AFFECT IN MARITAL THERAPY

Affect has been conceptualized in various ways. These conceptualizations have influenced the manner in which emotion is dealt with in marital therapy. Using a network theory of emotion, the role of the evocation of emotion in emotionally focused marital therapy to create intimacy and facilitate conflict resolution is discussed. Accessing underlying primary emotional responses in partners makes available adaptive action tendencies which promote problem solving and helps change self- and relationship definitions. The role of emotion in creating change in cognitions, motivation and communication patterns in marital therapy is discussed.     

PREDICTING MARITAL THERAPY DROPOUTS*

The purpose of this study was to predict therapy dropouts using data gathered at marital therpay intake. Intake data included standardized assessments and demographic information. The sample consisted of 474 couples who were seeking marital therapy and who attended at least one therapy session. Seventy-two couples met the dropout criteria, and a random sample of equal size was drawn from the rest of the couples for the analyses. Data from these two groups of couples were analyzed with multiple regression and discriminant analysis formulas. Three variables-having less than two children, having a male intake clinician, and a presenting problem relating only to one spouse-were significant predictors in accounting for couples who would drop out of therapy. In the best model, high phobic anxiety scores for husbands and a presenting problem relating to parenting, along with the other three variables, produced a model that accurately classified 82% of the couples who dropped out of therapy.     

WAITING LIST CONTROLLED TRIAL OF COGNITIVE MARITAL THERAPY IN SEVERE MARITAL DISCORD

Forty-one couples with severe marital discord participated in a controlled trial conducted to evaluate whether a form of marital therapy that is designed to enhance marital intimacy through facilitating self-disclosure of personal constructs was effective. The study found that there was no spontaneous remission in marital discord in couples on a 10-week waiting list. Couples subjectively reported improvement as a consequence of participating in marital therapy, and couples in therapy and on the waiting list showed a significant reduction in symptoms of nonpsychotic emotional illness. There was a significant pattern of improvement for wives in the therapy group compared to the waiting list group, but no such effect for the husbands.     

MARITAL THERAPY AND GENDER-LINKED FACTORS IN COMMUNICATION

Understanding the process of communication is important because communication is critical to all forms of psychotherapy. A proper understanding of communication is particularly important in marital therapy because communications is often a treatment target. A central question of this paper is whether or not communication training (CT) programs in marital therapy have been sufficiently sensitive to the complexities of gender in communication. A critical review of research on the role of gender in communication is presented. Existing data indicate that individuals tend to hold stereotypes of gender differences in language, but many of these purported differences have not been supported in empirical investigations. However, gender has been found to be linked to variables such as amount of conversation elicited, length of utterance, use of qualifying phrases, swearing, use of back channel cues, breaking of silences, function of tag questions, and compliment style. Numerous limitations of the empirical literature exploring gender differences in communication behavior are described. This paper advocates the development of models of communication in which gender is recognized as having significant implications.     

RELATING PROCESS TO OUTCOME IN MARITAL THERAPY

Although there are a growing number of outcome research studies in marital therapy, there is a complete absence of research on change processes, and how such processes relate to outcome. This study attempts to analyze the process of change in the "best" sessions of Emotionally Focused Marital Therapy (EFT) (Greenberg & Johnson, 1986). Client performance in therapy was rated on depth of experiencing and the quality of interpersonal interactions. The occurrence of particular change events arising from the theoretical principles of EFT was also noted. Results confirmed hypotheses that higher levels of experiencing and more autonomous and affiliative interactions characterized "best" sessions of couples who were successful in therapy. The implications for treatment are discussed.     

MARITAL PARADIGMS: COMPATIBILITY, TREATMENT, AND OUTCOME IN MARITAL THERAPY

Marital paradigms comprise the guiding images that serve as reference models for a couple's relationship. Such individualized images can be understood as variations on a small set of basic themes. An understanding of clients' marital paradigms can help foeus treatment on the most appropriategoals usingapproaches and techniques that are most effective for a particular couple. An unselected group of 103 couples seen in systems-oriented marital therapy were reviewed, to identify outcome and treatment issues as a function of marital paradigm. Based on outcome criteria that took marital paradigm into account, 92% of 38 cases where both partners identified with the same basic paradigm were judged to be treatment successes, while only 60% of the cases where the partners identified with different paradigms could be considered successful outcomes. Clinical approaches based on experience with marital therapy conducted within a paradigmatic framework are presented.     

HOME-BASED MARITAL THERAPY FOR MULTIPROBLEM FAMILIES*

This paper describes a project designed to reach low-income, multiproblem families, utilizing couples therapy in the home. By targeting a population of young couples under the age of 30 and with children no older than 7 years, the project aimed at prevention of severe family dysfunctioning and child disturbances. The major characteristics noted in the literature on multiproblem families are reviewed here, as are the treatment goals and techniques with such families. Most programs working with multiproblem families have focused primarily on the parental functioning in family therapy, and little has been reported on work with the couple in multiproblem families. The project described here used home visits by a male-female therapist team, including frequent individual and couple sessions. Therapeutic techniques based on modeling, role playing and demonstration were emphasized. In addition, tasks which increased the individual and couple functioning of the spouses were designed and successful completion was reinforced. An attempt was made to integrate the couple into the community and to create a network of support outside of the family, including friends and community services.     

THE NATIONAL MARITAL AND FAMILY THERAPY EXAMINATION PROGRAM

Examinations constitute one of the principal methods by which professions assess minimal competence in aspiring practitioners. The Examination in Marital and Family Therapy is used by most states which regulate the profession. This article provides the rationale for the examination program, describes its development and maintenance, and presents the knowledge base it samples. Administrative policies and procedures are also discussed as an aid to prospective licensure and certification candidates.     

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 from 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.     

DEPRESSION, BIOLOGY, MARRIAGE AND MARITAL THERAPY

Marital therapists have an, as yet, unrecognized contribution to make to the treatment of depression. It is incumbent upon them to keep abreast of the growing literatures concerning both biological and interpersonal aspects of depression, and to inform other mental health professionals, policy makers, and depressed persons and their families as to what marital therapy has to offer. Consistent with this goal, this article provides an introductory overview of recent findings concerning the biology of depression, the relative merits of medication versus psychotherapy, and the complex relationships between marriage and depression. While there is considerable evidence that many depressions have a biological component and that medication is an efficacious way of providing symptomatic relief, this in no way contradicts findings concerning the efficacy of psychotherapy and the importance of the marital relationship in the outcome of a depressive episode.     

PREDICTING DIVORCE AT MARITAL THERAPY INTAKE: WIVES' DISTRESS AND THE MARITAL STATUS INVENTORY*

The Marital Status Inventory (MSI), a measure of divorce potential was given to couples in six independent samples. Scores from the five clinical sites and one marital enrichment sample (N = 241 couples) were used to provide adequate reliability, discriminant validity and predictive validity data. Compound probability for the five clinical sites supports the contention that, overall, wives' are more distressed than their husbands. The MSI was also able to identify couples who later divorced. However, the Guttman properties of the MSI, previously identified, were not replicated. Clinical implications of the higher wives' scores for prediction of divorce and marital therapy are discussed.     

TOWARD AN OBJECT-RELATIONS APPROACH IN PSYCHOANALYTIC MARITAL THERAPY*

The purpose of this paper is to describe the features which distinguish psychoanalytic marital therapy from other forms of marital therapy, to describe briefly how important classical psychoanalytic concepts can be applied to marital therapy, to present in somewhat greater detail the author's view of how object-relations theories and, particularly, the work of three authors, Fairbairn, Kohut and Gilligan, can be applied to psychoanalytic marital therapy, and finally, to indicate certain directions for further study.     

READING ALOUD AS AN INITIAL ASSIGNMENT IN MARITAL THERAPY*

This paper suggests conjoint reading aloud as an initial assignment in behavioral marital therapy. The spouses are directed to read a book on marital conflict and communication five times during the week following the initial interview. At that interview they negotiate an agreement on when they will do the reading. Conjoint reading is compared with two alternative initial assignments, Caring Days and the Spouse Observation Checklist. It is argued that the advantage of the conjoint reading is that it addresses the experientially salient problems of verbal conflict. Details for instigating the assignment are presented.     

A NEW TECHNOLOGY FOR TEACHING/LEARNING MARITAL AND FAMILY THERAPY

A computer technology known as Group Support Systems (GSS) was pilot tested in a doctoral marital and family therapy (MFT) course to explore its usefulness in teaching/learning marital and family therapy. GSS allowed participants to combine face-to-face interaction with dialogue structured by GSS on personal computers. Through linked computers, each participant contributed to group discussions both simultaneously and anonymously. GSS was used to discuss a videotape, to conduct two role plays, and to write this paper. GSS was found to improve brain-storming, enhance collaboration, reduce hierarchical status among participants, increase self-reflection, create a trusting environment, and promote group-supported active learning. Recommendations for further MFT teaching, research, and application of GSS are presented.     

LEAVING THE CONSULTING ROOM TO PROVOKE ENACTMENT IN MARITAL THERAPY*

Enactment of emotionally intense, intimate behaviors is often important in marital therapy. But clients' concerns for privacy and their dependence on the therapist as a facilitator of communication can deter them from exhibiting such behavior in the therapist's presence. By walking out of the consulting room, the therapist can stimulate the enactment that would have been inhibited otherwise. Three case examples illustrate the technique. Specific points of procedure are considered, and the technique's limitations and risks are noted.     

DEPRESSION IN MATURE MARRIAGES: IMPACT AND IMPLICATIONS FOR MARITAL THERAPY

Recent reviews of MFT literature have shown a failure to address mental health issues of the aging. Chief among these issues is depression, one of the most common psychological disorders found in older people. Although the relationship between depression and aging is a well-researched topic, few studies approach this common problem from a systemic perspective. Using data from a national survey of preretirement- and retirement-aged couples, this paper discusses the association between depression and marital quality in mature marriages as well the possibility of mediating variables such as the personality construct hardiness. Implications for marital therapy with older couples experiencing depression and future research are discussed.