A Comparative Outcome Study of Behavioral Marital Therapy and Communication Therapy*

Distressed couples were assigned to Behavioral Marital Therapy, Communication Therapy, or a Wait-List. Treated couples demonstrated more change than controls in marital problems and general communication patterns, but not in feelings toward spouse or communication during conflict resolution discussions. Wives in treatment reported more positive change in personal, nonmarital problems than control wives. There were no overall differences between treatment groups; treated couples reported increases in marital satisfaction and communication from pretreatment to the 4-month follow-up. There was an interaction between age and response to treatment: young couples changed more in Behavioral Marital Therapy, while older couples responded better to Communication Therapy. Results are discussed in terms of the need for developing client-tailored treatment programs.     

Resistance in Marital Therapy*

This paper offers a conceptual approach as well as examples of resistance to marital therapy. It is aimed at beginning marital clinicians to provide an understanding of the natural existence of resistance to therapeutic change. A model which conceptualizes resistance based on two divergent emotions is presented. This model can aid the clinician in assessing each individual's willingness to improve throughout the process of therapy. The examples of marital resistance may aid clinicians to be more aware of the forms which resistance can take.     

Marital Therapy: An Integrative Behavioral-Learning Model*

An Integrative Model of marital therapy, based on behavioral-learning approaches and other current conceptions and marital therapy practices, was tested in' a four-stage therapy program. Treatment couples, as opposed to normal controls and clinical couples in a waiting-list condition, showed significant increase in caring (as measured by Shostrom's Caring Relationship Inventory) and satisfaction with the relationship (as measured by the Kelly-Tharp Marriage Role Questionnaire). Furthermore, the observed changes were attributable to the incremental treatment procedures, and positively correlated with gain scores on a learning-in-therapy measure. The clinical utility of the model, and the theoretical and methodological implications of the study are discussed.     

Consensus in the Marital Dyad: Couples' Perceptions of Contraception,Communication, and Family Life

Abstract

The present study was based on data collected (separately for husbands and wives) from 365 couples to determine levels of consensus on a series of variables related to the family forming process. Following Scheff (1967), consensus was operationalized as both agreement and coorientation in the marital dyad. The data generally indicated low levels of consensus on such variables as contraceptive efficacy, desired family size, child spacing, unwanted pregnancies, communication with spouse, and levels of alienation. The results are discussed within the framework of family planning and effective fertility control.     

Dimensions of Marital Therapy: A Comparative Analysis*

This paper offers a comparative analysis of the process of conjoint marital therapy within the three major contemporary models of treatment: psychoanalytic, behavioral, and systems theory. The specific dimensions of the treatment process that are examined are: (1) the role of the past and of the unconscious; (2) the nature and meaning of presenting problems and the role of assessment; (3) the relative importance of mediating vs. ultimate treatment goals; and (4) the nature of the therapists roles and functions. On the basis of this comparative analysis, some thoughts toward the future of the marital therapies are offered.     

Interpersonal Forgiveness in Emotion‐Focused Couples' Therapy: Relating Process to Outcome

The objective of this study was to relate the in‐session processes involved in interpersonal forgiveness to outcome. The sample consisted of 33 couples who received 10–12 sessions of Emotion‐focused couple therapy with the aim of resolving various forms of emotional injuries (i.e., transgression that violates the expectations of a close relationship, which leaves one partner feeling hurt and angry). The results of the present study were based on the analyses of 205 video‐taped segments from 33 couples' therapies. Hypotheses relating the role of three in‐session components of resolution, the injurer's “expression of shame”; the injured partner's “accepting response” to the shame, and the injured partner's “in‐session expression of forgiveness”, to outcome were tested using hierarchical linear regression analyses. Outcome measures included the Enright Forgiveness Inventory (The Enright Forgiveness Inventory user's manual. Madison: The International Forgiveness Institute, 2000), the Dyadic Adjustment Scale (Journal of Marriage and Family, 1976; 13: 723) and the The Interpersonal Trust Scale (Trust; Journal of Personality and Social Psychology, 1985; 49: 95).     

Behavioral Therapy for Marital Disharmony: An Educational Approach*

A behavioral approach to marital therapy in groups includes training in communication skills; increasing the recognition, initiation, and acknowledgement of pleasing interactions; redistributing time spent in recreational and social activities; and contingency contracting. These treatment modules are offered during eight to 10 sessions spaced over a three month period. The specific techniques are imbedded in a matrix consisting of an alliance between the spouses and the co-therapists, and group cohesiveness. Evaluations of the approach with 40 couples indicate that the group methods produce statistically significant improvements in marital satisfaction. An experimental comparison revealed that the behavioral methods led to significantly greater improvements in the observed interactions between spouses than in a group which used a discussion-interaction format.     

Marital Therapy — Practical Approaches to Longstanding Problems*

This paper details a practical guide to the therapy of certain longstanding marital problems. Bateson's (1972) notions of schismogenesis and restraint provide the basis for an understanding of these problems and their presentation for therapy in terms of a classification of processes. A series of hypotheses, derived from this classification of processes, is developed for highly competitive marriages, dominant/submissive marriages and for marriages with closeness/distance problems. These hypotheses enable the therapist to avoid inadvertently participating with couples in ways that perpetuate these problems. Intervention procedures that enable the therapist to participate with couples in ways that favour a more mutually satisfying resolution of such problems are discussed.     

Barriers to the Development of Marital Health as a Health Field*

The development of Marital Health as a bona fide health field is posited as the most viable means for obtaining funding for training, research and treatment concerning the marital dyad equal to such funding now available for other health fields. Obstacles to this development include (1) the failure to differentiate between the concepts of “healthy marriages” and “marital health as a health field,” (2) the erroneous assumption that marital health already exists as a health field, (3) the preindustrial myth of naturalism, and (4) criticisms of the health model that are based on the search for value-free models and terminology.     

The Functional Approach to Using Dreams in Marital and Family Therapy*

This paper presents a process based method for using dreams as an adjunct to marital and family therapy. Based on the functional orientation in psychology, this approach identifies and emphasizes personality and life area strengths rather than weaknesses. Dreams are viewed as pictures of feelings and as guides to the emotional dynamics operating for each individual in a family system. The process variables of expression, feeling, clarity, activity, and contact levels are emphasized. A case study illustrates the application of this approach in the treatment of a disturbed family system.     

Effectiveness of Narrative Therapy on Communication Patterns for Women Experiencing Low Marital Satisfaction

The current study was designed as quasi-experimental with a pretest and post-test evaluating the efficacy of narrative therapy on communication patterns for women experiencing low marital satisfaction. Thirty women experiencing low marital satisfaction were chosen using convenience sampling and were randomly assigned to an intervention and waiting list group. The intervention group was treated individually by narrative therapy in eight 45-minute sessions. Results from repeated measurement ANOVA revealed significant differences between and within the groups and interaction between and within groups. Independent and paired t-test results showed significant improvement in the intervention group in their marital satisfaction, male-demand/female-withdraw, and total demand/withdraw with maintenance at eight weeks follow-up. Results included increased marital satisfaction, reduced male-demand/female-withdraw, and reduced total demand/withdraw. Thus, results show that narrative therapy is effective in increasing the marital satisfaction indicators of male-demand/female-withdraw, total demand/withdraw, and marital satisfaction.     

Fire and Ice in Marital Communication: Hostile and Distancing Behaviors as Predictors of Marital Distress

This study examined the relationship between partner hostile responsiveness, as well as three types of withdrawing responses (intimacy avoidance, conflict avoidance and angry withdrawal) and both concurrent and prospective marital satisfaction in a community sample of couples. The primary predictor of marital outcomes for wives was partner hostile responsiveness, whereas for husbands it was partner withdrawal. Wives' intimacy avoidance contributed unique variance to the prediction of husbands' marital distress; husbands' conflict avoidance provided a buffering effect for wives in the context of high husband hostile responsiveness. Results underscore the importance of differentiating hostile and distancing behaviors and, further, assessing withdrawal outside of the context of marital conflict.     

Implementation of Behavioral Marital Therapy

Implementing behavioral marital therapy is discussed with emphasis on the techniques of problem-solving, communications training, behavioral contracting, and homework assignments. The therapist's intervention style and the aspects of treatment which aid in generalization and maintenance of therapeutic gains are also described, and a typical treatment session is outlined.     

Facilitative Aspects of Field Research with Deviant Street Populations*

The authors examine facilitative aspects of field research with deviant street populations. Based on the authors' research with the homeless and with male street prostitutes, the facilitative aspects include access to settings, social relationships, acquisition of information, and the maintenance of researcher interest. The authors argue that in each of these aspects street deviants may in some ways be easier to study than other populations. The paper concludes with suggestions for maximizing the efficiency and quality of fieldwork with specific deviant populations.     

Effects of Spouse Support and Hostility on Trajectories of Czech Couples' Marital Satisfaction and Instability

This article examines differences in the role of spouses' hostile and supportive behaviors in predicting level and change in marital satisfaction and marital instability. We propose 2 competing hypotheses. The first hypothesis proposes that hostility is relatively volatile and support is relatively stable, and that change in hostility affects change in marital outcomes over the course of the study, whereas the overall level of support functions to maintain the level of marital outcomes. The second hypothesis argues that change in marital satisfaction is a function of change in support, whereas change in marital instability is a function of change in hostility. We tested the hypotheses by fitting growth curves to 3 waves of panel data collected from 436 Czech couples between 1994 and 1996. The results offer some support for the first hypothesis. However, the dominant pattern was for level and change in spouses' reports of their hostility to affect both wives' and husbands' level and change in marital instability, respectively, and for the level and change in husbands' reports of their support to predict level and change in wives' marital satisfaction. Other variables suggested by previous research in the United States and by the Czech transition to a market economy are examined.     

Marital Therapy: Toleration of Differentness

This paper presents a way of understanding marriage and marital therapy in terms of Satir's concept of differentness. One important impetus toward marriage is the individual's need to feel complete through emotional fusion with the spouse. Individuals choose marriage partners who will give them a sense of completion. Marital balance is sought around the fulcrum of this need for unity. Any disturbance to the myth of unity of the two partners is seen as a personal threat by each. Marital balance or homeostatis is a way the partners disguise the unique differentness of each. Acknowledgement of the differentness and separateness of the other is seen as a threat to the self. The task of therapy is to help partners recognize and tolerate the differentness of the other.     

An Overview of Three Models of Marital Therapy

In this article three models of Marital or Couples Therapy are described. Framo's approch to working with couples illustrates Psychoanalytic Theory, Stuart — Social Learning Theory, and White — Systems Theory. For each model, the theory and the ensuing practice are discussed, with attention to the factors that lead to change, assessment, interventions, the role of the therapist. Each is placed within the Bernal and Baker (1979) level of intervention framework. Strengths of each model are highlighted. Each therapist's own style in session is described.     

Direct and Indirect Effects of Newlywed Couples' Neuroticism and Stressful Events on Marital Satisfaction Through Mutual Problem Solving

This investigation examined the role of neuroticism, stressful experiences, and mutual problem solving in newlywed couples' marital satisfaction. The vulnerability-stress-adaptation model of marital development was used as the basis of the proposed hypotheses. Dyadic analyses and tests of indirect effects were performed on data from 186 couples in the first 5 years of their marriage. Results indicate that husbands' and wives' work, job–home interference, and family stress were significantly associated with their own lower marital satisfaction. Significant partner effects further indicated that husbands' and wives' family stress was negatively associated with the marital satisfaction of their partner. Additionally, the relationships between (1) neuroticism and marital satisfaction and (2) stressful events and marital satisfaction can be partially explained by mutual problem solving for both husbands and wives. This study emphasizes the important role of problem-solving communication in newlywed couples' experiences of stressful events and marital satisfaction.     

Marital Therapy My Way — Creating a Workable Reality

This paper is one of a series in which experienced therapists were invited to outline their approach to marital therapy — Editor.