Cognitive marriage counseling with acutely disturbed in-patients

1980 edition ofThe Diagnostic and Statistical Manual of Mental Disorders III suggests that there is a deleterious interaction between Axes I psychiatric disorders and Axes IV psychosocial stressors such as marital disharmony. With acutely disturbed in-patients, marital problems are often found associated with the psychiatric disorder, but they are usually not treated until after the patient has been discharged to out-patient status. Offering concurrent treatment for both the Axes I disorder and the Axes IV stressors would seem to be a move in the direction of a more efficient and a more comprehensive treatment plan. A ten-session course of marriage counseling based on cognitive theory is now being offered to hospitalized psychiatric patients in a rural Veterans Administration Medical Center. The model does not propose to resolve all marital problems in therapy. The goal is to teach the hospitalized patient and their spouse cognitive principles that will enable them to more effectively resolve their own problems after the patient is discharged. It is anticipated that the cognitive principles learned in marriage counseling will also apply to the resolution of some of the problems associated with the psychiatric disorder. Thus the treatment for the Axes IV stressor enhances the treatment for the Axes I psychiatric disorder. This approach might well shorten the patients' hospitalization and reduce the risk of relapse after discharge. Preliminary results suggest that this course shows promise for both individual and marital adjustment.He holds a Primary Certificate with The Institute for Rational-Emotive Therapy, and is working on his Doctorate in Social Work at The Catholic University of America, Washington, D.C.