Behavioural Marital Therapy: An Overview

Prevention of Marital Distress: Current Issues in Programming and Research

Marital dissatisfaction is the most common presenting problem in adults seeking psychological services and is rated as the second most severe stress adults can experience after a death in the family. Almost every married couple is, at some time, at risk for marital distress, conflict, separation, and divorce and for the resulting stress on themselves and their children. Traditionally, theory and practice have focused on tertiary prevention of marital distress (i.e., marital therapies). However, marital therapy has limited efficacy and accesses only limited numbers of couples. Poor communication and dissatisfaction with interactions, assessed premaritally, are strong predictors of marital distress. Several marital distress prevention programs have been developed which generally or specifically target communication behaviour of pre- and early married couples. Outcome evaluations suggest such programs can lead to improved communication and problem-solving skills, improved relationship satisfaction, lower levels of marital violence, and diminished probability of marital dissolution. Suggestions for future research include a more fine-grained analysis of situation-specific cognition, affect, and psychophysiological responses during communication, incorporation of a self-regulatory model within prevention work, and the use of longitudinal research designs.

The role of the clinical psychologist in gynecological cancer

Gynecological cancers, which account for a substantial proportion of cancer cases in women, can precipitate a wide range of psychological difficulties including affective disturbances, sexual problems, certain somatic symptoms, and family issues. The clinical psychologist has a unique contribution to make in the assessment and treatment of the psychological needs of gynecological cancer patients, while also conducting research and providing training for health professionals regarding the psychological issues associated with gynecological cancer. Although the gynecological cancer setting affords the clinical psychologist multiple personal benefits, strategies must usually be implemented to minimize any negative impact arising from working in an area of considerable psychological stress.