The Impact of Behavioral Couple Therapy on Attachment in Distressed Couples

Emotion‐focused therapy (EFT; Greenberg & Johnson, 1988 Emotionally focused therapy for couples. New York: Guilford Press) is anchored in attachment theory (Johnson, 2003 Attachment processes in couples and families. New York: Guilford) and considers change in attachment schemas essential in the process of improving satisfaction in relationships (Johnson, 1999, Research and couples therapy: Where do we go from here? American Family Therapy Academy Newsletter). However, there are little data on how measures of attachment change over the course of EFT or any other couple therapy. The current study examines whether increases in attachment security predict improvements in marital satisfaction during behavioral couple therapy, which would suggest that change in attachment style is a key process variable even for a non‐attachment‐focused treatment. Multilevel models of data from 134 couples participating in a randomized clinical trial of integrative behavioral couple therapy and traditional behavioral couple therapy (Christensen et al. Journal of Consulting and Clinical Psychology, 72, 2004, 176) indicate that although there is a trend for early change in attachment‐related anxiety and avoidance to predict later change in marital satisfaction, early change in marital satisfaction strongly predicts change in attachment‐related anxiety through the end of treatment and 2‐year follow‐up. These findings suggest that changes in satisfaction may lead to changes in attachment rather than the reverse and that change in attachment may not be the mechanism of change in all efficacious couple therapy.     

Attachment Change in the Beginning Stages of Therapy: Examining Change Trajectories for Avoidance and Anxiety

The purpose of this study was to investigate the nature of self‐reported attachment change (avoidance and anxiety) in the context of six sessions of couple therapy designed to emphasize both therapist‐centered and couple‐centered (i.e., enactment‐based) clinical process during the beginning stages of therapy. A total of 48 couples with at least one partner who reported clinically significant relationship dissatisfaction participated in this study. Findings confirmed that some couples experience positive attachment‐related change (anxiety or avoidance), while also identifying a subset of individuals who may not experience optimal levels of attachment‐related change. In addition, findings point toward both differences and similarities between change trajectories for avoidance and anxiety. Finally, there was evidence that socio‐demographic factors may be associated with attachment change.     

Resolving Coparenting Dissatisfaction In Couples: A Preliminary Task Analysis Study

This study explored the change that unfolded when parents resolved their coparenting dissatisfaction during an Integrative Brief Systemic Intervention (IBSI) for parent couples. We conducted a task analysis (Greenberg, 2007) to build a model of resolving coparenting dissatisfaction. We compared a postulated model of change (rational model) based on theoretical and clinical assumptions to the observations of the actual change process that couples experienced in an IBSI (empirical analysis). The empirical analysis was conducted on six IBSI therapy cases (three exhibiting positive development and three exhibiting no development). We defined positive development in IBSI as moving from coparenting dissatisfaction to coparenting satisfaction. The final rational–empirical model included six steps that facilitated the resolution of coparenting dissatisfaction. This study contributes to deepening the knowledge of how coparenting may change during marital therapy.     

Emotional processes following disclosure of an extramarital affair

In-depth interviews with individuals who had experienced marital infidelity revealed a three-stage process following disclosure of an affair. The process starts with an "emotional roller coaster" and moves through a "moratorium" before efforts at trust building are recognized. Implications for the literature on forgiveness and the process of change in couples therapy are discussed as well as implications for future research and for practice.     

The impact of discernment counseling on individuals who decide to divorce: experiences of post‐divorce communication and coparenting

Discernment counseling is designed to help couples considering divorce arrive at a greater sense of clarity and confidence in their decision making about the future of their marriage. Possible outcomes include making no change to the marriage, divorcing, or attempting reconciliation through couples therapy. To date, no research has been done on whether or not discernment counseling helps couples who decide to divorce with their post‐divorce family life (i.e., coparenting). We surveyed 11 people (from male–female couples) and conducted in‐depth interviews with eight who had undergone discernment counseling and subsequently divorced to see what impact discernment counseling had on their post‐divorce coparenting relationship. We analyzed the data from a phenomenological perspective. Respondents described their discernment counseling experience as helpful for achieving clarity and honesty in the divorce decision‐making process, they shared their appreciation for the structure of the intervention, and indicated that it led to a greater coparental cooperation post‐divorce.     

The Dual-Career Commuter Family:

In the last 15 years, we have observed women entering the labor force in increasing numbers. This change has forced some families to adopt a commuting relationship where the spouses main- tain separate residences in different cities and reunite regularly. Although more families are attempting this alternative, relatively little research has examined this family pattern. This study assesses role strain, division of labor, and decision making for dual-career commuter couples. Thirty-nine couples were surveyed. The results suggest a fairly traditional division of household labor, moderate levels of stress, and an incomplete decision-making process for this nontraditional lifestyle.     

Lesbian Couples’ Relationship Quality Across the Transition to Parenthood

The transition to parenthood is a time of stress for many couples. Most research on the transition to parenthood has been conducted with middle‐class, heterosexual couples. The current study uses multilevel modeling to examine predictors of change in relationship quality (love and conflict) during the transition to parenthood in 29 lesbian couples. Predictors included personality variables, work context variables, social context variables, and couple characteristics. Results suggest that personality and couple characteristics were important predictors of change in love, whereas personality and expected social support were salient predictors of change in conflict. The importance of research on this key life transition for lesbian couples is discussed.     

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.     

Moving Up the Continuum of Hope: Developing a Theory of Hope and Understanding its Influence in Couples Therapy

For years therapists have suggested that hope is an important catalyst in the process of change. This study takes a grounded theory approach to address the need for a clearer conceptualization of hope, and to place interventions that increase hope within a therapeutic context so that therapists know how and when to use those interventions. Fifteen active and experienced marriage and family therapists from across the United States participated in hour-long phone interviews about hope in couples therapy. Moving Up the Continuum of Hope emerged as the core category from the grounded theory analysis of the data. This category represents a process, with general and specific conditions and consequences that increase a couple’s level of hope. This study serves as a foundation for future process research on couples therapy, as well as research on hope in other contexts (e.g., individual and family therapy) and with other perspectives (e.g., clients).     

Living apart together

Traditionally, marriage has been the social institution for couples that have been together for a long period. Some decades ago a new social institution appeared in the Western world: non-marital cohabitation, although this was slower to be accepted in some countries than in others. Living Apart Together (LAT) relationships, are a new phenomenon which seems to have the potential of becoming the third stage in the process of social change. In contrast to couples in commuting marriages which have one household in common, couples living in LAT relationships have one household each. We discuss some data on the frequency of LAT relationships in Sweden and Norway as well as some varieties of the phenomenon. Our analysis suggests that the existence of cohabitation as a social institution, alongside marriage, is a necessary precondition for LATs to be recognised as a social institution. LAT relationships could not exist unless a preceding social institution of cohabitation also exists.     

Outcomes of sexually open marriages

This study follows up a 1978 matched sample of 82 couples to find out if there were differences in marital stability between the sexually open and the sexually exclusive couples. In 1983 no statistically significant difference in marital stability was found. Of couples providing follow‐up data, 23 (68%) of the 34 sexually open couples and 32 (82%) of the 39 sexually exclusive couples were still together. Of the 23 couples who were sexually open in 1978, two couples had changed from a contract of sexual openness to one of sexual exclusivity; of the 32 couples originally exclusive, one couple changed in the interim to a sexually open marriage. In addition, data on marital happiness, extramarital sex, jealousy, changeableness, job change, and additional education are reported and a comparison between the two groups made. Differences between the two groups were found in number of people living in the household, job change, and additional education. Couples in the sexually open group were more likely to have either additional people or fewer people in their households. Both higher education for women and outside work for women were associated with marital instability, irrespective of group.     

Is Communication a Mechanism of Relationship Education Effects Among Rural African Americans?

Enhancing communication as a means of promoting relationship quality has been increasingly questioned, particularly for couples at elevated sociodemographic risk. In response, the current study investigated communication change as a mechanism accounting for changes in relationship satisfaction and confidence among 344 rural, predominantly low‐income African American couples with an early adolescent child who participated in a randomized controlled trial of the Protecting Strong African American Families (ProSAAF) program. Approximately 9 months after baseline assessment, intent‐to‐treat analyses indicated that ProSAAF couples demonstrated improved communication, satisfaction, and confidence when compared with couples in the control condition. Improvements in communication mediated ProSAAF effects on relationship satisfaction and confidence; conversely, neither satisfaction nor confidence mediated intervention effects on changes in communication. These results underscore the short‐term efficacy of a communication‐focused, culturally sensitive prevention program and suggest that communication is a possible mechanism of change in relationship quality among low‐income African American couples.     

MARITAL RELATIONSHIPS OF ALCOHOLIC,CONFLICTED, AND NONCONFLICTED COUPLES*

Twenty-six couples with alcoholic husbands, and 26 maritally conflicted and 26 nonconflicted couples without alcohol problems were compared. As predicted, the alcoholic and maritally conflicted couples did not differ, and both groups of problem couples showed greater relationship distress than nonconflicted couples on measures of marital stability, change desired, and positive communication behaviors. Contrary to predictions, alcoholic couples were not unique with respect to struggles for control, a pattern of wife dominance, a responsibility-avoiding style of communication by the alcoholic husband, or impaired perceptual accuracy. Unexpectedly, alcoholic husbands reported less marital unhappiness than both their wives and maritally conflicted husbands on most of the self-report marital satisfaction measures.     

All Shook Up: Sexuality of Mid- to Later Life Married Couples

The authors integrate theoretical work on the performance of gender with a life course perspective to frame an analysis of in-depth interviews with 17 long-term married couples. The findings indicated that couples' sexual experiences are characterized by change over time, yet that change is shaped by the intersection of gender and age. Midlife couples (ages 50 - 69) were distressed by changes in their sex lives likely because they impede couples from performing gendered sexuality. The source of this distress stems from age-related physical changes; however, it manifests in different ways for husbands and wives. In contrast, later life couples (ages 70 - 86) were more likely to emphasize the importance of emotional intimacy over sex as they age. Marital sex is a source of conflict for many midlife couples because of husbands' and wives' incongruent experiences, but later life husbands and wives tend to have more congruent experiences of marital sex.     

American Indian migration and economic opportunities

This article examines interstate migration and labor force participation among White, American Indian, and intermarried Indian/White couples in the US. The results show that endogamous American Indian couples are much less likely to change states of residence than are the other 2 groups of couples. The effect of interstate migration on labor force participation does not vary across the 3 groups of couples. The implications of these results for the assimilation and internal colonial models of race relations and for federal Indian policy are discussed     

AN ETHNOGRAPHY OF COUPLE AND THERAPIST EXPERIENCES IN REFLECTING TEAM PRACTICE

Couple and therapist perspectives about the use and process of reflecting team practice were analyzed using ethnographic research. A domain analysis was performed on postession interviews from both couples and therapists, and on field notes from each therapist. Seven couples and five therapists were interviewed at least twice over a 4-month period concerning their reactions to and perceptions of reflecting team practice. Six domains concerning reflecting team practice emerged from the analysis: (a)benefits of its use, (b) effects of gender, (c)recommended use, (d) contraindicated use, (e) the importance of creating spatial separateness between couple and team members, and (f) sequences of communication between the couple and team members that elicit change. The latter two domains described the process of reflecting team practice (i.e., steps in how it is used and how it is implemented). The role of ethnog rahy in reflecting team practice and in family therapy research is discussed.     

Moving beyond gender: processes that create relationship equality

Equality is related to relationship success, yet few couples achieve it. In this qualitative study, we examine how couples with children in two time cohorts (1982 and 2001) moved toward equality. The analysis identifies three types of couples: Postgender, gender legacy, and traditional. Movement toward equality is facilitated by: (a) Stimulus for change, including awareness of gender, commitment to family and work, and situational pressures; and (b) patterns that promote change, including active negotiation, challenges to gender entitlement, development of new competencies, and mutual attention to relationship and family tasks. Implications for practice are discussed.     

Predicting Follow‐up Outcomes in Emotionally Focused Couple Therapy: The Role of Change in Trust,Relationship‐Specific Attachment,and Emotional Engagement

Emotionally Focused Couple Therapy (EFT), an evidence‐based couple therapy (Johnson, Hunsley, Greenberg, & Schindler, 1999), strives to foster lasting change through the creation of secure attachment bonds in distressed couples. Although studies have demonstrated lasting change in follow‐up (Wiebe et al., in press), research is needed to investigate predictors of long‐term outcomes. Our goal was to investigate predictors of long‐term outcomes in relationship satisfaction. Relationship satisfaction was assessed across 24 months in a sample of 32 couples who received an average of 21 EFT sessions. Decreases in attachment avoidance were most predictive of higher relationship satisfaction across follow‐up. These findings support the theoretical assumption that EFT helps couples foster lasting change in relationship satisfaction through the facilitation of secure attachment bonds.     

The Impact of Blamer‐softening on Romantic Attachment in Emotionally Focused Couples Therapy

Emotionally Focused Couples Therapy (EFT; Johnson, 2004 ) treats relationship distress by targeting couples' relationship‐specific attachment insecurity. In this study, we used hierarchical linear modeling (Singer & Willett, 2003 ) to examine intercept and slope discontinuities in softened couples' trajectories of change in relationship satisfaction and relationship‐specific attachment over the course of therapy from a total sample of 32 couples. Softened couples (n = 16) reported a significant increase in relationship satisfaction and a significant decrease in attachment avoidance at the softening session. Although softened couples displayed an initial increase in relationship‐specific attachment anxiety at the softening session, their scores significantly decreased across post‐softening sessions. Results demonstrated the importance of the blamer‐softening change event in facilitating change in EFT.     

Continuity and change in work-life balance choices

This paper explores the ways in which the work-life balance choices made by heterosexual couples differ in different generations, how such choices are gendered, and the extent to which 'individualization' provides an adequate conceptualization of the effects of social change on heterosexual couples. It argues that processes of individualization need to be seen in the context of changing social institutions, and that it is the de-institutionalization of 'the family' and the life course that is leading to a de-gendering of work-life balance choices. The paper draws on findings from a restudy of the family and social change and a study of the gender dimensions of job insecurity both of which were carried out in the same geographical location. The studies provide evidence of generational change in work-life balance choices and increasing occupational differentiation between heterosexual partners. This leads to a situation where increasingly choices are made which blur gendered boundaries and which has been made possible by a process of de-institutionalization of the male breadwinner family. Our findings support the contention that processes of individualization are more apparent amongst younger than older generations and that, because of changes external to the family, there is more negotiation and pragmatism amongst younger generations about work-life choices.