The Therapeutic Palette: A Guide to Choice Points in Integrative Couple Therapy

This article describes the Therapeutic Palette approach to couple therapy. The Palette is organized in terms of three domains: Time Frame (past vs. present vs. future), Degree of Directiveness, and Change Entry Point (emotions, thoughts, behavior, physiology), and assists clinicians to draw from different schools of therapy in a flexible and purposeful way. In contrast to more structured, sequential approaches to integrative therapy, the Therapeutic Palette is designed to allow shifts among different theories and practices within one session. A detailed case vignette illustrates the approach.

Confronting Anxiety in Couple and Family Therapy Supervision: A Developmental Supervisory Model Based on Attachment Theory

Referencing relevant supervisory literature and attachment theory, this article presents a developmental couple and family therapy supervisory model that emphasises the efficacy of the supervisory relationship. Issues concerning anxiety, cognition and learning theory are addressed and phases in the supervisory process are identified and described. Cognitive, emotional and social development are linked to attachment theory and discussed in the supervisory context.     

Incorporating Internet‐based Interventions into Couple Therapy: Available Resources and Recommended Uses

Although there are a number of highly efficacious in‐person treatments designed to ameliorate relationship distress, only a small proportion of distressed couples seek out in‐person treatment. Recently developed internet‐based interventions based on these in‐person treatments are a promising way to circumvent common barriers to in‐person treatment and give more distressed couples access to these efficacious interventions. The overarching aims of this review are to provide couple and family therapists with a broad overview of the available internet‐based interventions and provide suggestions about how these interventions might be utilized before, during, or after in‐person treatment. The majority of the review centres on internet‐based interventions for distressed couples and covers four distinct types of resources: relationship advice websites; assessment/feedback interventions; enrichment interventions for satisfied couples; and interventions targeting at‐risk or distressed couples. Included is a case study of one couple's journey through a newly developed intervention targeting at‐risk couples, OurRelationship.com . Internet‐based interventions targeting individual psychopathology (e.g. anxiety and depression) are also reviewed. These interventions would be particularly useful as an adjunctive resource for in‐person couple or family therapy when referrals for a concurrent in‐person individual therapist are not feasible (because of time, financial, or geographic constraints). We close with three appendices: two appendices with information on currently available internet‐based interventions; and one appendix with recommendations on how to incorporate these resources into in‐person therapy.     

Differentiation of Self and the Process of Forgiveness: A Clinical Perspective for Couple and Family Therapy

In this article we explore the role of differentiation of self in facilitating forgiveness in the context of couple and family relationships. Differentiation is defined from the Bowen perspective as the ability to connect with others without being excessively emotionally reactive to the ebb and flow inherent in all significant relationships (being able to connect to others yet also being able to self‐regulate). Forgiveness is described as the releasing of an emotional injury via a complex psychological and relational process that is less an act of will than a discovery or possibility through understanding and empathy. Differentiation of self is related to emotional intelligence and empathy. The developmental and relational benefits of such are illustrated and discussed. A rationale for viewing differentiation and forgiveness in a contextual, historical, and relational attachment paradigm is suggested. Relevant clinical cases illustrate the dynamics of differentiation and forgiveness as discovery in the context of an understanding and empathic relational environment.     

‘Somebody Watching You’: Impact of Reflecting Teams on Hope in Couple Relationships

Reflecting teams (RTs) represent both an epistemological stance and a therapeutic technique. Most commonly associated with narrative and systemic approaches to therapy, RTs offer an outsider perspective that can bring hope and alternative narratives and perspectives for therapists and clients to explore. Relational hope is a little researched concept in the field of couple therapy research. This study explores the experience of RTs in couple relationships and the aspects of the experience that couples describe as connected to a sense of hope for their relationship. The study also considers whether difference in attachment style shows any relationship with hope in couple relationships before and after the clients’ session with a reflecting team. Couples completed questionnaires about their attachment style, demographics, and relational hope and were given the option to complete an interview about their experience with the reflecting team within 1 month of their therapy session. Our findings suggest that RTs contribute positively to hope in couple relationships particularly for clients who present with an anxious attachment style. This direction for research is important because there is very little research about hope in couple relationships despite its importance (Merolla, 2014; Snyder, 2002) and there is no research about what aspects of a reflecting team contribute to hope in couple relationships. Analysis of interviews indicates a number of features of the reflecting team feedback that were valued by clients.     

Relational Ethics and Moral Blindness: Startling Incongruities in Couple and Family Life

This article explores the common experience of working with couples and family members who describe their partners and children as important to them yet at the same time are cavalier, neglectful, ignorant, and even destructive in dealings with their loved ones. People who fail to relate ethically are said to be prone to have stagnant relationships, become corrupt in seeking solutions to moral problems, be more depressed, have poorer health problems, and experience lower quality relationships. This article describes ethical fading and moral blindness in couples and families and in our work as therapists. It argues a relational ethics frame that fosters ethical sensitivity and stronger moral identity both in ourselves and others is an important addition to our therapeutic repertoire.     

Projective Identification and the Fear of Failing: Making Sense of Practice Educators' Experiences of Failing Social Work Students in Practice Learning Settings

The study focuses on emotional processes that may arise for practice educators when working with struggling or failing students in practice learning settings. Informed by a thematic review of the literature exploring the phenomenon of ‘failing to fail’, the study draws on two UK qualitative studies that highlighted the emotional distress experienced by practice educators when working with a marginal or failing student. The study draws key examples from these prior studies and argues that the psychoanalytic concept of projective identification offers a plausible and illuminating account of the states of mind experienced and reported by some practice educators in the ‘failing to fail’ dilemma. The notion is proffered as a conceptual framework for practice educators to explore and apply to their own practice as a means of making explicit unconscious states of mind, helping to recognise and rationalise these, thus supporting confidence in making appropriate assessment decisions.     

Becoming Each Other: A Single Case Exploration of Relational Consciousness in Couple Therapy

The concept of “relational consciousness” has gained increasing attention in the last decades in the fields of philosophy, sociology, and psychotherapy. Yet human consciousness with its concomitant awareness of self and other as distinct is linguistically and culturally situated in the individual mind. This article explores the lived experience of shared consciousness in the practice of “becoming the other” with a focus on therapy with one couple. The historical development of our understanding of consciousness as a relational phenomenon is addressed with particular attention to the observations, insights, and practices of Lev Vygotsky, George Herbert Mead, and Gregory Bateson, who have each contributed substantially to our understanding of mind as relationally experienced and constructed. The article explores implications for practice and future directions this methodology might take.

Recognizing and utilizing projective identification in brief psychodynamic therapy: A case example

Projective identification is a means by which clients unconsciously communicate their affective, and often intolerable, experiences. Being on the receiving end of a client’s projective identifications can be elusive, confusing, and intense; consequently, the information afforded by projective identification is often disregarded in the therapeutic process. This paper will provide a case example of the author’s personal affective and clinical experiences with a 19-year-old client to illustrate the process of recognizing and utilizing projective identification in brief psychodynamic psychotherapy. Implications and challenges for utilizing projective identification in brief therapy are discussed.This paper was presented at the Annual Convention of the American Psychological Association, Honolulu, Hawaii, July 2004.     

The Discursive Performance of the Alliance in Family Therapy: A Conversation Analytic Perspective

Following the ‘discursive’ turn in family therapy, the attention of practitioners shifted towards understanding how culture and language shape meaning‐making in therapy. In this article, we demonstrate how conversation analysis (CA) can be used to examine the processes and outcomes of systemic/constructionist practice. We used CA to study collaborative interactions of a renowned constructionist therapist Karl Tomm and one client‐family. Viewing collaboration as a pivotal aspect of the therapeutic alliance, we demonstrate how the ‘split’ within‐system alliances were developed and sustained in the course of therapy and how they were discursively transformed into ‘intact’ alliances. The therapist's efforts to align with perspectives of family members (and subsystems) seemed pivotal in this process.