Behavioral Marital Therapy: An Outcome Evaluation of Conjoint,Group and One Spouse Treatment

Abstract

Behavioral Marital Therapy has focussed on the modification of marital behavior in conjoint and couples group settings. This study extends previously published outcome studies in that one treatment condition involved treating only one of the partners. Fifty-seven couples were consecutively assigned to one of the three treatment conditions. Outcome evaluations included an independent assessment, marital satisfaction, sexual adjustment and an assessment of target problems. The results revealed no significant differences between the three treatment conditions. However, couples in the conjoint treatment resolved their target problems more rapidly than the other two treatments. The implications of the result as well as issues of outcome prediction, cost-effectiveness and the viability of treating one spouse are discussed.     

Unrealistic beliefs of clinical couples: Their relationship to expectations,goals and satisfaction

Abstract

Forty-seven marital therapy couples completed inventories measuring unrealistic beliefs about self and unrealistic beliefs about marital relationships. In addition, they completed questionnaire measures of their expectations and goals for therapy and their levels of marital satisfaction. As hypothesized, the clients' unrealistic beliefs, particularly those regarding relationships, were negatively associated with their estimated chance for improvement in therapy, desire to improve rather than terminate the relationship, preference for marital versus individually oriented treatment, and overall marital satisfaction. These results are consistent with the theoretical rationale for cognitive therapy with clinical couples and suggest specific targets for intervention in this process. Directions for future research are discussed.     

Quality-of-life after penile prosthesis placed at radical prostatectomy

Abstract

The clinical and psychosocial effects of immediate penile prosthesis implantation at the time of radical prostatectomy (RP) were investigated in 97 consecutive patients and 68 partners. Prosthesis recipients reported more frequent sexual contact, fewer marital problems and slightly fewer sexual functioning problems than the RP-alone patients. There were no group differences on any sociodemographic characteristics, on disease recurrence, on physical and psychosocial functioning, or on reported depression. Patients who chose the prosthesis did, however, evidence less of a link between depression and functional limitations and between depression and marital problems. They also had lower levels of agreement with their partners in reporting their own depression, as compared to the patients who opted for RP surgery alone. We conclude that the penile prosthesis was associated with an increased frequency of sexual contact, a reduction in reported marital problems, and stylistic differences between the two patient groups in dealing with affect.     

Religious Homogamy, Marital Conflict, and Stability in Same-Faith and Interfaith Jewish Marriages

This study examined the relationship between a couple's similarity in religious beliefs and practices and their level of marital conflict and stability. One-hundred-fifty-five adult children of same-faith and interfaith Jewish marriages reported on each of their parents' religious beliefs and behaviors. Religious homogamy was defined as similar attitudes and beliefs about specific religious practices. The parents' level of marital conflict was obtained by having their adult children fill out the Children's Perception Questionnaire (Emery and O'Leary 1982). The major hypotheses tested were that a positive correlation would exist between religious homogamy and marital stability and this relationship would be mediated by the level of marital conflict. That is to say, as marital conflict increases, marital stability should decrease. It was expected that these correlations would still hold after controlling for religious denomination (same-faith and interfaith). Partial support for the model was found: more disagreement on Jewish issues predicted higher levels of marital conflict. Higher conflict, in turn, predicted less marital stability.     

Lay beliefs about the efficacy of self-reliance,seeking help and external control as strategies for overcoming obesity,drug addiction,marital problems,stuttering and insomnia

Abstract

This study was concerned with peoples' beliefs about the importance of twenty-four different contributors towards overcoming five relatively common personal health problems, namely: obesity, drug addiction, marital difficulties, stuttering and insomnia. One hundred and twenty-two subjects completed a five-page questionnaire indicating how effective each of these contributors were to overcoming the problems as specified. Factor analysis revealed an interpretable structure similar to previous studies (Luk and Bond, 1992): the emerging three factors were labelled ^'self-reliance”, “seeking help” and “external control”. Multiple regression showed that few individual difference variables as measured were related to perceived relevance of the different contributors. The results were discussed in terms of subjects' beliefs concerning the value of self-reliance as opposed to seeking help, and in relation to the importance of understanding lay beliefs about the efficacy of different forms of intervention.     

The prediction of safe sex behaviour: The role of intentions,attitudes, norms and control beliefs

Abstract

The present study was designed to examine the utility of the theory of reasoned action (Fishbein and Azjen, 1975) in relation to people's propensity to engage in a range of different safe sex strategies, including engaging in an exclusive sexual relationship, avoiding casual sex, and asking sexual partners about their previous sexual and IV drug use history. It was proposed that the intention to engage in a particular safe sex practice would be influenced by the person's attitude towards engaging in the practice, as well as his or her perception of the extent to which others thought they should do so (subjective norm), while behavioural intentions were proposed to predict actual behaviour. The study was also designed to examine whether, after control of the effects of the components of the theory of reasoned action, the person's generalised control beliefs would explain any additional variance in either behavioural intentions or actual behaviour. One hundred and two sexually active heterosexual students participated in the study. At the first wave of data collection, subjects completed measures of intentions, attitudes, and norms appropriate to each of the different behaviours. Measures of actual behaviour were obtained at follow-tip (three months after first period of data collection). The results of the study indicated that attitudes and norms predicted intentions for avoiding casual sex and asking sexual partners about their previous sexual and IV drug use history, while intentions predicted actual behaviour for all three safe sex strategies. Although there were no significant main effects of control beliefs on intentions or behaviour, subjects with internal control beliefs were more likely than their counterparts with external control beliefs to behave in accordance with their intentions to engage in an exclusive sexual relationship and ask sexual partners about their previous sexual and IV drug use history. Additional analyses revealed that the levels and determinants of intentions and actual behaviour were, in general, similar for males and females.     

The Effects of Religiosity on Preferences and Expectations for Marital Therapy Among Married Christians

Highly religious couples constitute a substantial portion of marital therapy clients in the U.S. Married Christian individuals ( N = 211) completed a survey of demographics and religiosity (religious values and Christian beliefs). They rated preferences and expectations for one of four marital therapy situations: Christian therapist using Christian practices (e.g., prayer or reference to Scripture), Christian therapist using psychological practices only, non-Christian therapist willing to use Christian practices, and non-Christian therapist using psychological practices only. High religious values and high Christian beliefs predicted ratings of marital therapy situations, where high was defined as one standard deviation above the mean of standardized norm groups. Low to moderate religious values or Christian beliefs did not predict ratings of marital therapy. It was concluded that highly religious couples present a special situation where the marketing, assessment, and practice of marital therapy might differ from therapy with other types of couples.     

Remarriage Beliefs as Predictors of Marital Quality and Positive Interaction in Stepcouples: An Actor–Partner Interdependence Model

Using an Actor–Partner Interdependence Model, we examined remarriage beliefs as predictors of marital quality and positive interaction in a sample of 179 stepcouples. Three beliefs were measured using subscales from the Remarriage Belief Inventory (RMBI) including success is slim, children are the priority, and finances should be pooled. Several significant actor and partner effects were found for both wives' and husbands' beliefs. Wives' marital quality was positively associated with their own beliefs that finances should be pooled and negatively associated with their own beliefs that success is slim. Wives' reports of their own and spouses' positive interaction were both positively associated with their beliefs that finances should be pooled. Their reports of spouses' positive interaction were also negatively associated with husbands' beliefs that success is slim. Husbands' marital quality was positively associated with wives' beliefs that children are the priority, positively associated with their own beliefs that finances should be pooled, and negatively with success is slim. Positive interaction for husbands was positively associated with wives' beliefs that finances should be pooled and negatively associated with their own beliefs that success is slim. Finally, husbands' reports of positive interaction for their spouses were positively associated with wives' beliefs that finances should be pooled. Implications for future research utilizing dyadic data analysis with stepcouples are addressed.     

Selective review,optimism and HIV risk perception

Abstract

Research suggests that review of risk factors increases optimism about health. The present experimental study explored the effects of reviewing risk increasing and risk decreasing factors on HIV risk perception (own risk, others' risk, optimism), self efficacy and behavioural intentions. 164 heterosexual subjects completed a questionnaire concerning their beliefs about HTV and their sexual behaviour. Subjects were allocated to either the risk increasing condition (eg. since being sexually active how often have you asked your partners HIV status?), the risk decreasing condition (eg. since being sexually active how often have you tried to select your sexual partners carefully?), or a control group. The results suggest that review of risk decreasing factors increased optimism and that this change in optimism was related to an increase in perceived others' risk. The results are discussed in terms of theories of selective focus and egocentricism in risk perception and the implications for health promotion.     

Evaluation of the effectiveness of mindfulness-based cognitive therapy to treat chronic insomnia

IntroductionAs having positive effects on reducing distress and symptoms associated with different mental and physical disorders, many studies have focused on mindfulness-based cognitive therapy.ObjectiveIt is suggested that mindfulness-based cognitive therapy (MBCT) could help reducing insomnia by focusing on certain cognitive factors associated to insomnia.MethodA pre-experimental, pre-test protocol with a post-test and three month follow-up was used to measure the effect of a group intervention of eight sessions and 12 participants.ResultsThe intervention had a positive effect on participants’ subjective evaluation regarding their sleep and the gains were maintained after three months. However, after the intervention, no significant effect was found on the objective measures of sleep. Two factors associated to the maintenance of insomnia, such as dysfunctional beliefs and attitudes about sleep and mental control strategies were improved following treatment and these improvements were maintained during the follow-up.ConclusionThe results of this study suggest that mindfulness-based cognitive therapy might be an interesting addition in the treatment of insomnia, given that it focuses on certain cognitive factors that contribute to the maintenance of insomnia.     

Positive illusions about a partner’s personality and relationship quality

Previous studies have shown individuals to hold positive biases about their relationships. The present study examined positive illusions about a partner’s specific personality characteristics in relation to relationship quality and personality. Both partners of 120 heterosexual couples participated in the present study, making it possible to examine both partner and actor effects. Results showed that although, in general, individuals did not hold positive illusions about a partner’s specific personality characteristics, positive illusions were positively related to relationship quality. In addition, interesting relations emerged between positive illusions about a partner’s personality and both individuals’ personality and marital duration.     

The psychosocial predictors of long-term distress in partners of patients with acute coronary syndrome

Objective: Partners of acute coronary syndrome (ACS) patients are at risk of experiencing long-term distress and the purpose of this study was to identify its predictors.

Design: Using an observational design, 80 partners of ACS patients completed validated questionnaires at three time points. The predictor variables, marital satisfaction and optimism were assessed three weeks after patient hospital discharge (T1). The outcomes, depressive symptoms and physical health status (from a quality of life scale) were measured 6 (T2) and 12 (T3) months post-discharge, and scores were combined to indicate the long-term response.

Main outcome measures: Depressive symptoms and physical health status.

Results: Partner depressive symptoms increased and physical health status deteriorated over the months following the patients’ ACS. After controlling for demographics, clinical severity of ACS and T1 levels of the outcome variable, partners’ long-term depressive symptoms were predicted by poor marital satisfaction and low optimism at T1, and poor physical health status was predicted by low T1 optimism.

Conclusion: Psychosocial factors are predictors of long-term distress for ACS partners. Partners in an unhappy marriage or with low optimism after ACS are at an increased risk of depression and low physical health status, and should be the target of additional support.     

An evaluation of a partial training program in psychiatric residency on the later practice of marital and family therapy

Abstract

This paper reports on the results of a survey of psychiatrists and residents who received marital and family therapy training during their second year of residency. The data indicate that such training has an immediate positive effect on practice and is carried forward into later practice. Practicing psychiatrists trained in marital and family therapy during residency report spending 25% of their caseloads in marital and family therapy which was seen as producing positive change in patients. In line with previous training, practicing psychiatrists define the unit of treatment as more than an identified patient and treat marital and family therapy cases themselves or refer to others for such therapy. Variations in practice and techniques raise questions regarding the structure and content of marital and family therapy training in psychiatry residency programs and point out the importance of such training in the later practice of psychiatry.     

Marital role strain,illness intrusiveness,and their impact on marital and individual adjustment in end-stage renal disease

Abstract

A marital role theory approach was used to investigate individual psychosocial well-being and marital adjustment in 89 end-stage renal disease (ESRD) patients and their spouses. Four different patient groups were selected according to a continuum of clinical milestones in the treatment of ESRD, including pre-dialysis (n=17), incenter dialysis (n=18), home dialysis (n=19), and posttransplant patients (n=17). A nephrology clinic control group (n=18) was also included. Standardized instruments were employed to investigate marital role strain (Marital Role Questionnaire, KDS-15), marital adjustment (Locke-Wallace Marital Adjustment Test), subjective well-being (Affect Balance Scale, Rosenberg Self-Esteem Inventory), and psychopathology (Symptom Checklist 90-R). Hierarchical multiple regression analyses provided strong and consistent support for the major hypotheses relating elevated marital role strain to compromised marital adjustment and individual well-being. Further analyses demonstrated that increased perceived intrusiveness of ESRD was significantly related to greater marital role strain, poorer marital adjustment, and decreased individual well-being. This is consistent with the idea that perceived intrusiveness may be an important mediator of marital role strain and of coping with chronic illness. “Objective” intrusiveness, defined in terms of patient group, was not significantly related to marital or individual well-being. These findings support a dyadic approach to the psychosocial study of chronic illness.     

Marital Estrangement,Positive Affect,and Locus of Control Among Spouses of Workaholics and Spouses of Nonworkaholics: A National Study

This study compared a sample of spouses of workaholics and spouses of nonworkaholics on ratings of marital estrangement, positive feelings toward husband, and locus of control. A random national sample of 326 participants drawn from the membership list of the American Counseling Association was surveyed. Spouses of workaholics reported greater marital estrangement and less positive affect towards husbands and higher external locus of control than spouses of nonworkaholics. These findings were the first empirical results to corroborate clinical and case study reports. Clinical implications of these findings are also presented.     

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.     

Partner Discrepancies in Distressed Marriages

ABSTRACT

Spousal discrepancy theory posits that partners with wide personality differences are at risk for marital distress. In this study, we assessed links between partner personality and interpersonal characteristics and marital distress in 244 couples who sought marital therapy. The sample was divided into three subgroups according to marital duration. Longer-married couples reflected significantly less impulsive, exploitive, and insensitive characteristics than couples in either shorter or intermediate marriages. Couples' marital distress was linked to larger discrepancies in personal distress, impulsivity, interpersonal insensitivity, and self-centered characteristics. While husbands' marital distress was linked to partner differences in personal distress and to impulsive, narcissistic, and competitive characteristics, wives' marital distress was primarily linked to partner discrepancies in self-centeredness.     

Comparison of reciprocity and discussion-type counseling for marital problems

Abstract

Reciprocity counseling had previously been found to increase reported marital happiness in a study using a within-subject design. Fifty-five couples served in the present study using a between-subjects design, additional response measures, and additional positive communication training. The reciprocity counseling provided behavioral contracting, communication training and instruction in mutual reinforcement, whereas the control procedure encouraged discussion of the problems. The reciprocity counseling produced significantly more improvement than the discussion-type counseling for the three marital adjustment measures after four sessions. The improvement was maintained during the 24 months of follow-up.     

Vers une nouvelle appréhension des mathématiques par traitement EMDR : actualités et perspectives

ObjectiveEMDR for Eye Movement Desensitization and Reprocessing developed since 1989 by F. Shapiro has demonstrated its effectiveness in the treatment of Post Traumatic Stress Disorder (PTSD). In Science of Education, no study has been previously developed in the application of EMDR protocols. The purpose of this article is to demonstrate the relevance and effectiveness of EMDR in supporting cognitive and emotional remediation of students in Master 1, with respect to mathematics, preparing Schools Teacher contest. The first encounters with the students revealed, through their discourse, an aversion to mathematics linked to one or more particularly painful experiences in a learning situation. Mathematics may cause anguish, sometimes tinged beliefs such as “I’ll never be able to… I am very bad at math”. This represents even an insurmountable obstacle in the professional life of some.MethodsNearly 170 students in Master 1 “Professor of the Schools” registered on the ESPE (College of the Teaching profession and Education) were asked about their relation to mathematics, both in their emotions as their self-efficacy. Among those who suggested a traumatic memory in a learning situation in mathematics, forty were selected and divided into two groups. The control group received two hours of information about relaxation techniques that could be used before mathematics. The other group benefited of the EMDR treatment according to the standard protocol in eight phases.ResultsThe results showed that students who received EMDR treatment experienced after treatment and one month later, a significant decline in their negative emotions with mathematics and an increase in the strength of their self-efficacy, unlike the control group.DiscussionEMDR demonstrates its effectiveness in reprocessing beliefs and emotions of students with respect to mathematics and opens ways of research in Educational Sciences. So, it will be necessary, from the principle of alternated bilateral stimulation, to develop specific protocols for the struggling students, to measure the effects in the long term and develop them in a group situation.     

Obsessive beliefs and uncertainty in obsessive compulsive and related patients

Background/objectiveThe aim of the present study was to examine obsessive beliefs and intolerance of uncertainty differences among patients Obsessive compulsive disoreder (OCD), trichotillomania, excoriation, generalized anxiety disorder (GAD) and a control group healthy.Method130 participants between the ages of 17 and 62 years (Mean = 29.56, SD = 11.81) diagnosed with OCD (n = 36), trichotillomania (n = 18), excoriation (n = 17), GAD (n = 31) and a healthy control group (n = 28) were evaluated by Obsessive Beliefs Spanish Inventory-Revised and Intolerance of Uncertainty Scale.ResultsThe trichotillomania group presented one of the highest obsessive beliefs highlighting over-importance of thoughts, thought action fusion-moral, importance of controlling one's thoughts. The OCD group also had higher scores in inflated responsibility and thought action fusion-likelihood. The GAD group excelled in inhibitory and prospective uncertainty. The level of depression influenced obsessive beliefs while anxiety affected inhibitory and prospective uncertainty.ConclusionsCognitive variables such as obsessive beliefs and Intolerance of Uncertainty should be considered in the prevention and intervention of obsessive and anxiety disorders.