Theoretical Framework
Nancy L. Beckerman in 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).
Background
John Launer, Professor Trisha Greenhalgh in Narrative-based Primary Care, 2017
Family therapists see families. They see family members together in twos or threes, or larger numbers. They see families of all kinds. There are no rules about patients having to be married, or a nuclear family, or anything else. There is no prior commitment to persuading families to stay together, or to break up, or to behave in any normative way; that is not the point of seeing them. Sometimes therapists see families together with other people who are involved in their lives, such as their social worker, schoolteacher, health visitor or GP. Sometimes they see parts of families because the other members cannot come or do not want to. They may see individuals, although when they do so the subject of conversation is often their family and their relationships. Quite often there is a series of meetings with different combinations of family members. Family therapy can take place in a single assessment session, or at intervals of a week, a fortnight, a month or more over a long period - perhaps a year or two. Different practitioners and institutions offer different arrangements to families, and obviously will offer a length of treatment in response to the seriousness of the presenting problem.
The Depressed and Bipolar Couple
Len Sperry, Katherine Helm, Jon Carlson in 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.
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.
Are Depressive Symptoms and Attachment Styles Associated with Observed and Perceived Partner Responsiveness in Couples Coping With Genito-Pelvic Pain ?
Published in The Journal of Sex Research, 2020
Myriam Bosisio, Myriam Pâquet, Katy Bois, Natalie O. Rosen, Sophie Bergeron
Findings from this study have several clinical and methodological implications. First, results reveal that depressive symptoms and anxious attachment may act as perceptual filters to partner’s responsiveness. Consequently, behaviors that could be objectively classified as having been understanding and validating may not be perceived as such by each member of the couple. Assessing and targeting depressive symptoms, in addition to the presence of relationship insecurity in couple therapy could increase the perception of partner responsiveness in each member of the couple. In turn, this could enhance their sexual and relational lives, knowing the important role partner responsiveness plays for couples coping with PVD (Bois et al., 2016, 2013; Rosen et al., 2016). Second, results suggest that the partners’ depressive symptoms could interfere with both partners’ capacity to be responsive to each other. Thus, although women carry a higher burden from the pain condition, clinicians should not underestimate the presence of depressive symptoms in their partners. Finally, future studies examining partner responsiveness should consider these interpersonal and intrapersonal factors as they are associated with one’s perception and may alter one’s capacity of being responsive to others.
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.
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