Stable, and two groups showing declines in marital satisfaction, one being medium and the other one being low in satisfaction at the beginning of the marriage, and we named them Medium Declining and Low Declining respectively. Spouses with lower initial marital satisfaction experienced a faster decline and suffered the highest divorce rate. Actor-Partner Interdependence Model (APIM) analysis revealed that one's group membership was predicted by their partner's membership, suggesting a mutual influence on marital development. Being in a covenant marriage was able to predict husbands' membership as covenant husbands were found to be more likely in the high stable group.     

A substantive and methodological review of couples group therapy outcome research

Outcome research on couples' group therapy is reviewed and discussed in terms of substantive findings and relevant methodological components. Research to date has found couples group therapy to be as effective as either individual, conjoint, or non-spouse group formats. These results, however, are based on the findings of only five studies, all of which displayed methodological limitations. Suggestions for future research involving couples groups are discussed.     

The Effect of Problem-Solving Based Family Therapy on Emotional Intimacy and Marital Quality of Cultural Couples in Tabriz

Abstract

This study aimed to investigate the effect of problem-solving based family therapy on the emotional intimacy and marital quality of cultural couples in Tabriz. The research method was quasi-experimental by designing the pretest and post-test with the experimental group. The statistical population of this research consisted of all cultural couples with marital problems referring to counseling centers of Tabriz Education in 2019. The research sample based on The Cochran formula consisted of 32 couples that were selected by purposeful sampling and were randomly assigned into two experimental and control groups. The experimental group was exposed to 10 sessions of problem-solving based family therapy and the control group received no interventions. The research tool was the Marital Quality Index and the Intimacy Questionnaire, which was completed by both groups at the beginning and end of the intervention. The collected data were analyzed using SPSS software and inferential statistics of covariance analysis were also investigated. The results of covariance analysis showed that problem-solving based family therapy had a significant impact on the emotional intimacy and marital quality of cultural couples. Therefore, problem-solving based family therapy can be used as a treatment in couples with marital problems.     

Communication and Interdependence in Geographically Separated Relationships

This article discusses the theoretic underpinnings of a framework for the analysis of communication in ongoing social relationships. A set of studies that have investigated various aspects of the framework are summarized. The majority of these studies have tested the notion that communication between members of ongoing relationships generates a shared view of the world that bonds relationship members. Relationship members who have achieved this type of bond are referred to as symbolically interdependent. The remainder of the article presents results of a study of the relationships between symbolic interdependence and time spent talking in groups of premarital couples that were either separated geographically or living in close proximity. Results supported the hypothesis that this relationship would be stronger in the group of geographically separated couples. Implications of the study are discussed as well as future directions for research on the perspective.     

(Mis-)Coordinating identities in the transition to parenthood: Investigating the co-development of partners’ parenting,domestic and provider identities before and after the birth of the first child

This research takes a socio-psychological perspective to studying the transition to parenthood, by longitudinally investigating how couples dyadically coordinate: (a) the changing centralities of parenting domestic and provider identities, and (b) the consequences of this for stress and relationship satisfaction. We collected longitudinal data from a Swiss community sample of 213 heterosexual, first-time parents, in approximately the 24th week of pregnancy (T1) and 2 years later (T2). Participants completed a sociogram task, sketching the centrality of parenting, domestic and provider identities, for themselves and their partner. We applied actor partner interdependence models to model changing identity centralities at T2, from the (coordination) of T1 identities, distinguishing effects due to one's partner and the individual. Results support identity coordination in couples, especially in the development of the domestic identity. This coordination also had longitudinal effects for couples’ well-being. Results emphasize the social forces that structure the self-concept, and their health consequences.     

Appraisal of Memory Functioning and Memory Performance in Healthy Ageing and Early-Stage Alzheimer's Disease

ABSTRACT

Background/Aims: To compare memory evaluations in healthy older people and people with Alzheimer's disease (AD) and present standardised individual and dyadic methods for classifying degree of memory awareness in the participants with dementia. Methods: Cross-sectional study evaluating awareness of memory functioning and performance and providing normative data for healthy individuals and couples, together with comparison data from people with AD. Results: As a group, older people are reasonably accurate raters of their own memory functioning and performance, although considerable individual differences can be observed, and control dyads show good comparative accuracy. Comparing normative data from the control group to data from participants with AD confirms that significant overestimation is a frequent feature among people with dementia, with approximately two-thirds showing this pattern, although significant under-estimation is also reliably observed in a small proportion of people with dementia. Different types of measure elicit different profiles of memory awareness in participants with dementia. Conclusion: Normative data from older individuals and couples provides useful percentile-based indices for determining level of memory awareness in people with dementia.     

Construing Couples: The Challenges of Marital Therapy

Many therapists report that working with couples is very difficult and stressful. In this article 1 offer a few evolving thoughts on working with couples, based on Kelly's Sociality corollary and the field of hermeneutic inquiry. The primary task of marital therapy is to work together with couples in coauthoring (or coconstructing) a story that (a) is specific to the concerns of each spouse, (b) is meaningful to the two of them as a couple, and (c) provides new options for effective action in the situation confronting them. This coauthoring process, if it is to be successful with couples, must address a number of related issues, including codefining the problem, connecting with the relevant system, codeveloping specific and workable goals, maintaining flexibility, and coconstructing alternatives.     

Impact evaluation of the family expectations program and moderation by sociodemographic disadvantage

The federal government, through the Administration for Children and Families (ACF), has funded community-based relationship education programs for couples, individuals, and families, with a strong focus on serving economically disadvantaged and racially diverse families. This study evaluated the impact of a 36-hour, workshop-based couple relationship education program that was funded by ACF using a randomized controlled trial (RCT) design and intent-to-treat (ITT) analyses. Participants were 1320 couples who were either expecting a baby or had a baby within the past 3 months, at the time of enrollment. Follow-up surveys were administered 12 months later. Analyses evaluated program impacts on relationship stability, constructive communication, and destructive conflict compared to a no-treatment control group. Analyses showed a statistically significant impact of the program on destructive conflict (d = 0.10) but not on constructive communication (d = 0.06) or stability (d_Cox = 0.10). Based on findings from previous evaluations, we also examined whether participants’ levels of sociodemographic disadvantage moderated these effects. There was significant moderation by sociodemographic disadvantage on constructive communication and destructive conflict, but not on stability. Effects were observed for those at higher levels of sociodemographic disadvantage.     

Dyadic Coping Among Couples with COPD: A Pilot Study

COPD (chronic obstructive pulmonary disease) is associated with psychological distress for patients as well as their partners. Dyadic coping can be negatively impacted by stressors. This study's objective was to compare the dyadic coping of couples in which one partner suffered from COPD with healthy couples of the same age. A total of 43 complete couples with COPD and 138 healthy couples participated in this pilot study. The surveys were sent by mail. The response rate of the COPD sample was 24.3%. In order to analyze the effect of gender and role (patient vs. partner) on dyadic coping, linear mixed models were calculated. To analyze the effect of gender and group (COPD group vs. normative comparison group) on dyadic coping, two-way analyses of variance were calculated for independent samples. COPD patients and their partners indicated that the patients received more support and were less able to provide support to their partners. This difference was also evident in comparison with the normative comparison group. In addition, couples with COPD perceived higher levels of negative coping and provided a considerably lower assessment of their positive dyadic coping. The dyadic coping of couples with COPD is unbalanced and more negative when compared to that of healthy couples. Interventions aimed at supporting COPD couples should seek to improve couples' dyadic coping in addition to individual coping strategies.     

A randomized clinical trial of a brief, problem-focused couple therapy for depression

The aim of this study was to evaluate a brief couple therapy for depression targeted for mildly discordant or nondiscordant couples struggling with the negative impact of depression. Subjects included women with major depression or dysthymia who had husbands without clinical depression. Thirty-five couples were randomly assigned to the 5-week intervention (n = 18) or a waitlist control group (n = 17), and followed up 1 and 3 months later. Results showed a significant effect of treatment in reducing women's depressive symptoms, with 67% of women improved and 40% to 47% recovered at follow-up, compared to only 17% improved and 8% recovered among women in the control group. Treatment was also effective in secondarily improving women's marital satisfaction, reducing husbands' levels of psychological distress and depression-specific burden, and improving both partners' understanding and acceptance of depression. The treatment was implemented in five 2-hour sessions, representing an efficient, cost-effective approach. Findings support the growing utility of brief, problem-focused couple interventions that simultaneously target depression, relational functioning, and psychological distress experienced by the loved ones of depressed persons.