Effectiveness of an Educational and Support Program for Family Members of a Substance Abuser

Abstract

This paper investigates the relationship between marital adjustment and congruency of couple preference regarding wife employment. Implications for marriage and family therapists are emphasized. Husband, wife, and couple scores were obtained on the Marital Status Inventory and Dyadic Adjustment Scale for eight work pattern categories. The first four (Dual-Career, Dual-Work, Pre-Dual-Career, Traditional Single-Career) were current couple work patterns perceived as desirable by both spouses. The last four categories (Incongruent Dual-Career, Incongruent Dual-Work, Incongruent Pre-Dual-Career, Incongruent Traditional Single-Career) were current couple work patterns that one spouse, in conflict with the other spouse, perceived as undesirable. In addition, number and ages of children and number of wife work hours were analyzed for their effects on marital adjustment in these couples. The results of this study indicate that marital adjustment is negatively influenced only when the wife wants to work in her career, is not employed, and her husband does not want her to be employed now or in the future. Possible reasons for these findings and suggestions for further research are included.     

Starting over: a tentative theory exploring the effects of past relationships on postbereavement remarried couples

Using grounded theory methodology 24 participants were asked to discuss how the death of a previous spouse, either theirs or their partner's, was currently affecting their second marriage. Participants were interviewed individually and as a couple. The central category was memories of the deceased spouse. Six additional categories emerged from the data: past spouse on pedestal, current/past comparison, insecurity of current spouse, curiosity about past spouse/relationship, partner's response to curiosity, and impact on the current relationship. Existing literature, auditors, and participant feedback were all used to validate the results. Expanding on a tentative theory (Brimhall, Wampler, & Kimball, 2008), provisional hypotheses were developed, thus helping clinicians who work with complex issues involving remarried couples.     

Restoration of Intimacy and Connection in the Treatment of Couples with Substance Abuse Issues

SUMMARY

Addictions destroy both individuals and in particular their intimate relationships. Couples remain together for many reasons and when one partner has an addiction, the spouse has the fantasy that when the addiction is addressed the couple relationship will return to ‘normal.’ This article focuses on couple issues that have not been addressed in addiction treatment facilities and examines the role of the couple therapist versus the addiction counselor. Techniques and clinical interventions with this population are discussed and illustrated by case examples.     

Health Dynamics of Military and Veteran Couples: A Biopsychorelational Overview

The purpose of this review article is to present the current state of military and veteran couple??s health by addressing biological, psychological, and relational risks and resiliencies. Articles were selected using key words such as ??military couple, dyad, or relationship?? and were searched in the following databases: PsychInfo, Military and Government Collection, and Medline. Literature trends reveal that the role of the military spouse is no longer secondary, but is crucial to the health of the military and veteran couple. The spouse is recommended to be a part of the biopsychosocial assessment that service members receive and also be assessed themselves for stress derived symptoms such as hypertension, post traumatic stress, and depression. Assessments for health should occur sooner after deployment and at more frequent intervals given the dynamic nature of stress on health over time. The health of service members and veterans is couched within their personal and familial relationships, thus medical family therapists are the most well prepared to attend to the dynamics between health, stress, and relational well-being across the lifespan of military and veteran couples.     

Potential Bone-Marrow Donors and Their Spouses: The Effects of Volunteerism on Distress Levels1

The current study sought to provide a better understanding of the reactions of bone-marrow volunteers to the possibility of donating by examining these volunteers in the context of their closest relationships. Using Tesser's (1988) self-evaluation maintenance (SEM) model as a guide, we examined the influence of spouses who are also volunteers on each member of the couple's distress levels and on the marrow volunteer's ambivalence about donating. We also examined the independent effects of known risk factors for donation-related distress and the combined effects of spouse volunteer status and these risk factors on distress levels. Questionnaire data were collected from 278 couples selected from 39 bone-marrow donor centers. Results demonstrated that when spouses of potential donors were engaged in any type of volunteer activity, members of the couple felt greater anxiety than when spouses were not volunteers. Additionally, other variables were found to have a conjoint effect with spouse volunteer status on volunteer and spouse anxiety levels.     

How do humility prototypes affect the association between perceptions of spouse’s humility and depressive symptoms and couple conflict?

ABSTRACT

Relational humility (RH) is associated with positive outcomes (e.g., fewer depressive symptoms; less couple conflict). Traditional conceptualizations of RH rely on other-report measures, but do not account for how one’s perception of another’s humility relates to one’s RH prototype (i.e., one’s expectations of how humble others, such as a spouse, should be). The current study (N = 69 couples; mean age = 30.80 years; 71% white) analyzed the effect of RH prototypes on the association between participants’ perception of their spouse’s RH and their reports of depressive symptoms and couple conflict. RH prototype was tested as both a moderator and a mediator to these associations. Actor-partner independence moderation and mediation models indicated that RH prototype functions as a moderator in the association between perceived spousal RH and both depressive symptoms and couple conflict, wherein greater discrepancies between spousal RH and RH prototype was associated with more depressive symptoms and conflict.     

Alcohol abuse—an interactional approach

In this article, the author points out the usefulness of applying an interactional approach to the treatment of alcoholic abuse. First, the relational significance of the symptom is discussed and an analysis is made of the principal communication patterns existing between the partners of the couple.
The essential contents of the therapeutic strategy are then described, as well as the homeostatic reactions of the system: two types of intervention were applied, paradoxical and structural, which were aimed at eliminating the symptom and gradually changing the couple's relationship.     

Distinct Psychological Characteristics Predict Resilience and Recovery Throughout Widowhood

The dual-process model proposes that early and later bereavement involves different types of stressors and adaptation processes (Stroebe & Schut, 1999, 2010). It is thus possible that different factors facilitate adaptation during the early months versus subsequent years following widowhood. Elevated depressive symptoms, though prevalent after widowhood, may indicate problematic adaptation, as they are associated with poor long-term physical and mental health outcomes. We predicted that neutral death acceptance would be associated with less increase in depression during early widowhood (when confronted with loss-oriented stressors), whereas perceived control would predict depressive symptom decline during later widowhood (when adapting to controllable restoration-oriented stressors). Older adults (N = 265) reported on neutral death acceptance, perceived control, and depression before widowhood and on depression 0.5, 1.5, and 4.0 years after the death of their spouse. Bilinear spline growth modeling revealed that, on average, depressive symptoms increased from before to 0.5 years after spouse death and fell from 0.5 to 4.0 years after spouse death. Neutral death acceptance predicted a smaller increase in depression from before to 0.5 years after spouse death, as well as a smaller subsequent decrease in depression from 0.5 to 4.0 years after spouse death. Perceived control predicted a larger decrease in depression from 0.5 to 4.0 years after spouse death. Neutral death acceptance and perceived control had unique associations with resilience and recovery throughout early and later widowhood. These variables may be fruitful targets in interventions for depression throughout the full course of widowhood.     

Heavenly Sex: The Moral Authority of an Impossible Dream

Abstract

Writing out of an Augustinian tradition in which faith is understood as hope for the absolutely desirable, the author presents an argument for the ethical privileging of the sexual couple. The ideality of heaven is unrealizable under the conditions of time and space, in part because of its paradoxicality. Although heaven is not to be thought only in terms of sexual imagery, it cannot be thought asexually. It is because the ‘other’ in a couple is both him or herself and representative of all others that the couple — and by extension monogamous marriage — most closely answers to the ideal implicit in the intentionality of sex, namely, the intensity of the one-on-one and the scope of the orgy. Although he does not develop the argument, because of the representative nature of the spouse, the author has laid the foundations for an appreciation of the sacramentality of the monogamously committed couple.     

Addressing power in couples therapy: Integrating socio-emotional relationship therapy and emotionally focused therapy

Romantic relationships are more satisfying and fulfilling when power is balanced relatively equally between partners (Leonhardt et al., Journal of Family Psychology, 34, 2020, and 1). Yet, few couples therapy models explicitly outline how to confront relational power issues (Knudson-Martin & Huenergardt, 2015, Socio-emotional relationship therapy: Bridging emotion, societal context, and couple interaction, Springer). Emotionally Focused Therapy (EFT; Johnson, 2020, The practice of emotionally focused couple therapy, Routledge) is a well-established, evidence-based therapy modality that many therapists use with couple clients, yet despite its effectiveness, it does not provide direction for explicitly addressing and treating power differentials in couple relationships. In this paper, we explore the integration of EFT with Socio-emotional Relationship Therapy (SERT), a model overlay that acknowledges the impact of social discourse on enactments of power in intimate couple relationships. We first address the importance of understanding power in couple relationships, addressing power in couples therapy, and provide a brief overview of SERT and EFT. We then introduce an integration of the models intended to help therapists balance power, increase connection, and secure attachment bonds between romantic partners.     

Post-traumatic stress disorder in a Danish population of elderly bereaved

The objectives of this study were to examine psychological sequalae of loss of a spouse in late life especially the occurrence of post-traumatic stress disorder (PTSD) and possible predictors of PTSD and symptom development. Fifty-four bereaved Danes (mean age 75 years) from five geographically different areas were studied by the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), and the Crisis Support Scale (CSS). One month after the loss, 27% of the subjects had PTSD. Six months after the loss, this number decreased to 17%; if the A2 criterion was dismissed, the number increased to 24%. Lack of expressive ability, numbing, fear of death or illness, and helplessness in relation to the loss predicted 73% of the variance of the HTQ-total scores. The study concluded that for a considerable number of elderly, losing a spouse in late life appeared to be a traumatic experience. Pre- and peritraumatic factors together with numbing were important predictors of traumatization. Research implications are discussed.     

The impact of a stillbirth on a marriage

The crippling consequences on family life of the failure to mourn a stillbirth adequately are demonstrated in a vulnerable couple. They were helped by brief, planned, focal, conjoint marital psychotherapy which is described.     

Stepfamily Education: A Case Study

Stepfamily education programs are becoming increasingly common. While research on these programs is also increasing, the extant literature tends to be quantitative and cross-sectional. To more fully understand the stepfamily education experience, this case study focuses on the perceptions, feelings, and reports of one participating couple in the Smart Steps program. The nuances and complexities of this single case highlight the sequentiality and reasons for seeking out and participating in stepfamily education. A holistic portrayal of the perceived benefits of attending is also provided, including improvements with spouse, ex-spouse, and children.     

Childhood Obesity in a Chinese Family Context

This qualitative study explored themes that described families with obese children in Chinese society. Eight obese children and their families participated in the study. Six of the children were male and two were female, ranging in age from 7 to 13. The themes found were: over-involvement between allied parent and obese child, coalition, diffused boundary between extended family and nuclear family, lack of conflict resolution, and disengaged couple boundary. In this study, the significant role that may be played by the extended family in contributing to a child’s obesity, as well as female power dominance in the domestic sphere are considered. Implications for therapy are discussed.     

Facilitated Disclosure Versus Clinical Accommodation of Infidelity Secrets: An Early Pivot Point in Couple Therapy. Part 2: Therapy Ethics,Pragmatics, and Protocol

In couple therapy, one partner's private disclosure of infidelity presents a potentially polarizing issue involving the therapist's decision to facilitate disclosure or accommodate non-disclosure. Some therapists may assume accommodating an infidelity secret is the most compassionate and efficient option. We consider this decision in the context of therapy ethics of equal advocacy and confidentiality, implications for individual and relationship healing, and pragmatic aspects of conducting therapy. We conclude that measured disclosure of infidelity, determined by the aggrieved spouse, best resolves the potential collision of multilateral advocacy with confidentiality and offers the best prospects for a working therapy alliance and couple healing and renewal. A clinical protocol for facilitating disclosure of infidelity secrets is presented.     

Attachment and spousal caregiving

A community sample of 362 married couples participated in a study of attachment and spousal caregiving, which combined qualitative and quantitative components. The qualitative component focused on actual experiences of caregiving, assessed by participants' semi‐structured accounts of a situation involving their role as caregiver for their spouse. Attachment styles and their underlying dimensions (comfort with closeness, anxiety over relationships) were related to the type of support provided, the coping strategies used in the situation, caregivers' feelings about the quality of their care, perceived effects on the couple bond, and the emotional tone of the accounts. The quantitative component tested a theoretical model of factors predicting willingness to provide care for the spouse if he or she should become dependent in later life. Measures of attachment and caregiving styles, attachment to spouse, and anticipated burden provided reliable prediction of willingness to care. The results support the conceptualization of attachment and caregiving as interrelated features of marital bonds, and they have important implications for patterns of family caregiving.     

Spouses' Cortisol Associations and Moderators: Testing Physiological Synchrony and Connectedness in Everyday Life

In this study, associations were examined between cortisol levels of wives and husbands in 47 heterosexual married couples. Both partners' salivary cortisol levels were measured at the same moments seven times a day on 2 typical weekdays. After accounting for the effects of the diurnal rhythm of cortisol and relevant control variables, dyadic hierarchical linear modeling indicated significant positive linkages between partners' cortisol levels, consistent with the hypothesized within‐couple physiological synchrony. Variables reflecting more (spousal presence) or less connectedness (loneliness, being alone) were also collected at the time of each cortisol sample. Results indicated that husbands' cortisol levels were higher at moments they reported feeling lonelier and lower at moments they were in the presence of their spouse. Wives' cortisol levels were higher at moments they were alone. In addition, wife–husband cortisol synchrony was stronger for husbands who spent relatively more time with their spouse across the study period—even after accounting for time spent with others in general. These findings suggest that marital partners evidence positive within‐couple cortisol associations, and that connectedness (particularly physical closeness) may underpin spouses' physiological synchrony.     

Women Living with Men who Use Viagra

ABSTRACT

Since the launch of Viagra, there have been few studies on the perspective of the female partner. Through a multiple case study approach drawing from phenomenology and the constant comparative method of analysis, this qualitative exploratory study examines the stories of four women living with a spouse who is currently taking Viagra. Findings highlight the need for a more holistic approach to treating erectile dysfunction that supports both partners within the couple relationship. It is also suggested that greater attention should be given to the relationship and to the sexual needs of women.