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Theoretical Framework
Published in Nancy L. Beckerman, Couples of Mixed HIV Status, 2012
The most widely studied approaches of couple therapy have been behavioral marital therapy and its offspring, cognitive-behavioral couple therapy (Baucom et al., 1998; Gurman, Kniskern, and Pinsof, 1986). The extensive quantitative studies through the past three decades primarily measured outcomes regarding marital satisfaction. Behavioral marital therapies and cognitive behavioral marital therapies were consistently found to be effective in improving overall marital satisfaction (Dattilio, 1993, 1994; Gurman, Kniskern, and Pinsof, 1986; Gottman, 1999; Hahlweg and Markman, 1988; Hahlweg et al., 1984; Jacobsen and Addis, 1993; Jacobsen, 1991; Liberian, 1970). Subsequent research of behavioral and cognitive marital therapies indicated equally positive evaluations of these approaches (Alexander, Holtzworth-Munroe, and Jameson, 1994).
The Depressed and Bipolar Couple
Published in Len Sperry, Katherine Helm, Jon Carlson, The Disordered Couple, 2019
Couple therapy has long been identified as a valuable adjunctive treatment for depression (Whisman & Beach, 2015). Early advocacy for couple therapy for depression underscored its utility as a social support mechanism. Clinical research suggests that couple therapy is comparable in effectiveness to that of individual treatment in reducing depressive symptoms and is more effective than individual therapy in the improvement of relationship satisfaction and in achieving specific couple goals such as reduced criticism (Whisman & Beach, 2015). Similarly, some limited research suggests that marital psychoeducation sessions provided to partners of BP patients demonstrated better functioning overall and drug adherence (Vieta, 2013), lower rates of relapse, and less severe symptoms (Miklowitz, George, Richards, Simoneau, & Suddath, 2003). Couple therapy may be beneficial when relational stress has played a role in the onset or maintenance of depressive symptoms or as an adjunctive therapy to each partner’s individual therapy to provide psychoeducation and as a space to specifically focus on relational dynamics, improvements to communication, and problem-solving skills. Taken together, this research demonstrates that a multipronged clinical focus may be necessary and that working to improve the relationship can help the couple as well as the mental health of both individual partners (Epstein & Baucom, 2002). For purposes of the present discussion, a brief outline of the stages of couple therapy for depression will be presented given its empirical support. These stages of couple therapy for depression are also aligned with other couple models; it can thereby be easily integrated with other couples theoretical approaches.
Family and paediatric interventions
Published in Tamara Ownsworth, Self-Identity after Brain Injury, 2014
As an example from our own research, the Making Sense of Brain Tumour (MSoBT) Project is a 10-session home-based psychotherapy and rehabilitation programme for people with brain tumour and their caregivers (Ownsworth et al., 2013). Approximately 60 per cent of people with brain tumour (n = 50) involved family members (mainly a spouse) in their therapy. For some families, we found that the well-being and support needs of the person with brain tumour were closely intertwined with that of the caregiver. In particular, the husband of one participant referred to ‘our tumour’ and ‘when we got treated’. Such caregivers were often actively involved from the outset and attended each session. Other caregivers were initially reluctant to be involved, seemingly because they felt their relative with brain tumour needed the support rather than themselves. When these caregivers decided to join later sessions they usually came to recognise the importance of receiving support for their own well-being. A main aim of the therapy was to create a setting conducive to each member expressing their concerns and goals in the programme. Accordingly, a combination of individual, spouse/caregiver and couple therapy sessions was conducted. Common goals included: Learning to manage the effects of brain tumour, for example, cognitive difficulties (e.g., memory, concentration, organisation), loss of motivation and fatigue;Managing low mood, anxiety, stress and existential issues regarding the diagnosis, uncertain prognosis, re-growth and end-of-life issues;Coping with behavioural changes, including anger, impulsivity and apathy;Supporting occupational re-engagement and role functioning (e.g., return to work, parenting skills);Addressing fears/concerns of the participant's family (e.g., communicating news to children, developing a family care plan, preparing an advanced health directive and palliative care services);Improving relationship functioning (e.g., communication, intimacy and sexual functioning, strategies for managing aphasia).
Behavioral couples therapy for brain injury: single case methodology with bi-phasic design
Published in Brain Injury, 2023
Ndidi T Boakye, Kathryn M Taylor, Sarah Corrie
Beyond populations with brain injury, in 2018, NHS Digital (15) reported that people who had access to couple therapy as part of mental health provision were more likely to recover from symptoms of depression and anxiety than those who did not. The findings showed a higher recovery rate from depression when the couple was treated (56.1% recovery rate) compared to individual treatment (49.3%). These figures demonstrate the extent to which people’s relationships are intertwined with their mental health difficulties and long-term health conditions. NHS Digital (15) recommended that people who are experiencing relationship distress in the context of long-term illness should be able to access couple therapy. There is some evidence that couple therapy can reduce carer burden and address unmet needs unique to the uninjured partner (16). This is in keeping with research findings that emphasize the need for support for partners and families to prevent problems in the long term (4).
The potent cocktail of love, intimacy, sex, and power: an assessment pyramid for couples therapy
Published in Sexual and Relationship Therapy, 2021
Emotions that have been previously identified can often help to elaborate on the meaning that is associated with a couple’s behavior in the assessment pyramid. Inversely, meaning may elaborate emotion as well. The meaning may be linked to the systemic communication model of Watzlawick et al. (2011) in which the authors conceptualize the content level or behavioral level, and the context or the relationship level which helps elaborate the meaning of communication between partners. Thus, couple interactions may be explained not only by the behavior but also by the relationship between them that influences their behavior. Cognitive-behavioral couple therapists have added the element of meaning and beliefs to their work with couples (Christensen & Jacobson, 2000), enhanced by the work of Dattilio (2010) and his emphasis on “Socratic questioning,” a strategy made popular in couple therapy by the Milan group in the 1980s (Cecchin, 1987). Thus, both cognitive-behavioral couple therapy and systemic therapies use this approach for increasing clients’ insights about their specific problems. In the systemic communication model (Watzlawick et al., 2011), meaning is frequently associated with the relationship level because partners may speculate consciously or unconsciously about the nature of their relationship, informed by the behavior they observe in each other. This in turn helps each of the partners to decide on the next behavior they will show their partner, depending on their interpretation of previous communication and what they believe it means for the relationship.
Couple Therapy for Depression
Published in Issues in Mental Health Nursing, 2020
Couple therapy is a psychological intervention involving the presence of both partners of a committed relationship in sessions led by a trained therapist. The aim is twofold, which includes modifying negative interactional patterns and promoting supportive aspects of a close relationship by focussing on mutual relationship respect (Lebow, Chambers, Christensen, & Johnson, 2012). Evidence suggests that there is a link between depression and relationship variables (Denton, Golden, & Walsh, 2003) and couple therapy for couples with a depressed partner focuses on this association between depressive symptoms and relationship distress. This intervention also concentrates on the role of relational negative factors in onset and maintenance of depression, as well as the buffering effects of intimacy and interpersonal support.