Comparison of integrated systemic and emotionally focused approaches to couples therapy.

Compared couples receiving 2 marital therapy approaches and a control group over a 10-wk treatment period. Integrated systemic therapy (IST) and an emotionally focused approach were both found to be superior to the control and to be equally effective in alleviating marital distress, facilitating conflict resolution and goal attainment, and reducing target complaints at termination. IST couples, however, showed greater maintenance of gains from termination to 4-mo follow-up on marital satisfaction and goal attainment. Clients' perceptions of how change occurred and issues related to the use of a team of observers in IST are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supplementing behavioral marital therapy with cognitive restructuring and emotional expressiveness training: An outcome investigation.

The current study investigated whether the effectiveness of behavioral marital therapy (BMT) would be increased by the addition of cognitive restructuring (CGR) and/or emotional expressiveness training (EET) for maritally distressed couples. Sixty such couples were randomly assigned to 1 of 3 therapists and 1 of 5 treatment conditions (BMT Alone, CGR?+?BMT, BMT?+?EET, CGR?+?BMT?+?EET, or waiting list) for 12 weeks of conjoint marital therapy. Within each treatment condition, couples typically improved on the variables focused on in treatment. However, comparisons among active treatment conditions showed few significant differences among treatments; the treatments were equally effective in increasing marital adjustment. Thus, the addition of CGR and EET did not appear to increase the overall effectiveness of treatment. Possible reasons for the current findings are provided, and suggestions for future marital outcome investigations are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A component analysis of behavioral marital therapy: The relative effectiveness of behavior exchange and communication/problem-solving training.

Compared the relative effectiveness of behavioral marital therapy (BMT) with 2 of its major components, behavior exchange (BE) and communication/problem-solving training (CPT), each presented in isolation. 33 married couples seeking therapy were randomly assigned to 1 of these 3 treatments or to a waiting-list control group. Three doctoral candidates and 1 masters-level counselor served as therapists. All treatments involved 12–26 therapy sessions. The effects of therapy were evaluated using measures of global marital satisfaction (Dyadic Adjustment Scale), presenting problem checklists, and spouse reports of behavior at home. Treated couples showed significant improvement, relative to untreated couples. Complete BMT was no more effective than either BE or CPT at posttest. BE led to significantly greater increases in positive behavior than CPT. At a 6-mo follow-up, there was a tendency for BE couples to reverse their progress, whereas couples receiving CPT—either alone or in conjunction with BE—generally maintained their treatment gains or continued to improve. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selecting behavioral marital interventions: An algorithm for matching couples and treatments.

Presents an algorithm, based on 12 questions, for matching couples and marital interventions. The algorithm can be used to determine the appropriateness of divorce counseling, nonmarital treatments, couples crisis intervention, structured behavior exchange, communication skills training, problem-solving training, marital rule clarification/restructuring, and specific treatment procedures (e.g., sex therapy). (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Videotape replay in marital therapy.

24 couples seeking outpatient treatment for marital problems were randomly assigned to 1 of 4 treatment conditions and to 1 of 4 therapists. Two of the treatment formats involved the use of videotape feedback as part of the marital therapy procedure. To measure the expected additive effects of videotherapy techniques, comparisons between couples were made of marital adjustment, self-concept, and satisfaction with therapy (e.g., Marital Adjustment Scale, Pre-Counseling Inventory). At the conclusion of therapy, both marital adjustment reports and self-perception scores had significantly increased from the pretreatment data obtained for all groups. There was a significant therapist effect and a significant overall therapist-by-treatment format interaction, but the expected main effect for treatment format was not obtained. The interpretable patterns found in the significant therapist-by-treatment interactions suggest that there is an enhancement effect for at least some forms of psychotherapy in which some clinicians employ video techniques. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital stability, mental health, and marital satisfaction.

Administered a test of emotional stability and a marital satisfaction scale to 50 couples seeking help with their marriage and to 50 couples with stable marriages. The stable group scored significantly higher on each of the 4 subtests of the emotional stability test as well as on the total score. For the stable group there was a significant relationship between marital satisfaction and emotional stability, but this finding did not hold for the group seeking help. The hypothesis was not supported that women who marry men with emotional problems are more unstable themselves, or that if 1 partner in a marriage is emotionally unstable the other tends to also become emotionally unstable. (19 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Husbands' and wives' alcohol use disorders and marital interactions as longitudinal predictors of marital adjustment.

In this longitudinal study, the relationships among wives' and husbands' lifetime alcoholism status, marital behaviors, and marital adjustment were tested. Participants were 105 couples from the Michigan Longitudinal Study (MLS), an ongoing multimethod investigation of substance use in a community-based sample of alcoholics, nonalcoholics, and their families. At baseline (T1), husbands and wives completed a series of diagnostic measures, and lifetime diagnosis of alcohol use disorder (AUD, as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed.), was assessed. Couples completed a problem-solving marital interaction task 3 years later at T2, which was coded for the ratio of positive to negative behaviors. Couples also completed a measure of marital adjustment at T4 (9 years after T1 and 6 years after T2). Results showed that husbands' lifetime AUD predicted lower levels of their wife's positive marital behaviors 3 years later but was not related to their own or their wife's marital adjustment 9 years from baseline. By contrast, wives' lifetime AUD had direct negative associations with their own and their husband's marital satisfaction 9 years later, and wives' marital behaviors during the problem-solving task predicted their own and their husband's marital satisfaction 6 years later. Findings indicate that marital adjustment in alcoholic couples may be driven more by the wives' than the husbands' AUD and marital behavior. Implications for intervention with alcoholic couples were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Communication and intimacy in the marriages of depressed patients.

Marital discord is common among depressed patients. To explain the concurrence of depression and marital discord, it was hypothesized that depressed patients and their spouses have weak relationship-coping abilities, specifically communication, problem solving, and capacity for intimacy. 17 depressed patients and their spouses were compared with 17 control couples on a communication task, an intimacy interview, and self-reports of marital satisfaction. Results indicated that, compared with control Ss, the depressed patients and their spouses (1) reported greater marital dissatisfaction, (2) demonstrated poorer communication and problem-solving ability, and (3) were more likely to have an impaired capacity for establishing and maintaining intimacy. The implications for understanding the development of depression and marital discord are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intimacy maturity and its correlates in young married couples.

Intimate relationships, like the individuals who participate in them, are conceived of as following developmental processes. Five dimensions of intimacy—relationship orientation, caring–concern, commitment, sexuality, and communication—are identified, and an approach to assessing relationship maturity on each of these dimensions is described. In a study of 31 young married couples, scores on each dimension of intimacy maturity were analyzed in relation to gender, gender role (as assessed through an adaptation of the Bem Sex Role Inventory), and scores of the Dyadic Adjustment Scale. There were no significant differences between husbands and wives on any of the intimacy or marital adjustment scales and only a marginal difference on 1 gender role scale (agency). Patterns of correlations among intimacy, marital adjustment, and gender role scores varied by gender. Not only do there appear to be 2 marriages (his and hers) in every marriage (as suggested by J. Bernard [1982]), but the correlates of these marriages also vary. (58 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of differentiation of self in marital adjustment.

In the present investigation, Murray Bowen's (1978) theoretical propositions about the relationship between differentiation of self and quality of marital relationships were tested. Couples' levels of differentiation explained substantial variance in marital adjustment: 74% of variance in husband marital adjustment scores and 61 % of variance in wife marital adjustment scores were accounted for by couple differentiation of self-scores. Greater husband emotional cutoff uniquely accounted for husband and wife marital discord. Contrary to family systems theory, actual couples were no more similar on differentiation than were randomly matched couples. Finally, greater complementarity among couples along the specific dimensions of emotional cutoff and emotional reactivity predicted greater marital distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotionally focused marital intervention for couples with chronically ill children.

Couples with chronically ill children are at risk for experiencing marital distress. The present study was a randomized control trial that assessed the efficacy of emotionally focused therapy (EFT) in decreasing marital distress in this population of couples. Thirty-two couples with chronically ill children seen at a tertiary care pediatric hospital were randomly assigned to EFT or to a waitlist control group. EFT couples demonstrated significant decreases in marital distress at posttreatment and at a 5-month follow-up in comparison to controls. Clinical improvements in marital functioning following EFT were also demonstrated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of success in emotionally focused marital therapy

This study examined client variables expected to predict success in emotionally focused marital therapy (EFT), now the second most validated form of marital therapy after the behavioral approaches. The relationship of attachment quality, level of emotional self-disclosure, level of interpersonal trust, and traditionality to the therapy outcome variables, marital adjustment, intimacy, and therapist ratings of improvement, was examined. These variables were chosen for their relevance to the theory and practice of EFT and to intimate relationships in general. Overall, therapeutic alliance predicted successful outcome; the task dimension of the alliance in particular predicted couples' satisfaction. More specifically, one dimension of female partners' trust, their faith in their partner, predicted couples' satisfaction at follow-up. Females' faith also significantly predicted males' level of intimacy at follow-up. Males who were most likely to be nondistressed at termination indicated higher levels of proximity seeking on an attachment measure at intake, and older males and males whose partners had higher levels of faith in them were more likely to be nondistressed at follow-up. Traditionality was not found to be significantly related to outcome. Couples who made the most gains at follow-up also indicated lower initial marital satisfaction and included males who indicated lower levels of use of attachment figure on the attachment measure at intake. Males who made the largest gains at termination were older and were rated as less expressive by their partner on self-disclosure measures at intake. Age was the only variable significantly related to males' gains in satisfaction at follow-up. Implications for the practice of marital therapy and future research are delineated.     

Short-term couples group psychotherapy: A tale of four fights.

Describes a short-term psychotherapy group in which 4 couples and 2 therapists meet for 15 weekly group sessions to unravel the recurrent "fight" found at the center of most chronic marital conflict. The author offers a psychodynamic model to conceptualize the marital argument and to point toward intervention strategy. The techniques the co-therapists use, however, represent a pragmatic mixture of psychodynamic, psychoeducational, and cognitive behavioral skills. Moreover, since the group unfolds in predictable phases, the therapists can vary the focus and intensity of their interventions to capitalize on this characteristic sequence of group process. At termination, successful participants have explored the conscious and unconscious origins of their fight in some depth and have fashioned "tools" to help them recognize and forestall the previously explosive conflict. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specific and nonspecific factors in the effectiveness of a behavioral approach to the treatment of marital discord.

Compared 2 behavioral treatments for marital discord with a nonspecific control and a waiting-list control. The behavioral treatments combined training in problem-solving skills with training in contingency management procedures, differing only with respect to the contracting form: One group learned to form good faith contracts, and the other, quid pro quo contracts. 32 couples were randomly assigned to 1 of these 2 treatment conditions and 1 of 3 therapists. Improvement was assessed by 2 observational measures and by 2 self-report questionnaires, Marital Adjustment and Marital Happiness Scales. On all measures, both behavioral groups improved significantly more than waiting-list couples. On 3 of the 4 measures, behavioral couples improved significantly more than nonspecific couples. The 2 behavioral groups did not differ from one another on any of the measures. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do Psychotherapists Have Better Marriages Than Nonpsychotherapists? Do Therapeutic Skills and Experience Relate to Marriage Adjustment?

Couples in which 1 or both members were psychotherapists were compared with nontherapist couples for marriage adjustment (MA). The authors predicted higher MA scores for the therapists and a positive correlation between the MA of therapists and years of therapy training, years of practice, rating of therapeutic ability, length of marital therapy training, number of marital therapy clients, experience as a marital therapist, and self-rating as a marital therapist. Therapist and nontherapist couples did not differ on MA. Only self-rated ability as a marital therapist correlated positively with MA. For men, ability as a therapist, as a marital therapist, and marital therapist experience correlated significantly with MA. For female therapists only self-rated ability as a marital therapist correlated significantly with MA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negative life events, marital interaction, and the longitudinal course of newlywed marriage

Life events and problem-solving behavior were examined relative to longitudinal change in depressive symptoms and marital adjustment over 18 months in 60 newlywed couples. Spouses' problem-solving behavior moderated, but did not mediate, the relationship between life events and adjustment. Some behaviors contributed to spouses being more resilient to life events, and some behaviors made spouses more vulnerable. In particular, wives' anger facilitated their adjustment to major and interpersonal events such that their depressive symptoms declined and their marital satisfaction increased. Husbands' humor contributed to marital instability when spouses reported more major events. The results further specify the vulnerability-stress-adaptation model of marriage and expand on the role of behavior in marriage.     

Emotional behavior in long-term marriage.

In exploring the emotional climate of long-term marriages, this study used an observational coding system to identify specific emotional behaviors expressed by middle-aged and older spouses during discussions of a marital problem. One hundred and fifty-six couples differing in age and marital satisfaction were studied. Emotional behaviors expressed by couples differed as a function of age, gender, and marital satisfaction. In older couples, the resolution of conflict was less emotionally negative and more affectionate than in middle-aged marriages. Differences between husbands and wives and between happy and unhappy marriages were also found. Wives were more affectively negative than husbands, whereas husbands were more defensive than wives, and unhappy marriages involved greater exchange of negative affect than happy marriages. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Prevention of marital distress: A longitudinal investigation.

This study examines the impact of an intervention designed to prevent divorce and marital distress. Both short- and long-term effects of a cognitive-behavioral marital distress prevention program were assessed. Forty-two couples planning marriage were matched and randomly assigned to intervention (n?=?21) and control (n?=?21) conditions. Couples participated in pre- and postintervention assessment sessions and in similar assessment sessions 1? years and 3 years later. The intervention emphasized communication and problem-solving skills, clarifying and sharing expectations, and sensual/sexual enhancement. Although postintervention results indicated that couples learned the skills taught in the program, no group differences emerged on self-report measures of relationship quality. At 1? years, intervention couples showed higher levels of relationship satisfaction than control couples. At 3 years, intervention couples showed higher levels of both relationship satisfaction and sexual satisfaction and lower levels of problem intensity. These data support cost-effective prevention programs for attacking the major social problem of divorce. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supportive versus cognitive–behavioral intervention programs in achieving adjustment to home peritoneal kidney dialysis.

Two psychological interventions given for 8 weeks, supportive and cognitive–behavioral, were compared in achieving psychosocial adjustment to home peritoneal kidney dialysis. Participants were divided into 3 groups of patients and their spouses: a supportive group (18 couples), a cognitive–behavioral group (18 couples), and a no-intervention control group (24 couples). A group of 97 healthy participants served as a baseline control group. Self-report measurements were made before treatment (T?), halfway through (T?), and after treatment (T?). Results indicated that, without treatment, the no-intervention control group demonstrated a deterioration of psychosocial adjustment going from T? to T?. Both interventions were effective in aiding patients and spouses in maintaining psychosocial adjustment in comparison with the no-intervention control group, with few differences between treatments. Most improvement was obtained in the emotional, cognitive, and interpersonal areas, with smaller gains made in the behavioral area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)