Universal processes and common factors in couple therapy and relationship education

Across nearly all cultures, sharing a lifelong committed relationship with an intimate partner comprises an almost universal and strongly held ambition. Nevertheless, cross-national data reliably indicate a high prevalence of relationship distress and dissolution, with adverse emotional and physical health consequences for adult partners and their children. This introduction to the special section summarizes findings regarding the effectiveness of couple therapy for treating general relationship distress, couple-based interventions for individual mental or physical health problems, and couple relationship education programs aimed at helping couples sustain a healthy committed relationship. Within each of these approaches, evidence regarding potential mediators of interventions' effectiveness is reviewed, and critical unanswered questions are highlighted. Discussion concludes with a brief introduction to each of the articles comprising this special section on universal processes in couple therapy and relationship education.     

The relationship between sex role characteristics,couple satisfaction and couple problem-solving skills

Abstract

This study explored the association between sex roles and relationship adjustment and communication skills. Baucom's (1976) sex role inventory was administered to couples who also reported on their relationship satisfaction and engaged in problem-solving exercises. Stepwise multiple regression analyses showed a significant positive relationship between femininity and satisfaction as well as between femininity and positive problem-solving behavior, and a significant negative relationship between femininity and aversive problem-solving strategies. Additional tests revealed no significant relationship between androgyny and either relationship satisfaction or problem-solving strategies. Results suggest that clinical interests might be better served by studies less focused on attempts to validate Bem's model of androgyny.     

Therapeutic alliance and progress in couple therapy: multiple perspectives

Therapeutic alliance research in couple therapy using multiple perspectives and longitudinal data has been sparse. This study used structural equation modelling to explore relationships between changes in alliance and in progress from clients' and therapists' perspective in a fairly large sample of couples (N=195) during the initial stage of therapy at an on‐campus training clinic. Self‐rated alliance was measured after sessions 2 through 4 with the Working Alliance Inventory. There was very little change in alliance over the early sessions of therapy, and changes in alliance did not always account for changes in relationship satisfaction. Husbands' perceptions of satisfaction and alliance seem to play an important role in the dynamics of the therapeutic process. Findings suggest a reciprocal relationship between perceptions of alliance and progress in therapy when combining perceptions of therapists and couple clients. Clinical implications and future research are discussed.     

the relationship between career and couple burnout: Implications for career and couple counseling

The importance of work and love for healthy functioning is well documented. This article addresses the relationship between them. The authors argue, based on a psychoanalytic‐existential perspective, that people's choice of work and love is related to similar unresolved childhood issues and that career burnout and couple burnout are related to failure in the existential quest aimed at solving these issues. The existence of a relationship between career burnout and couple burnout is demonstrated by several clinical examples and the results of an exploratory cross‐cultural study involving Israeli, Spanish, Portuguese, American, British, and Finnish students. Implications for career and couple counseling are drawn.     

Low-level relationship aggression and couple therapy outcomes.

Increasing evidence supports the efficacy of conjoint therapies that focus on intimate partner violence for couples who engage in mild to moderate physical aggression but want to preserve the relationship and end the aggression. However, there has been no examination of how this population responds to couple therapy that does not have a specific focus on aggression. This lacuna in the research literature is of concern because couples with a history of low-level aggression often seek couple therapy, but couple therapy without a focus on violence is thought to potentially exacerbate aggression. In the current study, the authors examined the efficacy of non-aggression-focused behavioral couple therapy for couples with and without a history of mild physical aggression. One hundred thirty-four couples, 45% of whom had experienced low-level aggression in the year prior to therapy, completed up to 26 sessions of couple therapy and 2 years of follow-up assessments. Results demonstrated no significant differences in relationship and individual outcomes by history of aggression. In addition, couples maintained very low levels of physical aggression during and after treatment and showed reductions in psychological aggression when relationship and individual functioning improved.     

Anxiety and chronic couple relationship stress moderate adrenocortical response to couple interaction in expectant parents

The study examines whether anxiety or chronic relationship stress alter the way that couple conflict affects cortisol levels for women and men during the transition to parenthood. Saliva samples, assayed for cortisol, were collected before and after couple interaction from 128 heterosexual couples expecting their first child. Confirming prior research, expectant mothers had higher cortisol levels than their spouses, and gestational age was linked to women's cortisol level. Negativity during couple interaction was associated with greater cortisol reactivity for men, but not women. Tests of moderation indicated little relation between negativity and cortisol recovery for individuals with a low level of anxiety or little history of chronic arguing with the partner. However, among individuals with elevated levels of either of these two factors, negativity was linked to less cortisol recovery for men, but more cortisol recovery for women. Consistent results were also found for the relation between low warmth in the couple interaction and both reactivity and recovery for men and women high in anxiety. Future research should examine whether pregnancy is responsible for these different gender patterns, or whether the inhibition of negativity is stressful for women with high levels of risk.     

International perspectives in psychological research

The following two papers by (1) Bond and Sabourin and (2) d'Ydewalle and Denis were prepared for the World Social Science Report. They illustrate some of the current scope and diversity of the discipline.     

The self in the couple relationship: part 1

This paper discusses the importance of the ‘good-enough’ development of the core self in the couple relationship. It argues that difficulties in the development of the self lie behind a significant number of troubled couple relationships. Part 1 focuses on individual psychotherapy and how changes to the core self are often attended by shifts in the marital relationship. It traces how this occurs through clinical material and analyses what kinds of changes to the self are needed for the couple relationship to function well. Psychodynamic theory is used to understand the core changes over time and how these are related to significant second-order change in the couple relationship. The construct of the ‘transitional space’ is used to theorize the couple relationship. Implications for the practice of individual psychotherapy are discussed. In Part 2, the significance of change in the experience of the self of one or both partners for a successful outcome of couples therapy is discussed, along with the place of work with individual partner(s) in the course of conjoint couples therapy.     

Aggression and love in the relationship of the couple

In this paper I examine the interplay of love and aggression in a couple's emotional relationship. I explore the activation of dominant repressed or dissociated object relations with the parental figures, and the unconscious collusion of both partners to enact these past relationships in the present. I then examine the couple's relationship as determined by differences in male and female development, as well as the counterpart of these differences--unconscious moves toward "twinship" and complementarity. Unresolved oedipal conflicts are explored as a major cause of invasion of the couple's sexual boundaries, and a vehicle for the expression of dissociated aggression from many sources. Perversity--the "recruitment of love at the service of aggression"--as a threat to the basic fabric of a couple's love life is one alternative to the normal channels for elaboration of aggression in their relationship. Protective functions of the couple's interaction with their social network are examined in the context of their elaborating and integrating aggression with love.     

Notes towards a psychoanalytic understanding of the couple relationship

In this paper an attempt is made to demonstrate how a particular orientation to contemporary psychoanalytic concepts may be useful to an understanding of the nature of the marital, or couple, relationship. The unconscious forces which may attract two people to each other, which may influence the patterns of their interaction and which may result in psychic stagnation or development are outlined. The second part of the paper addresses the nature of the therapeutic relationship with the patient couple. A hypothesis is offered regarding possible diagnostic criteria for choosing whether to work with a couple presenting for couple psychotherapy employing one psychotherapist or two psychotherapists working as a co-therapy pair. (The usual practice of myself and my colleagues at the Tavistock Institute of Marital Studies is to see our patient couples with a co-therapist partner).     

The self in the couple relationship: part 2

Part 1 of this paper examined some of the ways in which individual therapy, by assisting in the development of a more cohesive sense of self in the individual, inevitably has an impact on the individual's relationships, especially their relationship with a partner. This paper approaches the topic of the significance of ‘the self’ in the couple relationship from an alternative direction. It focuses on the significance of ‘the self’ for couples therapy, and argues that couples therapy may sometimes need to include therapeutic work with one partner to facilitate change in the relationship. In both parts of the paper, a conceptualization of the couple relationship as ‘a transitional space’ is central.     

International perspectives on tests used with children and youths

The results of an international survey of tests used with children and youths in 44 countries are reported. A total of 455 tests were identified. The median number of tests used in each country is 15; the range is 41 to 2. Measures of intelligence, personality, and achievement are most common. Foreign-developed tests generally are cited more frequently than locally developed tests. Reliability, validity, and normative studies generally are available on two thirds or fewer of the tests. However, locally developed tests generally were thought to have better psychometric qualities than foreign-developed tests.     

Congruity of observed social support behaviors and couple relationship quality

This study examined the role of congruity in couples' social support behaviors on relational outcomes. Participants (N = 123 couples, M_age = 26.91, SD = 8.46) completed surveys on relationship satisfaction and discord. Positive and negative behaviors were then observed during supportive interactions. Results revealed that the detrimental effect of negative behaviors on satisfaction was buffered by a partner's engagement in fewer negative behaviors or intensified by more negative behaviors. Further, the beneficial effect of positive behaviors on reducing discord was amplified by a partner's engagement in more positive behaviors or offset by fewer positive behaviors. Last, the detrimental effect of negative behaviors on discord was buffered by a partner's engagement in more positive behaviors. These findings highlight the complex nature of dyadic relationships and provide insights for developing interventions focused on improving romantic relationship quality.     

The relationship of sex-role norms to couple and parental demographics

Four underlying, common sex role factors were identified via separate factor analyses on husbands' and wives' responses to a battery of Likert items tapping sex role norms. Canonical correlation analyses showed that sex role norms were significantly related to couple and parental demographics. Modern sex role norms were positively related to wife's education, occupational status and income, to wife's mother's occupation and work experience, and to husband's education, but negatively related to presence of young children.     

Patient and partner correlates of couple relationship functioning in bipolar disorder

Extensive research in unipolar depressed and population-based samples has shown cross-partner associations between depressive symptoms and relationship adjustment. Yet despite evidence that bipolar disorder (BPD) is a more chronic and severe illness than unipolar depression, that individuals with BPD are at risk for interpersonal dysfunction, and that critical, unsupportive relationships are predictive of the course of depressive symptoms in BPD, there have been limited efforts to understand the correlates of relationship functioning within BPD. The current study addresses this gap in the literature by examining the associations between the depressive and manic symptoms of individuals with BPD, their partner's depressive symptoms, and relationship functioning, using a multimethod, multi-informant approach. Results revealed that the depressive symptoms of the individual with BPD were associated with poorer relationship functioning, particularly when the partner without BPD also had elevated depressive symptoms. In addition, an interaction between the individual with BPD's depressive and manic symptoms was observed, such that manic symptoms were associated with increased observed hostility and poorer partner relationship adjustment, but only when depressive symptoms were also elevated. These effects persisted even after overall mental health of both partners was controlled.