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.     

A Multi‐Family Group Intervention for Adolescent Depression: The BEST MOOD Program

Depression is the most common mental disorder for young people, and it is associated with educational underachievement, self‐harm, and suicidality. Current psychological therapies for adolescent depression are usually focused only on individual‐level change and often neglect family or contextual influences. The efficacy of interventions may be enhanced with a broader therapeutic focus on family factors such as communication, conflict, support, and cohesion. This article describes a structured multi‐family group approach to the treatment of adolescent depression: Behaviour Exchange Systems Therapy for adolescent depression (BEST MOOD). BEST MOOD is a manualized intervention that is designed to address both individual and family factors in the treatment of adolescent depression. BEST MOOD adopts a family systems approach that also incorporates psychoeducation and elements of attachment theories. The program consists of eight multifamily group therapy sessions delivered over 2 hours per week, where parents attend the first four sessions and young people and siblings join from week 5. The program design is specifically aimed to engage youth who are initially resistant to treatment and to optimize youth and family mental health outcomes. This article presents an overview of the theoretical model, session content, and evaluations to date, and provides a case study to illustrate the approach.     

What Are They Thinking? A National Study of Stability and Change in Divorce Ideation

This study reports on a nationally representative sample of married individuals ages 25–50 (N = 3,000) surveyed twice (1 year apart) to investigate the phenomenon of divorce ideation, or what people are thinking when they are thinking about divorce. Twenty‐eight percent of respondents had thought their marriage was in serious trouble in the past but not recently. Another 25% had thoughts about divorce in the last 6 months. Latent Class Analysis revealed three distinct groups among those thinking about divorce at Time 1: soft thinkers (49%), long‐term‐serious thinkers (45%), and conflicted thinkers (6%). Yet, divorce ideation was not static; 31% of Time 1 thinkers were not thinking about it 1 year later (and 36% of nonthinkers at Time 1 were thinking about it 1 year later). Also, Latent Transition Analysis revealed 49% of Time 1 long‐term‐serious thinkers, 56% of soft thinkers, and 51% of conflicted thinkers had shifted groups at Time 2, mostly in the direction of less and softer thinking about divorce. Overall, divorce ideation is common but dynamic, and it is not necessarily an indication of imminent marital dissolution.     

Religion as Cultural Models: Developing an Emic Measure of Religiosity

Despite a century's worth of work, lacunae remain in our understanding of the religion‐health relationship. Scholars in this field have called for increasingly sophisticated conceptualizations of religiosity that refine its connection to well‐being, accounting for both positive and negative associations, while being sensitive to the cultural variations in the experience of religion. This article argues that cognitive anthropological methods provide a novel approach to these issues by conceptualizing aspects of religion as culturally shared “styles of life.” Specifically, the combined approaches of cultural consensus and cultural consonance provide an emically valid measure of religiosity that is then linked to health through the psychosocial stress paradigm. Utilizing research among Brazilian Pentecostals within the state of São Paulo, this intrareligious study evaluates the predictive power of religious cultural consonance relative to widely used and established religiosity scales. Religious consonance is found to have a stronger correlation with psychological well‐being than comparable measures, suggesting that existing standardized measures miss important dimensions of the religion‐health relationship. As such, this article outlines an important area of collaboration between anthropologists and other religion‐health researchers.     

Supervising away from home: clinical,cultural and professional challenges

This paper explores some challenges of supervising clinical work of trainees, known as ‘routers’, who live in countries with diverse cultural, social and political traditions, and the analysts who travel to supervise them. It is written as an evolving dialogue between the authors, who explore together the effects of their own culture of origin, and in particular the legacy and values of their own training institutes on the styles and models of analytic supervision. Their dialogue is framed around the meaning of home and experiences of homesickness for analysts working away from home in an interactive field of strangeness in countries where analytical psychology is a relatively new discipline. The authors outline the findings from their own qualitative survey, where other supervisors working abroad, and those they have supervised, describe their experiences and their encounters with difference. The dialogue ends with both authors discussing what they have learned about teaching and supervising abroad, the implications for more flexible use of Jungian concepts, and how such visits have changed their clinical practice in their home countries.     

FATHER PLAY: IS IT SPECIAL?

Both mothers and fathers play with their children, but research on parent–child play interactions is conducted with mothers three times more often than it is with fathers. The articles in this special issue address this gap by focusing on the nature and quality of father–child play, across cultural contexts, and considering whether father play offers something unique and special for early human development, in infancy or early childhood. The studies show that fathers can be just as developmentally supportive as are mothers in terms of being playful and engaged with their children in ways that are related to greater child socioemotional competence, emotion regulation, and vocabulary, and to less aggression, anxiety, and negativity. We encourage future research to examine the cultural influences, family system dynamics, and specificity of timing and types of father–child play in relation to children's developmental competence.