Congnitive Therapy with Couples

Abstract

Cognitive Therapy a Deux Cognitive Therapy with Couples. Dattilio, F. M, & Padesky, C. A. Sarasota, FL: Professional Resource Exchange, Inc., 1990. (136 pp.) $15.95 (paperback). Theoretical and applied writing about the treatment of couples has lagged behind that concerning the treatment of individuals and families (Nichols & Everett, 1986). In writing Cognitive Therapy with Couples, Dattilio and Padesky make a significant contribution to the application of Cognitive Therapy to the field of couples counseling. Because the cognitive aspects of a couple's interactive style are of interest to therapists from varied theoretical persuasions, the book will be of interest to a broad array of practitioners and students. The book begins with a brief overview of Cognitive Therapy as developed by Aaron T. Beck (Beck, 1976,1988). Although the chapter on cognitive theory is brief, it is sufficient to provide the reader with enough amplification of the model to understand the theory-application-connection described in the assessment and the techniques sections of the book. The second chapter builds on the cognitive model presented in the first chapter by illuminating three aspects of Cognitive Therapy and their application to working with couples. These include: the modification of unrealistic marital expectations; the correction of faulty attribution of blame for problems in their relationship; and the use of self-instruction to decrease dysfunctional interaction in the relationship. In Chapters 3 and 4, the authors turn their attention to the application of Cognitive Therapy in working with couples. In Chapter 3 the process and procedures for assessing a couple's problems from a cognitive perspective are explained. Particular attention is given to identifying problem areas and the automatic thoughts and underlying beliefs that support the problems. Recognition is given to the role families of origin play in shaping the central myths couples hold in their relationship. In Chapter 4, the heart of the book, the techniques of change applicable to cognitive work with couples are defined and illustrated through case examples. These techniques range from teaching couples pertinent aspects of the cognitive model and how to identify cognitive distortions in their relationship to more change-oriented interventions; i.e., imagery, dispelling automatic thoughts, increasing positive aspects of the relationship and improving the nature of communication within the relationship. Several specific interventions that may be used under each of these broad headings are provided. Chapter 5 addresses the process issues of working with a couple over the course of therapy. Topics such as frequency of sessions, conjoint versus individual sessions, use of homework and the solidification of therapeutic gain are discussed. In Chapter 6 the authors consider how to address, from a cognitive perspective, special circumstances that occur frequently in therapy with couples. Eight special circumstances are discussed and include: crisis; violence; infidelity; differential desires for continuance of the marriage; couple's therapy when there is a psychiatric disorder present; cultural issues; and therapy with gay and lesbian couples. Finally, a case study is provided that illustrates the assessment process, specific cognitively based interventions, and the stages of therapy. Specific attention is given to identifying the automatic thoughts of each spouse and the challenging of these thoughts through the development of alternative thoughts. …