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MFT 561 > Couple Therapy: An Overview > Flashcards

Couple Therapy: An Overview Flashcards

1
Q

In the past, couples therapy was a:

A

last resort. . Freud, Rogers, early cognitive behavioral work was all about working with individuals and based on the intrapsychic level.

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2
Q

What is the now the preferred method for treating relationship distress:

A

Couples Therapy

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3
Q

Individual Therapy for couples is where:

A

partner can change that individual’s own contribution to the relationship

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4
Q

What is the strength of the couple therapy approach?

A

having a look at their own perspectives and their combined relationship

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5
Q

What would you want to do as a couple’s therapist?

A

As a couple’s therapist, you will do individual therapy but if you want relational change, you want BOTH people and take a systemic approach. Couples therapy require you to have distinct training.

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6
Q

How can couple therapists instill hope to clients?

A

Therapists can provide hopeful messages - (you can state)
1) 70-75% of couples have found therapy to have a positive impact.

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7
Q

Couples gains/progress attenuate over time:

A

1) Gains maintained at 6 months
2) 2-5 yrs gains significantly decline
- This is why long term follow up is important (if couples come back into therapy for check-in or refreshers it is a positive sign)
-Therapist should normalize the experience (gains decline over time - not their fault)

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8
Q

Confidentiality and mandated reporting land on the consensus to:

A

protect the children

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9
Q

What is not reportable?

A

Violence between two adult partners

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10
Q

What is reportable?

A

violence between two adult partners in the presence of a child (w/willful cruelty-sense of child in jeopardy

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11
Q

What is the association between epidemiology and couple relationships

A

-Strong association between couple relationships & health well-being
-We know that if Partner A reports that Partner B is cold and makes them feel unloved, they are more likely to have distress/decline in physical health.
-Chicken-Egg analogy: is it the depression that caused the relationship distress OR is it the relationship distress that caused the depression?

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12
Q

Does Marital Distress get better on its own?

A

-Not typically: Martial distress typically doesn’t improve without treatment (Baucom et al., 2003)
-There is a certain threshold in which marital distress cannot cross and get better on its own. Ex.) Chronic sense of relational unease, unresolved feelings (jealousy, anger, feeling misunderstood, etc.) dose not go away or get better on its own without therapeutic intervention/ treatment.
Shadish and Baldwin (2005) BCT: concluded that component studies indicated that communication and problem solving strategies led to most the treatment effects

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13
Q

Emotional disengagement (lack of emotional support that is subtle):

A

predicts more negative outcomes

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14
Q

What is the best predictor of couple therapy treatment success?

A

the initial distress level (the earlier they begin therapy the better)

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15
Q

What happens if couples wait too long for therapy?

A

-Recurring negative interaction cycles resulting in a restricted range of available options

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16
Q

What are the 5 preconditions for change?

A
  1. Safety
  2. Fairness
  3. Normalizing
  4. Hope
  5. Therapist Pacing
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17
Q

Preconditions for change (safety)

A

-trusting connection with therapist
-not fearing repercussions partner
- couple need to feel a sense of safety in the room for all three parties (trust the therapist is not out to get them or judge them AND trust/don’t have fear of their partner)

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18
Q

Preconditions for Change ( Fairness)

A

-therapists must maintain balance
-both partners feel understood by therapists (feel validated, does not mean 50-50 split all the time) (need to balance the clients and how much they control/interact)

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19
Q

Preconditions for Change (Normalization)

A

-clients felt problems were not unusual
- before people can change, people want people to know their problems are not unusual.

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20
Q

Preconditions for Change - Hope

A

-confidence in process - expected things to get better
-One way to instill hope is to talk about unique strengths that come form thorough intial assessment.

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21
Q

Preconditions for Change (Therapist Pacing)

A

-slowed the pace for each partner to ensure they were comfortable
-Therapist pacing is the precondition for couples change. Partners will be in different places in their paces. So you want to work with getting each partner at somewhat similar pace/level. (especially relevant for extramarital affair)

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22
Q

What is an affective alliance

A

-Each partner feels understood
-Each partner feels therapy addressing key concerns
-Our job is to help integrate their own perspectives and make sure that the couple have a sense of buy-in/ consensus.

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23
Q

In Couples alliance a Triadic Consensus must occur. What is a Triadic Consensus?

A

all 3 parties agree w/
-Presenting problem
-Treatment goals
-Approach to treatment (interventions)

24
Q

Men tend to have ___ alliance after 1 session (couples therapy)

A

lower

25
Q

Why do men have a low alliance after 1 session?

A

-socialization
-feeling blamed, “IP”

26
Q

What is key early in the session?

A

early session alliance is key (must maintain alliance all of therapy)

27
Q

What are major behavioral models in couples therapy?

A

-Behavioral Couple Therapy (BCT)
-Cognitive-Behavioral Couple Therapy (CBCT)
-Integrative-Behavioral Couple Therapy (IBCT)

28
Q

What are some major experiential models in therapy?

A

-Emotionally-Focused Couple Therapy (EFT)
-Acceptance and Commitment Therapy (ACT)

29
Q

What are some major models of insight-oriented therapy?

A

-Bowenian or Transgenerational Couple Therapy
-Psychodynamic Couple Therapy

30
Q

Behavior couple therapy focuses on:

A

change behavior / dynamics

31
Q

Experiential models focus on:

A

Change through what is happening in-session

32
Q

Insight oriented models focus on:

A

change the insight (ex. Use genograms to illustrate all the patterns)

33
Q

What Are the Most Empirically Supported Treatments?

A

-Behavioral couple therapy (BCT, CBCT, IBCT)
-Emotion-focused couple therapy (EFCT)

34
Q

Behavioral Couples Therapy (BCT) was developed by:

A

-Neil Jacobsen in the 1970s
-used the traditional model of classical conditioning and reinforcement theory to places emphasis on behavior change
-Relationship is the function of behaviors awarded and punished

35
Q

Behavior Couple Therapy Interventions:

A

1) Behavior Exchange: each partner makes positive changes independent of their spouses behavior to increase marital satisfaction
2) Communication Training
3) Problem-Solving Training
4) Aimed at increasing skills to reduce conflict and increase intimacy

36
Q

Behavior Couple Therapy - Behavior Change:

A

1) act in ways that will increase marital satisfaction
2) Have partner A make a list of 7 behaviors that will make their other partner happy and vice versa
3) Encourage the couple to behave in the way that would make them the ideal partner for the other.
4) Identify meaningful behaviors that will increase marital satisfaction for each other and in doing that the marriage will improve.
5)Very basic intervention: no backstory, behavioral based: know what will make better outcome and do it! Ex.) I’ll do the dishes so that my partner has a break.
6) This works well BUT it is short-term. Won’t save all marriages. You want to frame it as a BEGINNING INTERVENTION

37
Q

Behavior Couple Therapy - Communication Training

A

you help people to communicate with one another better

38
Q

Behavioral Couple Therapy (BCT) - Problem Solving Training

A

aimed at increasing skills that will reduce conflict, most often things that couple have done in the past for each other.

39
Q

What is CBCT?

A

beliefs about relationship

40
Q

Who founded Integrative Behavioral Couples Therapy (IBCT)

A

Jacobson and Christensen

41
Q

TBCT (traditional) produces change but:

A

not long term
-couple change behaviors, learns how to communicate, and practice problem solving skills but it doesn’t really last)

42
Q

IBCT added the concept of:

A

-acceptance: (unified detachment, empathetic joining)
-you’re challenging not just the behaviors but learn to accept the partner and deepening the relational interactions)

43
Q

IBCT creates:

A

-joint-awareness of patterns
- gives couples emotional distance from patterns so couples could look at them more objectively
-Contigency-shaped rather than rule governed change (change occurs not thru the deliberate employment of rules or guidelines but by exposing partners to new experiences that create contingencies that shape new behavior.

44
Q

Who founded emotion focused couple therapy (EFT)?

A

Susan Johnson & Les Greenberg

45
Q

What is emotionally focused couple therapy linked to?

A

-attachment theory: connecting to caregivers, unmet needs leads to protest behaviors, human need for relation and comfort  we transfer all this as we become adults onto our partners = adult emotional bonds)

46
Q

What does EFT help with?

A

-Expanding constricted cycles & emotional response (goes back to undoing the negative interaction cycles on the scatterplot diagram!)
-helps you find out what happened, what emotional injuries occurred, etc.

47
Q

Look at chart

A

slide 19

48
Q

What are Couple Therapy Competencies?

A

1) Couple-based formulation
2) Building a couple-based alliance
3) Managing in-session conflict
4) Foster between-couple intimacy, communication, and security
- Skills training
-Sharing concerns without blame
-behavioral activities
-emotional reaching

49
Q

What is Couple based formulation?

A

looking at couple individually but also their bidirectional relationship

50
Q

Couples Therapy: Assessment - Sessions 1-3

A
  • Based on Ecological Model
    1) Couple interactions
    2) Individual characteristics
    3) Contextual factors (culture, race, religion, age, sexuality, etc.)
    4) Life events (job loss, child illness, etc.)
  • Conjoint interview (session 1- meet with both partners)
  • Individual interviews (sessions 2 & 3- meet with partner A and B on their own, assessing for their own things)
51
Q

Couples Therapy: Feedback session and Beginning Treatment- Session 4

A

-Feedback session (begin session 4)
-Couples Conceptualization
1) How they got here (integrate both stories)
2) Where they want to go (integrate both stories)
3) How you are going to get them there? (Triadic Consensus Model and interventions)
-done with both partners

52
Q

Challenges and Diversity

A

-Address similarities and challenges
1)Coping with discrimination
2) Negotiation levels of outness
3) Managing internalized stigma
4) Negotiating sexual boundaries of openness

53
Q

What can therapists do to help with commitment ambivalence

A

ask is each partner’s level of commitment (on a scale of 1-10 how committed are you?) that can be part of your focus of treatment

54
Q

In Couple Therapy how do you track outcome?

A

Pre-Mid-Post - track outcomes - is it working?
Couple Satisfaction Index (CSI-16)
Outcome Questionnaire (OQ-45)

55
Q

In couples Therapy what should the therapist do for long-term change?

A

-Emphasize continued effort and work
-Plan of action for coping with backsliding
-Returning for booster sessions when problems begin not when marital crisis occurs

56
Q

Couples Therapy - Emotional Validation is Important

A

emotional validation (showing empathy for a partner’s feelings without necessarily being in agreement

MFT 561 (3 decks)

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