Emotionally Focused Couple Therapy

Abstract

Working with couples who are both survivors of emotional abuse and are currently in an emotionally abusive relationship can be particularly challenging for the clinician. This article focuses on Emotionally Focused Couple Therapy as a recommended practice approach for clients who are caught in emotionally abusive patterns with one another. The article reviews relevant literature on this approach and illustrates the specific interventions applied lo an emotionally abusive couple.     

Principle‐Based Integrative Therapy with Couples: Theory and a Case Example

The Principle‐Based Integrative Therapy (PBIT) framework harnesses the principles of change underlying each theoretical model within integrative couple therapy treatments. PBIT has commonalities with other integrative approaches, and additional advantages stemming from its four tenets that guide therapists in combining strengths across models and overcoming each of their deficiencies. Tenet 1 advises that each model adds a core principle or mechanism of action that other models do not automatically address. Tenet 2 focuses on how techniques of one model may actualize the principles of other models. Tenet 3 ensures complementarity and a lack of conflict across principles. A case study and common case considerations are presented to illustrate how Tenets 1–3 can work in integrating Cognitive‐Behavioral, Multicultural, and Emotionally Focused Therapy models in working with a couple. Finally, Tenet 4 advocates for the use of models and empirically supported principles that also have received empirical support with diverse populations. Prerequisites and training implications for PBIT, and future clinical and research directions to further the utility of PBIT are discussed.     

Non-suicidal Self-Injury (NSSI): A Case for Using Emotionally Focused Family Therapy

Non-suicidal self-injury (NSSI) is defined by engaging in self destructive behaviors specifically targeted toward the body without suicidal intent. It is a mental health phenomenon increasing in occurrence. Marriage and family therapists will need to know how to treat this clinical presentation, as it is gaining recognition as a diagnostic category in the 2013 Diagnostic and Statistical Manual used to identify mental illness. This paper provides background information about NSSI, and includes an argument for testing the treatment of this disorder with Emotionally Focused Family Therapy. A clinical example is included.     

Interpreting imaginative play in child psychotherapy: Towards a phenomenological hermeneutic approach

Abstract

Despite renewed interest and technical advances in play therapy with children, its theoretical basis remains weak. A phenomenological hermeneutic approach to play therapy offers a philosophically grounded theoretical understanding of the meaning of children's expressions through imaginative play in a therapeutic context. Drawing upon Gadamer's ontological concept of play and Ricoeur's theory of interpretation, a child's imaginative play is seen as a text that calls for interpretation. The understanding and interpretation of imaginative play in play therapy is illustrated by means of a case vignette of a young physically abused child.     

Managing Child Behavior Problems in Children With Autism Spectrum Disorders: Utilizing Structural and Solution Focused Therapy With Primary Caregivers

Previous therapeutic models for modifying and managing problem behaviors in children with an Autism Spectrum Disorder have, typically, focused on working directly with the diagnosed child. The exclusion of other family member involvement in treatment displayed a need for creating a systemic model for managing children's problem behaviors. This model proposes Solution Focused Brief Therapy (SFBT) and Structural Family Therapy (SFT) with a focus on the caregivers of children with ASDs to reduce parental stress, increase parental self-efficacy, and ultimately begin to manage child behavior problems.     

Multiple Perspectives of Parent-Adolescent Sexuality Communication: Phenomenological Description of a Rashoman Effect∗

Due to methodological limitations, past meta-analytic research was not able to identify which treatment was most effective for specific marital distress levels. By converting pre-and post-test scores from marital research into equivalent Dyadic Adjustment Scale scores, it was possible to isolate mild, moderate, and severe levels of marital distress. Results show that Emotionally Focused Therapy is significantly more effective than isolated Behavioral Marital Therapy interventions for the treatment of moderate marital distress. Future directions of outcome research are also discussed.     

Introducing the Expectations and Preference Scales for Couple Therapy (EPSCT): Development,Psychometric Evaluation,and Suggested Use in Practice and Research

While it is known that client factors account for the largest proportion of outcome variance across treatment modalities, little is known about how clients’ characteristics affect the process and effectiveness of couple therapy. To further knowledge in this area, we created a brief, practice‐friendly measure, the Expectation and Preference Scales for Couple Therapy (EPSCT). Three self‐report scales assess clients’ Outcome expectations (e.g., I expect our relationship to improve as a result of couple therapy) and role expectations for Self (e.g., I expect to listen to my partner's concerns) and Partner (e.g., I expect my partner to blame me). Three Cognitive‐Behavioral, Emotionally Focused, and Family Systems preference scales use a forced‐choice format to measure the comparative strength of respondents’ preferences for interventions broadly reflective of each approach. A large item pool was developed from relevant literature and clinical experience and refined based on face and content analyses with two panels of experienced couple therapists and researchers. Across four studies with 1,175 participants, the scales’ internal consistency reliabilities were similar and their construct validity was supported with confirmatory factor analyses and significant correlations with several established measures, including expectation measures developed for individual psychotherapy and measures of attitudes toward professional help seeking and valuing personal growth. Across all studies, participants had stronger role expectations for themselves than their partners, although gender effects differed by sample. We discuss how to use the 15‐item EPSCT in clinical practice and in future research as a predictor of couple therapy processes and outcomes.     

Personhood of the Therapist in Couples Therapy

SUMMARY

Integrity Therapy (Lander, 1986; Lander & Nahon, 1992a, 1995a; Mowrer, 1961b, 1964a) views the personhood of the therapist as the very essence of therapy. By meeting the deepest part of the therapist with the deepest self of individuals in therapy, a healing process unfolds which opens up the healing potential of both the individuals and the couple. This article offers couple therapists and other mental health professionals an Integrity Therapy perspective of the personhood of the therapist and its therapeutic potential for helping couples in distress to reclaim their personhood. Two aspects of the Integrity Therapy approach which play a critical role in enhancing therapists' use of their personhood in the therapeutic process are explored: (a) the use of therapist self-disclosure, and (b) therapists' awareness and therapeutic use of counter-transference issues.     

Conceptual and Application Issues: Emotionally Focused Therapy With Gay Male Couples

Therapists working with couples are likely to see gay male couples in their practice yet there is a lack of training to prepare therapists to work with gay couples. Emotionally Focused Therapy (EFT) is an empirically supported approach to couples therapy and offers a clear structure and map for working with gay male couples. This article reviews some of the issues that are specific to EFT work with gay men. Given the range of minority stressors that gay men contend with EFT is particularly appropriate for work with gay male couples because of the focus on the attachment bond. Building a secure relationship is an important source of resilience that can buffer against prejudice and discrimination and provide a secure base for individual and couple exploration.     

Structural Family Therapy and Autism Spectrum Disorder: Bridging the Disciplinary Divide

ABSTRACT

Applied Behavior Analysis (ABA) is an evidence-based practice approach for the treatment of individuals with autism. The systemic effects of autism suggest that family therapy would considerably enhance the treatment of individuals with autism. Marriage and family therapy (MFT) training does not routinely include exposure to autism beyond the associated diagnostic criteria. Structural Family Therapy (SFT) is a systemic model that is familiar to those trained in family therapy and appropriate for the needs of families affected by autism. Therefore, the authors have used SFT as a foundation for supervising MFT trainees working in an autism treatment setting.     

Experiences Delivering a Marital Intervention for Couples With Children With Autism Spectrum Disorder

Previous researchers have indicated that parents of children with autism spectrum disorder (ASD) are vulnerable to relationship stress, lower marital satisfaction, and potential relationship dissolution. We describe the experiences of three couples who participated in a 10-week, in-home couples therapy intervention using Emotionally Focused Therapy (EFT). Each couple and their progress through the intervention are described using therapist and supervisor reflections, and qualitative evaluation interviews with the participants after termination. Based on the experiences of the couples, we conclude that couples would benefit from an in-home couples therapy intervention aimed to strengthen their relationships.     

“Dream More,Learn More,Care More,and Be More”: The Imagination Library Influencing Storybook Reading and Early Literacy

Abstract

This study examined the free book giving program of Dolly Parton's Imagination Library and its influence upon storybook reading and early literacy within one county-wide setting in the United States. Family literacy and early literacy experiences are known to be critical to young children's literacy development. The study found that childre who received the Imagination Library books were statistically different from those children who did not participate in the free book giving program. This study has implications for the early literacy outcomes for young children and their families, as well as other communities who utilize Dolly Parton's Imagination Library.     

“Broken Together”: Spirituality and Religion as Coping Strategies for Couples Dealing with the Death of a Child: A Literature Review with Clinical Implications

The death of a child is an event that can fall into the category of uncontrollable life events, testing the limits of the ability to control of bereaved parents. The literature reviewed showed that religious/spiritual coping is a unique way of coping and may be particularly important for couples who have lost a child. When assessing the couples’ coping strategies, marital therapists would be wise to look for religious/spiritual mechanisms that can be employed in the therapeutic process. Furthermore, the reviewers propose Emotionally Focused Couple Therapy (Johnson, 2004, The practice of emotionally focused couple therapy: Creating connection, Routledge, New York) as well suited for helping couples grieving the death of their child.     

Introduction to Behavioural Family Therapy for families with young children

This paper presents some suggestions for the implementation of Behavioural Family Therapy for families with young children. It attempts to bridge the gap between clinical research and practice by emphasizing the process of therapy delivery rather than the specific content of the behavioural approach. Suggestions for teaching behaviour management skills, contracting and the effective use of rewards and punishments are given. The common mistakes made by those working with Behavioural Family Therapy are addressed, and suggestions for working with single-parent families are given.     

Healing the Attachment Injury of Marital Infidelity Using Emotionally Focused Couples Therapy: A Case Illustration

This case illustration is a demonstration of a therapist handling the betrayal of infidelity through the application of Emotionally Focused Couples Therapy (EFT), specifically utilizing the attachment injury resolution model. An actual dialogue from a key couples session is included as it applies to the model, providing clinicians with an example for how EFT can be applied to the common clinical occurrence of infidelity.     

Children's active play imagery

ObjectiveThe purpose of the present study was to examine how children's use of imagery in their active play can facilitate Deci and Ryan's (2002) three basic psychological needs (i.e., competence, relatedness, and autonomy) in their active play. A secondary purpose was to examine the content of children's mental images associated with their active play.DesignFocus Groups.MethodOne hundred and four participants (male and female) aged 7–14 years old were recruited from various summer camps.ResultsThe results indicated children use active play imagery and their use of imagery facilitates the satisfaction of the three basic needs (i.e., imagery → behaviour → need satisfaction). With respect to autonomy, children imaged activities that are their favourite, enjoyable, and they do often. For relatedness they imaged friends, family, and others (e.g., professional athletes), while for competence they imaged themselves being good at the activity. Age and gender differences emerged for relatedness and competence. Furthermore, the content of children's images included when participants imaged as well as the speed of their images (i.e., slow motion, real time, or fast).ConclusionThese findings may enable the development of imagery interventions to increase children's motivation to be physically active.     

Brief Therapy: Focused Solution Development

This article describes the form of brief therapy developed at the Brief Family Therapy Center. We have chosen a title similar to Weakland, Fisch, Watzlawick, and Bodin's classic paper, "Brief Therapy: Focused Problem Resolution" (20) to emphasize our view that there is a conceptual relationship and a developmental connection between the points of view expressed in the two papers.     

Supervisors' and Supervisees' perceptions of the effectiveness of family therapy supervisor interpersonal skills

Abstract

This study surveyed a randomly selected group of Approved Supervisors of the American Association for Marriage and Family Therapy (n=318) and their supervisees (n=299) on their perceptions of the effectiveness of several supervisor interpersonal skills. Both supervisors and supervisees had high ratings for the majority of the interpersonal skills and rated “respects the supervisee” most effective. Trends in supervisors' and supervisees' responses were assessed for (a) theoretical orientation, (b) supervision setting, (c) gender, (d) number of years supervising family therapists (for supervisors), and (e) number of years practicing family therapy (for supervisees).     

Parent-Child Interaction Therapy for ADHD: A Conceptual Overview and Critical Literature Review

ABSTRACT

Attention-Deficit/Hyperactivity Disorder (ADHD), a chronic disorder beginning in childhood, is identifiable and diagnostically valid during the preschool years. Compared to school-aged children, preschoolers have not received as much attention in the literature. Parent-Child Interaction Therapy (PCIT) is an empirically-supported parent training program for young children with disruptive behaviors that may also be effective in treating ADHD. The purpose of the current article was to explore the theoretical rationale for utilizing PCIT with this population and to conduct a literature review of published PCIT treatment outcome studies that measured ADHD symptoms. The literature demonstrates that children with ADHD have been included in PCIT research and evidence suggests that PCIT may be effective for young children with ADHD. However, future research is needed to specifically examine the effects of PCIT on ADHD.