Finding focus in a difficult landscape: Therapists’ experiences with challenging video guidance processes for parent–infant dyads

Marte Meo video guidance uses filmed interaction of the actual parent–infant dyad in the guidance of caregivers. Exploring the challenges that therapists meet in the guidance of parent–infant dyads may illuminate important aspects of the method itself as well as the therapists’ role and requirements. This could lead to method development and improved practice, but is hitherto little addressed. In this paper, we explore how skilled therapists experience and handle challenging or failing guidance processes with parent–infant dyads. We analyzed interviews with 13 Marte Meo therapists/supervisors using team-based reflexive thematic analysis. Four main themes were identified: promoting relational growth in a coercive context, building an alliance that feels safe for the parents, looking at positive moments in difficult lives, and handling intense feelings as a therapist. Our findings show that therapists experience specific therapeutic and ethical challenges with a vulnerable subgroup of parent–infant dyads where child protective issues arise, where caregivers’ insecurities impede the therapeutic relationship, and where caregivers have unsolved relational or mental health problems. The therapists’ role becomes pivotal and demanding with regard to the therapeutic alliance, the therapeutic interventions in the guidance process, and their own need for regulation, supervision, and structure. Identification of these vulnerable dyads early in the process could facilitate a better adaptation and practice of video guidance. Our findings suggest a need for supporting structures, clinical supervision, and training that address these challenges.     

What are the Marital Problems of Happy Couples? A Multimethod,Two-Sample Investigation

How couples handle marital conflict may depend on what issues they are facing, as some issues may be more difficult to resolve than others. What is unclear, however, is what issues happy couples face and how these issues may be different for couples depending on their developmental stage. To explore this possibility, the current study used both self-reports and observations drawn from two separate samples of happily married couples—one early in middle adulthood (N = 57 couples; average marital duration = 9 years) and one in older adulthood (N = 64 couples; average marital duration = 42 years). Results indicated that all issues were relatively minor, but early middle-aged couples reported more significant problems than did older couples. As to determining the most salient topic for happy couples, it depended on the spouses’ gender, developmental stage, and how salience was assessed (i.e., highest rated issue vs. most discussed issue). Only moderate links were found between what happy couples said was their most serious concern and what they actually tried to resolve during observations of marital problem-solving, but there were differences in how spouses behaved based on the proportion of their time discussing certain topics. Findings suggest that more attention should be devoted to understanding what marital issues happy couples discuss and why, as doing so may reveal how couples maintain their marital happiness.