A Triadic-behavioral approach to encopresis

Abstract

This paper describes the training and supervisory components of a doctoral level, pre-internship clinical experience, designed to teach Ph.D. candidates a contextual or systemic approach to therapy. The training occurred in a university-based departmental clinic which balanced the three interdependent areas of training, service and research. The therapeutic orientation was a problem-focused, goal-oriented, directive therapy candidates a contextual or systemic approach to therapy. The training designed to view and treat individuals in their social contexts. From this perspective, students were able to gain experience with individuals, couples and families. The paper discusses the function and components of the weekly supervision seminar and describes the integrative and sequential use of several innovative supervisory methods such as live supervision, peer consultation and videotape playback supervision.     

Couple Therapy in the Presence of Mental Disorders

Abstract

Mental disorders and relationship discord commonly occur together and couples where one or both parties suffer from a mental disorder are commonly seen in couple therapy. Symptoms of mental disorders can usefully be conceptualized cybernetically and viewed as part of negative feedback loops that couples become trapped in without denying the potential contribution of biological or other types of knowledge. Most of the existing research focuses on couples and depression and couple therapy has been found to have efficaciousness as a treatment of depression especially when depression occurs along with relationship discord. There is less research on couple therapy and other mental disorders but general guidelines are offered that couple therapists can use with any of the mental disorders.     

David and Judith

SUMMARY

This paper begins with a discussion of Dialogicai Psychotherapy-that “healing through meeting” which comes when the relation between therapist and patient is central-and explores inclusion, making present, confirmation, and the “normative limitation of mutuality.” Secondly, it discusses a Dialogicai Psychotherapy particularly important for couples therapy-Ivan Bos-zormenyi-Nagy's Contextual (intergenerational family) Therapy with its emphases on multidirected partiality, trustbuilding, rejunction, and the intergeneration merit ledger. The third part of the paper applies Dialogicai and Contextual therapy to the case of David and Judith, a couple who show clearly the importance of families of origin.     

Emotionally-focused therapy and treatment as usual comparison groups in decreasing depression: A clinical pilot study

Abstract

Decades of research have shown that depression can have deleterious effects on couple relationships. Emotionally-focused therapy (EFT; Johnson, 2004 Johnson, S. M. (2004). The practice of emotionally focused couple therapy: Creating connection. East Sussex, UK: Brunner-Routledge. [Google Scholar]) is an empirically validated form of couple therapy, which has shown effectiveness in reducing depressive symptoms in couples where the wife has depression. The aim of the current pilot study was to examine the extent to which EFT and the comparison treatment as usual (TAU) therapy group decrease depressive symptoms in distressed couples. Results show that both groups were effective in decreasing depressive symptoms, with EFT showing a clinically significant reduction. Clinical implications and future research are discussed.     

Commitment

SUMMARY

This article addresses the issue of commitment and its importance in developing and sustaining an enriching relationship. The author describes commitment, its dynamics, and its implications for treating couples in conflict. The author also describes the conditions in which the issue of commitment is addressed in therapy and treatment interventions that can be used to help couples resolve their differences.     

Using Narrative Therapy in the Treatment of Adult Survivors of Childhood Sexual Abuse in the Context of Couple Therapy

Abstract

Childhood Sexual Abuse (CSA) is a prevalent social issue. Many theoretical approaches have been applied to the treatment of CSA, these approaches predominately focus on the treatment of children and adolescents, failing to address adulthood and couples’ relations. This limited focus fails to address long-lasting relational implications CSA survivors face. This paper proposes the application of a systemic therapeutic modality, Narrative therapy when treating adult survivors of CSA in couple therapy. The treatment of CSA in the context of couple therapy will be discussed. Clinical vignettes will be used. Implications for clinical practice and future research will be discussed.     

A Cross-Cultural Perspective on Couple Differences

SUMMARY

This paper challenges the idea that differences between partners in couple relationships are inherently problematic. A “cross-cultural” perspective on differences in couples that considers partners' reactions to difference as the problem is presented. Couples therapy from a cross-cultural perspective begins with a detailed' assessment of perceived differences, reactions to differences, the context in which the differences have developed, and the purposes they serve. Therapeutic tasks involve managing maladaptive reactions to differences, learning to accept differences, and co-designing a common couple culture.     

A Systems Approach to Sex Therapy with Gay Male Couples

SUMMARY

Sex therapy with gay male couples is difficult for many family and relationship therapists. Family therapists lack knowledge of the nature of sex therapy, gay male culture and sexuality, the dynamics of gay male couples, and the sexual issues gay male couples are likely to bring to sex therapy. Countertransference also makes sex therapy with gay male couples difficult for some family and relationship therapists. This paper addresses those issues and then explains a systems approach to sex therapy with gay male couples.     

Case Report: Object Relations Family Therapy as a Model for Genetic Counseling

Object relations family therapy (ORFT) is a psychoanalytically based approach for the treatment of couples and families which stresses the importance of past relationships. The therapist assumes a parentlike role and provides a holding environment in which clients can explore unconscious motivations. This paper will discuss the applicability of this method to genetic counseling. The case of a couple seen for recurrent trisomies will be presented and used as an example to discuss how ORFT might serve as a framework in a genetic counseling session.     

The Perceived Relative Strength of the Therapeutic Alliance

ABSTRACT

The association between the perceived relative strength of the therapeutic alliance in couples therapy and psychotherapeutic outcome was investigated. The perceived relative strength of the couples therapeutic alliance was classified into three categories: a balancedalliance (an individual perceives his/her own alliance and the partner's alliance as approximately equal in strength), a positively biasedor blessedalliance (an individual perceives his/her alliance as stronger than the perception of the partner's alliance) and a negatively biasedor just biasedalliance (an individual perceives his/her alliance as weaker than the perception of the partner's alliance). The impact of a consensus or non-consensus within each partner about the perceived relative strength of the alliance on outcome was also investigated. The Alliance Inventory for Couples was used as a measure of the alliance and outcome was assessed with the Family Environment Scale and the Marital Satisfaction Scale. No statistically reliable relation was found between perceived relative strength of the alliance and improved outcome. Consensus was also not predictive of outcome. These findings failed to confirm previous theoretical propositions and empirical research. Possible reasons for discrepancies between the current findings and previous research are provided. The distinction between perceived strength and strength based upon independent self-report measures; and the designation of biased, blessed and balanced alliances merit future research.     

New and Expanded Concepts in Neurophysiology,Psychology, and Sociology Complementary to Llorens' Developmental Theory: Achieving Growth and Development through Occupation for Neonatal Infants and their Families

ABSTRACT

Introduction: This issue expands the Llorens’ Developmental Theory of Occupational Therapy. Llorens drew from multiple theorists from the disciplines of sociology, neurophysiology, biology, ecology, psychology, occupational science, and psychodynamics to provide the profession of occupational therapy with a unified theory to facilitate growth and development for people of all ages—from infancy to old age.

Purpose: The purpose of this issue is to analyze, synthesize, and evaluate the continued relevance of Llorens' theory. In addition, the author evaluates, recommends, and applies updated theoretical premises in the realms of psychodynamics, neurophysiology, contextual ecology, and cognitive science that reflect the relevance of occupational therapy practice for infants and their families in the neonatal intensive care unit.

New Psychological Elements: Through the appropriate use of purposeful occupational activity and affective object relationships, the expanded Developmental Theory of Occupational Therapy provides a unified theory of occupation enablement as intrinsic spatiotemporal adaptation and as extrinsic socio ? cultural and physically contextual occupational adaptation to achieve growth and development across the lifespan.     

Intercultural Therapy with Latino Immigrants and White Partners

SUMMARY

Interethnic and interracial marriages of Latinos and White Americans are on the rise and will continue to reshape the identities of individuals, couples, families, and communities. Clinicians working with these intercultural couples find no systematic training to address what is becoming a significant segment of our society. Couple therapists, however, cannot be culturally competent and effective based solely on knowledge of some dimensions of a couple's cultural backgrounds. Using clinical and theoretical ideas, the author defines clinical work with these couples as an explicit intercultural exchange. Our task as clinicians requires a rethinking of our conversations with these couples. It involves a caring therapeutic approach that is sustained on relational and systemic levels, and intercultural conversational skills inspired by clinical and other literatures that are explicitly dedicated to work with cultural difference and the “other.”     

Feminism and Hermeneutics

Feminists often look to postmodern philosophy for a framework within which to treat difference. We might more productively look to a hermeneutic philosophy that emphasizes the interpretive dimensions of difference and allows us to acknowledge the partiality of our understanding. Hence, we might also recognize the importance of a hermeneutic conversation unconstrained by relations of power or ideology in which all nonexclusionary interpretive voices can be educated by one another.     

Communication Questions for Couples

ABSTRACT

In this article, I share a series of questions to help couples, either in therapy or as a homework assignment, reflect upon various aspects of their relationship. The questions also provide the less articulate, less emotionally available partner a structured platform to share and connect. This activity gives many couples a sense of hope since it provides opportunities to practice relating more intimately and to experience the closeness that often results.     

Fostering Strength and Resiliency in Same-Sex Couples

Abstract

Same-sex couples are presented widiin tiieir cultural contexts to examine how those contexts might influence me strength and resilience of their relationships. We are particularly interested in the ability of the couple relationship to fulfill family functions that serve the social, psychological, and physical needs of each of the partners and society (Patterson, 2002a). Three family functions: family formation and membership, nurturance and socialization, and protection of vulnerable members, are particularly germane to same-sex couples. We examine several topic areas related to these three functions in order to assist clinicians in identifying factors that may prohibit same-sex couples from becoming and remaining strong and resilient.     

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.     

Psychological intervention with couples coping with breast cancer: A systematic review

Objective: Information about psychological intervention with couples coping with breast cancer is not well-disseminated. This can be explained, at least in part, by the absence of knowledge about the efficacy of this kind of intervention. The aim of the present systematic review is to identify and describe psychological interventions for couples coping with breast cancer and evaluate their efficacy.

Design: Studies identified by a searching multiple literature databases related to health and psychology between 1975 and 2013. Rigorous inclusion and exclusion criteria were utilised.

Results: Of 129 abstracts, 13 were extracted for further analysis and a final ten studies were deemed eligible for inclusion. Data were extracted from each study regarding study sample characteristics, design, results and methodological limitations. The results obtained were mixed in regard to efficacy, although the overwhelming majority of studies (eight studies) found benefits for both women and their partners in some dimensions, such as quality of life, psychological distress, relationship functioning and physical symptoms associated with cancer.

Conclusion: Psychological interventions for couples coping with breast cancer appear to be effective for both women and their partners. However, further studies are needed to evaluate the efficacy of couple-based interventions and, to identify for whom and how they are more effective.     

The Effectiveness of Emotionally Focused Couples Therapy With Veterans With PTSD: A Pilot Study

The current study is a pilot project conducted at Baltimore VA Medical Center investigating the use of emotionally focused couples therapy (EFT) for couples in which one partner is a veteran who has been diagnosed with posttraumatic stress disorder (PTSD). Fifteen couples enrolled in the study and seven of these couples completed treatment (26 to 36 weekly sessions of EFT). Both partners were assessed on measures of relationship satisfaction, psychological distress, depression, and quality of life, and veterans were assessed on measures of PTSD symptoms at baseline and 2 weeks after the intervention. Paired t-tests were used to compare scores before and after EFT. In terms of results, the veterans' partners reported significant improvements in relationship and life satisfaction and in decreased depression and a decrease in psychological distress. Veterans demonstrated a significant decrease in self-reported symptoms of PTSD. These results provide preliminary evidence for the usefulness of EFT to help foster improved relationship satisfaction, and psychological well-being for veterans with PTSD and their partners who completed treatment.     

Increasing Couple Intimacy Using Virginia Satir's Temperature Reading

SUMMARY

This article describes the process of using Virginia Satir's Temperature Reading, a communication tool, to increase intimacy with couples. It presents a rationale and theory for using a daiiy couple Temperature Reading to develop communication skills for learning how to share intimately in relationships. Temperature Reading provides a safe environment where each member of the couple can learn to share personal information and can practice listening to the other in a supportive and cooperative manner. Therapists and couples alike can utilize this process as described here.