Dyadic Playfulness Differences Between Sexual and Marital Therapy Couples

Thirty-three clinical couples (17 sex therapy and 16 marital therapy) and fifty non-clinical couples were examined for potential differences in relationship playfulness utilizing the Couples Play Questionnaire. For clinical couples, Spanier's Dyadic Adjustment Scale, and Edmond's Marital Conventionalization Scale scores were also comparcd. Both sex therapy and marital therapy couples were found to be deficient in play compared to non-clinical couples, while marital therapy couples were found to be most deficient. Greater marital conventionalization scores were found for sex therapy couples suggesting that they favorably distort their self-assessmcnts. Results suggest that sex therapy couples may be the more inflexible of the three sample groups and may need therapeutic assistance with general relationship play as well as sexual play.     

Problems Confronting the Female Therapist Doing Couple Therapy*

This paper describes some of the special problems confronting the female therapist doing couple therapy. They are grouped into four main categories, identified by a specific characteristic of the couple: the passive male, the aggressive male, the submissive female, and the dominant, aggressive female. The dynamics of each problem are delineated and suggestions for dealing with them, in marital as well as sex therapy, are presented. Additional observations are made on the values of using appropriate role modeling, and of forming and shifting supportive alliances, as therapeutic techniques.     

Marital Role Ideals and Perception of Marital Role Behavior in Distressed and Non Distressed Couples

Eighty non-patient couples, 50 couples seeking sex therapy, and 50 couples seeking marital therapy, were asked to report on whom they felt should and who actually does assume responsibility in eight major marital role areas. When the degree of individual “role strain”, that is, the discrepancy between role ideals and role behavior was examined, the marital therapy patients were found to be experiencing the most role strain. Husband-wife discrepancies with respect to who does have the various role assignments were found to be higher in the marital therapy couples. These data are interpreted in terms of their implications for diagnosis and treatment of sexually and maritally distressed couples.     

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.     

Affective disorders

Unipolar depressive disorders are especially common among persons presenting with marital and family problems, rendering their impact on the treatment of marital and family problems of interest to every marriage and family therapist. The current paper describes empirically based decision making rules for determining who may benefit most from marital and family therapy interventions. Using well-controlled outcome research, it is concluded that both marital therapy and parenting interventions can play an important role in the treatment of many but not all depressed persons. Predictors of treatment response are discussed and recent epidemiological research is used to examine the size of the population that may respond especially well to marital therapy. Future directions for research are suggested and public policy implications are discussed.     

Underground Markets as Fields in Transition: Sex Work in New York City

Most ethnographers visualize their fieldwork study vis‐à‐vis their long‐term commitment to a bounded sociospatial context—an “ecology.” In this manner, the majority of ethnographic studies are presented as studies not only of practices but also of recognizable physical ecologies that breathe life into the practices—for example, homes, ghettos, firms, schools, and so on. In the pages that follow, I consider the ways in which the status of place has shifted in urban sex work. The shifting commerce of sexual services in New York enables me to open up a set of methodological issues about the role of space in ethnographic work. One in particular is at the core of this paper: namely, because so many ethnographic labors begin with the selection of a field site, what conceptual issues arise that fieldworkers must pay attention to vis‐à‐vis that decision? For example, the field site may change, the field site may itself be shaped by wider societal forces, and it may be simply dissolve over time. How does any of this impact a technique that is premised on the dependability of “sitting” so that others may be dependably followed? I draw on the notion of “strategic action fields” to present an alternative analytic framework, one more useful for the challenges ethnographers face.     

Dimensions of Marital Therapy: A Comparative Analysis*

This paper offers a comparative analysis of the process of conjoint marital therapy within the three major contemporary models of treatment: psychoanalytic, behavioral, and systems theory. The specific dimensions of the treatment process that are examined are: (1) the role of the past and of the unconscious; (2) the nature and meaning of presenting problems and the role of assessment; (3) the relative importance of mediating vs. ultimate treatment goals; and (4) the nature of the therapists roles and functions. On the basis of this comparative analysis, some thoughts toward the future of the marital therapies are offered.     

Perceptions of Marriage Related to Engagement in Conjoint Therapy

The pre-treatment marital perceptions of 36 continuing couples were compared with those of 13 couples who terminated conjoint family therapy prior to the third session. Few statistically reliable differences between the groups were found in this pilot study, but the over-all pattern of results was consistent with clinical theory and empirical findings in related areas. Compared to terminators, continuing husbands had a more positive view of family life and perceived themselves as more closely allied with their wives. Continuing wives were more dissatisfied with matters in the family than either their husbands or terminating wives, but they also had more power vis a vis their husbands than did terminating wives. The results were interpreted in relation to a negotiation model of conjoint therapy.     

Behavioral treatment of marital discord

Many techniques derived from various family therapies such as filial therapy (Stover & Guerney, 1967), conjugal therapy (Ely, 1970), conjoint parent/child therapy (Wertheim, 1959), conjoint marital therapy (Haley, 1963; Satir, 1964, 1965), and conjoint family therapy (Satir, 1964, 1965) have recently been incorporated into the practice skills repertory of clinical social workers. Of all of these approaches the behavioral view has a substantial pool of accumulated data to support its wide use in practice (Jacobson & Martin, 1976). However, virtually no detailed explanation of the behavioral view appears in the social work literature, thus hindering its application. To alleviate this deficiency this article reviews the following topics: basic philosophy; behavioral exchange and marital satisfaction; development of marital conflict; clinical implications; clinical assessment; tools for intervention; and procedural guidelines for the treatment process.     

Preliminary estimates of cost-effectiveness for marital therapy

Cost‐effectiveness of marital therapy was examined beginning with a simple question: If government or health insurers paid for the screening and, where indicated, empirically supported treatment of 100,000 randomly selected married persons (i.e., 50,000 couples) from the general population, would the financial benefits outweigh costs? Two empirically supported forms of marital therapy, behavioral marital therapy and emotionally focused therapy, were considered in aggregate as possible treatments of choice. Marital therapy appears to be cost‐effective when paid for by government to reduce public costs of divorce or when paid for by insurers to offset the increased health‐care expenses associated with divorce. Implications and specific needs for future research to substantiate these conclusions are discussed.     

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.     

Abstracts

Beal, E. W. Current trends in the training of family therapists.
Bryson, R. B., Bryson, J. B., Licht, M. H., & Licht, B. G. The professional pair.
Cromwell, R. E., Olson, D. H. L., & Founier, D. G. Tools and techniques for diagnosis and evaluation in marital and family therapy.
Hartley, D., Roback, H. B., & Abramowitz, S. I. Deterioration effects in encounter groups.
Jones, W. P. Some implications of the sixteen personality factor questionnaire for marital guidance.
Kelly, G. F. The counselor and human sexuality.
Mace, D., & Mace, V. The selection, training, and certification of facilitators for marriage enrichment programs.
Masters, W. H. & Johnson, V. E. Principles of the new sex therapy.
McConnell, L. G. An examination of the counselor's skills when counseling with sexual problems.
Meyer, J. K. Training and accreditation for the treatment of sexual disorders.
Robertielle, R. C. The decline and fall of sex.
Rubin, Z., & Mitchell, C. Couples research as couples counseling.
Sager, C. J. The role of sex therapy in marital therapy.
Whittaker, J. K. Causes of childhood disorders: New findings.     

The treatment of sexual problems in marital and family therapy

With the proliferation of new research data and clinical practice techniques for dealing with sexual dysfunction, many family and marital therapists whose patients express sexual complaints experience the need to integrate this knowledge into their practice. For many couples and therapists, the rapid treatment approaches to sexual difficulties are inappropriate or ineffectual, yet the current literature addresses itself to either sex therapyper se or marital therapy and rarely deals with an integration of the two. This paper presents guidelines for assessing the sexual difficulties in the context of the relationship and outlines techniques for addressing the sexual difficulties directly while maintaining a more traditional marital therapy approach.     

Psychotherapeutic Considerations for Working with Betrayed Spouses: A Four‐task Recovery Model

The treatment of infidelity is one of the most challenging and misunderstood aspects of marital therapy, with therapists frequently making treatment decisions based on faulty assumptions. By too quickly trying to ‘fix’ the marriage or by assuming that the betrayed spouse contributed to the unfaithful partner's infidelity, the therapeutic process can inadvertently re‐traumatise an already emotionally fragile client, while not addressing his or her emotional needs. This paper addresses therapeutic considerations for working with the betrayed partner, and provides practical guidelines for addressing the psychological and emotional needs of a betrayed client. A grounded theory model of the recovery path for betrayed partners is presented, as well as suggestions for further research.     

Marital Sex Role Orientation and Adjustment to Separation and Divorce

In order to examine the relationship between sex role orientation and adjustment to marital disruption, a sample of 143 newly separated persons was interviewed two months after separation, and then again 6, 18, and 30 months later. A measure of marital sex role orientation was administered at the time of the initial interview, and dependent measures of adjustment were obtained at each of the four interviews. In the case of women, high family orientation, and to a lesser extent, low self orientation were found to be associated with poor postseparation adjustment. Female marital sex role orientation appears to be a clear and meaningful concept. In the case of men, however, the concept is poorly elaborated and not yet adequately assessed. Suggestions toward the improved conceptualization and measurement of male marital sex role orientation are provided.     

The Couple Relationship as the Focus of Sex Therapy: The Integration of Sex Therapy Ideas and Techniques with Marital and Family Therapy

The marriage and family therapist needs basic information about techniques used in sex therapy in order to deal with the sexual issues they may encounter in their practice. This paper outlines a method of incorporating the psychotherapeutic techniques presently used in sex therapy into the marriage and family counselling setting when there is a sexual issue involved. The paper is separated into (1) a discussion of the problem, (2) recovering the relationship as the focus for sex therapy, and (3) the main approaches to treatment. Next, (4) practice issues are considered, with a presentation of couple therapy using concepts and techniques of sex therapy, including discussions on A. Identification of Organic Causes, B. Identification of Psychological Issues, C. Examination of Interpersonal Issues, and D. Assessment of Systemic Issues. (5) Some more common interventions are then presented.     

The Long Term Effect of Parental Divorce:

The present study examined the effects of a subject's sex, level of religiosity, and marital history of family origin on the development on marital role expectations in a sample of 80 college students. The results indicated that the marital roles expectations were a result of an interaction of the three variables examined. While it has been proposed that parental divorce leads to the development of "inappropriate" marital role expectations, the present study failed to support this conclusion. It appears that marital role development is the result of a complex interaction of a number of variables and not as easily explained as some would suggest. The differential influence of religiosity on the development of marital role expectation is discussed with implications for further research. The "role-model" rationale of the transmission of marital instability is discussed in light of these results.     

WHO'S DRAGGING THEIR FEET? HUSBANDS AND WIVES SEEKING MARITAL THERAPY

Despite its demonstrated efficacy, marital therapy's impact has been limited by couples' general reluctance to seek help until their problems become severe. To understand this delay, 147 married couples (294 individuals) in the process of seeking marital therapy were surveyed. Using multilevel confirmatory factor analysis, three relatively independent steps (problem recognition, treatment consideration, and treatment seeking) were identified. On average, wives were rated as completing all three steps before their husbands. Gender-role orientation, demographics, relationship satisfaction, and specific relationship problems (especially husbands' dissatisfaction with sex) were also predictive of the steps toward therapy. Implications for 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.