Cognitive marital therapy

This article reviews recent applications of cognitive therapy to the treatment of marital distress. Three categories of cognitive phenomena that can decrease marital satisfaction and elicit dysfunctional interactions between spouses are described. First, automatic thoughts that comprise an individual's stream-of-consciousness thinking about marital events can be biased by systematic cognitive distortions. Inaccurate attributions about the causes of marital problems are a major form of such automatic thoughts. Second, individuals' behaviors toward their partners are influenced by their expectancies about the probabilities of the partner's subsequent responses, and these expectancies also are susceptible to systematic distortion. Third, an individual's unrealistic or irrational beliefs about the nature of intimate relationships can produce distress and dysfunctional behavioral responses toward the partner. Methods for assessing and modifying these dysfunctional cognitions, particularly in conjoint treatment, are described. Similarities and differences between cognitive therapy and rational-emotive therapy in the treatment of marital problems are noted.     

A rational-emotive theory of marital dysfunction and marital therapy

This article first discusses some rational-emotive perspectives on marital and couples therapy, including what constitutes a good relationship, some important differences between rational-emotive and other couples therapy approaches, and an RET classification of relationship problems. Second, this article also sketches out ways in which social exchange principles can be integrated into rational-emotive couples therapy.This is a revised version of a paper that originally appeared in A. Ellis and M. Bernard's (Eds.) 1985 text,Applications of Rational Emotive Therapy, Plenum Publishing Co., New York.     

Couple therapy,family therapy and systemic interventions for adult‐focused problems: the current evidence base

This paper updates previous similar reviews published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews and controlled trials for the effectiveness of couple therapy, family therapy, and systemic interventions for adults with a range or relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, either alone or as part of multimodal programmes, for relationship distress, psychosexual problems, intimate partner violence, anxiety disorders, mood disorders, alcohol problems, psychosis and adjustment to chronic physical illness.     

Family therapy and systemic interventions for child‐focused problems: the current evidence base

This review updates previous similar papers published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews, narrative literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with common mental health problems and other difficulties. In this context, systemic interventions include both family therapy and other family‐based approaches such as parent training, or parent implemented behavioural programmes. The evidence supports the effectiveness of systemic interventions either alone or as part of multimodal programmes for sleep, feeding and attachment problems in infancy; recovery from child abuse and neglect; conduct problems, emotional problems, eating disorders, somatic problems, and first episode psychosis.     

A Clinical approach to marital problems: Evaluation and management

Abstract

This study reviews two instruments designed to assess marital complaints as related to marital behavior: the Areas of Change Questionnaire (AC) and the Comprehensive Areas of Change Questionnaire (CAC). Although the AC is a reliable measure, it evaluates only 13 of the 29 categories of marital problems (Mead&;Vatcher, 1985) described by Geiss and O'Leary (1981). The CAC was developed to measure all 29 categories. Fifty distressed and 50 nondistressed couples were administered the CAC and the Marital Adjustment Test (MAT: Locke&;Wallace, 1959). The CAC is reliable overall, r=.84 and 20 out of 29 categories are reliable r=.40 or greater. Test-retest reliability was greater than r=.82 for all but one scoring method and for 21 of the 29 categories for all respondents with 2 additional categories stable for men and 2 different categories stable for women. The CAC differentiates distressed from nondistressed couples M=59.96 and 11.74 and individuals M=29.98 and 5.87, respectively. The CAC correlates with the MAT r=? .50 and ? .67 for nondistressed and distressed couples, respectively, when 5 extreme scores were removed from the distressed sample. Clinical utility of the CAC is discussed and further research into the nature of marital complaints is recommended.     

Early stages in experiential marital therapy

The treatment of marital issues in symbolic-experiential therapy unfolds in somewhat predictable stages, though some of these may be imposed by tasks required by the therapist. The first stage calls for defining the dominant symbolic theme in the couple's struggle, and for engaging with that symbolic structure from a certain posture. Opening strategies are discussed for dilemmas concerning power, closeness, depth, flexibility, balance, and time. The second major stage requires that the couple take initiative in exposing issues and in changing problematic communication patterns. Covert relationship and family of origin issues are exposed, with insight being a goal. The third stage involves negotiated behavioral change, with the therapist implicitly suggesting a regressive stage. A second paper, Later Stages in Experiential Marital Therapy discusses regressive work with couples, including engagement with the family of origin.     

Cultural tensions in strategic marital therapy

Whether the elements of a good marital relationship are universal is the question addressed in this case study of therapy with a couple who were culturally different from the therapist. The conflicts between the therapeutic strategies, which were based on a strategic therapy model, and the customs of the couple from a foreign culture, made it difficult to evaluate whether the therapist was on target with interventions. On one hand, therapists need to guard against being misled into believing that customs are cultural imperatives which never can be changed. On the other hand, they need to be aware of the impact and possible ramifications of challenging long-held, culturally-based beliefs and behaviors. The following case study details the dilemmas faced by a therapist working with an Asian-Indian couple who presented themselves as being bound by their cultural background and heritage.Grateful acknowledgement is made by the author to Etienne Phipps, PhD, whose comments give direction and substance to all my work.     

The evidence base for couple therapy,family therapy and systemic interventions for adult‐focused problems

This review updates similar articles published in JFT in 2000 and 2009. It presents evidence from meta‐analyses, systematic literature reviews and controlled trials for the effectiveness of couple and family therapy for adults with various relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, either alone or as part of multi‐modal programmes, for relationship distress, psychosexual problems, intimate partner violence, anxiety disorders, mood disorders, alcohol problems, schizophrenia and adjustment to chronic physical illness.     

Behavioral-systems marital and family therapy: Integration and clinical application

Abstract

This paper describes our integration of two of the more prevalent approaches to marital and family therapy: the behavioral (social learning) and the family systems (communication theory) approaches. A discussion of the development of family rules from a behavioral point of view is presented as an example of conceptual integration. However, the major intent of the paper is to present a rather detailed explication of the authors' multivaried strategies for intervention, which are designed to integrate and innovate upon the major behavioral and family systems treatment techniques.     

Developmental perspectives and family therapy: The marital life cycle

Developmental perspectives have been part of family therapy for more than two decades with a primary focus on the family life cycle and individual development. Most efforts at recognizing a marital life cycle have subsumed marital tasks under rubrics based primarily on parental roles. This paper offers a marital life cycle based on marital development with specific tasks for each of four stages-the marital breakup and remarriage phases are not included here-and provides implications for therapy.     

Love: an important dimension in marital research and therapy

How do men and women describe and assess their relationship? What themes are decisive for its quality and stability? To answer such questions, we investigated a random sample of 204 married couples (reference sample), and 31 married couples undergoing psychotherapy (clinical sample) using a newly developed questionnaire. The participating couples were asked to evaluate a total of 19 themes with respect to their importance for the couple's connectedness. Although only rarely directly addressed in couple therapy and in‐vestigated in couple research, the theme “Love” proved to be the decisive factor for quality and stability. The results of the present study, therefore, indicate that “Love” should be investigated more thoroughly in couple research and included more actively in diagnostic and therapeutic procedures.     

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.