Marital Status and Gender Similarity in Marital Therapy

This analogue study was designed to examine the effects of therapists' marital status and therapist and participant sex on participants' perceptions of therapist and expectations for therapy. Each partner of 20 couples presenting for marital therapy at four outpatient counseling centers independently completed one of four protocols. The protocols differed only on the therapist's marital status and sex. Results revealed that neither therapist marital status nor therapist sex had an effect on participants' perceptions of therapists or therapy expectations. Female participants, however, perceived therapists as more trustworthy, attractive, and expert and had higher expectations for therapy than did male participants.     

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.     

Multiple approaches to the treatment of violent couples

Abstract

The relationship of the discrepancy between couple's actual level of intimacy and desired level of intimacy and marital adjustment was explored using data from 185 randomly selected couples who completed the Personal Assessment of Intimacy in Relationships and the Marital Adjustment Test. Multivariate and univariate regression analyses indicated that the discrepancy between actual and desired intimacy of husbands and wives was highly predictive of marital adjustment (R²=.665). Particularly interesting was that couples with low intimacy scores who did not desire more intimacy had good marital adjustment. The relationship between intimacy and marital adjustment was curvilinear, and wives' marital adjustment was more affected by intimacy than husbands'. Implications for marital therapy are discussed.     

Strengthening Family Resilience

Abstract

Researchers in the field of marriage and family therapy have largely ignored the effect of gender bias on clinical decision making. The purpose of this study was to explore if patient gender influenced prognostic judgments and if male and female therapists utilized different client characteristics when formulating prognostic judgments. Prognostic judgments were based on clinical profiles of couples seeking marital therapy for inhibited sexual desire. The multidimensional scaling procedure, KYST, was utilized to analyze the data. The findings indicated that the identified patient's gender did not influence prognostic judgments. However, therapist gender did influence the client characteristics used to formulate prognostic judgments.     

Patient activity and outcome in group psychotherapy: new findings

The relation of patient verbal activity to pretherapy symptom status and outcome was examined for ninety patients in time-limited group psychotherapy. For each half-hour segment the most verbally active member, or main actor (MA), was identified. Verbal activity was measured by counting the number of times each patient was MA during the course of the group. Outcome was assessed by administering a battery of instruments pre- and posttherapy and by obtaining direct ratings of patient benefit from the patient, therapist, and an independent rater: the number of times MA was found to be significantly correlated with four pretherapy measures, indicating that the most disturbed patients were most active in these groups; the number of times MA was also correlated with patient and therapist benefit ratings, indicating that therapists and patients themselves agreed that those who spoke the most benefited the most. However, partial correlations between number of times MA and other outcome measures did not produce any significant relationships. Thus, it does not appear that patient verbal activity is related to outcome, as measured by objective instruments.     

Differentiation of Self Predicts Life Satisfaction through Marital Adjustment

Abstract

Previous studies have documented the link between differentiation of self and life satisfaction. However, the underlying mechanisms explaining these associations are yet to be tested at the dyadic level. This study examined the mediating role of marital adjustment in the association between differentiation of self and life satisfaction among 113 Turkish heterosexual married couples (N?=?226). Analyses using the Common Fate Model demonstrated that differentiation of self was associated with higher levels of marital adjustment and life satisfaction, such that marital adjustment was positively associated with life satisfaction, and in turn, marital adjustment fully mediated this association. Implications are discussed for clinicians and cross-cultural researchers who seek to promote greater life satisfaction by targeting both differentiation and marital adjustment.     

Psychodrama: Rehearsal for Living

Abstract

The current study examined therapist characteristics that are related to the use of spiritual and religious interventions in group therapy and to perceived barriers to attending to spirituality in group therapy among a sample of experienced group therapists. Results demonstrated that greater therapist spirituality was associated with more frequent use of both spiritual and religious interventions, as well as lower perceived barriers to attending to spirituality in group therapy. Religious commitment was only uniquely related to perceived barriers, such that therapists with higher religious commitment actually perceived greater barriers. Training in religion and spirituality and comfort with spiritual discussions was also related to therapists’ use of religious and spiritual interventions and perceived barriers.     

A Place at the Table: Integrating Diet and Nutrition into Family Therapy Practice

Most schools of family therapy directly or indirectly recognize that personal qualities of the therapist influence therapy process. If personal qualities of therapists are associated with therapy process, it seems plausible that there would be some interaction between their personal relationships and therapy process. The present study examines the relationship between emotion management at home and emotion management at work to job satisfaction and marital satisfaction of marriage and family therapists. Results suggest that men and women experience a different interaction between emotion management, relationship satisfaction, and job satisfaction.     

Group Psychotherapy in the Treatment of Some Neurodermatoses

The relation of patient verbal activity to pretherapy symptom status and outcome was examined for ninety patients in time-limited group psychotherapy. For each half-hour segment the most verbally active member, or main actor (MA), was identified. Verbal activity was measured by counting the number of times each patient was MA during the course of the group. Outcome was assessed by administering a battery of instruments pre- and posttherapy and by obtaining direct ratings of patient benefit from the patient, therapist, and an independent rater: the number of times MA was found to be significantly correlated with four pretherapy measures, indicating that the most disturbed patients were most active in these group; the number of times MA was also correlated with patient and therapist benefit ratings, indicating that therapists and patients themselves agreed that those who spoke the most benefited the most. However, partial correlations between number of times MA and other outcome measures did not produce any significant relationships. Thus, it does not appear that patient verbal activity is related to outcome, as measured by objective instruments.     

Improving Delivery Behaviors During Exposure for Pediatric OCD: A Multiple Baseline Training Trial With Community Therapists

This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting.     

Marriage encounter casualties: A preliminary investigation

Abstract

The purpose of this exploratory study was to investigate the relationship between participation in Marriage Encounter, the largest marriage enrichment program in the world, and subsequent marital or family distress. Analyzing 13 case reports from seven marital therapists, the authors suggest that Marriage Encounter weekends can cause marital or family deterioration for some couples through increased marital conflict, avoidance of constructive problem solving, or marital enmeshment at the expense of children. It appears that the most harmful aspect of the Marriage Encounter experience is its induction of intense couple-centered communication, leading to emotional overload in some couples. The authors offer several recommendations intended to lower the risks associated with participation in Marriage Encounter.     

Form and content in the conjoint treatment of sexual dysfunction: A controlled study

Forty eight couples with impotence, anorgasmia or loss of libido were randomly allocated to one of three treatment conditions: (i) modified Masters and Johnson (male and female therapist), (ii) modified Masters and Johnson (one therapist) and (iii) marital therapy and relaxation comparison procedure (one therapist). The major variables investigated were type of therapy, number of therapists (one or two) and sex of therapist. Post-treatment and one year follow-up assessments showed no significant difference in outcome between treatment approaches. No significant effects were found for sex of therapist and the interaction between sex of therapist and sex of presenter.     

A comparison of sexually dysfunctional, maritally disturbed and well-adjusted couples

Married couples seeking sex therapy, marital therapy, or no form of therapy were compared with respect to personality, sexual and marital functioning. The Sexual Dysfunction and Marital Difficulties groups (15 and 10 couples respectively) were obtained from the waiting lists of a sexual dysfunction service and marital therapy unit. Non-Problem subjects (15 couples) were from a volunteer sample. Personal adjustment, sexual and marital functioning were assessed by means of the Eysenck Personality Inventory, a Sexual Behavior Questionnaire, the Locke-Wallace Marital Adjustment Survey, and the Azrin Marital Happiness Scale. Results indicated that although all three groups were within the normal range, problem couples had higher ‘neuroticism’ scores than did Non-Problem couples. Marital Problem couples were the most debilitated. Their marital adjustment was lowest, and their sexual functioning was comparable to the Sexual Dysfunction group. Marital adjustment of the Sexual Dysfunction couples was significantly higher than that of the Marital Difficulties couples. Therapeutic and theoretical implications of the differentiating characteristics in the three couple categories are discussed.     

Sequential analysis as a method of feedback for family therapy process

Abstract

The purpose of this study was to examine the relationship between therapist verbal behavior and family cooperation and resistance during the second session of family therapy with juvenile delinquents. Sequential analysis was used to investigate the impact of one therapist's behavior on family resistance and cooperation in a sample of 12 families. The results of the sequential analysis revealed that therapist “support” and “teach” behaviors were associated with significant increases in the likelihood of family cooperation. The study provides an example of how sequential analysis can be used to inform family therapists about the impact of their behavior on families.     

THE THERAPIST'S EXPERIENCE OF PSYCHOTHERAPY: SOME DIMENSIONS AND DETERMINANTS

Eleven dimensions of therapists' experiences during psychotherapy ses- sions were derived, factor analytically, for a sample of 17 therapists. These therapists completed a standard questionnaire after each of 8 or more sessions with 31 female patients. In general, the 11 dimensions reflected various experiences of (a) being helpful towards patients, (b) attempting to deal with difSicult patients, (c) making non-therapeutic responses to patients, and (d) entrapment in personally distressing situations with patients. Personal-social characteristics of patients and therapists were examined as possible determinants of therapist experience. Among other characteristics, patients' employment and marital status, diagnosis and previous treatment, influenced certain therapist experience dimensions-as did therapists' profession, marital status, and personal psychotherapy.     

Commitment: A variable in women's response to marital therapy

Abstract

The relationship between commitment to one's marriage at the onset of therapy and changes during marital therapy was examined. In a sample of 42 couples seeking marital therapy, wives' commitment level accounted for a significant amount of unique variance in marital satisfaction before therapy and gains in marital satisfaction resulting from therapy. In keeping with earlier findings, results for men were less striking, and often nonsignificant. The importance of considering the variable of commitment in marital research is discussed.     

Understanding general and specific connections between psychopathology and marital distress: a model based approach

Marital distress is linked to many types of mental disorders; however, no study to date has examined this link in the context of empirically based hierarchical models of psychopathology. There may be general associations between low levels of marital quality and broad groups of comorbid psychiatric disorders as well as links between marital adjustment and specific types of mental disorders. The authors examined this issue in a sample (N = 929 couples) of currently married couples from the Minnesota Twin Family Study who completed self-report measures of relationship adjustment and were also assessed for common mental disorders. Structural equation modeling indicated that (a) higher standing on latent factors of internalizing (INT) and externalizing (EXT) psychopathology was associated with lower standing on latent factors of general marital adjustment for both husbands and wives, (b) the magnitude of these effects was similar across husbands and wives, and (c) there were no residual associations between any specific mental disorder and overall relationship adjustment after controlling for the INT and EXT factors. These findings point to the utility of hierarchical models in understanding psychopathology and its correlates. Much of the link between mental disorder and marital distress operated at the level of broad spectrums of psychopathological variation (i.e., higher levels of marital distress were associated with disorder comorbidity), suggesting that the temperamental core of these spectrums contributes not only to symptoms of mental illness but to the behaviors that lead to impaired marital quality in adulthood.     

Exploration of Cross-Cultural Couples’ Marital Adjustment: Iranian American Women Married to European American Men

This article presents a qualitative, phenomenological study which explored cross-cultural marital adjustment among intermarried Iranian American women and their European American husbands. Twelve couples participated in individual and joint interviews. Analysis of the interviews suggests that although cross-cultural differences exist between the couples, these differences were not preventing successful marital adjustment. The interviews revealed that successful marital adjustment relied heavily on certain positive features or “strengths,” which worked as buffers to cross-cultural differences. The findings of this study add to the limited literature on Iranian Americans, intermarriage, and cross-cultural marital adjustment, and have implications for counselors and marriage and family therapists working with cross-cultural couples.     

Marital therapy outcome measured by therapist, client, and behavior change

The present research examined marital therapy outcome, in a sample of 88 couples and 22 therapists, through the use of multidimensional criteria from multiple perspectives. Three paper-and-pencil patient self-report instruments were used to measure different aspects of the couple relationship. In addition, therapist post-therapy ratings and objective observer ratings of the couple behavior during therapy were obtained. Past debates about what the "right" criteria might be for measuring therapeutic change prompted our strategy. Special attention was focused on those criteria that could be classified as "inside" or "outside" of the couple relationship. Data analysis revealed a significant relationship between the couples' and therapists' ratings of improvement in therapy. Additionally, husband and wife negative acts (behaviors) in therapy were also significantly correlated with therapists' ratings of improvement. Both statistically significant and clinically significant criteria were employed to evaluate the therapy outcome. Improvement due to therapy as measured by the three self-report instruments varied from 38% to 58%. These differences appeared to stem from the different kinds of information yielded by the specific tests.     

Qualifications for Membership in the A.G.P.A.

A model of the development of group therapists is presented. It is proposed that student group therapists proceed through a sequence of stages, each of which is marked by characteristic therapist behavior. During the initial Group shock phase, the student reacts to the novelty of group therapy stimuli with individual therapy or content-oriented approaches. Reappraisal is a period of some therapist inhibition, frustration, or self-doubt. One step behind is a phase characterized by a gradual recognition of the process level of analysis, despite difficulty supplying the interventions autonomously. Using the here-and-now is a period of active intervention about interpersonal phenomena among group members. The techniques for highlighting this material are refined in the Polishing skills phase. The usefulness of models in training is discussed.