The Infertility Resilience Model: Assessing Individual,Couple, and External Predictive Factors

Resilience in couples experiencing infertility is critical to decrease the impact of infertility-related stress and sustain positive interactions and collective perceptions in couples. The Infertility Resilience Model (IRM) presented in this article provides a framework within which various individual, couple, and external factors that influence resilience can be understood. Although numerous approaches have been applied to infertility, few of them have examined resilience and the interconnections between individual, couple, and external influences. The concepts and connections within the model can be used by clinicians for assessment and interventions when working with couples facing infertility.     

Couple Enrichment Approaches

Abstract

Contemporary couple enrichment approaches are classified and select programs described. The research on their effectiveness is summarized and their usefulness as primary interventions or as adjunct interventions for couples in therapy is highlighted. Directions for future research and practice are suggested.     

The Embodied Couple

SUMMARY

Herein is described the use of a specific physical posture for couples to assume for the purpose of assessing the dynamics of their relationship. Its careful and artful use creates a microcosm of the couple's interactive style, revealing significant behaviors and feelings in the therapist's presence.     

Multi-Level Couple Therapy: Applying a Metacommunicational Framework of Couple Interactions

Excerpts from a couple therapy case are cited to illustrate the practical significance of a multi-level framework in understanding couple interactions. The clinical implications of the metacommunicational framework, as a metaphor for examining and understanding relational processes, are discussed. Also, the pragmatics of following “process” at a variety of levels when working with punctuational differences, developing therapy strategies and goals, and measuring the progress of couple therapy are discussed.     

Couple communication in stepfamilies

Effective communication is assumed to help sustain couple relationships and is a key focus of most relationship education programs. We assessed couple problem-solving communication in 65 stepfamily and 52 first-time-marrying couples, with each group stratified into high risk and low risk for relationship problems based on family-of-origin experiences. Relative to partners in first-time couples, partners in stepfamily couples were less positive, less negative, and more likely to withdraw from discussion. Risk was associated with communication in first-time but not stepfamily couples. Stepfamily couples do not exhibit the negative communication evident in high-risk first-time-marrying couples, and available relationship education programs that focus on reducing negative communication are unlikely to meet the needs of stepfamilies.     

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.     

Couple Therapy and Addictions

Abstract

Therapies for alcoholism, substance abuse, and other addictions traditionally focus on characteristics of individuals such as behaviors, thoughts, and emotions. These kinds of programs tend to target problems inside the abusing person rather than a relational system. Treatments that are more recent locate the problems within systems of people. Regardless of the locus or cause of the abuse or addiction, seen as arising from disease processes, systemic dynamics, or other mechanisms that lead to unfortunate habits and behaviors, utilizing the individual's partner or family in therapy has become an important part of successful treatment. This article reviews models of couple treatment for alcoholics and substance abusers in terms of initiation into treatment, primary treatment, and relapse prevention.     

Gender-Role Differences in Decision-Making Orientations and Decision-Making Skills1

The relationship between gender role identification and decision making orientations was examined. Decision making was analyzed in terms of decision making orientation (behavioral, cognitive, and emotional) and decision making skills (problem definition and formulation, generation of alternative solutions, choice process, solution implementation, and verification). The results revealed a 2-factor characterization of general decision making in terms of approach-avoidance tendencies and self-appraisals of decision skills. A masculinity model was supported for decision making orientation, with masculinity serving as the only significant predictor. In contrast, an androgyny model was supported for decision making skills, with masculinity and femininity serving as significant predictors.     

Couple relationship education in Australia

In Australia, the strengthening of marriage through relationship education has received strong governmental policy support and some modest financial support. Couple relationship education services are offered by a variety of community-based, church-affiliated, and church-based providers. There is a strong emphasis on providing programs that are developed locally in response to perceived couple needs and government policies. Available evaluations show that most couples who attend education value the service, but relationship education providers need to do a better job reaching out to couples at high risk for future relationship problems, and more research is needed on the effects of education on long-term marital outcomes. There is significant scope for building on current initiatives to incorporate evidence-based approaches and to expand the program reach to more couples.     

Relational Drawings in Couple Therapy

In couple therapy sessions, partners often get into long and drawn-out discussions, heavy with pain, resentment, and blame. It is vital for the therapist to avoid becoming entangled in these escalating interactions. In this article, as one way of avoiding these interactions, a protocol is proposed of using relational drawings in couple therapy for opening space for new stories. This approach is strongly rooted in extensive therapeutic experience, as well as in dialogical ideas. Not the content of the partners' imagery is central, but rather the dialogical exchange about the drawings. In particular, the focus of the therapist is on the partners' interactions, their hesitations and their surprises. Working in this way opens space for the partners to reflect on what they experience as crucial in their bond. The protocol is illustrated with two detailed case examples.     

The Effectiveness of Couple Therapy

Abstract

Most theories and methods about couple dierapy are developed and tested in Anglo-Saxon countries. In this clinical study, we tested these theories and methods within a Swedish public health context. We assessed the outcomes of 131 couples (262 individuals) using the Dyadic Adjustment Scale (DAS) and the Family Climate (FC) survey. Initially, the couples displayed severe marital distress and a dysfunctional family climate. Both marital satisfaction and family climate improved considerably, which confirmed the effectiveness of these methods in a Swedish context.     

Dropping Out of Couple Therapy

Abstract

Current literature on dropouts in marriage and family therapy includes few studies that focus exclusively on couple therapy and only a limited number of qualitative studies. Clients' perceptions of premature termination are seldom considered. This qualitative case study describes, from both the clients' and the therapist's perspectives, one couple's experience of dropping out of couple therapy after three, sessions. Findings from this case study are compared with existing literature and a fourfold typology of dropouts is proposed. We offer recommendations for future research of dropouts in couple therapy.     

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.     

Remarital Issues in Couple Therapy

Abstract

Remarriage and cohabitation after divorce are becoming societal norms. Given the increasing numbers of these couples, mental health professionals will encounter them in their clinical practice. There are unique issues associated with remarriage (e.g., role and boundary ambiguity, unrealistic expectations) that can hinder the family reorganization process and exacerbate typical communication problems experienced by couples. Therefore, therapists must have knowledge of these challenges to provide the most effective treatment. A brief overview of the remarriage and stepfamily literature, and recommendations for clinicians are presented.     

Catastrophic Conditions in Couple Systems

SUMMARY

A presentation of case studies forms the focus for an exploration of the discovery of an abortion or adoption used as the management of an unwelcome pregnancy which occurred in the context of the marital system. Managing an impasse in the middle phase of therapy in each case led to the emergence of information which then allowed the therapist to work with the couple system to alleviate the core situation out of which presenting problems emanated. In these cases the unwelcome pregnancy had the potential to be cataclysmic to the couple system. Therefore, the possibility that a couple is concealing an abortion or an adoption should be considered by couples' therapists when there is little or no response to usual strategies for change. The reason for concealment is immaterial. What is paramount is that the therapist bring the event to the fore of treatment and work with a couple to put closure on what is generally an unresolved issue.