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.     

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.     

AN EXPERIENTIAL APPROACH TO FAMILY-OF-ORIGIN WORK WITH MARITAL AND FAMILY THERAPY TRAINEES

An experiential approach to family-of-origin work with marital and family therapy students is offered as a complement to didactic study. Recommendations are made for structuring courses to include family-of-origin work without blurring the roles of instructor and therapist.     

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.     

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.     

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.     

SEXUAL ATTARACTION AND ROMANTIC LOVE: FORGOTTEN VARIABLES IN MARITAL THERAPY*

The purpose of this paper is to address the lack of attention in the mariage therapy literature ot romantic love and sexual attraction. Although mot coupples marry because of romantic love and tent to divorce when they “fall out of love,” few guidelines are available to therapists concerning how to deal with love as an issue in therapy. In contrast to models of marriage therapy which focus on rational skill devlopment, the model presented here is based on the assumption that marriage problems are emotional in nature and that the success of marital theapists is dependent upon skill in addressing emotional states. Based on recent findings in neurobioloy, this model contends that the affective dimension of love is precognitive and similar to the attchment between infant and parnent. By providing nonverbal and precognitive experience whithin therapy that can alter the emotional pattern of couples, therapists can increase the likelihood of a successful outcome.     

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.     

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.     

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.     

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.     

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.     

MARITAL AND FAMILY THERAPY CERTIFICATION AND LICENSING EXAMINATIONS: ONE MODEL*

The design of the North Carolina Marital and Family Therapy Certification Examination is outlined by its authors to provide a frame of reference for the development of other licensing and certification instruments. The purpose, procedures, resources, guidelines, content, and normative data of the examination are described. The model is offered to stimulate meaningful dialogue on marital and family therapy licensing and certification instrumentation. Guidelines toward the development of a national marital and family therapy examination are also presented.     

DYSFUNCTIONAL MARITAL CONFLICT: AN INTEGRATIVE INTERPERSONAL-INTRAPSYCHIC MODEL*

An integrative interpersonal-intrapsychic model of dysfunctional marital conflict is presented and research support for the model is reviewed. The therapeutic applications of the model are discussed and illustrated with a clinical example.     

NONVERBAL RECIPROCITY IN NONDISTRESSED MARITAL PARTNERS: AN EXAMINATION OF BASE RATE CHANGE*

The present study sought to incorporate recent suggestions for reciprocity research into an experimental design which could use behavioral base rate change as a method for determining nonverbal reciprocity in nondistressed couples. This study examined reciprocity by surreptitiously manipulating the touching behavior of one spouse, and monitoring responses of the other spouse. Forty couples were randomly assigned to either an experimental or control group. Couples were videotaped engaging in an assigned task which permitted interaction. During the interaction, positive touches, smiles, and headnods were monitored. Following instruction to do so, selected spouses in the experimental group increased their rate of touches. Results indicated that, in response, naive spouses subsequently increased their rate of touches. The results of this experiment provide supportive evidence for the lawful nature of reciprocity. The implications of these findings, and suggestions for subsequent reciprocity research, are forwarded.     

PUBLISHED SCHOLARSHIP ON MARITAL THERAPY

This article is a content analysis of 10 prominent marital and family therapy journals during a 6-year period. Marital therapy articles were the focus of the analysis. Prolific authours, institutions, types of articles being published, and publication outlet were described. The aim is to survey the field and facilitate future scholarship.