Couple Therapy Research Articles

Dyadic Alliance Development Over the First Six Couple Therapy Sessions: The Roleof Relationship Adjustment, Symptom Distress, and Attachment

Dyadic Alliance Development Over the First Six Couple Therapy Sessions: The Roleof Relationship Adjustment, Symptom Distress, and Attachment

Evaluating Experimental Studies in Couple Therapy: Some Implications for Assessment and Best Practices

This article is written to help therapists who are not clinical researchers assess the quality of experimental studies that are designed to compare the relative merits of different approaches to treating distressed couples. To illustrate some of the major difficulties encountered in conducting comparative research with couples (instrumentation, pretreatment assessment, internal validity, external validity, reliability of treatments, outcome evaluation, etc.) hypothetical examples are presented. Suggestions for addressing some of the salient methodological issues identified in the article and implications for determining best practices are offered for consideration.

Measuring the dynamics of grace at work

ABSTRACT Long studied in religious traditions, grace has also been explored in psychology and in contexts as diverse as marriage counseling, psychotherapy, and anthropology. We establish that most of the Dimensions of Grace Scales (DGS) work well, with some adjustments, in a religiously diverse group of employees from a variety of work organizations. We develop and refine three measures: grace from bosses, grace from co-workers, and respondents’ own grace-giving practice. We establish an initial nomological net for the construct of grace in the workplace, drawing on aspects of the DGS, grace from co-workers, grace from bosses, and grace-giving, along with trait kindness and forgiveness. We identify several relationships between this group of constructs and thriving at work (both vitality and learning), job satisfaction and intent to quit. The model suggests a workplace climate of grace is both life-giving and likely related to organizational performance.

Attachment Orientations: Associations with Romantic Partners’ Self-Regulation and Dyadic Coping

The ability to effectively cope with stress is impacted by early relationship experiences and, thus, is related to attachment security. We examined how different forms of attachment insecurity (namely, attachment anxiety and attachment avoidance) impact romantic partners’ capacity for coping with stress individually (via self-regulation) and together (via dyadic coping) in a community sample of 261 heterosexual couples. We also explored links between these coping strategies and measures of well-being. Multiple regression analyses in this cross-sectional, self-report study indicated that attachment avoidance, but not anxiety, was linked to less effective dyadic coping. In men, this was also the case for partner’s attachment avoidance. Attachment anxiety, but not avoidance, was related to self-regulation problems for women, while in men, both facets of attachment insecurity were negatively associated with self-regulation. Individual and dyadic coping strategies each uniquely contributed to individuals’ well-being and satisfaction with life. Relationship interventions and counseling processes might benefit from sensitizing clients for biographical influences on their coping strategies.

Toward a culturally sensitive application of Emotionally Focused Couples Therapy: A qualitative study of therapists' experience using EFT in Spanish-speaking countries/cultures.

The purpose of the current study was to identify specific ways Emotionally Focused Couples Therapy (EFT; S. Johnson) could be adapted to better meet the needs of clients in Spanish-speaking countries throughout Europe and the Americas. The results were drawn from responses to a qualitative questionnaire regarding the experiences of learning and applying EFT; 103 therapists in 12 different countries where Spanish is spoken responded to the survey. Overall, the results suggest that the therapists surveyed consider EFT to be a "good fit" for many Spanish-speaking clients because of its focus on emotion, attachment theory, close interpersonal relationships, and model-specific interventions that match cultural values. Participants suggested a few culture-specific modifications regarding how to access and process emotion with men in therapy, translation of key EFT concepts and phrases into Spanish, and navigating the intersection of two cultural values (respeto and personalismo). Fewer modifications were suggested by therapists as they discussed application of the model than while learning it.

Relationship between Quality of Marriages, Marital Counseling and Management of Oral Lesions among Married Female Worshippers attending Religious Worship Centers in South Western Population in Nigeria.

BACKGROUND/ AIMS AND OBJECTIVES
 Quality of marriage is a strong indicator of human health. Happily married people tend to show signs of better health when compared to the unmarried. Women in unhappy homes are under chronic stress, they show impaired social behavior, mental stress disorders and cardiovascular diseases. Information on the effects of marriage on oral health is very scanty despite the huge influence of oral health care on the quality of life. 
 METHODOLODY
 This is a longitudinal designed study of female religious worshippers in a south western state of Nigeria. Religious Worship Centres (RWCs) were selected at random in the city. Married females in the selected RWCs were contacted through their leaders on the scheduled date. They were offered health education and were asked to complete a structured questionnaire on their oral health and quality of their marriages. Extra oral and intra oral examination were carried out and the findings recorded. Scaling and polishing, marital counseling with emphasis on the needs to maintain quality marriages, and appropriate routine dental treatments were delivered to all participants. Data analysis was done with STATA 16 software. Relationship between frequency of oral lesions before and after intervention was analyzed for using ttest, p >0.01.
 RESULTS
 A total of 113 married female religious worshippers participated in the study. Their mean age was 57.9 years SD 12.8. Majority (101, 92%) currently reside with their husbands, 2(2%) divorced and 7% widowed. 81 (71.7%) had good quality of marriages while 32 (28.3%) had poor quality of marriages. Oral lesions seen before intervention are periodontitis (30, 26.5%), xerostomia (25, 22.1%), mouth odour (22, 19.1%) and Orofacial/TMJ pain (27, 23.3%). Lesions are significantly more prevalent among those with poor quality of marriages. After intervention the prevalence of mouth odour, periodontitis, xerostomia and extra marital romantic relationship reduced significantly by 82% (p=0.04), 53% (p=0.001), 76% (p=0.001) and 89 %( p=0.024) respectively.
 CONSCLUSION
 One third of married, self employed women in their fifth decade of life had poor quality of marriages. Oral lesions are more prevalent among married women with poor quality of marriage and they also have 94.4% chance of getting involved in extra marital romantic relationship. Significant oral lessons were mouth odour, Orofacial pain, xerostomia and periodontitis. Treatment of oral lesions coupled with marital counseling significantly reduced the prevalence of oral lesions and enhanced their marital life.
 Key words: Quality

The Positive Relational Couples Therapy Model: A Group Therapeutic Approach for LGBTQIA+ Military Couples

Given the history of discrimination and increased mental health risks surrounding LGBTQIA+ service members, group counseling is a practical approach for practitioners to mitigate effects in a therapeutic setting. This article synthesizes the Positive Relational Couples Therapy (PRCT) model, incorporating concepts of the Multicultural and Social Justice Counseling Competencies (MSJCC), Relational-Cultural Theory (RCT), the PERMA model, and Gottman's Method Couples Therapy as a group process to provide a conceptual framework. An outline of the PRCT model and case illustration are provided for practitioners for group counseling with LGBTQIA+ military couples. Practical group considerations and implications for this work are discussed.

Counselor Educator- and Student-Produced Podcasts: Technical Considerations and Educational Applications for Marriage and Family Counseling Courses

Podcasts continue to grow in popularity and availability. Recent advances in podcast mobile apps and recording technology have simplified the process for producing high quality podcast content. Consequently, the popularity of podcasts and the ease with which they can now be produced offer counselor educators and students a breadth of opportunities for recording and integrating their own podcasts within marriage and family counseling courses. This article provides an overview of basic podcast technology and recording methods, proposes a variety of educational applications, and offers suggestions for future research.

Amelia and the Patel Family: Helping Parents of Boomerang Children Shift from Stressors to Strengths

Increasingly, adults between the ages of 20 and 35 are living with their parent or parents for extended periods of time. This phenomenon, commonly referred to as “boomerang child coresidence,” poses a range of benefits and challenges for families. The authors of this article consulted an expert about boomerang child coresidence to identify ethical dilemmas family counselors may encounter as they work with families experiencing boomerang child coresidence. In this article, the authors wrote a fictional case study incorporating intersectional issues related to a family with a boomerang family member and then asked an expert to respond to questions about the case study. The respondent to this case study highlights key ethical, cultural, and systemic considerations, and provides recommendations for couples and family counselors to apply the International Association of Marriage and Family Counselors Code of Ethics in their work with parents of boomerang children.

Case of Marital Therapy Using I-ATTACH: An Indian Model of Marital Therapy Intervention

ABSTRACT The following case study demonstrates the potential of a culturally sensitive, integrated model of marital therapy intervention designed and developed using data from and research done in India. This integrated approach utilizes humanistic-existential approaches as the base frame of reference and techniques from the approaches falling within the theoretical frame of systemic and social constructionist approaches have been assimilated into it. The model is called the Indian model for Attunement To Tackle Active Conflict And Helplessness with married couples (I-ATTACH). This case demonstrates the application of the approach with a couple married for 2 years who saw an escalation of marital problems leading to talks of separation post the birth of their child 6 months ago. The couple completed both pre-treatment and post-treatment assessment measures that included a self-reported standardized questionnaire, a 5 point scaled questionnaire designed by the authors and a semi-structured questionnaire to assess for the couple’s assessment regarding the effectiveness of the intervention. After the pre-treatment assessment, the couple engaged in 16 joint and 2 individual intervention sessions of I-ATTACH. A description of the model and the stage-wise progress of the couple is discussed and the assessment data presented for both pre-treatment and post-treatment.

Looking Back and Venturing Forth: Perspectives in Marriage and Family Counseling From a Content Analysis of The Family Journal

The Family Journal is a quarterly peer-reviewed professional journal that has undergone substantial changes in the last three years. A content analysis of the first 13 years of the journal (Southern, 2006) provided a context for understanding changes over time. The preliminary results of a pilot content analysis for 2023 (Volume 31, Issues 1–4) identified types and subtypes of published articles as well as categories, subcategories, and domains. The pilot testing refined categories and raised important issues for the ongoing content analysis. One of the major challenges involves the proliferation of international manuscripts and quantitative research designs. The mission of the journal is to balance theory, research, and practice for the predominantly clinical readership. The review concludes with some guiding questions for ongoing research and practice in marriage and family counseling.

Strategi Komunikasi Kementerian Agama Kota Bengkulu Mencegah Stunting melalui Bimbingan Perkawinan Kepada Calon Pengantin

The Government of the Republic of Indonesia through Presidential Regulation Number 72 of 2021 has designated prospective brides (catin) as one of the targets for accelerating stunting reduction from the upstream sector in order to achieve a quality generation of the nation. One of the roles carried out by the Ministry of Religion of the Republic of Indonesia is by preventing stunting through marriage guidance to prospective brides and grooms (Bimwin Catin). As a vertical agency at the Regency/City level, the Bengkulu City Ministry of Religion also provides marriage guidance to prospective brides and grooms (Bimwin Catin). The aim of this research is to find out the communication strategies used by the Bengkulu City Ministry of Religion to prevent stunting through marriage guidance to prospective brides and grooms in 2022. The research uses a qualitative approach through case studies. Data collection techniques used were observation, in-depth interviews and documentation. Researchers used communication strategy steps from Hafied Cangara (2014), consisting of selecting and determining communicators, setting targets and analyzing audience needs, techniques for composing messages, choosing media/communication channels, and analyzing communication effects. The results of this research are (1) The Bengkulu City Ministry of Religion prioritizes State Civil Apparatus (ASN) who have a Bimwin facilitator certificate as communicators, (2) Prospective brides and grooms are the target audience with a need for an audience of 500 people in 2022, (3) The City Ministry of Religion Bengkulu uses persuasive techniques in compiling and conveying messages to the prospective bride and groom, (4) the Ministry of Religion of Bengkulu City chooses public communication channels in the form of socialization in holding Bimwin Catin, (5) the Ministry of Religion of Bengkulu City receives a positive response where the prospective bride and groom experience a change in attitude after receiving information related to stunting

Enhancing Interpersonal Communication in Couples With Special Needs Children: An Examination of Behavioral Couple Therapy Interventions

This case report aims to report the handling of cases of ineffective communication between husband and wife in families who have children with special needs. The problem that arises in this family is the problem of ineffective communication. This problem causes disharmony within the family which has an impact on children with special needs. Participants were husband and wife who had been married for 40 years. The husband works as a casual laborer and the wife is a housewife. The methods used are interviews and observation as an assessment as well as behavioral couple therapy intervention with behavior exchange techniques and communication skills training as an effort to overcome husband–wife communication problems. The results of the intervention showed that previously ineffective communication had changed to become more effective. Changes in communication make husband and wife closer. Wives begin to serve their husbands, such as preparing food and other household needs as well as dividing the tasks of caring for children. Husbands also started to work more diligently, and wanted to eat their wives’ cooking which they previously didn’t want to do. In conclusion, behavioral couples therapy can overcome the problem of ineffective communication between husband and wife. This finding is interesting because post-covid family problems are still common and can reduce the quality of a couple’s relationship.
 Keywords: aversive communication, behavoral couple therapy, couple

Support Seeking Tactics Used by Family Caregivers of Relatives With Dementia: Influences on Network Support and Caregiving Burden

Social support for family members who care for a relative with dementia can mitigate caregiving burden. Yet, in that evidence points to these caretakers as often experiencing isolation and loneliness while providing dementia-related care, a need remains to better understand factors contributing to their adverse support experiences. Accordingly, this study applies sensitive interaction systems theory (SIST) to examine how caregivers’ direct versus indirect support-seeking behaviors relate to the quality of support responses they receive from a member of their social network. Associations between network support responses and caregiving burden are also investigated. Family caregivers ( n = 411) completed a Qualtrics survey. Results from path analysis indicated that family caregivers’ direct support seeking was related to supportive responses from a network member, while their indirect tactics to gain assistance predicted unsupportive reactions. Supportive and unsupportive network responses to family caregivers' support seeking were both related to greater caregiving burden. Additionally, indirect support seeking predicted greater caregiving burden, while this relationship was also partially mediated by unsupportive network responses. Findings highlight the utility of marriage and family counseling efforts to help family caregivers identify and practice strategies for communicating their varying dementia-care support needs to others while also managing unconstructive responses shared within their social network. Caregivers may additionally benefit from counseling to help them to develop coping skills beyond support seeking.

Exploring Intervention with South Asian Women in the United States Experiencing Domestic Violence

ABSTRACT Purpose The current study reports intervention from the perspective of abused South Asian women in the United States (U.S.) aligning with the Center for Disease Control (CDC’s) ecological model. Material and Methods In-depth telephonic interviews were conducted with a convenience sample of 20 South Asian women in the U.S. The interviews were analyzed using thematic analysis. Results Utilizing the CDC’s ecological model, the following themes emerged for prevention at the individual level: walk away the first-time abuse occurred; at the relationship level: pre-marital counseling and at the societal level: act on the red flags before the wedding, address the stringent gender roles, socialization, and blame. For protection, the following themes emerged at the individual level: self-determination and strength, protection of children, and financial independence. At the relationship level, the theme of marital counseling emerged and at the community level, the theme of community resources emerged. Discussion The South Asian natal family or family members in positions of power can recognize red flags, raise their voice, take constructive action to address misogyny, rigid patriarchal attitudes, and prevent abuse before it occurs. Conclusion There is an urgent need to recognize and work at both preventative and protective levels to address the abuse among South Asian women in the U.S.

Marriage Counseling in the Religious Institutions of Bosnia and Herzegovina

Cilj je rada predstaviti bračno savjetovanje u vjerskim ustanovama u Bosni i Hercegovini. Koristeći polustrukturirane intervjue, u radu su predstavljena iskustva teologa radi uvida u izazove i probleme s kojima se suočavaju supružnici. Iskustva teologa i stručnjaka u vjerskim ustanovama predstavljena u radu mogu doprinijeti boljemu razumijevanju novonastalih promjena u bračnim odnosima i važna su karika u planiranju djelovanja usmjerenih na očuvanje bosanskohercegovačke obitelji.

KONSEP KEKUDUSAN MENURUT IMAMAT 18 DAN IMPLIKASINYA TERHADAP KONSELING PRANIKAH KAUM MUDA DI GEREJA BETHEL INDONESIA TABGHA BATAM CENTER

Pre-marital counseling is an activity held for unmarried parties, in connection with their wedding plans. These parties come to the counselor to make their decisions so that they are more stable and can make better adjustments in the future. Marriage counseling or what is commonly called marriage counseling is an effort to help the prospective bride and groom. Marriage counseling is carried out by professional counselors. The goal is that they can develop and be able to solve the problems they face through ways of mutual respect, tolerance, and communication, in order to achieve family motivation, development, independence, and the welfare of all family members.
 The purpose of personal counseling specifically has the main and foremost goal in mentoring, namely introducing the counselee to Jesus Christ with the power of the Holy Spirit and the grace of God and helping the counselee to become like Christ. This counseling is a service process so that the counselee has a life change and experiences recovery from the intervention of the Holy Spirit and accepts the Lord Jesus as a personal Savior so that the counselee lives and grows in a better spirituality.
 This service can be done by a counselor or a servant of God to help church members free from dark powers. Through this counseling service, the counselor will check the personal acceptance of Jesus; confession to God; ask forgiveness from God; deliverance prayer service; convinced of a new identity in Christ. Discipleship ministry (follow up) is very important for people who have just been released from the bonds of dark power. The strategy that the church must do is to make disciples or guide personally so that the counselee knows more about Jesus and grows more in Jesus Christ.
 Holiness is a state or quality of being holy. Holiness is a sign of a believer's spiritual life that must be continuously strived for, including ethical behavior. The Christian life and holiness are an inseparable unity in the believer. God's holiness has a lot to do with the people He chooses. Election/covenant is a unique expression of God's holiness. Because God is holy, God also requires His people to live holy lives (Leviticus 11:44). God shows His holiness in His actions for the salvation of the people He has chosen (Num. 20:13).

Emotionally Focused Couple Therapy with a Late-Life Couple: From Despair to Integrity

This commentary discusses the therapy of "Alice" and "Steve," a late-life married couple using Emotionally Focused Couple Therapy (EFCT) with a special emphasis on navigating Erik Erikson’s final psychosocial stage, that of Integrity vs. Despair. The support and validation offered the couple by a university-based student clinician allowed the couple to rewrite the narrative of their relationship in ways that helped them connect and be present for each other in a time of illness and impending loss. Implications for the benefits of teletherapy for expanding access are discussed.

Reflecting on the Themes of Aging, Caregiving, Narrative, and Multiculturalism in the EFCT Case of "Alice" and "Steve"'

In this article, I respond to commentaries by Drs. Karen Skean and Elisabeth Brown (2024), and by Dr. Shalonda Kelly (2024) on my presentation of the case of "Alice" and "Steve" (Mendelson, 2024), a later-life couple I treated using Emotionally Focused Couple Therapy (EFCT). Skean and Brown (2024) meaningfully address the role of EFCT in redefining a relationship narrative within the contexts of caregiving, illness, and loss, drawing from Erik Erikson’s final psychosocial stage of integrity vs. despair and highlighting the benefits of teletherapy for broader access. Kelly (2024) thoughtfully acknowledges both the possibilities and limitations of integrating EFCT and multiculturalism in treating diverse couples, noting areas where the therapist can bridge differences in partners’ worldviews; power; experiences and contexts; and felt sense of distance. In the following response, I reflect on their emotionally and intellectually compelling commentaries and offer feedback to foster discussion on the adaptation of EFCT to work within our clients’ unique generational and cultural frameworks.

The Successful Integration of Emotionally Focused Couple Therapy (EFCT) and Multicultural Theory: Drew Mendelson’s Psychotherapy with "Alice" and "Steve"

In reading Drew Mendelson’s case study, I am inspired and hopeful about the possibilities for our field to address diversity. Although there are many things to admire and discuss about Mendelson’s work, and many implications that it has for clinicians, I am choosing to focus this commentary solely on aspects of diversity, something that Mendelson clearly thinks and cares about, and something that the field is still learning how to integrate into treatment. I will discuss how Mendelson shared his knowledge of the challenges that later-life couples face, recognizing age as an aspect of diversity that needs more attention. Then I will discuss the couple that Mendelson treated and analyze how Mendelson used cultural competence to assess the role of diversity in their lives and to bridge differences between him and the couple and between the two partners. Given that Mendelson used Emotionally Focused Couple Therapy (EFCT) with this case, I will review the aspects of EFCT that appear to be quite useful for working with diverse couples, as well as a set of fatal flaws that hinder the ability of EFCT and other Western treatments to address diversity fully. Based upon those observations, I conclude with the reasons why I believe that Mendelson successfully integrated EFCT and multiculturalism to tailor treatment to the couple, "Alice" and "Steve."