Therapeutic alliance and treatment progress in couple psychotherapy

This study examined the ability of the therapeutic alliance to predict treatment progress on individual- and relationship-level variables from the early to middle phase of couple treatment. Although alliance did not predict progress in individual functioning, it accounted for 5-22% of the variance in improvement in marital distress. Women's mid-treatment alliance uniquely predicted improvement in marital distress, over and above early treatment alliance. When men's alliances with the therapist were stronger than their partners' at session 8, couples showed more improvement in marital distress. Treatment response was also positively associated with women's ratings of their partners' alliance. Results confirm that the therapeutic alliance in conjoint treatment is composed of distinct client subsystems that are useful predictors of treatment progress.     

Pressure to Attend Therapy,Dyadic Adjustment,and Adverse Childhood Experiences: Direct and Indirect Effects on the Therapeutic Alliance in Couples Therapy

In this study we examine the role that pressure to attend therapy, dyadic adjustment, and adverse childhood experiences (ACEs) play in developing the therapeutic alliance. A total of 351 couples received treatment as usual at three family therapy training clinics. Participants rated predictor variables at intake and alliance at the fourth session. Results of a path analysis indicate that each partner's dyadic adjustment is directly associated with the quality of her or his own alliance. In addition, when male partners report more ACEs and pressure to attend treatment, their own alliance scores decrease. Additionally, when one partner reports feeling pressure to attend therapy, the other partner's alliance decreases. Finally, for males, there is an indirect effect of dyadic adjustment on alliance through pressure to attend therapy. These results suggest that clinicians should routinely assess relationship adjustment, how pressured each partner is feeling to attend treatment, and ACEs; as these may impact alliance quality.     

MORNING AND NIGHT COUPLES: THE EFFECT OF WAKE AND SLEEP PATTERNS ON MARITAL ADJUSTMENT*

This study explored the effects of spouses' wake and sleep patterns on marital adjustment. A total of 150 couples from three states completed questions on wake/sleep patterns, marital interaction, marital adjustment, and problem solving. Couples whose wake and sleep patterns were mismatched (e.g., an evening person married to a morning person) reported significantly less marital adjustment, more marital conflict, less time spent in serious conversation, less time spent in shared activities and less frequent sexual intercourse than matched couples. Contrary to expectations for matched couples, night couples did not report more involvement in extra-familial social activities than morning couples. Morning couples engaged in sexual intercourse more frequently in the morning than night couples; night couples had sex more often in the evening than morning couples. There were no significant differences in the intercourse rates for morning couples and night couples. Compared to matched couples, mismatched couples with high marital adjustment reported more flexibility and adaptability in their marital problem solving. The implications of these findings for premarital counseling and marital therapy are discussed.     

Predicting Spouses’ Perceptions of Their Parenting Alliance

This study used marital‐ and individual‐level variables to predict spouses’ perceived parenting alliance. One hundred married couples completed measures of parenting alliance, marital consensus, marital power, and depression. Analyses revealed that marital consensus was a significant predictor of parenting alliance for both parents, and that depression also was a significant predictor for wives. Analyses using both spouses’ data indicated that wives’ perceptions of consensus and depression significantly predicted both spouses’ parenting alliance, suggesting that wives are the barometer of the marital relationship ( Floyd & Markman, 1983 ) and of the parenting relationship as well. Implications for research are discussed.     

FACILITATING INTIMACY: INTERVENTIONS AND EFFECTS

The Present study investigated by effects of two sets of marital interventions taken from Emotionally Focused Therapy (EFT) and Cognitive Marital Therapy (CMT) on level of marital intimacy, dyadic trust, and dyadic adjustment. It was hypothesized that both EFT and CMT would have a positive effect on levels of intimacy, trust, and adjustment as compared to a wait-list control group and that there would be a differential effect in favor of EFT as compared to CMT. Thirty-six couples free of marital distress and seeking to enhance theor intimate relationship were randomaly assigned to EFT, CMT, or a wai-list control group. Therapists' interventions were monitored and found to be faithfully implemented. Groups were equivalent on demographic variables and the quality of the therapeutic alliance. Both EFT and CMT group posttest means were found to be significantly higher than controls on the self-report measures of intimacy, Observational measures of intimacy revealed differential effects in favor of EFT as comopared to CMT at posttest. At a 10-week follow-up, EFT group means were significantly higher than CMT on self-reported intimacy and adjustment.     

The Short French Internet Addiction Test Adapted to Online Sexual Activities: Validation and Links With Online Sexual Preferences and Addiction Symptoms

The goal of this study was to investigate the psychometric properties of a French version of the short Internet Addiction Test adapted to online sexual activities (s-IAT-sex). The French version of the s-IAT-sex was administered to a sample of 401 men. The participants also completed a questionnaire that screened for sexual addiction (PATHOS). The relationships of s-IAT-sex scores with time spent online for online sexual activities (OSAs) and the types of OSAs favored were also considered. Confirmatory analyses supported a two-factor model of s-IAT-sex, corresponding to the factorial structure found in earlier studies that used the short IAT. The first factor regroups loss of control and time management, whereas the second factor regroups craving and social problems. Internal consistency for each factor was evaluated with Cronbach's α coefficient, resulting in .87 for Factor 1, .76 for Factor 2, and .88 for the global scale. Concurrent validity was supported by relationships with symptoms of sexual addiction, types of OSAs practiced, and time spent online for OSAs. The prevalence of sexual addiction (measured by PATHOS) was 28.1% in the current sample of self-selected male OSA users. The French version of the s-IAT-sex presents good psychometric properties and constitutes a useful tool for researchers and practitioners.     

Gaze in married couples

This study examined the looking behavior of married couples during a 10 minute interaction segment. The variables examined included marital adjustment level, interaction role (speaking or listening) and type of message. Wives were more likely to look at their spouses than husbands were, and speakers were more likely to look at their partners than were listeners. While high marital adjustment spouses looked less over all types of mesages, low marital adjustment spouses particularly looked more than the highs on negative messages, suggesting either a confrontation component to the looking, or a strong need to monitor the partner's reactions in such situations. There was also evidence of more displayed competitiveness in the low marital adjustment couples. Correlational analyses revealed that there were different relationships between the looking behavior of the speaking spouse and the looking behavior of the listening spouse, and between the spouses' patterns of looking when speaking or listening and that these differences were dependent on marital adjustment level.     

An exploratory investigation of marital functioning and order of spousal onset in couples concordant for psychopathology

Individuals with a psychiatric disorder are significantly more likely to have a spouse with a clinical diagnosis--marital concordance. We used a community sample of 304 couples concordant for either major depressive disorder (MDD) or substance use disorders (SUDs) to examine the relationship between marital functioning and gendered patterns of mental health diagnosis onset. For SUD concordance, couples in which wives onset before husbands--despite typical later onset for men--reported lower levels of marital satisfaction compared with couples in which the husband onset first. For MDD concordance, couples in which husbands onset with depression before wives--despite typical later onset for men--reported lower levels of marital satisfaction. These results suggest that for couples concordant for mental diagnoses, it is most problematic for marital functioning for one partner to have an atypically early onset. Implications for treatment targets in marital therapy are discussed.     

Marital distress,co-occurring depression,and marital therapy: a review

This article reviews several factors that contribute to marital distress and co-occurring depression and also reviews empirically supported therapies. Gender contributes to marital distress and depression but does not appear to be the cause of either. Marital distress and depression appear to have bidirectional influence on each other. The depressed spouse's depression has a marked impact on the marital adjustment of the nondepressed spouse. Both marital distress and depression appear to be chronic. It is recommended that treatment be designed to help couples be supportive of each another, to adapt, and to cope with the depressive symptoms within the framework of their ongoing marital relations.     

Computer-Assisted Diagnosis of Alcoholism

The use of computer-assisted interviews in the diagnosis of psychiatric conditions has increased since researchhas shown such interviews to have adequate psychometric properties and to be acceptable to patients. This study uses a computer-assisted format to assess drinking behaviors and alcohol-related symptoms in 50 veterans hospitalized for alcohol dependence. A computerized version of the Michigan Alcohol Screening Test (C-MAST) is compared to the standardized MAST, substantiating the earlier finding that individuals are more willing to reveal negatively-sanctioned behaviors to a computer than to an individual or on a questionnaire. The usefulness of such an assessment tool in general practice is discussed.     

Effects of Religiosity,Forgiveness, and Spousal Empathy on Marital Adjustment

This study focused on married couples in a region of the United States that previous research has identified as having high rates of both religiosity and divorce. As a result, this study was designed to examine the effects of religiosity, forgiveness, and spousal empathy on marital adjustment. To investigate these constructs, married couples in this region were recruited (n?=?829) to participate in a cross-sectional, self-report telephone survey. Results indicate that religious service attendance and spousal empathy have direct positive effects on marital adjustment in European American married men; while religious service attendance, forgiveness, and spousal empathy have direct positive effects on marital adjustment in European American married women. Among African-American participants, only spousal empathy had a direct effect on marital adjustment for both men and women. Finally, spousal empathy moderated the association between previous marriage and current marital adjustment among European American married women.     

“It's About Us”: Marital Adjustment and Marital Adaptation in Couples Who Adopt Children From the Child Welfare System

This article examines, using grounded theory methodology, the marital relationships of couples who adopted children from the child welfare system. Twenty-two spouses in four focus groups reported initial marital adjustment that featured husbands' support of their wives' initiation of adoption and management of child needs. About one half of these couples also developed time together and mutual influence to achieve a state of marital adaptation characterized by deeper intimate connection. Professionals are encouraged to understand the potential course of development of these marital relationships and to integrate attention to marital development into service throughout the entire adoption process.     

Longitudinal Associations Between Husbands' and Wives' Depressive Symptoms

Although concordance between husbands' and wives' mental health problems is often reported, questions remain about the nature of these relations. Extending research in this area, this study examined dynamic-longitudinal pathways among husbands' and wives' depressive symptoms and marital satisfaction as a moderator of associations. Participants were 296 heterosexual couples. Husbands and wives reported on their depressive symptoms and marital satisfaction. Results from dynamic bivariate latent difference score analyses indicated unidirectional longitudinal coupling such that higher levels of husbands' depressive symptoms predicted subsequent elevations in wives' depressive symptoms over time. This relation was stronger among couples reporting marital distress as compared to couples reporting higher marital satisfaction. The findings underscore the importance of considering one's spouses' depressive symptoms in treatment efforts.     

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.     

Two‐Year Follow‐Up of the Efficacy of the PREP Training on Iranian Newlyweds

The aim of the present study was to replicate the efficacy of the Prevention and Relationship Education Program (PREP) training on marital satisfaction and dyadic adjustment among a group of Iranian newlyweds. One hundred and sixty heterosexual couples (N = 320 participants) were randomly assigned to an experimental or a wait list control group. Data from one hundred and forty‐eight couples were analyzed. Participants completed the ENRICH Marital Satisfaction Scale (The Family Journal, 1, 1993, 196–207) and Dyadic Adjustment Scale (The Journal of Sex Research, 39, 1976, 190–196) at pretest, posttest, 1‐year follow‐up, and 2‐year follow‐up. Results indicated that mean marital satisfaction and dyadic adjustment scores between the experimental and control groups were significantly different at posttest. Therefore, PREP training improved marital satisfaction and dyadic adjustment of couples at posttest. The data suggests that PREP training program can be introduced as an effective relationship education program for Iranian newlyweds.     

MARITAL THERAPY: QUALITIES OF COUPLES WHO FARE BETTER OR WORSE IN TREATMENT

To evaluate the effectiveness of couples therapy and determine the characteristics and qualities of couples who fare best in treatment, 139 couples presenting at a nonlaboratory sliding-fee clinic in Dallas, Texas, were evaluated. Observational and self-report measures of the Beavers Systems Model were taken at the first session and, for some subjects, at termination. Therapists also rated the couples on goal attainment and on dimensions of the therapeutic alliance. Not surprisingly, there was a direct association between number of sessions and goal attainment, with couples attending only one or two sessions having the lowest goal attainment. There were also significant family functioning qualities associated with success: more competent couples fared better in therapy. Another consistent finding was that couples with no children did better in treatment than those who were also parents. It is interesting that remarried couples without children did best in treatment, followed by first-married couples with no children, first-married couples with children, and, finally, remarried couples with children. Implications for screening and clinical work with couples are presented.     

Antecedents and consequences of negative marital stressors

Many couples seeking therapy report the occurrence of severe, negative marital stressors (e.g., infidelity, threats of marital dissolution). In addition, existing research has demonstrated that these marital stressors precipitate Major Depressive Episodes and psychological symptoms. This longitudinal study examines the antecedents and consequences of negative marital stressors to help clinicians and researchers develop interventions that might prevent these stressors and their outcomes. Forty-one women completed a semistructured interview and measures of marital discord and depressive symptoms within one month after experiencing a marital stressor (baseline) and at a 16-month follow up. The results indicate that baseline marital discorded contributes to the occurrence of additional marital stressors during the follow-up period. Although baseline depressive symptoms do not predict additional marital stressors, depressive symptoms along with marital discord predict future depressive symptoms. Finally, baseline marital discord and additional marital stressors contribute to future marital dissolution. Clinical and research implications are discussed.     

The Course of Dyadic Adjustment and Depressive Symptoms During and After Couples Therapy: A Prospective Follow-up Study of Inpatient Treatment

A clinical sample of adult patients suffering from relational distress and concurrent psychiatric symptoms was followed from admission, through residential couple therapy, to 1-year follow-up. At follow-up, 9.8% were separated. The remaining couples showed significant improvement in dyadic adjustment at posttreatment. However, at 1-year follow-up, a subgroup of 25% of the positive treatment responders had deteriorated to below their admission levels of dyadic adjustment. Contrary to expectation, the deteriorated group had showed significantly less distress both in depressive symptoms and in one early maladaptive schema domain—Impaired Autonomy—at admission, when compared with the rest of the sample, which suggests the need for further research and possible replication in this area.     

Factors associated with relationship dissolution and post-dissolution adjustment among lesbian adoptive couples

ABSTRACT

Same-sex adoptive couples are increasingly visible, yet few studies have addressed relationship stability and dissolution among these couples. In this study, using a theoretical framework based on Investment Models and Vulnerability-Stress-Adaptation Theory, factors associated with dissolution and post-dissolution adjustment among 27 lesbian adoptive couples were examined across two points. At Wave 1, all 27 couples were together; children were on average 3 years old. Results revealed that nearly one third broke up over 5 years (between Waves 1 and 2). Factors related to shorter relationship length and undermining coparenting at Wave 1 distinguished women who later broke up versus stayed together. Worse mental health at Wave 2 characterized women in dissolved rather than sustained relationships, even with comparable individual adjustment at Wave 1. Weaker parenting alliance and greater dissatisfaction with childcare divisions were reported by women no longer with their partners at Wave 2 as compared with those in enduring partnerships. This research has implications for understanding lesbian relationship dynamics and associations with individual adjustment.