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With the growing Muslim population in the United States, Islamophobia and discriminatory acts toward Muslims have been increasing. Negative images in the media, which have strengthened stereotypes about Islam, have affected Muslim individuals, couples, and families. Although the impact of islamophobia has been addressed for individuals, not enough attention has been paid to Muslim couples who experience discrimination due to their religious beliefs. Experience of harassment and negativity is likely to profoundly affect individuals’ couple and family relationships. This lack of research may leave mental health professionals unprepared to sufficiently help Muslim couples that encounter discrimination. Thus, the present study discusses Muslims and their experiences in the U. S. before considering important concerns about couple relationships for mental health professionals working with this population. The purpose is to provide guidance and possible strategies to assist couple therapists for culturally competent practice with Muslim couples.

Using concepts developed by Goffman and the theory of inter-corporeality, this paper describes non-speaking spouses' responses to complaints made about them by the other spouse in the context of couple therapy first consultations. While the turn-taking system of couple therapy effectively precludes the possibility of a direct verbal response, non-speaking spouses often display bodily their disengagement from their spouse's talk. Using multimodal conversation analysis as the method, we show the repertoire of such disengagement behaviors and trace the moment-by-moment contexts in which they arise. While disengagement behaviors embody their producer's inattention to their spouse's talk, at the same time, they are, paradoxically, interactional moves produced in the presence of others, conveying their producer's negative stance to the ongoing talk. We argue that the timing of these disengagement practices involves anticipation of the direction of talk: non-speaking spouses display disengagement in moments when the speaking spouse's talk takes a direction toward an intensification of complaints about them.

Despite evidence that empirically supported couple therapies improve marital relationships, relatively few couples seek help when they need it. Low-income couples are particularly unlikely to engage in relationship interventions despite being at greater risk for distress and dissolution than their higher-income counterparts. The present study aimed to clarify how premarital education influences couples' progression through different stages of later help-seeking, as identified in prior research. Using 5 waves of self-report data from a sample of 431 ethnically diverse newlywed couples living in low-income neighborhoods, analyses revealed that wives who received premarital education later considered seeking therapy at a higher level of relationship satisfaction and lower level of problem severity than those who did not receive premarital education, though this was not true for husbands. Wives who received premarital education were also more likely as newlyweds to say that they would seek therapy if their relationship was in trouble, though husbands were not. Spouses who considered seeking therapy were more likely to follow through with participation if they had received premarital education, whereas if they had not received premarital education they were more likely to consider seeking therapy without following through. Similarly, among couples who received therapy, those who also received premarital education sought therapy earlier than those who did not receive premarital education, though not at a higher level of relationship satisfaction. Taken together, these results suggest that participation in premarital education is linked with later help-seeking by empowering couples to take steps throughout their marriage to maintain their relationship. (PsycINFO Database Record

Background: Couple relationship distress is common and associated with poor physical, psychological, and relational outcomes for both partners. Emotionally Focused Therapy for couples (EFT) is a short-term structured approach based on attachment theory that integrates a humanistic, experiential approach to restructuring emotional experience and a systemic structural approach to restructuring interactions. This model has been shown to be an effective treatment for couple distress. The supporting research, however, has only been conducted with English-speaking couples. Despite Spanish being the second-most spoken language and meaningful cultural differences between English- and Spanish-speaking countries, the efficacy of EFT has not been examined in this cultural context. This study will examine the efficacy of EFT in this particular context and advance the understanding of potential mechanisms of change.Methods: We will use a multicenter randomized wait-list controlled design to examine the efficacy of EFT in a Spanish-speaking sample of moderately distressed couples. One hundred forty individuals in 70 couples in Argentina, Costa Rica, Guatemala, Mexico, and Spain will be randomly assigned to receive 19-21 sessions of EFT or be placed on a waitlist. Outcomes on a range of relational and individual mental health variables will be assessed prior to random assignment, throughout treatment, and at the conclusion of treatment. Primary outcomes will include dyadic adjustment, couple satisfaction, and attachment. Secondary variables, such as loneliness, parenting, affective communication, and sexual satisfaction, will be included as potential mediators of the treatment effect. Couples in the treatment group will also be assessed at 3-, 6-, 12-, 18-, and 24-month follow-ups. Process variables such as the therapeutic alliance will also be assessed routinely in couples assigned to the treatment group. Couples in the waitlist will receive a psycho-educational program based on EFT after completing the study.Discussion: This study will be the first RCT of Emotionally Focused Therapy in a Spanish-speaking context. The results of the study will inform researchers interested in whether treatments developed and tested in the USA and Canada can be effective in differing cultural contexts. It may also point researchers and clinicians to areas where cultural adaptation is needed to improve efficacy.Trial Registration: ClinicalTrials.gov NCT04277325. Registered on February 20, 2020. [ABSTRACT FROM AUTHOR]

Provoked vestibulodynia (PVD) is a chronic vulvovaginal pain condition affecting 8%–10% of women and is associated with negative sexual sequalae. Our randomized clinical trial comparing cognitive–behavioral couple therapy (CBCT) to a medical intervention (lidocaine) found that both treatments improved affected women's pain and both affected women's and partners' sexual outcomes, with CBCT demonstrating more benefits (Bergeron et al., 2021). The goal of this study was to examine two putative mediators of CBCT's treatment effects: collaborative and negative sexual communication patterns (SCPs). Women with PVD and their partners were randomly assigned to 12 weeks of CBCT (N = 53) or lidocaine (N = 55). Outcome measures (sexual satisfaction, function, and distress) were collected at pre-treatment, post-treatment, and 6-month follow-up, and in-treatment measures of the mediators were taken at Weeks 1, 4, 8, and 12 of treatment. Results showed that affected women's reports of improving collaborative communication mediated the effect of CBCT, but not lidocaine, on post-treatment sexual satisfaction (women with PVD and partners), sexual function (women with PVD), and sexual distress (women with PVD). For partners, collaborative communication improved equally in both treatments. Given that there were no differences in negative SCPs between the CBCT and lidocaine conditions, it was not possible to examine negative communication as a potential mediator. From the perspective of women with PVD, CBCT helped couples communicate about their sexual problems in more collaborative ways, which was in turn beneficial for improving the sexual well-being of both members of the couple. [ABSTRACT FROM AUTHOR]

Although minimization of blaming and denials of responsibility are key components of many approaches to couple therapy, there has been little attention paid to how partners absolve themselves of responsibility and counter attributions of blame. In this study, we used thematic analysis to examine 40 videorecorded sessions of couple therapy. The study shows that injuring partners denied responsibility for harm by shifting it to sources outside of themselves, thereby justifying their own actions and minimizing negative consequences. More subtle ways of deflecting responsibility—partial or qualified admission of fault—were also observed. The implications for couple therapy are discussed. [ABSTRACT FROM AUTHOR]

Relationship power, which refers to the ability to influence one's romantic partner, is an important organizing principle in the assessment and treatment of couples. Power imbalance is predictive of various dimensions of marital quality, which explains why it is often a central focus of couple therapy. Despite the importance of relationship power in couple therapy, assessing power in clinical settings has been hindered by the lack of a validated measure of power that has high clinical utility. Data from 640 married couples associated with the Flourishing Families Project were used to develop the Perceived Power Imbalance Scale by conducting exploratory factor analysis, confirmatory factor analysis, dyadic predictive validity analysis, and measurement equivalence analysis. Although power has been conceptualized as consisting of both outcome power and process power, results indicated that the final scale consisted of four items that only tapped aspects of process power. The scale demonstrated good reliability and was a significant predictor of marital quality, marital instability, and depression. [ABSTRACT FROM AUTHOR]

The aim of this paper is to empirically assess the reliability of the plan formulation method for couples, a procedure for formulating the case, planning, and monitoring the couple therapies according to control-mastery theory. We hypothesized that when couples are looking for couple therapy, they have an unconscious couple's plan for the therapy, which includes the couple's goals; the pathogenic beliefs that the partners want to disprove; the traumas from which these beliefs originated and that the partners want to master; the vicious relational circles that make the couple suffer and that the couple wants to break; the virtuous relational circles that are expressions of the couple's resources and that the couple wants to fuel; and the relational insights that may help the couple get better. Our study involved 15 couples treated by four experienced therapists. Four raters independently formulated each couple's plan based on the first three sessions following a standard procedure, and we calculated the intraclass correlation for pooled judges' ratings. For a subsample of three couples—who before and after treatment had completed the dyadic adjustment scale (DAS) and the outcome questionnaire-45.2 (OQ-45.2)—the compatibility of the therapists' interventions with the couples' and partners' plans was assessed. The relationship between the ratings of compatibility, DAS and OQ-45.2, was assessed. The results showed excellent interjudge reliability for each couple's plan formulation (average ICC = 0.82), attesting to the validity of the procedure; and preliminary data on the therapeutic process suggested that therapists' interventions compatible with couple's plans could help partners achieve good outcomes. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder is among the most pervasive substance use disorders in the United States, with a lifetime prevalence of 30%. Recommended treatment options include evidence-based behavioral interventions; smartphone-based interventions confer a number of benefits such as portability, continuous access, and stigma avoidance; and research suggests that interventions involving couples may outperform those for patients only. In this context, a behavioral intervention delivered to couples through smartphones may serve as an effective adjunct to alcohol use disorder treatment., Objective: This pilot study aimed to (1) evaluate the feasibility of comparing a patient-only (Addiction version of the Comprehensive Health Enhancement Support System; A-CHESS) versus a couple-focused (Partner version of the Comprehensive Health Enhancement Support System; Partner-CHESS) eHealth app for alcohol misuse delivered by smartphone, (2) assess perceptions about and use of the 2 apps, and (3) examine initial indications of differences in primary clinical outcomes between patient groups using the 2 apps. Broadly, these aims serve to assess the feasibility of the study protocol for a larger randomized controlled trial., Methods: A total of 33 romantic couples were randomized to 6 months of A-CHESS app use (active treatment control) or Partner-CHESS app use (experimental). Couples comprised a patient with current alcohol use disorder (25/33, 76% male) and a romantic partner (26/33, 79% female). Patients and partners in both arms completed outcome measure surveys at 0, 2, 4, and 6 months. Primary outcomes were patients' percentage of days with heavy drinking and percentage of days with any drinking, measured by timeline follow back. Secondary outcomes included app use and perceptions, and multiple psychosocial variables., Results: At 6 months, 78% (14/18) of Partner-CHESS patients and 73% (11/15) of A-CHESS patients were still using the intervention. The apps were rated helpful on a 5-point scale (1=not at all helpful, 5=extremely helpful) by 89% (29/33) of both Partner-CHESS patients (mean 3.7, SD 1) and partners (mean 3.6, SD 0.9) and by 87% (13/15) of A-CHESS patients (mean 3.1, SD 0.9). At 6 months, Partner-CHESS patients had a nonsignificantly lower percentage of days with heavy drinking compared with A-CHESS patients (β=-17.4, 95% CI -36.1 to 1.4; P=.07; Hedges g=-0.53), while the percentage of drinking days was relatively equal between patient groups (β=-2.1, 95% CI -24.8 to 20.7; P=.85; Hedges g=-0.12)., Conclusions: Initial results support the feasibility of evaluating patient-only and couple-focused, smartphone-based interventions for alcohol misuse. Results suggest that both interventions are perceived as helpful and indicate maintained engagement of most participants for 6 months. A future, fully powered trial is warranted to evaluate the relative effectiveness of both interventions., Trial Registration: ClinicalTrials.gov NCT04059549; https://clinicaltrials.gov/ct2/show/NCT04059549., (©David H Gustafson Sr, David H Gustafson Jr, Marie-Louise Mares, Darcie C Johnston, Olivia J Vjorn, John J Curtin, Elizabeth E Epstein, Genie L Bailey. Originally published in JMIR Formative Research (https://formative.jmir.org), 01.11.2024.)

In this research, for examining the effect of monotheistic integrated group therapy on married women's positive feelings toward their spouses, 24 married women, referring to the Family Counseling Center of the Association of Parents and Teachers of Naqadeh, were selected as the sample by the convenience sampling. These people had scored low in the scale of positive feelings toward spouse. This research was conducted with a quasi-experimental method and a pretest-posttest design with a control group and a one-month follow-up phase. After assimilating the selected people based on control variables, they were randomly placed in the two test and control groups of 12. First, the two groups took the test of positive feelings toward spouse. Then, 12 sessions of monotheistic integrated group therapy were held for the test group, and 12 sessions of free discussion were held for the control group. After the intervention and one month later, each of two groups completed the scales again. The data were analyzed by the analysis of covariance and with the help of SPSS-24. According to the findings, after the monotheistic integrated group therapy, the rate of positive feelings toward spouse in the test group was meaningfully higher in comparison with the control group (P=0.01, f=48.51). This result was maintained until one month after the end of therapy sessions. In addition, the effect of monotheistic integrated group therapy on the improvement of married women's positive feelings toward their spouses was confirmed; thus, family counselors can use this therapy model to reduce family problems and increase couples' positive feelings toward each other.

This research aimed to investigate the effect of short-term solution-focused couple therapy on irrational thoughts and marital adjustment of incompatible couples. This is a quasiexperimental research with pretest/posttest and control group. The population consisted of all couples visiting Behzisti counseling centers in Rasht between 2019 to 2020. The sample for this study was selected 16 couples and couples who wished to participate in the study were selected using convenience sampling, and randomly assigned to experimental and control groups. The instruments used in this study included Spanier Dyadic Adjustment Scale (DAS) and Irrational Beliefs Test-Ahwaz (4 IBT-A). After random assignment of experimental and control groups, the experimental intervention (solution-focused therapy), was performed on the experimental group for 7 sessions of 90-minute once a week and after completing the training program, posttest was taken from both groups. The results of covariance analysis (univariate) of data showed that the solution-focused training through helping couples remind the days that they were compatible with each other and pointing to their past successful relationships resulted in increasing marital adjustment and also by encouraging them to positive talk, reduced irrational thoughts of couples in experimental group compared with the control group. [ABSTRACT FROM AUTHOR]

The author presents a reflection about analytic therapy with couples using the method of Sandplay. The research has been in place for over a decade and was carried out by a group of analysts who are also members of LAI, Analytic Laboratory of Images. The article touches on some aspects of a therapy concept founded on Jungian analytical psychology, which was elaborated in years of work with couples, integrating the concepts of the collective unconscious, the role of affective tone complexes, the individuation process. Among the main lines of this research there is the innovative use of Sandplay in couple therapy. Exposing a clinical case, the article presents the sense of introducing in couple analytic therapy the “game action”, suited to promote contact with emotions and the emerging of imagination. Sandplay, shared by the partners in an analytic context, is presented in its value of affective communication, contact with the content of the complexes and possible access port to the symbolic function. [ABSTRACT FROM AUTHOR]

In general, arousal of emotions is often felt and expressed as a somatic experience in the body. In Emotionally Focused Couple Therapy (EFT), the deepening of emotional experiencing enables therapeutic change. This research explores the experiences of eight experienced EFT trainer therapists regarding their somatic experiences in their work with couples. Using interpretative phenomenological analysis of transcribed in‐depth interviews, this research data yielded three core themes that captured therapists' experiences of using their own and couples' somatic experiences in therapy: (1) the importance and relevance of somatic experiences, (2) therapists' use of their own somatic experiences, and (3) working with clients' somatic experiences. The findings suggest that therapists do focus on their own and couples' somatic experiences in their work with couples, and that EFT therapists could benefit from a map to guide therapists how to focus on felt, somatic experiences as a way of maintaining an emphasis on emotional experience. [ABSTRACT FROM AUTHOR]

Forgiveness as a psychological process is a promising approach to integrate into couple counseling to help couples recover from serious relational transgressions (RT). And yet, there is still no consensus in the literature to better understand the processes couples must get through during couple therapy to mutually forgive each other. The aim of this paper is to conduct a literature review on forgiveness and couple interventions. To achieve this, a keyword search in six databases resulted in the retrieval of 35 references. Study selection and analysis were guided by a scoping review framework. Further, the majority of documented RT concerned infidelity. However, only 34% of the retrieved documents are empirical studies. From the whole corpus emerges the observation that forgiveness is a complex, iterative, non-linear process requiring significant investment from both members of the couple; it can be grouped into six subprocesses that are more or less sequential. For future studies, it would be interesting to validate if forgiveness processes differ according to RT experienced. [ABSTRACT FROM AUTHOR]

Couples have a unique perspective to share about the therapy they receive. The current study uses a mixed-methods design to examine what couples report about most and least helpful elements of two behaviorally-based treatments tested in a large clinical trial of couple therapy. Results indicate that responses are highly variable and fall into five main themes, which are then compared between treatment conditions, genders, and outcome groups. One interesting finding is that all groups reported wanting more discussion of sexual issues. Findings are discussed in the context of common factors research, recent developments toward unified principles of change in couple therapy, and model-specific differences. [ABSTRACT FROM AUTHOR]

Background: Cancer diagnosis and treatment represent a real upheaval both for the patient and for his or her life partner. Adjustment to cancer has been widely studied at the individual level, however, there is little in the literature about the experiences of the couple as an entity. This is especially true with regard to a population facing advanced cancer. This systematic review aimed to make an inventory of 1) the current knowledge relating to the experience of the patient-partner dyad when confronted with advanced cancer, and 2) the psychosocial interventions specifically centered on this dyad. Method: This review was conducted using the Cochrane methodology. The eligibility criteria for the literature review were: one of the members of the dyad being treated for advanced cancer, dyad composed of the patient and his/her life partner. Databases from PubMed, PsycArticle, PsycInfo, Psychology and Behavioral Sciences Collection and Scopus were investigated. A thematic content analysis on the basis of admitted articles made it possible to respond to each of our research objectives. Results: Three hundred eighty-nine citations were found. Twenty were admitted to the systematic review of the literature. It highlighted the following experiences of the advanced cancer patient-life partner dyad: uncertainty about the future, disjointed time, intrusion into the couple's intimacy, attachment style and caregiving within the couple, couple's adjustment to cancer symptomatology, the couple's supportive care needs, role changes, nature of communication within the couple, anticipation of the coming death, and the meanings and beliefs around death. This review also describes the range of couple therapies used in the context of advanced cancer: emotionally focused-couple therapy, existential therapy, art therapy, support therapy and couple communication and intimacy promotion. These therapies seem to have individual beneficial effects for both the patient and his or her life partner as well as improving marital functioning. Conclusions: These results clearly highlight that consideration of the couple and communication within the couple during care are fundamental to dyadic adjustment to advanced cancer. Further studies (qualitative and quantitative) are needed to better understand the couple's experience in order to adapt the management of the couple facing advanced cancer. [ABSTRACT FROM AUTHOR]

This article describes the treatment framework and core therapeutic principles of the integrative brief systemic intervention (IBSI), a manualized six‐session intervention intended for parents seeking couple therapy. IBSI aims to work on the couple's presenting problem, considering its specific impact in the marital and coparenting domains. The basic premise of IBSI is to consider that, when working with couples who have children, therapeutic work on their coparenting alliance may be used as a lever, as both parents may be particularly motivated to improve their relationship for their children's benefit. Increasing the coparenting alliance may then facilitate work on deeper conflicts within the marital relationship. The core therapeutic principles of IBSI are: (1) joining with the couple as romantic partners and a coparenting team from the start of the therapeutic process; (2) supporting the parents in increasing their awareness regarding their children's behavior and emotional experiences when facing their parents' conflicts; and (3) working on the spill‐ and cross‐over effects between marital and coparenting relationships (i.e., exploring how conflict or positivity spills over from one relationship to the other or crosses over from one partner to the other). Therapeutic work following these main therapeutic principles is expected to improve the quality of both relationships. A clinical case is provided to illustrate the core therapeutic principles of IBSI. [ABSTRACT FROM AUTHOR]

This study examined how individual pretreatment symptoms (depression and anxiety) predicted longitudinal, relational processes in couples therapy (the therapeutic alliance and couple satisfaction). This study included 99 heterosexual couples receiving systemic couples therapy. Partners reported their individual pretreatment symptoms of depression and anxiety before intake. Each member reported their therapeutic alliance with the therapist at the end of sessions 2–8, as well as their couple satisfaction before intake and at the end of sessions 4 and 8. A Latent Profile Analysis revealed four profiles characterizing couples on their pretreatment psychological symptoms, namely both higher (where both members of the couple had higher depressive and anxiety symptoms), female higher, male higher, and both lower profiles. Furthermore, longitudinal, dyadic multilevel models revealed that men in male higher, female higher, and both higher profiles had higher initial alliance levels, compared to men in the both lower profile. In contrast, only female partners in the both higher profile had a higher initial therapeutic alliance than those in the both lower profile. Men in the both higher profile had faster reductions in their alliance, whereas other profiles did not predict changes in male or female alliance. Additionally, the male higher and both higher profiles predicted a lower initial level of couple satisfaction in males but not females. The profiles did not predict changes in couple satisfaction, which may be a result of lowered power due to missing data. Findings were discussed in the context of systemic family theory, with clinical implications for distressed couples. [ABSTRACT FROM AUTHOR]

Partners in intimate relationships rely on each other to meet essential emotional needs. This mutual dependence creates reciprocal obligations, engendering a moral dimension to intimate relationships. This moral dimension involves questions of fairness, equity, and justice which are often central to couples' presenting complaints in treatment. This paper proposes that moral considerations in couple therapy are not only inevitable, but potentially beneficial, and illustrates how they can inform the therapist's case conceptualizations and interventions. This paper will also explore the therapist's responsible use of her moral influence through an examination of personal values. This paper utilizes concepts from psychodynamic and family systems theory to illustrate key points, but the ideas presented apply to therapists with diverse theoretical orientations. [ABSTRACT FROM AUTHOR]

BackgroundCancer diagnosis and treatment represent a real upheaval both for the patient and for his or her life partner. Adjustment to cancer has been widely studied at the individual level, however, there is little in the literature about the experiences of the couple as an entity. This is especially true with regard to a population facing advanced cancer. This systematic review aimed to make an inventory of 1) the current knowledge relating to the experience of the patient-partner dyad when confronted with advanced cancer, and 2) the psychosocial interventions specifically centered on this dyad.MethodThis review was conducted using the Cochrane methodology. The eligibility criteria for the literature review were: one of the members of the dyad being treated for advanced cancer, dyad composed of the patient and his/her life partner. Databases from PubMed, PsycArticle, PsycInfo, Psychology and Behavioral Sciences Collection and Scopus were investigated. A thematic content analysis on the basis of admitted articles made it possible to respond to each of our research objectives.ResultsThree hundred eighty-nine citations were found. Twenty were admitted to the systematic review of the literature. It highlighted the following experiences of the advanced cancer patient-life partner dyad: uncertainty about the future, disjointed time, intrusion into the couple's intimacy, attachment style and caregiving within the couple, couple's adjustment to cancer symptomatology, the couple's supportive care needs, role changes, nature of communication within the couple, anticipation of the coming death, and the meanings and beliefs around death. This review also describes the range of couple therapies used in the context of advanced cancer: emotionally focused-couple therapy, existential therapy, art therapy, support therapy and couple communication and intimacy promotion. These therapies seem to have individual beneficial effects for both the patient and his or her life partner as well as improving marital functioning.ConclusionsThese results clearly highlight that consideration of the couple and communication within the couple during care are fundamental to dyadic adjustment to advanced cancer. Further studies (qualitative and quantitative) are needed to better understand the couple's experience in order to adapt the management of the couple facing advanced cancer.

Introduction: All of those who want to get married and start a family are looking for a happy, successful and long-term cohabitation and expect a fair relationship with equal rewards and costs. Current study's aim is comparison the effect of group counseling based on Gottman method couple therapy and systemic-behavioral on relational ethics of married women in Tehran. Materials and Methods: The research is an experimental one with repeated measurement and with pre-test, post-test and follow up with two experimental groups and one control group and to collect data from the Relational Ethics Questionnaire (RES) were used. Multivariate analysis of covariance was performed using SPSS software version 23 on the data. The statistical population Included 100 married women who voluntarily referred to Mahmid and Frazahn Counseling Centers in Tehran in 2019. From this population, 36 people who received the lowest scores of the Relational Ethics Questionnaire were selected and randomly divided into three groups of 12 each. Experimental and control groups were selected randomly for the implementation of Gottman's couple therapy and systemic-behavioral. Pre-test was performed on all three groups and after 14 sessions of group couple therapy, post-test was taken and one month later, follow-up test was performed on the groups. Findings: The findings showed that: Gottman method couple therapy and systemic-behavioral on relational ethics and its components has been effective and that this effect had remained constant in the follow-up phase but there was no significant difference between these two methods in terms of effectiveness on relational ethics (p= 0/531). Conclusion: Considering the effectiveness of the researched approaches, it is suggested to use these approaches in order to resolve marital conflicts and increase relationshinal ethics.

Leveraging military veterans' intimate relationships during treatment has the potential to concurrently improve posttraumatic stress disorder (PTSD) symptoms and relationship quality. Cognitive-Behavioral Conjoint Therapy (CBCT) and an 8-session Brief Cognitive-Behavioral Conjoint Therapy (bCBCT) are manualized treatments designed to simultaneously improve PTSD and relationship functioning for couples in which one partner has PTSD. Although efficacious in improving PTSD, the effects of CBCT on relationship satisfaction are small, especially among veterans. Intranasal oxytocin, which targets mechanisms of PTSD and relationship quality, may enhance the efficacy of bCBCT. The purpose of this 4-year clinical trial is to compare the outcomes of bCBCT augmented with intranasal oxytocin versus bCBCT plus placebo. We will also explore potential mechanisms of action: self-reported communication skills, empathy, and trust. We will recruit 120 dyads (i.e., veteran with PTSD and their intimate partner) from the VA San Diego Healthcare System. Veterans will be administered 40 international units of oxytocin (n = 60) or placebo (n = 60) 30 min before each of 8 bCBCT sessions delivered via telehealth. Clinical and functioning outcomes will be assessed at five timepoints (baseline, mid-treatment, post-treatment, and 3- and 6-month follow-up). Study findings will reveal the efficacy of oxytocin-assisted brief couple therapy for PTSD, which could serve as highly scalable option for couples coping with PTSD, as well as provide preliminary evidence of interpersonal mechanisms of change. ClinicalTrials.gov Identifier: NCT06194851 [ABSTRACT FROM AUTHOR]

Purpose: Employment and family/social relationships are 2 of the highest priorities among those in substance use recovery. This study examined the relationship of work status with couple adjustment and other recovery capital treatment outcomes among symptomatic alcohol, substance use, and gambling participants (N = 38) using data collected in a randomized trial comparing a systemic Congruence Couple Therapy (CCT) and individual-based Treatment-as-Usual (TAU). Method: Change scores and associations between work status and couple adjustment together with 8 other recovery outcome variables at post-treatment (5 months from baseline) and follow-up (8 months from baseline) in TAU (n = 17) and CCT (n = 21) were analyzed. Results: Number of those working increased with both CCT and TAU but without reaching significance in either CCT (Cochran's Q = 5.429, P =.066) or TAU (Cochran's Q = 2.800, P =.247). Relative to those not working in the combined sample, those working showed significantly improved scores in post-treatment and follow-up in addictive symptoms, couple adjustment, psychiatric symptoms, depression, and life stress. Separating the CCT and TAU groups, similar trend was found in the CCT group but was inconsistent in the TAU group. Conclusion: Significantly greater improvement in addictive symptoms and recovery capital of couple adjustment, mental health, and life stress was found in the working vs not-working group. Compared to individual-based TAU, exploratory findings indicate that the systemic treatment of CCT showed a clearer and more consistent difference in improved working days, addictive symptoms and recovery capital. Replication with larger samples is needed to generalize these results. [ABSTRACT FROM AUTHOR]

Objective: This three-arm randomized trial tested a brief version of cognitive-behavioral conjoint therapy (bCBCT) delivered in two modalities compared to couples' psychoeducation in a sample of U.S. veterans with posttraumatic stress disorder (PTSD) and their intimate partners. Method: Couples were randomized to receive (a) in-person, office-based bCBCT (OB-bCBCT), (b) bCBCT delivered via home-based telehealth (HB-bCBCT), or (c) an in-person psychoeducation comparison condition (PTSD family education [OB-PFE]). Primary outcomes were clinician-assessed PTSD severity (Clinician Administered PTSD Scale), self-reported psychosocial functioning (Brief Inventory of Psychosocial Functioning), and relationship satisfaction (Couples Satisfaction Index) at posttreatment and through 6-month follow-up. Results: PTSD symptoms significantly decreased by posttreatment with all three treatments, but compared to PFE, PTSD symptoms declined significantly more for veterans in OB-bCBCT (between-group d = 0.59 [0.17, 1.01]) and HB-bCBCT (between-group d = 0.76 [0.33, 1.19]) treatments. There were no significant differences between OB-bCBCT and HB-bCBCT. Psychosocial functioning and relationship satisfaction showed significant small to moderate improvements, with no differences between treatments. All changes were maintained through 6-month follow-up. Conclusions: A briefer, more scalable version of CBCT showed sustained effectiveness relative to an active control for improving PTSD symptoms when delivered in-person or via telehealth. Both bCBCT and couples' psychoeducation improved psychosocial and relational outcomes. These results could have a major impact on PTSD treatment delivery within large systems of care where access to brief, evidence-based PTSD treatments incorporating family members are needed. What is the public health significance of this article?: Cognitive behavioral conjoint therapy effectively reduces PTSD symptoms in veterans when delivered either in-person or through telehealth. This treatment is also effective in improving psychosocial functioning and marital satisfaction, again via either delivery modality. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the feasibility, preliminary effects, and acceptability of the first comprehensive couple‐based treatment for suicide, called Treatment for Relationships and Safety Together (TR&ST). Method: In a preliminary examination, five couples (N = 10) participated in 10 weekly sessions of TR&ST. All couples included a veteran who reported active suicidal ideation at baseline and their partner. Couples completed measures of relationship functioning, perceived burdensomeness, thwarted belonging, and suicidal ideation at baseline, mid‐treatment, and posttreatment. Results: TR&ST was feasible to deliver. Veteran and partner relationship functioning improved and veteran perceived burdensomeness, thwarted belonging, and suicidal ideation decreased. There were no suicide related behaviors, hospitalizations, or crisis line calls during the study. TR&ST seemed acceptable to couples (100% retention and high satisfaction ratings). Conclusion: Couple‐based suicide prevention may provide an additional avenue for suicide prevention in veterans. [ABSTRACT FROM AUTHOR]

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We designed this theory-building study to discover how split alliances are manifested in couple therapy. From an archival database, we selected four cases in which the partners' self-reported alliances with the therapist were highly discrepant. An intensive analysis of each session was conducted to model the underlying therapeutic system based on interactional frequencies, a measure of interpersonal closeness, and identify alliance-related behaviors exhibited by clients and therapists using the multidimensional System for Observing Family Therapy Alliances. Results showed consistencies as well as variability across cases, largely reflecting the four (heterosexual) couples' pre-disposing problems and relational characteristics. Spatial maps of each session reflected the unbalanced alliance perceptions in two of the four cases. Whereas behavioral indicators of clients' engagement and emotional connection with their therapists varied widely, a problematic within-system alliance was observed in every case. Cross-blaming and discussion of an attachment injury were also observed across cases. While the therapists were largely engaging, affirming and supportive, in two split alliance sessions they displayed considerably more empathy for the male partner than the female partner. In many ways the results supported and extended the literature on alliances in general and split alliances in particular. [ABSTRACT FROM AUTHOR]

In line with the growing recognition of the role of embodiment, affect and implicit processes in psychotherapy, several recent studies examine the role of physiological synchrony in the process and outcome of psychotherapy. This study aims to introduce Partial Directed Coherence (PDC) as a novel approach to calculating psychophysiological synchrony and examine its potential to contribute to our understanding of the therapy process. The study adopts a single-case, mixed-method design and examines physiological synchrony in one-couple therapy in relation to the therapeutic alliance and a narrative analysis of meaning construction in the sessions. Interpersonal Physiological Synchrony (IPS) was calculated, via a windowed approach, through PDC of a Heart Rate Variability-derived physiological index, which was measured in the third and penultimate sessions. Our mixed-method analysis shows that PDC quantified significant moments of IPS within and across the sessions, modeling the characteristics of interpersonal interaction as well as the effects of therapy on the interactional dynamics. The findings of this study point to the complex interplay between explicit and implicit levels of interaction and the potential contribution of including physiological synchrony in the study of interactional processes in psychotherapy. [ABSTRACT FROM AUTHOR]

Background: Research on interpersonal synchrony has mostly focused on a single modality, and hence little is known about the connections between different types of social attunement. In this study, the relationship between sympathetic nervous system synchrony, movement synchrony, and the amount of speech were studied in couple therapy. Methods: Data comprised 12 couple therapy cases (24 clients and 10 therapists working in pairs as co-therapists). Synchrony in electrodermal activity, head and body movement, and the amount of speech and simultaneous speech during the sessions were analyzed in 12 sessions at the start of couple therapy (all 72 dyads) and eight sessions at the end of therapy (48 dyads). Synchrony was calculated from cross-correlations using time lags and compared to segment-shuffled pseudo synchrony. The associations between the synchrony modalities and speech were analyzed using complex modeling (Mplus). Findings: Couple therapy participants' synchrony mostly occurred in-phase (positive synchrony). Anti-phase (negative) synchrony was more common in movement than in sympathetic nervous system activity. Synchrony in sympathetic nervous system activity only correlated with movement synchrony between the client-therapist dyads (r = 0.66 body synchrony, r = 0.59 head synchrony). Movement synchrony and the amount of speech correlated negatively between spouses (r = −0.62 body synchrony, r = −0.47 head synchrony) and co-therapists (r = −0.39 body synchrony, r = −0.28 head synchrony), meaning that the more time the dyad members talked during the session, the less bodily synchrony they exhibited. Conclusion: The different roles and relationships in couple therapy were associated with the extent to which synchrony modalities were linked with each other. In the relationship between clients and therapists, synchrony in arousal levels and movement "walked hand in hand", whereas in the other relationships (spouse or colleague) they were not linked. Generally, more talk time by the therapy participants was associated with anti-phase movement synchrony. If, as suggested, emotions prepare us for motor action, an important finding of this study is that sympathetic nervous system activity can also synchronize with that of others independently of motor action. [ABSTRACT FROM AUTHOR]

The practice of integrating various therapeutic disciplines and models in therapy has traditionally been the domain of the experienced practitioner. To encourage the newly trained systemic therapist to embark on their journey in the artistry of integrative practice, this paper addresses the question: 'What guidance and encouragement could be offered to the beginning family therapist to practice in an integrative way?' Central to this paper is the view that the discipline of systemic thinking itself facilitates integration. Based on the notion that complex models of integrative practice may not serve the beginning clinician, three suggestions are offered. First, the overarching theories that support systemic family therapy also provide a platform for moving between schools of family therapy and our professions of origin. Second, the role of common factors is a useful and important guiding principle to practice in an integrative way. And finally, an essential ingredient of integrative practice is the return to therapeutic presence and attunement. [ABSTRACT FROM AUTHOR]

Background and Objective: Performance and interactions of the couples having important roles in family sustainability. This study was done to evaluate the effectiveness of emotion-focused therapy on the performance component of couples referring to counseling centers. Methods: In this clinical trial study, 28 couples with marital problems were randomly divided into intervention and control groups. Subjects had score lower than the cut-off point (120 points) using McMaster Family Assessment Device. Subjects in experimental group participated in ten sessions of an hour and a half of the emotion-focused therapy. Pre-test, post-test and one month follow-up were performed for each subject. Results: The therapy had impact on increasing all of the performance components of couples, and the survival of the effect of treatment was evident in one month follow up. There was a significant difference between the scores of the two groups in all of the components of the post-test variable of family functioning (P

Background: Given the rising rate of infertility, the prevalence of mental health disorders in infertile couples is undeniable. The present study aimed to investigate the effects of Integrative Behavioral Couple Therapy (IBCT) on infertility self-efficacy, dyadic adjustment, and sexual satisfaction in infertile couples. Methods: The present single-case experimental study used a multiple-baseline design. The statistical population of the study included all infertile couples referring to infertility centers in Ahvaz City, Iran, in 2019. The research instruments included the Infertility Self-Efficacy Scale (ISE), the Dyadic Adjustment Scale (DAS), and the Sexual Satisfaction Questionnaire (SSQ). Following a diagnostic interview, 3 couples were selected using the convenience sampling technique. Integrative behavioral couple therapy was conducted in twelve 120-minute sessions for the intervention group. The second couple entered the study in the second session of the first couple; the third couple enrolled the treatment plan in the third session of the first couple and the second session of the second couple. All questionnaires were completed in the first, third, sixth, eighth, and tenth sessions; the study participants were followed up and re-assessed two months later. The collected data were analyzed in SPSS using chart analysis, reliable change index, and significance statistics. Results: The provided IBCT increased infertility self-efficacy (39.04%), dyadic adjustment (25.91%), and sexual satisfaction (55.01%) in infertile couples. Besides, the improvement lasted throughout the follow-up which indicated the effectiveness of IBCT on infertility self-efficiency, dyadic adjustment, and sexual satisfaction in the study subjects. Conclusion: IBCT can be effective in improving personal and marital variables in infertile couples with infertility problems in addition to their marital problems.

BackgroundResearch on interpersonal synchrony has mostly focused on a single modality, and hence little is known about the connections between different types of social attunement. In this study, the relationship between sympathetic nervous system synchrony, movement synchrony, and the amount of speech were studied in couple therapy.MethodsData comprised 12 couple therapy cases (24 clients and 10 therapists working in pairs as co-therapists). Synchrony in electrodermal activity, head and body movement, and the amount of speech and simultaneous speech during the sessions were analyzed in 12 sessions at the start of couple therapy (all 72 dyads) and eight sessions at the end of therapy (48 dyads). Synchrony was calculated from cross-correlations using time lags and compared to segment-shuffled pseudo synchrony. The associations between the synchrony modalities and speech were analyzed using complex modeling (Mplus).FindingsCouple therapy participants’ synchrony mostly occurred in-phase (positive synchrony). Anti-phase (negative) synchrony was more common in movement than in sympathetic nervous system activity. Synchrony in sympathetic nervous system activity only correlated with movement synchrony between the client-therapist dyads (r = 0.66 body synchrony, r = 0.59 head synchrony). Movement synchrony and the amount of speech correlated negatively between spouses (r = −0.62 body synchrony, r = −0.47 head synchrony) and co-therapists (r = −0.39 body synchrony, r = −0.28 head synchrony), meaning that the more time the dyad members talked during the session, the less bodily synchrony they exhibited.ConclusionThe different roles and relationships in couple therapy were associated with the extent to which synchrony modalities were linked with each other. In the relationship between clients and therapists, synchrony in arousal levels and movement “walked hand in hand”, whereas in the other relationships (spouse or colleague) they were not linked. Generally, more talk time by the therapy participants was associated with anti-phase movement synchrony. If, as suggested, emotions prepare us for motor action, an important finding of this study is that sympathetic nervous system activity can also synchronize with that of others independently of motor action.

Introduction: In recent years, researchers have attempted to assess the effectiveness of couple therapies. This research aimed to evaluate the Integrative Behavioral Couple Therapy (IBCT) and Affective Reconstructive Couple Therapy (ARCT) as treatments for marital conventionalization and global distress. Materials and Methods: The statistical population of the present study consisted of couples referring to counseling centers in district 3 of Tehran in 2017. The sampling method of this study was purposeful. Twenty-four couples divided into two experimental groups and one control group. They completed Marriage Satisfaction Questionnaire-Revised Snyder (1979). The experimental groups received 12 ninety-minute sessions of IBCT or ARCT, whereas the control group received no interventions. Data analyzed through MANCOVA test with repeated measures, and SPSS software version 24. Results: The findings indicated that integrative behavior therapy significantly affected marital conventionalization and global distress (F= 23.361, P< 0.001). Also, affective reconstructive couple therapy had significant effects on marital conventionalization (F= 13.566, P< 0.001) and global distress (F= 10.267, P< 0.003). In addition, both therapies have been effective one-month follow-ups. Conclusion: The study found that integrative behavioral couple therapy and affective reconstructive couple therapy are effective to increase marital conventionalization and reduce global distress. Teaching integrative behavior couple therapy and affective reconstructive couple therapy can be effective for psychologists, health professionals, couple therapists, and family counselors to improve marital satisfaction. [ABSTRACT FROM AUTHOR]

Trauma exposure is a pervasive issue worldwide. People exposed to traumatic events may develop PTSD, depression, anxiety, and other mental health symptoms. Family and intimate partner relationship problems also are frequently associated with trauma exposure. The purpose of this study was to conduct a systematic research synthesis of the empirical evidence on systemic interventions for traumatic event exposure from 2010 to 2019. A search of peer‐reviewed research resulted in 31 articles that met inclusion criteria and were included in this review. Systemic interventions were grouped by modality (e.g., parent‐child, couple, group). The collective evidence was strongest for systemic youth‐caregiver interventions, group, and couple treatment categories for traumatic event exposure. Youth‐centered interventions that included various combinations of family member participation can be considered probably efficacious. Overall, results indicated that systemic interventions for traumatic event exposure were successful in reducing posttraumatic stress symptoms including PTSD, depression, and anxiety, and improving relational outcomes. [ABSTRACT FROM AUTHOR]

This paper presents a systematic review study that aimed to map how the scientific literature is characterized concerning family or couple interventions and therapies regarding lesbian, gay and bisexual (LGB) individuals. The searches were conducted in the Web of Science, BVS, PsycINFO, and PUBMED databases, from 2009 to 2019, in Portuguese and English. The PRISMA protocol guidelines were followed and the CONSORT Statement and its extension for non-pharmacological interventions instruments were used. Frequencies and content analysis were performed at software NVivo. After considering the inclusion and exclusion criteria, gender-nonconforming19 articles were retrieved. The results revealed a greater focus on the North American context, mainly on psychoeducational interventions that worked on marital status and family systems with LGB teenagers or young adults. Adaptation of well-consolidated practical approaches was the most used and multiple formats were applied to conduct interventions, using film-based, cognitive-behavioral and systemic techniques. It is argued that theoretical and empirical research focused on stigma and discrimination at marital and family levels is needed in other contexts, such as Global South countries. Future directions and limitations are presented. [ABSTRACT FROM AUTHOR]

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