From Couple Therapy 1.0 to a Comprehensive Model: A Roadmap for Sequencing and Integrating Systemic,Psychodynamic, and Behavioral Approaches in Couple Therapy

Couple therapy is a complex undertaking that proceeds best by integrating various schools of thought. Grounded in an in‐depth review of the clinical and research literature, and drawing on the author's 40‐plus years of experience, this paper presents a comprehensive, flexible, and user‐friendly roadmap for conducting couple therapy. It begins by describing “Couple Therapy 1.0,” the basic conjoint couple therapy format in which partners talk to each other with the help of the therapist. After noting the limitations of this model, the paper introduces upgrades derived from systemic, psychodynamic, and behavioral/educational approaches, and shows how to combine and sequence them. The most important upgrade is the early focus on the couple's negative interaction cycle, which causes them pain and impedes their ability to address it. Using a clinical case example, the paper shows how all three approaches can improve couple process as a prerequisite for better problem solving. Additional modules and sequencing choice points are also discussed, including discernment counseling and encouraging positive couple experiences.     

New Sexism in Couple Therapy: A Discursive Analysis

The persistence of gender inequality in postindustrial societies is puzzling in light of a plethora of changes that destabilize it, including shifts in economy, legislation, and the proliferation of feminist politics. In family relations, such persistence manifests as a disconnect between couples aspiring to be more egalitarian yet continuing to enact traditional gender roles and hierarchies. There is an emerging consensus that gender inequality persists because of people's continued reliance on sexist ideology or gendered assumptions that constitute women as innately distinct from and inferior to men. Sexist ideology changes its form to accommodate to changing socio‐economic conditions. Contemporary forms of sexism are old ways of legitimizing male power articulated in new and creative ways, often by incorporating feminist arguments. To effectively recognize and address “new sexism,” scholars and practitioners require new, innovative research frameworks. Our objective in writing this article is two‐fold. First, we seek to advance discursive (i.e., focused on language in use) approaches to the study of sexism. Second, we present the results of a discursive analysis of “new” sexist discourse in the context of couple therapy. The study provides preliminary evidence that, despite endorsing egalitarian norms, couples studied continue to rely on gender binaries and remain entrenched in old‐fashioned patterns of gender inequality. Implications of these results for the practice of couple therapy and for future research are discussed.     

Promoting Translational Research Among Movement Science,Occupational Science,and Occupational Therapy

Integration of research in the fields of neural control of movement and biomechanics (collectively referred to as movement science) with the field of human occupation directly benefits both areas of study. Specifically, incorporating many of the quantitative scientific methods and analyses employed in movement science can help accelerate the development of rehabilitation-relevant research in occupational therapy (OT) and occupational science (OS). Reciprocally, OT and OS, which focus on the performance of everyday activities (occupations) to promote health and well-being, provide theoretical frameworks to guide research on the performance of actions in the context of social, psychological, and environmental factors. Given both fields’ mutual interest in the study of movement as it relates to health and disease, the authors posit that combining OS and OT theories and principles with the theories and methods in movement science may lead to new, impactful, and clinically relevant knowledge. The first step is to ensure that individuals with OS or OT backgrounds are academically prepared to pursue advanced study in movement science. In this article, the authors propose 2 strategies to address this need.     

Long-Term Follow-Up of an Occupation-Based Group Addressing Occupational Performance and Satisfaction in University Freshmen

The long-term impact of a 5-week, occupation-based intervention to address the life transition of university students into young adulthood is presented here. Study participants showed statistically significant gains from baseline to long-term follow-up in both occupational performance and performance satisfaction. In post hoc analyses, occupational performance maintained a level of significance. During a time of rapid change, occupation-based interventions have the potential to provide transitioning university freshmen students the skills that they need for a successful transition into a university. Changes in the structure, timing, and focus of the intervention and studies using more diverse and larger samples are warranted.     

The Impact of Social Anxiety on Occupational Participation in College Life

Social anxiety is a reality for many college students. This study explored the impact of social anxiety on the occupational participation in daily life of six Irish students. Semi-structured interviews were used to explore participants’ daily routines, coping mechanisms, and interaction with the environment. The study aims to inform occupational therapists, academics, and other healthcare professionals of the impact of the condition on the daily life of college students. Qualitative data analysis showed that participants described negative beliefs about themselves and had concerns about how they were perceived by others. This affected their ability to fully participate in the student role.     

Development of a therapists’ self-report measure of pluralistic thought and practice: the Therapy Pluralism Inventory

This study aimed to develop a self-report measure of pluralistic thought and practice. Following pilot development, a 23-item inventory was placed on an online survey site, and 474 participants satisfactorily completed the measure. Respondents were trainee or qualified therapists, predominantly female, based in the UK, and of a humanistic or integrative/eclectic orientation. A principal components analysis resulted in two scales, Pluralistic Philosophy and Pluralistic Practice, which had good internal consistency (Cronbach’s α?=?.72 and .80, respectively). Confirmatory factor analysis showed good model fit for this two factor solution. The Therapy Pluralism Inventory (TPI) has potential for use in training and research, although additional validity and normative data are needed.     

'Hearts on their sleeves': the use of systemic biofeedback in school settings

This article describes how a biofeedback device is used to 'externalize' internal physiological states. Heart rate monitors, emitting audible signals when a specific threshold is reached, are fitted to children and members of the family. This can help all those present to make connections between problematic behaviours and internal states of emotional/physical arousal. Devices may be worn for up to twenty-four hours and computer graph printouts of fluctuating heart rates can assist in contextualizing problematic interactions, particularly if other family members are also fitted with heart rate monitors. In this way biofeedback becomes 'systemic' as people are alerted to the interconnectedness of each others' states. Participants are not only helped to identify stressors leading to heightened states of emotional arousal and resulting 'out-of-control' behaviours, but also to find ways of employing (self-)calming strategies. This article outlines the application of systemic biofeedback in school settings with children at risk of exclusion. With the help of these biofeedback devices pupils begin to manage themselves in situations which would previously have resulted in stressed, angry or violent behaviours.