Principles of Marital Therapy Midterm

Created by cmatzenb 

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Purpose for Pre-Marital Counseling

Stimulate DISCUSSION about the couple's relationship
Identify and build relationship STRENGTHS
Identify and resolve relationship GROWTH areas
Teach EFFECTIVE relationship SKILLS
Empower Couples to turn stumbling blocks into STEPPING STONES

Nearly __________ of currently married individuals reported some sort of premarital education experience.

one-third (31%)

The percentage of individuals who received premarital education has increased from ____ in the 1960s, to ______ in the 1980s, and _____ in the recent period.

22%
32%
44%

Premarital education is associated with roughly a _____ decline in the odds of divorce for the couple.

30%

Common Topics of Premarital Education/Counseling

1. Communication/Conflict Resolution
2. Financial
3. Expectations
4. Religious Beliefs
5. Sexual Dynamic
6. Parenting/Kids
7. Family of Origin
8. Boundaries (family of origin, etc.)
9. Future/Goals
10. Differences
11. Commitment
12. Roles/Household Responsibilities
13. Free Time
14. Baggage

How does CBCT define a "healthy relationship?"

• One that contributes to the growth, development, well-being, and needs fulfillment of each partner.

• One in which both partners contribute to the well-being of the relationship as a unit.

• One in which the partners have positive connections to their physical and social environment

• Can be distinguished by the couple's ability to adapt to changing demands and constraints

What is an "unhealthy relationship" in CBCT?

• Characterized by a scarcity of positive outcomes available for each partner and deficits in communication and problem solving skills.

• Differences in individual and relational needs:
i. Relationship-focused needs
ii. Autonomy
iii. Control
iv. Achievement

• Primary distress - distress resulting from unmet fundamental needs

• Secondary distress - result from partners' use of maladaptive strategies in response to primary distress

Integrative Behavioral Couple Therapy (IBCT) History

o It was started as Traditional Behavioral Couple Therapy (TBCT), but they realized it needed an additional component of acceptance to be effective.

Integrative Behavioral Couple Therapy (IBCT) Founders(s)

Neil Jacobson
Andrew Christensen

Integrative Behavioral Couple Therapy (IBCT) Technique Categories

acceptance strategies
tolerance strategies
change strategies

o Primarily the therapist will use acceptance strategies.
 If a couple appears to be stuck the therapist may then use tolerance strategies to help them move on.
 Often acceptance and tolerance strategies will bring about the changes the couple is looking for without having to use a specific change strategy.

Object Relations Couple Therapy Primary Ideas/Theory

In a mutual reciprocal process, husband & wife connect according to unconscious complementarity of object relations.

 Projection - wife sees in spouse qualities (whether true or not) denied or overvalued in her self

 Projective identification - spouse may or may not identify with projection

o Concordant identification - identify with projected part of wife's self

o Complementary identification- identify with object that applies to that part of wife self

 Healing potential lies in the gap between the original and new object processes

 Containment - spouse accepting projection, temporarily identifying with it, modifying it, and returning it to wife in a detoxified form

o No containment - growth is blocked.

 Introjective identification - wife receives modified version of herself and assimilates her view of self to it.

o Grows in capacity to distinguish self and other.

 Simultaneously wife is receiving spouse's projections and returning them to him

Object Relations Couple Therapy Goals

• To recognize and rework the couple's mutual projective and introjective identifications.

• To improve the couple's contextual holding capacity so that the partners can provide for each other's needs for attachment and autonomy, and developmental progression.

• To recover the centered holding relationship that allows for unconscious communication between the spouses, shown in their capacity for empathy, intimacy, and sexuality.

• To promote individuation of the spouses and differentiation of needs including the need for individual therapy or psychoanalysis.

• To return the couple with confidence to the tasks of the current developmental stage in the couple's life cycle.

Transgenerational Couple Therapy Differentiation Definition

The ability to experience difference, the self as separate although in relation to everyone else.

Narrative Couples Therapy Founder(s)

Michael White
David Epston (based his work on Bateson's)

Narrative Couples Therapy Role of Therapist

Facilitate relevant and focused conversations/progress through questions, reflection, etc.

Externalize the problem. Help couples understand that they are not the problem. The problem is the problem.

Narrative Couples Therapy Goals

Rather than setting "goals", which can be limiting, narrative therapy helps people live out "stories" in their lives that are beneficial/satisfying to their life.

"Goal setting" in narrative therapy is referred to as "projects" or "directions in life" in order to think about the possibilities that could happen in ones "story" of life.

Solution-Focused Couple Therapy Founder(s)

• Steve de Shazer
• Insoo Kim Berg

Solution-Focused Couple Therapy Primary Ideas/Theory

• Steve de Shazer viewed Solution-Focused Therapy as more of an explanation of a specific way to talk with clients rather than a theory.

• Present-Future Focused

• Use language to help client change their perceptions which they believe will change their behavior. (Focus on what they want rather what they don't want)

Solution-Focused Couple Therapy Techniques

• "Focuses on collaborative conversations between clients and therapist rather than therapists doing something to the clients." (Therapist does not take the expert role.)

• Questions that "invite clients to organize and focus their attention, energy, and understanding" toward a solution rather than problem. (ex. Miracle question, exceptions, scaling)

Brief Strategic Couple Therapy Founder(s)

Richard Fisch
John Weakland
Paul Watzlawick
their colleagues at the MRI

Brief Strategic Couple Therapy Roles of the Therapist

- The essential role is to persuade at least one participant in the couple to do "less of the same" solution that keeps the complaint going.

- The therapist works with the "customer," or person most concerned about the problem. They might not even work with the resistant spouse, for the sake of preserving maneuverability.

- Therapist keeps control, while rarely exerting control directly with authoritative prescriptions or an expert role. Rather, taking a "one-down" stance is common, listening with an empathetic curiosity. This promotes client cooperation.

- Avoid client apprehension and resistance by conveying that only the clients can decide whether and when to change.

Brief Strategic Couple Therapy Techniques

- Framing suggestions in terms compatible with clients' own language and metaphor

- Telling the client to go slow
- Going slow comes from the idea that clients are more likely to cooperate with small suggestions, and it relaxes the sense of urgency that would fuel the problem- maintaining solution efforts.

- Cautioning them about the dangers of improvement

- Making a U-turn

- Giving instructions about how to make the problem worse.

- Prescribe the symptoms, getting clients' to see how their responses feed into one another. This also interrupts the cycle's heaviness and seriousness.

- Help couples reevaluate the problem as "no problem", or as something they can live with. This is often done through reframing.

Structural Couple Therapy Founder(s)

Salvador Minuchin

Structural Couple Therapy View of Couple

family subsystem

Structural Couple Therapy Functional Couple

•Boundary that is rigid enough to define them as a couple, but permeable enough to allow for adaptive exchange with environment

• Tolerate and encourage partners differences

• View differences as a resource instead of a threat

Structural Couple Therapy Dysfunctional Couple

• Boundary that is diffuse or rigid.

• Does not behave as subsystem, but as a world of their own, resulting in functional and emotional overload

• Differences are either not tolerated, or become warring positions, which deprives couple of resources.

Integrative Couple Therapy (ICT) Problem Development

o Marital dysfunction springs from both partners' inability to see themselves and each other as whole persons; conflict prevents awareness of anxiety towards relational intimacy

o Conflict happens when the rules of the relationship which are vital to either person's sense of self are infringed upon; couples try to fix their problems through implicit behavior modification

My Model of Choice So Far and How I Would Use Theories/Principles/Techniques

Solution Focused Therapy
• Focus on Solutions rather than problems
• Do not believe that it is always necessary to understand the problem in order to find a solution
• Present-Future Focused
• "Focuses on collaborative conversations between clients and therapist rather than therapists doing something to the clients." (p. 265) (Therapist does not take the expert role.)
• Questions that "invite clients to organize and focus their attention, energy, and understanding" toward a solution rather than problem. (p. 265) (ex. Miracle question, exceptions, scaling)

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