Sessions Of Couple Therapy Research Articles

The Added Value of Studying Embodied Responses in Couple Therapy Research: A Case Study.

This article reports on the added value of embodied responses identified through sympathetic nervous system (SNS) activity in couple therapy research. It focuses on moments of change and the timing of therapeutic interventions or therapeutic moves in a couple therapy session. The data for this single-case study comprise couple therapy process videotapes recorded in a multi-camera setting, and measurements of participants' SNS activity. The voluntary participants were a marital couple in their late thirties and two middle-aged male psychotherapists. The division into topic segments showed how the key issue of seeking help, which was found to comprise three separate components, was repeatedly dealt with in the session. SNS activity showed different degrees of synchronization between the couple, between the therapists, and between the couple and therapists during the dialogue pertaining to these three components. The issue of timing emerged as a complex, even ambivalent, phenomenon. Arousal in the therapists was in line with their therapeutic activity, whereas in the clients it was more anticipatory. The approach used here rendered visible some of the intensity that therapeutic dialogue can generate when dealing with issues of relationship change in the couple context and showed how this intensity can be dialogically regulated in the therapeutic system.

Constructing Unfinalizability: A Subject Positioning Analysis of a Couple's Therapy Session Hosted by Tom Andersen.

The notion of subject positions is a useful tool in thinking through therapeutic interactions. In this article, I discuss positioning as an everyday phenomenon, and highlight the relational and social power dynamics that shape the subject positions persons may inhabit. Analysis is presented of the positional dynamics that play out in the couple's therapy session facilitated by Tom Andersen. Analysis suggests that Andersen adopts a not-knowing, uncertain, and curious position, while constructing the couple as competent, unfinalizable persons able to negotiate the choice-points that arise in front of them. However, if subject positions are grounded in social power dynamics, the session leaves a particular question unanswered: How will these emergent positions take hold outside of the consulting room?

Humor as interactional affordances: an ecological perspective on humor in social interaction

AbstractIn adopting new theoretical advancements within linguistics and ecological psychology, this paper investigates humor from an ecological perspective in naturally occurring social interaction. In doing so, it is claimed that the notions of language as coordination and values-realizing can provide a new understanding of humor as it appears in human interaction. This argument will be unfolded as a rethinking of Wallace Chafe’s notion of nonseriousness (Chafe, 2007) that re-conceptualizes Chafe’s idea of a ‘mental state’ of nonseriousness in terms of interactional affordances and values realizing. This perspective is laid out in in-depth analyses of video recordings of two real-life examples from different settings: two siblings playing and a sequence from a couple-therapy session. It is claimed that both examples of interactional humor can be explained by re-conceptualizing humor as a distinct way of being together. Thus, the emergence of humor is enabled by a shift in the coordinative dynamics rather than by a transfer of semantic ‘content’ from a speaker to a hearer. Finally, humor is investigated as a temporal phenomenon integrating immediate ’here-and-now’ environmental features with socio-cultural expectations on a longer time-scale. In this way humor is viewed as a particular type of values-realizing activity that constrains our actions, re-directs our attention, and thereby enables us to act in a more playful and joyous manner.

A multivariate dynamic systems model for psychotherapy with more than one client.

The dynamics of the give and take between therapist and client(s) is frequently of interest to therapy process researchers. Characterizing the ways that therapists respond to clients and clients respond to therapists can be challenging in therapeutic encounters involving a single therapist and a single client. The complexity of this challenge increases as the number of people involved in a therapeutic encounter increases not only because there are more people responding to one another but also because the patterns of responding can become more complex. This manuscript demonstrates how dyadic cross-lagged panel models can be extended to psychotherapeutic encounters involving 3 people and used to test processes that exist between dyadic subsets of the larger group as well as the group as one cohesive unit. Three hundred seventy-nine talk turns of fundamental frequency from a couple therapy session were modeled using 3 dyadic cross-lagged panel models, and each individual's respiratory sinus arrhythmia (RSA) was treated as a moderator. Although the regression coefficients for each dyadic subset (e.g., therapist-husband) were nonsignificant, an eigenvalue/eigenvector decomposition of the regression coefficients from the 3 dyadic cross-lagged panel models suggests that interdependence exists at the level of the whole group (i.e., therapist-husband-wife) rather than between pairs of individuals within the group (e.g., husband-wife). Further, an interaction involving husband's RSA suggested that interdependence involving the husband ceased when the husband displayed greater regulatory effort. This combination of statistical methods allows for clearly distinguishing between dyadic therapeutic processes and group-level therapeutic processes. (PsycINFO Database Record

Comparing the effectiveness of the emotionally-focused couple therapy and the problem-centered systems therapy of the family on marital burnout in spouses of recovering addicts

Introduction: Marital burnout can be considered both an underlying factor for serious martial problems and a consequence of these problems. The present study was conducted to determine the effectiveness of the emotionally-focused couple therapy (EFCT) and the problem-centered systems therapy of the family (PCSTF) on marital burnout in spouses of recovering addicts. Methods: The present quasi-experimental study was conducted on 27 eligible couples as volunteers. After conducting the pretest using the couple burnout measure, the participants were randomly assigned to three groups of 9, including a control group, an EFCT experimental group and a PCSTF experimental group. The study couples then individually attended 11 couple therapy sessions based on PCSTF and EFCT models. Posttests were ultimately conducted and the data collected were analyzed using ANCOVA. Results: The results obtained indicated significant reductions in marital burnout in both the EFCT and the PCSTF models compared to in the control group, while the effects of the two models were not significantly different. Conclusion: Although these two different therapeutic approaches address different dimensions of married life, both cause reductions in marital burnout. Integrating these treatment methods of marital burnout therefore seems to be effective.

Método “Investigaciones Dialógicas de Cambio” para el análisis del Proceso Terapéutico: traducción y adaptación al idioma Español

Este artículo presenta la traducción y adaptación al idioma Español del método “Investigaciones Dialógicas de Cambio” (IDC). Este método se enmarca en el enfoque dialógico y en la aproximación del Diálogo Abierto (DA) para el tratamiento psicoterapéutico. Se revisan brevemente los principales conceptos del DA que nutren el método IDC y a continuación se presenta el método. Se analiza una sesión de terapia de pareja para mostrar cómo se aplica el método. Los resultados muestran un cambio en las posiciones y voces de los clientes en el proceso terapéutico. Así mismo, también se muestran las estrategias utilizadas por los terapeutas para generar diálogo y promover cambio en terapia. Finalmente, se revisan las aportaciones que este método puede generar para el análisis del proceso terapéutico.

Affective Arousal During Blaming in Couple Therapy: Combining Analyses of Verbal Discourse and Physiological Responses in Two Case Studies

Blaming one’s partner is common in couple therapy and such moral comment often evokes affective arousal. How people attune to each other as whole embodied beings is a current focus of interest in psychotherapy research. This study contributes to the literature by looking at attunement during critical moments in therapy interaction. Responses to blaming in verbal dialogue and at the level of the autonomic nervous system (ANS) were investigated in two couple therapy cases with a client couple and two therapists. Video-recorded couple therapy sessions were analyzed using discursive psychology and a narrative approach. The use of positioning, a discourse analytic tool, was also studied. ANS responses of the participants, including the therapists, were measured as electrodermal activity. The findings demonstrate how identity blaming, i.e. positioning the other person in ways counter to their preferred identity narrative, was accompanied by increased electrodermal activity in most participants. In the two cases studied, blaming centered on the themes of loyalty, trust and parenting. It is argued that identity blaming in these thematic domains increases the arousal level of the partners, since disloyalty, unfaithfulness and irresponsible parenting threaten the stability of the relationship.

Women with alcohol dependence: A randomized trial of couple versus individual plus couple therapy.

Couple therapy for women with alcohol use disorders (AUDs) yields positive drinking outcomes, but many women prefer individual to conjoint treatment. The present study compared conjoint cognitive-behavioral therapy (CBT) for women with AUDs to a blend of individual and conjoint therapy. Participants were 59 women with AUDs (95% Caucasian, mean age = 46 years) and their male partners randomly assigned to 12 sessions of Alcohol Behavioral Couple Therapy (ABCT) or to a blend of 5 individual CBT sessions and 7 sessions of ABCT (Blended-ABCT). Drinking and relationship satisfaction were assessed during and for 1-year posttreatment. Treatment conditions did not differ significantly on number of treatment sessions attended, percentage of drinking days (PDD), or percentage of heavy drinking days (PDH), during or in the 12 months following treatment. However, effect size estimates suggested a small to moderate effect of Blended-ABCT over ABCT in number of treatment sessions attended (d = -.41), and first- and second-half within treatment PDD (d = -.41, d = -.28), and PDH (d = -.46, d = -.38). Moderator analyses found that women lower in baseline sociotropy had lower PDH across treatment weeks 1-8 than in Blended-ABCT than ABCT and that women lower in self-efficacy had lower PDH during follow-up in Blended-ABCT than in ABCT. The 2 treatment groups did not differ significantly in within-treatment or posttreatment relationship satisfaction. Results suggest that blending individual and conjoint treatment yields similar or slightly better outcomes than ABCT, is responsive to women's expressed desire for individual sessions as part of their treatment, and decreases the challenges of scheduling conjoint sessions. (PsycINFO Database Record

Sympathetic Nervous System Synchrony in Couple Therapy.

The aim of this study was to test whether there is statistically significant sympathetic nervous system (SNS) synchrony between participants in couple therapy. To our knowledge, this is the first study to measure psychophysiological synchrony during therapy in a multiactor setting. The study focuses on electrodermal activity (EDA) in the second couple therapy session from 10 different cases (20 clients, 10 therapists working in pairs). The EDA concordance index was used as a measure of SNS synchrony between dyads, and synchrony was found in 85% of all the dyads. Surprisingly, co-therapists exhibited the highest levels of synchrony, whereas couples exhibited the lowest synchrony. The client-therapist synchrony was lower than that of the co-therapists, but higher than that of the couples. A Video Abstract is available next to the online version of this article on the JMFT web site.

The Pathological Gambler and his Spouse: How do their Narratives Match?

This case study compares the narratives of a pathological gambler and his spouse concerning family, marital and individual matters. It does so through identifying each of the key players' narratives individually (analysis of self-report questionnaires) and interactively (couples therapy sessions analysis). The results show that the gambler has a rather more positive view of gambling-related issues than does his spouse, and this fact is most apparent when it comes to marital and family issues. The gambler's perspective is less positive when it comes to non-relationship issues (financial and professional issues). A few hypotheses are put forward to explain these results and these are summarized in three effects: denial, idealization/guilt relief, and disappointment/retaliation. Some implications for clinical practice are also identified, such as the need to set therapy objectives which are truly shared by both members of the couple, as well as guidelines for future research, such as studies focused on gender differences.

Examining Attachment Avoidance and Attachment Anxiety Across Eight Sessions of Couple Therapy.

This study examined initial levels of attachment anxiety and avoidance, as well as their patterns of change, across eight sessions of couple therapy. Participants were 461 couples in a treatment-as-usual setting. Dyadic latent growth modeling was used to determine whether couples started therapy at similar levels of attachment anxiety and avoidance and whether attachment anxiety and avoidance changed. An actor partner interdependence model was used to see whether partner attachment anxiety was related to avoidance. Results showed relative stability of attachment anxiety and avoidance over the course of therapy, with the only change being a slight decline in attachment anxiety among women. Results showed that a person's attachment anxiety was not related to their partner's avoidance and vice versa.

A Contextual Analysis of High-Fidelity and Low-Fidelity Sessions in Emotion-Focused Couples Therapy

The purpose of this study was to explore and compare high-fidelity and low-fidelity Emotionally Focused Couples Therapy sessions across the course of treatment. Data were taken from sessions 3, 7, and 11 from two different couples. Grounded theory was used to identify emerging themes from the data. Further, a word frequency query was performed to understand the differences in language use. Results indicated that more primary emotion words were used in high-fidelity than low-fidelity sessions, while more cognitive words were used in the low-fidelity sessions. Different themes were found when comparing the high- and low-fidelity sessions and include primary focus and identifying the couples' cycle. Additional results and clinical implications are discussed.

Predicting premature termination with alliance at sessions 1 and 3: an exploratory study

Research has demonstrated that the therapeutic alliance is associated with termination status and treatment outcomes regardless of therapy models and the number of people involved in the treatment. Compared to individual therapy, however, relatively less attention has been paid to the therapeutic alliance as a predictor of premature termination of couple and family therapy. In the current study, videotape recordings of two samples of couples in therapy – one in the first session and the other in the third session – were analysed to examine the association between the therapeutic alliance and termination status. A total of 34 videotapes were analysed in this exploratory study. All the tapes were rated for the therapeutic alliance using the Vanderbilt therapeutic alliance scale, which allowed observers to code behaviour and interactions between couples and their therapist. The results of this study, though preliminary, suggested that the therapeutic alliance measured at the first session was more predictive of premature termination than was the alliance at the third session, which somewhat challenges findings from studies of individual psychotherapy.Practitioner points Assessing the therapeutic alliance in the first couple therapy session may be more important in predicting later premature termination than in the third session. In particular, new therapists in training may need to pay special attention to their alliance with clients from the very beginning of therapy.

Up and Down or Down and Up? The Process of Change in Constructive Couple Behavior during Traditional and Integrative Behavioral Couple Therapy

Observed positive and negative spouse behavior during sessions of Traditional (TBCT) and Integrative Behavioral Couples Therapy (IBCT) were compared for couples with successful outcomes and their unsuccessful counterparts. One hundred and thirty-four married chronically and seriously distressed couples (on average in their forties and 80% Caucasian) were randomly assigned to TBCT or IBCT. Trained observers made ratings of 1224 segments from approximately 956 sessions sampled from the course of up to 26 sessions. Multilevel modeling was used to examine change over time. TBCT treatment responders demonstrated a boost-drop pattern, increasing in constructive behaviors early (more positive behaviors and less negative behaviors) but decreasing later. IBCT responders demonstrated an opposite, drop-boost pattern, decreasing in constructive behaviors early and increasing later. Patterns were significant for positive behaviors (p < .05) and approached significance for negative behaviors (p = .05). In both treatments, nonresponders showed a significant pattern of decline in positive and increase in negative behaviors over time, although a trend (p = .05) indicates that TBCT nonresponders initially declined in negative behaviors. This study helps clarify the different process of change in two behavioral couple therapies, which may assist in treatment development and provide a guide for therapists in considering behavioral markers of change during treatment.

The Synergy of Concurrent Couple and Child Therapies Viewed Through the Lens of Link and Field Theories

This case discussion will explore the benefits of using a family treatment model in which a psychoanalytic couple therapy and an individual child therapy are conducted conjointly by the same clinician. This psychoanalyst will discuss the rationale for designing this treatment strategy for this particular family. This study will provide, at different phases of the treatment, samples of dream material, play narratives, and vignettes from the child therapy and the couple therapy sessions. Transference and countertransference elements will be discussed, with particular reference to exploring how the integration of these elements, in these separate but interrelated treatment contexts, can provide an enriched lens through which to consider treatment of the family as a whole. The case relates to link theory and analytic field concepts through an explication of the intergenerational and professional network implications of concurrent therapies.

“Ask the Person that Lived It. That Would Be Me.” A Discursive Therapy Approach to Countering Social Inequalities In a Couple's Therapy Session

Using a discursive therapy approach that draws heavily from collaborative therapy, the author of this article demonstrates how the therapist (author) used the interdependent philosophical assumptions of not-knowing, being public, and honoring a client's story as a means to counteracting social inequalities experienced by a biracial, court-directed couple presenting for therapy. This therapeutic approach is demonstrated within the context of four different dialogical interplays that occurred during the couple's second therapy session. The implications of clinical work with marginalized couples and families and for the family therapy profession are discussed.

The Shift from Monologue to Dialogue in a Couple Therapy Session: Dialogical Investigation of Change from the Therapists’ Point of View

As part of a larger research project on couple therapy for depression, this qualitative case study examines the nature of dialogue. Drawing on Bakhtinian concepts, the investigation shows how the conversation shifts from a monologue to dialogue. Among the findings are: first, the process of listening is integral to the transforming experience. That is, the careful listening of the therapist can evoke new voices, just as the experience of one of the partners' "listening in" to the conversation between the other partner and the therapist can create movement and new trajectories. The latter is a qualitative difference between dialogic therapy with a couple and that with an individual. Second, the therapist not only acts as creative listener, but as the dialogue unfolds, actively contributes to meaning-making. Third, the study upholds having a team of researchers as a polyphonic forum and the usefulness of Bakhtinian concepts in clinical research on dialogue in multi-actor sessions.

The Impact of Therapist Actions on the Balance of Power Within the Couple System: A Qualitative Analysis of Therapy Sessions

Power inequality is an important concern in couple therapy, yet little research addresses how therapists deal with this issue. This qualitative, grounded theory analysis of 21 transcripts of couple therapy sessions examined how therapist actions influenced the balance of power between partners in the moment to moment processes of therapy. The analysis identified five kinds of therapist actions that perpetuated power imbalances: (a) discounting the person in the one-down position, (b) allowing the one-up person to define the conversation, (c) reinforcing dominant person's negative comments about partner, (d) using professional privilege to assume experience of the one-down person, and (e) speaking as though the relationship was equal when it was not. Six other actions helped interrupt current power imbalances and encouraged more equal power: (a) using therapist voice to create balance, (b) creating space for one-down voice, (c) naming power discrepancies, (d) validating competence of the one-down person, (e) suggesting new options, and (f) encouraging powerful partner to shift to a relational perspective. The results help couple therapists develop greater sensitivity and awareness of the impact of their interventions on the power balance of the couple.

United We Stand: Emotionally Focused Therapy for Couples in the Treatment of Posttraumatic Stress Disorder

We present emotionally focused therapy (EFT) for couples as a viable treatment option for posttraumatic stress disorder (PTSD). We outline the empirical evidence of a link between interpersonal relationships and posttraumatic stress, with an emphasis on social support as a buffer for the development of PTSD symptoms. This leads into a discussion of the usefulness of attachment theory in the conceptualization and treatment of PTSD, followed by a description of the EFT approach and its empirical evidence. We present a clinical case with excerpts from EFT couple therapy sessions in which one partner was diagnosed with PTSD. The article concludes with clinical recommendations for helping people confront and overcome the pain and the fear that PTSD provokes.

Use of metaphors in Chinese family therapy: a qualitative study

The use of metaphors in family therapy has been extensively written about in western literature, yet very few studies on this subject have been conducted in China. The goal of this study was to summarize the metaphors used by Chinese family therapists. Transcriptions from 36 hours of video‐recorded family and couple therapy sessions from eighteen Chinese family patients were qualitatively analysed to identify categories of therapist‐produced metaphors that are applicable to the Chinese context. Two major categories emerged: verbal and non‐verbal metaphors. Verbal metaphors included four subgroups: story, object comparison, sayings and age. Nonverbal metaphors involved two subgroups: gesture and spatialization. The influence of the Chinese culture on the use of metaphor is discussed. This study adds to the greater understanding of how to integrate metaphors in therapy in the Chinese context.