Doing Couple Therapy (2025)

ADAPTING ENACTMENTS TO COUPLE REACTIVITY: FIVE DEVELOPMENTAL STAGES

Journal of Marital and Family Therapy, 2003

Interest in change interventions that are common to different models of relationship therapy has spurred investigation of enactments as one such candidate. In change-focused enactments, therapists structure and coach couple/family interaction, as opposed to channeling interaction through the therapist. Still, varying levels of couple/family distress, volatility, and reactivity mean that readiness for enactment intervention varies along a broad continuum and changes over the course of therapy. This suggests the need for differentiated enactments. Currently, however, no model exists for adapting enactments to changing relationship conditions. We propose a five-stage developmental model of clinical operations in couple therapy that adapts the process and structure of enactments to changing levels of relationship distress, interactional volatility, and emotional reactivity. The model increases the possibility for therapists to use enactments successfully over the entire course of couple therapy. Issues to be considered in using the couple enactments model as a template for the development of enactment models for other relationship systems are noted.

Couples Therapy for Women Survivors of Child Sexual Abuse Who Are in Addictions Recovery: A Comparative Case Study of Treatment Process and Outcome

Journal of Marital and Family Therapy, 2007

Treatment for women who are survivors of child sexual abuse and who have a history of substance abuse has largely involved gender-specijic interventions. This study examines the use of conjoint couple therapy with a cohort of women who were survivors of child sexual abuse and who are in addiction recovery and with their partners. A comparative case study analysis incorporated standardized clinical measures with client and therapist interviews. Brief conjoint therapy was found to assist couples in the spec$ic relationship skill areas of communication and mutual problem solving. Furthel; substantive gains were found in the realm of affective relations. The women reported an increase in support from their male partners, and the men reported a decrease in negative emotional atmosphere in the relationship.

Fostering new relational experience: clinical process in couple psychotherapy

Psychotherapy (Chicago, Ill.), 2014

One of the most critical goals for couple psychotherapy is to foster a new relational experience in the session where the couple feels safe enough to reveal more vulnerable emotions and to explore their defensive withdrawal, aggressive attacking, or blaming. The lived intimate experience in the session offers the couple an opportunity to gain integrative insight into their feelings, expectations, and behaviors that ultimately hinder intimacy. The clinical processes that are necessary include empathizing with the couple and facilitating safety within the session, looking for opportunities to explore emotions, ruptures, and unconscious motivations that maintain distance in the relationship, and creating a new relational experience in the session that has the potential to engender integrative insight. These clinical processes will be presented with empirical support. Experts from a session will be used to highlight how these processes influence the couple and promote increased intimacy...

Enhancing Narrative Couple Therapy Process with an Enactment Scaffolding

Contemporary Family Therapy, 2000

Despite the growing popularity of narrative approaches to couple and family therapy and the demonstrated effectiveness of enactments-a clinical process typically articulated and utilized in more modern or positivistic approaches to therapy-there is very little, if any, literature exploring how enactments may fit within a narrative therapeutic framework. In this paper we suggest: That narrative therapy theoretical assumptions, principles, and therapeutic processes may coexist within an enactment framework articulated by Butler and Gardner; that such assumptions and processes may be enhanced when clinicians use an enactment "scaffolding" throughout the therapeutic process; and that this enactment framework "empirically informs" the narrative therapy process and strengthens the stance of narrative therapy under the scrutiny of those claiming a need for an evidence basis in psychotherapy.

How Couples Manage Interracial and Intercultural Differences: Implications for Clinical Practice

Journal of Marital and Family Therapy, 2013

“The relationship past can't be the future”: couple counsellors' experiences of working with infidelity

Sexual and Relationship Therapy, 2014

Infidelity is both common and difficult to work with therapeutically, but little research to date has examined the experiences of those who work with this presenting problem. This study explores couple counsellors' experiences of working with couples affected by infidelity. Semistructured interviews were conducted with seven experienced couple counsellors working for a nation-wide relationship counselling organization in the United Kingdom. A thematic analysis of the interview transcripts revealed a shared pattern of experiences and challenges, providing greater insight into the specific constellations and difficulties practitioners face when working with issues around infidelity. Practical implications for working with this presenting problem are discussed as well as the potential impact of counsellors' own implicit theories on their practice with infidelity.

Emotions in the Practice of Systemic Therapy

Emotions are connected to meaning making in human interactions. This can be seen not just in terms of the immediate participants and their developmental history but also through broader cultural, social, and gender lenses. In times of relational tension, which require system flexibility, some emotional interaction can constrain alternative actions or meanings being constructed. Therapists can hypothesize about these emotional dances (including those that are taking place in the therapist/client system) and such hypotheses can inform interventions aimed at generating different emotional sequences. If participants in therapy experience alternative emotional responses as a result of therapeutic intervention, then change can occur (e.g., a greater sense of agency or hope, or a different perception of the situation).

Using Acceptance and Commitment Therapy to Treat Distressed Couples: A Case Study With Two Couples

Cognitive and Behavioral Practice, 2009

... The first couple, Landon (33) and Wendy (28) reported low levels of marital satisfaction and high levels of conflict due to rigidity in joint decision-making. Landon was raised in Europe and moved to the United States as an adult. ...

Emotion-Focused Therapy–Therapist Fidelity Scale (EFT-TFS): Conceptual Development and Content Validity

Journal of Couple & Relationship Therapy, 2009

The Emotion Focused Therapy-Therapist Fidelity Scale (EFT-TFS) is introduced as a scale to measure a therapist's fidelity to the EFT model. The rationale and conceptual development of the scale are presented. Members of an EFT electronic mailing list who participated in a survey (n=130) rated all of the items as highly important for the practice providing support for the content validity of the scale. Finally, the 13 items of the EFT-TFS are presented. Future research directions for the EFT-TFS are presented.

The path to a secure bond: Emotionally focused couple therapy

Journal of Clinical Psychology, 2006

Emotionally focused therapy (EFT) for couples combines experiential and systemic techniques to expand emotional responses and cycles of interaction. This approach has also been used to treat depression, chronic illness, and anxiety disorders. EFT appears to translate well across culture and class, focusing on universal key emotions and attachment needs. From the EFT perspective, adult love is a hardwired, adaptive attachment response. The therapist's in-session focus is on the processing of emotions and key interactional patterns as they occur in the present, because emotional experiences are the primary instruments of change in this approach. The therapist is a relationship consultant who offers a safe platform whereby each partner can distill, expand, and transform experience and find new ways to connect with the other. The case presented here illustrates the three stages of EFT: deescalation, restructuring interactions, and consolidation.