Couple dynamics and attributions when one partner has an acquired hearing loss: implications for couple therapy

We discuss the communication difficulties that many couples face when one partner has a hearing loss. We also discuss the role of attribution theory in understanding the marital distress of these couples. Finally, we offer interventions to support better communication between couples facing the challenges of hearing loss.     

Object relations couple therapy for a married Korean man with sexual dysfunction

This study uses James Donovan's object relations couple therapy to examine the triangle of focus (conflict style, couple characteristics, and family of origin) and triangle of conflict (anxiety, defence mechanisms, and hidden emotions) of a married Korean man with sexual dysfunction (reduced sexual desire, premature ejaculation, and erectile dysfunction). This qualitative study uses thematic analysis to identify, describe, and analyse a family therapy case study. The aim of this study is to examine the couple's interaction patterns and experiences of conflicts related to the husband's erectile dysfunction. The researchers induced patterns or topics by repeatedly reading and comparing the data. Then, they textualised and analysed the relevant data. To ensure the reliability and validity of the data analysis, the researchers conducted shared coding sessions to review and discuss the initial codes and the generated main themes and subthemes, triangulating the qualitative data. Findings show that a newlywed husband's sexual dysfunction is associated with his emotional resistance towards his wife's unilateral pursuit over their sexual relationship and the negative emotions triggered by their dysfunctional interactions. Further, couple characteristics, conflict style (dysfunctional interactions), and family-of-origin factors (transference and patrilocality) influenced their sexual relationship. Therefore, therapists who counsel Korean couples with sexual issues may pay attention to the sociocultural factors, interactional patterns, and psychological factors associated with unresolved issues with their families of origin.     

Integrating cognitive-behavioral and expressive therapy interventions:applying the trauma outcome process in treating children with sexually abusive behavior problems

This article presents intervention strategies based on the Trauma Outcome Process, an integrated treatment model for guiding clinical practice with children with sexually abusive behavior problems. The steps for completing a comprehensive assessment are reviewed, and strategies are presented to help clinicians create a therapeutic alliance and increase these children's self-awareness of their thoughts, feelings, and body sensations. Treatment techniques based on an integrated approach combining cognitive-behavioral and expressive therapy approaches are described. These exercises help children accept responsibility for sexually inappropriate behavior and select adaptive responses for coping with the effects of traumatic experiences.     

Introduction to the special section: The role of cognitive-behavioral interventions in couple and family therapy

Marriage and family therapists' perspectives on cognitive–behavior family therapy (CBFT) have seen major changes over the years. The focus on cognitions and behaviors in treatment is now widely embraced by marriage and family therapists because of the effectiveness of the approach and its flexibility and integrative potential. This article provides an introduction to the special section and a brief history and overview of the application of CBFT to the field and some of the benefits it can provide to the growing and ever-challenging area of couples and family therapy.     

The feminist/emotionally focused therapy practice model: an integrated approach for couple therapy

Emotionally focused therapy (EFT) is a well-developed, empirically tested practice model for couple therapy that integrates systems, experiential, and attachment theories. Feminist family therapy theory has provided a critique of biased assumptions about gender at play in traditional family therapy practice and the historical absence of discussions of power in family therapy theory. This article presents an integrated feminist/EFT practice model for use in couple therapy, using a case from practice to illustrate key concepts. Broadly, the integrated model addresses gender roles and individual emotional experience using a systemic framework for understanding couple interaction. The model provides practitioners with a sophisticated, comprehensive, and relevant practice approach for working with the issues and challenges emerging for contemporary heterosexual couples.     

Assessing readiness for couple therapy: the Stages of Relationship Change Questionnaire

Client readiness for change is garnering increased interest both conceptually and methodologically. This article describes the reliability, validity, and utility of a measure of readiness for couple relationship change, Schneider's (2003) Stages of Relationship Change Questionnaire (SRCQ). Based on the Transtheoretical Model of Change, the instrument measures change along nine domains of marital functioning. Results indicate that this one-factor instrument may reliably measure readiness for change and discriminate between various stages of change. Most in this sample (n = 406) were in early stages of change, with men more often in the stage of precontemplation and women more often in contemplation. The SRCQ can be completed and scored in under 10 min. Clinical use and research implications are discussed.     

The effectiveness of couple therapy in Germany: a replication study

The utility of couple therapy has been investigated in a number of controlled clinical efficacy investigations, demonstrating the superiority of most forms of couple therapy relative to control groups. Despite its widespread use, the effectiveness of couple therapy in field settings is largely unknown. In 1997, Hahlweg and Klann published an effectiveness study of couple therapy as practiced in German and Austrian marital counseling agencies. The purpose of the current investigation was to replicate their earlier findings in a similar setting with identical measures. The findings demonstrate that the results are remarkably similar across the two studies and that couple therapy in these applied settings helps to alleviate relationship distress as well as individuals' depression.     

Sexual addiction and marriage and family therapy: facilitating individual and relationship healing through couple therapy

In recent decades there has been an increase in literature regarding sexual addiction as well as a growing number of clients presenting in therapy with problems related to their sexual behaviors (including internet sexual addiction). This article (a) presents a synthesis of the research on the impact of sexual addiction on the addict, the partner, and the couple; (b) outlines the process of healing for each based on the research synthesis; and (c) discusses the role of marriage and family therapy in facilitating both individual and relationship healing from sexual addiction. Implications for future research in sexual addiction, generally, and in marriage and family therapy, specifically, are presented.     

Theory,culture, and behavior: Object relations in context

The purpose of this article is to explore aspects of contemporary object relations theory in relation to sociocultural variations in family constellation, childrearing practices, and race and ethnicity. The theoretical framework for this exploration derives from Winnicott's concept of the potential space between person and environment as the location of cultural experience. The author argues that Winnicott's ideas provide a clinically useful way to think about transactions between the internal world of object relations and the external world of cultural diversity. The article concludes with some implications for social work practice.     

Intervention research in couple and family therapy: a methodological and substantive review and an introduction to the special issue

This article serves as an introduction to this third version of research reviews of couple and family therapy (CFT) that have appeared in this journal beginning in 1995. It also presents a methodological and substantive overview of research in couple and family therapy from about 2001/2002 to 2010/2011 (the period covered in this issue), while also making connections with previous research. The article introduces quantitative research reviews of family-based intervention research that appear in this issue on 10 substantive areas including conduct disorder/delinquency, drug abuse, childhood and adolescent disorders (not including the aforementioned), family psycho-education for major mental illness, alcoholism, couple distress, relationship education, affective disorders, interpersonal violence, and chronic illness. The paper also introduces the first qualitative research paper in this series, as well as a paper that highlights current methodologies in meta-analysis. The first part of this article rates the 10 content areas on 12 dimensions of methodological strength for quantitative research and makes generalizations about the state of quantitative methodology in CFT. The latter part of the papers summarizes and makes comments on the substantive findings in the 12 papers in this issue, as well as on the field as a whole.     

Randomized controlled trial of emotionally focused couple therapy compared to treatment as usual for depression: Outcomes and mechanisms of change

This randomized controlled trial examined the effectiveness of Emotionally Focused Therapy (EFT) for depression and relationship satisfaction versus usual care (i.e., couple therapy other than EFT), and explored mechanisms of change. Mixed model trajectory analyses of 16 couples indicated EFT was associated with greater improvement in relationship satisfaction among men and women. Men receiving EFT reported greater improvements in depressive symptoms compared to usual care. Unified structural equation modeling revealed changes in relationship satisfaction preceded changes in depressive symptoms in one cluster of partners, while changes in depression preceded changes in relationship satisfaction in a second cluster. Two other clusters reported simultaneous changes in satisfaction and depression. This study provides encouraging results on the effectiveness of EFT for depression, and insight into mechanisms of change.     

Attachment injuries in couple relationships: a new perspective on impasses in couples therapy

This article identifies and operationalizes the newly defined construct of attachment injury. An attachment injury occurs when one partner violates the expectation that the other will offer comfort and caring in times of danger or distress. This incident becomes a clinically recurring theme and creates an impasse that blocks relationship repair in couples therapy. An attachment injury is characterized by an abandonment or by a betrayal of trust during a critical moment of need. The injurious incident defines the relationship as insecure and maintains relationship distress because it is continually used as a standard for the dependability of the offending partner. The concept of an attachment injury is defined here in the context of emotionally focused therapy, an empirically validated, short-term approach to modifying distress in couples. The broad theoretical underpinnings of this concept may be found in attachment theory as applied to adult romantic relationships. Through the delineation of attachment injury events and the ongoing development of a detailed model of resolution, couples therapists will be better able to identify, describe, and effectively treat such injuries and address the therapeutic impasses that are associated with them.     

Short-term and long-term effects of training in emotionally focused couple therapy: professional and personal aspects

This study investigated the immediate and long-term personal and professional effects of a 4-day externship training in emotionally focused couple therapy (EFT). EFT externship training uses lecture, discussion, video vignettes, live demonstrations, and role-plays to convey an attachment-based approach to working with couples. The two samples included clinicians (N = 76) who completed surveys immediately before and after training, and a subset of these clinicians (N = 29) who completed measures an average of 8 months later. Results indicate that following training, participants increased in their EFT knowledge and competence, became more open to their feelings, were more self-compassionate, were less likely to use avoidant attachment behaviors, and improved their own personal relationships.     

Use of standardized assessment instruments in couple therapy: the role of attitudes and professional factors

The study examined therapeutic approach, professional affiliation, training, seniority, and work setting as predictors of attitudes toward standardized instruments and their use in couple therapy. Data were gathered from 163 certified marriage and family therapists in Israel. Results showed that 27.6% of marital therapists used standardized instruments for assessment. More positive attitudes toward standardized instruments were associated with the extent of training in their use and with a structural-strategic approach. Logistic regression analysis indicated that positive attitudes, training, and work setting best predict the application of standardized assessment instruments. Reasons for the relative lack of use of standardized assessment instruments are discussed. It is recommended that more training in assessment instruments be included in marriage and family therapy training.     

Changes in couple,parenting, and individual functioning following Family Expectations program participation

The current study investigated changes in couple, parenting, and individual functioning following participation in Family Expectations, a relationship and parenting education program for new or expectant parents. The sample comprised 339 couples who participated in most sessions of the Family Expectations program and completed assessments at three different time points over a 12-month period. Study analyses examined: (a) change shortly following completion of the program, (b) associations between short-term change and subsequent change in outcomes at 12-month follow-up, and (c) differences in short-term change between married and unmarried couples. Significant improvements were observed in all three domains at short-term follow-up. Short-term changes, particularly for psychological distress, were predictive of long-term change in multiple domains. Few moderation effects by marital status were evident; those that appeared suggested stronger effects for married participants compared to unmarried. Study findings inform ongoing discussions into the utility of federally-funded relationship and parenting programming.