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Khalifian C, Rashkovsky K, Mitchell E, Bismark A, Wagner AC, Knopp KC. A novel framework for ketamine-assisted couple therapy. Front Psychiatry 2024; 15:1376646. [PMID: 39193577 PMCID: PMC11347343 DOI: 10.3389/fpsyt.2024.1376646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 07/17/2024] [Indexed: 08/29/2024] Open
Abstract
Intimate relationship distress is prevalent and is associated with poorer health, mental health, and mortality outcomes. Evidence-based couple therapies target cognitive, behavioral, and emotional processes that underlie relationship dysfunction. Increasing research and clinical evidence supports the efficacy of ketamine-assisted psychotherapy (KAP) for addressing clinical mental health concerns, including depression, anxiety disorders, posttraumatic stress disorder, and more. The purported mechanisms of KAP are also likely to improve psychosocial and relational functioning for patients and may be useful for supporting change mechanisms in couple therapy. This paper reviews the current evidence for therapeutic ketamine and KAP and outlines how the mechanisms of ketamine therapy may also augment the cognitive, behavioral, and emotional interventions in the most commonly used evidence-based couple therapies. Key mechanisms include increased neuroplasticity, changes in functional connectivity, adaptive dissociation, decreased inhibition, and reduced avoidance. Given the reciprocal interaction between relationship dysfunction and mental health problems, ketamine may also help alleviate relationship distress by directly treating clinical mental health symptoms. We then outline a proposed framework for ketamine-assisted couple therapy, addressing the application of KAP preparation, dosing, and integration to a dyadic intervention framework in a way that can be applied to different couple therapy modalities. This clinical framework for couples' KAP may be useful for clinicians and researchers working to improve the efficacy of couple therapy, particularly when one or both partners has accompanying mental health concerns.
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Affiliation(s)
- C. Khalifian
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - K. Rashkovsky
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - E. Mitchell
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - A. Bismark
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - A. C. Wagner
- Remedy, Toronto, ON, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - K. C. Knopp
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
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Voils CI, Shaw RJ, Gavin KL, Hetzel SJ, Lewis MA, Pabich S, Johnson HM, Elwert F, Mao L, Gray KE, Yuroff A, Garza K, Yancy WS, Porter LS. Outcomes from Partner2Lose: a randomized controlled trial to evaluate 24-month weight loss in a partner-assisted intervention. BMC Public Health 2024; 24:1948. [PMID: 39033273 PMCID: PMC11265014 DOI: 10.1186/s12889-024-19464-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/12/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Partner support is associated with better weight loss outcomes in observational studies, but randomized trials show mixed results for including partners. Unclear is whether teaching communication skills to couples will improve weight loss in a person attempting weight loss (index participant). PURPOSE To compare the efficacy of a partner-assisted intervention versus participant-only weight management program on 24-month weight loss. METHODS This community-based study took place in Madison, WI. Index participants were eligible if they met obesity guideline criteria to receive weight loss counseling, were aged 18-74 years, lived with a partner, and had no medical contraindications to weight loss; partners were aged 18-74 years and not underweight. Couples were randomized 1:1 to a partner-assisted or participant-only intervention. Index participants in both arms received an evidence-based weight management program. In the partner-assisted arm, partners attended half of the intervention sessions, and couples were trained in communication skills. The primary outcome was index participant weight at 24 months, assessed by masked personnel; secondary outcomes were 24-month self-reported caloric intake and average daily steps assessed by an activity tracker. General linear mixed models were used to compare group differences in these outcomes following intent-to-treat principles. RESULTS Among couples assigned to partner-assisted (n = 115) or participant-only intervention (n = 116), most index participants identified as female (67%) and non-Hispanic White (87%). Average baseline age was 47.27 years (SD 11.51 years) and weight was 106.55 kg (SD 19.41 kg). The estimated mean 24-month weight loss was similar in the partner-assisted (2.66 kg) and participant-only arms (2.89 kg) (estimated mean difference, 0.23 kg [95% CI, -1.58, 2.04 kg], p=0.80). There were no differences in 24-month average daily caloric intake (estimated mean difference 50 cal [95% CI: -233, 132 cal], p=0.59) or steps (estimated mean difference 806 steps [95% CI: -1675, 64 steps], p=0.07). The percentage of participants reporting an adverse event with at least possible attribution to the intervention did not differ by arm (partner-assisted: 9%, participant-only, 3%, p = 0.11). CONCLUSIONS Partner-assisted and individual weight management interventions led to similar outcomes in index participants. TRIAL REGISTRATION Clinicaltrials.gov NCT03801174, January 11, 2019.
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Affiliation(s)
- Corrine I Voils
- Department of Surgery, University of Wisconsin-Madison School of Medicine & Public Health, 600 Highland Ave, K6/100 CSC, Madison, WI, 53792-1690, USA.
- William S Middleton Memorial Veterans Hospital, 2500 Overlook Terrace (151), Madison, WI, 53705, USA.
| | - Ryan J Shaw
- Duke University School of Nursing, 307 Trent Dr, Durham, NC27710, , DUMC 3322, USA
| | - Kara L Gavin
- Medical College of Wisconsin Center for Advancing Population Sciences, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Scott J Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin - Madison, School of Medicine and Public Health, 207G WARF 610 Walnut St., Madison, WI, 53726, USA
| | - Megan A Lewis
- RTI International, 3040 East Cornwallis Rd., Research Triangle Park, P.O. Box 12194, NC, 27709-2194, USA
| | - Samantha Pabich
- School of Medicine and Public Health, Department of Medicine, University of Wisconsin - Madison, 451 1685 Highland Ave, Madison, WI, 4144, USA
| | - Heather M Johnson
- Baptist Health South Florida/Charles E. Schmidt College of Medicine, Florida Atlantic University, 690 Meadows Road, Boca Raton, FL, 33486, USA
| | - Felix Elwert
- Department of Sociology, Department of Biostatistics and Medical Informatics, Department of Population Health Sciences, University of Wisconsin-Madison, 1800 Observatory Dr, Madison, WI, 53706, USA
| | - Lu Mao
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, 207A WARF 610 Walnut St., Madison, WI, 53726, USA
| | - Kristen E Gray
- VA Puget Sound Health Care System, Health Services Research & Development, 1660 S. Columbian Way, Seattle, WA98108, S-152, USA
- Department of Health Systems and Population Health, University of Washington, 3980 15 Ave NE, Box 351621, Seattle, WA, 98195, USA
| | - Alice Yuroff
- University of Wisconsin-Madison School of Medicine & Public Health, Wisconsin Research and Education Network, 610 Whitney Way Suite 200, Madison, WI, 53705, USA
| | - Katya Garza
- Department of Surgery, University of Wisconsin-Madison School of Medicine & Public Health, 600 Highland Ave, K6/100 CSC, Madison, WI, 53792-1690, USA
| | - William S Yancy
- Department of Medicine, Duke University School of Medicine, 501 Douglas Street, Durham, NC, 27705, USA
| | - Laura S Porter
- Department of Psychiatry & Behavioral Sciences, Duke School of Medicine, Durham, NC, 27710, USA
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Weber DM, Halverson TF, Daruwala SE, Pugh MJ, Calhoun PS, Beckham JC, Kimbrel NA. Love Is Not All You Need: Understanding the Association Between Relationship Status and Relationship Dysfunction With Self-Directed Violence in Veterans. Arch Suicide Res 2024; 28:844-859. [PMID: 37548583 DOI: 10.1080/13811118.2023.2237097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Research indicates that being married is associated with reduced risk of suicide and self-directed violence (SDV) relative to being divorced. Simultaneously, difficulties within relationships predict poorer health outcomes. However, research on relationship status rarely examines relationship functioning, obfuscating the joint contribution of these variables for SDV risk. METHOD Veterans (N = 1,049) completed a survey that included assessment of relationship status, relationship functioning, and SDV history. Logistic regression models tested how (a) relationship status, (b) relationship dysfunction, and (c) being divorced compared to being in a low- or high-dysfunction relationship were associated with SDV, controlling for several intrapersonal risk factors. RESULTS Veterans in a relationship did not differ in SDV history compared to divorced/separated veterans. However, more dysfunction within relationships was associated with greater odds of a history of SDV and suicidal cognitions. Finally, SDV histories were more likely among veterans endorsing high-dysfunction relationships compared with (a) low-dysfunction relationships and (b) divorced veterans. CONCLUSION It may be insufficient to only consider relationship status when evaluating interpersonal risk factors for SDV. A single item assessing relationship dysfunction was associated with enacted SDV and suicidal cognitions over and above intrapersonal risk factors. Integrating such single-item measures into clinical practice could improve identification and subsequent tailored intervention for veterans at greater risk for SDV.
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Siegel JA, Mendoza RR, Tesselaar JM, DeJesus J, Elbe CI, Caravelli NS, Troy L, Fenton M, Victoria B, Herrera J, Blashill AJ. "I felt so powerful to have this love in me": A grounded theory analysis of the experiences of people living with and recovering from eating disorders while in diverse romantic relationships. Body Image 2024; 49:101709. [PMID: 38615591 DOI: 10.1016/j.bodyim.2024.101709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/16/2024]
Abstract
Romantic partners have the potential to influence attitudes and behaviors related to body image and disordered eating. However, the role that romantic relationships can play in eating disorder (ED) recovery has not been comprehensively investigated. The present study aimed to explore the ways that people living with and recovering from EDs experience their romantic relationships, with the specific objective of developing a novel theoretical framework, grounded in the experiences of people in diverse romantic relationships, to guide future research on the topic. Semi-structured individual interviews were conducted with 66 people (45 cisgender women, 11 cisgender men, 9 nonbinary people, and 1 transgender man) living with and recovering from EDs while in romantic relationships. Our grounded theory analysis yielded a theoretical model of ED management in romantic relationships, revealing that Individual and Relationship Characteristics intersected with Relationship-Related Stressors and were navigated using Eating Disorder and Relationship Management Strategies. Combined with Partner Support and Tensions, these management strategies were related to Relationship and Mental Health Outcomes, which affected and were affected by Future Concerns. Future researchers should continue to build on, expand, and modify this model and further explore the role of romantic relationships in the experience of people living with EDs.
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Affiliation(s)
| | | | | | | | - Connor I Elbe
- Department of Psychology, San Diego State University, USA
| | | | - Lynae Troy
- Department of Psychology, San Diego State University, USA
| | - Margo Fenton
- Department of Psychology, San Diego State University, USA
| | | | | | - Aaron J Blashill
- Department of Psychology, San Diego State University, SDSU/UCSD Joint Doctoral Program in Clinical Psychology, USA
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Voils C, Shaw R, Gavin K, Hetzel S, Lewis M, Pabich S, Johnson H, Elwert F, Mao L, Gray K, Yuroff A, Garza K, Yancy W, Porter L. Primary outcomes from Partner2Lose: A randomized controlled trial to evaluate partner involvement on long-term weight loss. RESEARCH SQUARE 2024:rs.3.rs-4001003. [PMID: 38559225 PMCID: PMC10980155 DOI: 10.21203/rs.3.rs-4001003/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background Partner support is associated with better weight loss outcomes in observational studies, but randomized trials show mixed results for including partners. Unclear is whether teaching communication skills to couples will improve weight loss in index participants. Purpose To compare the efficacy of a partner-assisted intervention versus participant-only weight management program on long-term weight loss. Methods This community-based study took place in Madison, WI. Index participants were eligible if they met obesity guideline criteria to receive weight loss counseling, were aged 74 years or younger, lived with a partner, and had no medical contraindications to weight loss; partners were aged 74 years or younger and not underweight. Couples were randomized 1:1 to a partner-assisted or participant-only intervention. Index participants in both arms received an evidence-based weight management program. In the partner-assisted arm, partners attended half of the intervention sessions, and couples were trained in communication skills. The primary outcome was index participant weight at 24 months, assessed by masked personnel; secondary outcomes were 24-month self-reported caloric intake and average daily steps assessed by an activity tracker. General linear mixed models were used to compare group differences in these outcomes following intent-to-treat principles. Results Among couples assigned to partner-assisted (n=115) or participant-only intervention (n=116), most index participants identified as female (67%) and non-Hispanic White (87%). Average baseline age was 47.27 years (SD 11.51 years) and weight was 106.55 kg (SD 19.41 kg). The estimated mean 24-month weight loss was similar in the partner-assisted (2.66 kg) and participant-only arms (2.89 kg) (estimated mean difference, 0.23 kg [95% CI, -1.58, 2.04 kg]). There were no differences in 24-month average daily caloric intake (50 cal [95% CI: -233, 132 cal]) or steps (806 steps [95% CI: -1675, 64 steps]). The percentage of participants reporting an adverse event with at least possible attribution to the intervention did not differ by arm (partner-assisted: 9%, participant-only, 3%, p=0.11). Conclusions Partner-assisted and individual weight management interventions led to similar outcomes in index participants. Trial registration Clinicaltrials.gov NCT03801174.
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Affiliation(s)
- Corrine Voils
- University of Wisconsin-Madison School of Medicine & Public Health
| | | | | | - Scott Hetzel
- University of Wisconsin-Madison School of Medicine & Public Health
| | | | - Samantha Pabich
- University of Wisconsin-Madison School of Medicine & Public Health
| | - Heather Johnson
- Baptist Health South Florida/Charles E. Schmidt College of Medicine, Florida Atlantic University
| | | | - Lu Mao
- University of Wisconsin School of Medicine and Public Health
| | | | - Alice Yuroff
- University of Wisconsin-Madison School of Medicine & Public Health
| | - Katya Garza
- University of Wisconsin-Madison School of Medicine & Public Health
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Belus JM, Hines AC, Magidson JF, Iwamoto D, Rose AL, Li A, Barnabas RV, van Heerden A. Development and Empirical Test of the Research-Informed South African Relationship Functioning Assessment (SARFA). PERSONAL RELATIONSHIPS 2024; 31:44-66. [PMID: 38708292 PMCID: PMC11068037 DOI: 10.1111/pere.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 09/15/2023] [Indexed: 05/07/2024]
Abstract
Intimate partners play an important role in chronic diseases. Despite the chronic disease burden increase in sub-Saharan Africa, very few culturally-relevant quantitative measures of intimate relationship functioning are available. We conducted an empirical investigation evaluating the psychometric properties of the South African Relationship Functioning Assessment (SARFA) assessing healthy relationship functioning in N = 150 community members (50% women; M age = 27.2 years) living in the Vulindlela area of KwaZulu-Natal, South Africa. Item development was based on prior qualitative research from two South African communities. All assessments were conducted in isiZulu, participants' primary language. An exploratory factor analysis was conducted on the initial 39-item measure. The best-fitting model consisted of one factor with 22 items. The SARFA's internal consistency was α = .94. Convergent validity was observed via significant positive associations (all rs ≥ .38, p < .001) between the SARFA's total score and measures of trust, emotional intimacy, constructive communication, sexual satisfaction, and relationship control (women only). Divergent validity was observed for women only. Encouraging initial psychometric properties of a culturally-relevant measure of relationship functioning in KwaZulu-Natal may have relevance to other communities and potential to be used in research involving couples and health in chronic disease-burdened communities.
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Affiliation(s)
- Jennifer M Belus
- University Hospital Basel, Department of Clinical Research, Basel, Switzerland
- University of Basel, Basel, Switzerland
- University of Maryland, Department of Psychology, College Park, MD, USA
| | - Abigail C Hines
- University of Maryland, Department of Psychology, College Park, MD, USA
| | | | - Derek Iwamoto
- University of Maryland, Department of Psychology, College Park, MD, USA
| | - Alexandra L Rose
- University of Maryland, Department of Psychology, College Park, MD, USA
| | - Alison Li
- Orlando Regional Medical Center, Cardiovascular Intensive Care Unit, Orlando, FL, USA
| | - Ruanne V Barnabas
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Alastair van Heerden
- Centre for Community Based Research, Human Sciences Research Council, Pietermaritzburg, South Africa
- SAMRC/WITS Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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Don BP, Simpson JA, Fredrickson BL, Algoe SB. Interparental Positivity Spillover Theory: How Parents' Positive Relational Interactions Influence Children. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2024:17456916231220626. [PMID: 38252555 DOI: 10.1177/17456916231220626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Interparental interactions have an important influence on child well-being and development. Yet prior theory and research have primarily focused on interparental conflict as contributing to child maladjustment, which leaves out the critical question of how interparental positive interactions-such as expressed gratitude, capitalization, and shared laughter-may benefit child growth and development. In this article, we integrate theory and research in family, relationship, and affective science to propose a new framework for understanding how the heretofore underexamined positive interparental interactions influence children: interparental positivity spillover theory (IPST). IPST proposes that, distinct from the influence of conflict, interparental positive interactions spill over into children's experiences in the form of their (a) experience of positive emotions, (b) beneficially altered perceptions of their parents, and (c) emulation of their parents' positive interpersonal behaviors. This spillover is theorized to promote beneficial cognitive, behavioral, social, and physiological outcomes in children in the short term (i.e., immediately after a specific episode of interparental positivity, or on a given day) as well as cumulatively across time. As a framework, IPST generates a host of novel and testable predictions to guide future research, all of which have important implications for the mental health, well-being, and positive development of children and families.
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Affiliation(s)
- Brian P Don
- School of Psychology, University of Auckland
| | | | | | - Sara B Algoe
- Department of Psychology, University of North Carolina at Chapel Hill
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8
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Crenshaw AO, Libet J, Petty K, Teves JB, Huang A, Mitchell J. Subjective emotion trajectories in couple therapy and associations with improvement in relationship satisfaction. FAMILY PROCESS 2023; 62:1542-1554. [PMID: 36575606 DOI: 10.1111/famp.12843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 06/17/2023]
Abstract
Existing couple therapies are generally effective for reducing romantic relationship distress and divorce, but therapy outcomes remain poor for many. Outcomes can be improved through greater understanding of session-by-session therapeutic processes, particularly in real-world treatment settings. Modern couple therapy models commonly emphasize the importance of emotional experiences as key change processes, yet few empirical studies have tested the merits of this focus. The present study addresses this limitation by examining trajectories of subjective emotions and their association with change in a key relationship outcome, relationship satisfaction, among military veterans and their partners at a VA Medical Center. Partners rated their relationship satisfaction prior to couple therapy sessions and subjective emotions immediately after sessions. Consistent with hypotheses, both hard (e.g., anger) and soft (e.g., sadness) negative emotions decreased significantly over the course of therapy. Those couples with greater decreases in hard negative, but not soft negative, emotions showed significantly more improvement in relationship satisfaction. Positive emotions did not significantly change across couples in general, but those couples whose positive emotions did increase also showed more improvement in relationship satisfaction. These results suggest change in subjective emotions may be one process underlying improvement in couple therapy and lend empirical support to the emphasis on emotion-based change processes underlying acceptance-based and emotion-focused couple therapies.
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Affiliation(s)
- Alexander O Crenshaw
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Julian Libet
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Karen Petty
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jenna B Teves
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Alice Huang
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
| | - Jerez Mitchell
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
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Landolt SA, Weitkamp K, Roth M, Sisson NM, Bodenmann G. Dyadic coping and mental health in couples: A systematic review. Clin Psychol Rev 2023; 106:102344. [PMID: 37866090 DOI: 10.1016/j.cpr.2023.102344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023]
Abstract
Globally, one out of three people suffer from a mental health issue during their lifetime. In romantic relationships, impaired mental health does not only affect the individual but also their partner and therefore needs to be coped with dyadically. In this systematic review, we summarize research examining dyadic coping (DC) in the context of mental health and individual and relational outcomes. We searched for peer-reviewed articles published between January 1990 and April 2023 on PsycInfo, Medline, and PSYNDEX on DC and mental health within romantic relationships. A total of 60 qualitative, quantitative, and intervention studies met the inclusion criteria, reporting on 16,394 individuals and 4,945 dyads. To synthesize the studies, we used a narrative synthesis approach. Overall, stress expression and positive DC yielded beneficial individual and relational outcomes, whereas, for negative DC, the opposite was true. Results differed between mental health clusters and context played an important role (e.g., symptom severity, life phase). Due to the great diversity of studies and variables, further research should focus on understudied mental health clusters (e.g., anxiety disorders). Clinicians are advised to view mental health issues as a dyadic rather than an individual phenomenon ("we-disease") and develop tailored couple-centered interventions.
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Affiliation(s)
| | | | - Michelle Roth
- Department of Psychology, University of Zurich, Switzerland
| | - Natalie M Sisson
- Department of Psychology, University of Toronto Mississauga, Canada
| | - Guy Bodenmann
- Department of Psychology, University of Zurich, Switzerland
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Gil M, Kim SS, Kim D, Kim S. Online coaching blended couple-oriented intervention for preventing depression among Korean middle adulthood: A feasibility study. FAMILY PROCESS 2023; 62:1478-1505. [PMID: 37641515 DOI: 10.1111/famp.12924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/27/2023] [Accepted: 07/22/2023] [Indexed: 08/31/2023]
Abstract
Depression and marital satisfaction have a reciprocal cause-and-effect relationship. Thus, couple relationships should be considered to maximize the effectiveness of couple-oriented interventions for depression. Moreover, developing culturally tailored couple-oriented interventions is critical for improving cultural acceptability and enhancing the perceived effectiveness of the interventions. A new culturally tailored MindGuide Couple intervention was developed to prevent Korean middle adulthood depression and enhance couple relationships using intervention mapping. This feasibility study used a single-arm, pre- and post-test, and 2-month follow-up design to explore the reach, acceptability, and preliminary effectiveness of this preventive intervention. Reach was assessed by recruitment, retention, and completion rates; acceptability was measured based on helpfulness, suitability, and satisfaction; and preliminary effectiveness was measured by depression (CES-D), positive and negative affect (PANAS), satisfaction with life (SWLS), couple satisfaction (CSI), and healthy relationship between spouses (FRAS). Fifteen middle-aged couples participated in four psychoeducational and asynchronous online modules and four synchronous coaching sessions via videoconferencing for 5-7 weeks. Data were analyzed using descriptive statistics and repeated measures with analysis of variance. With a 94.1% completion rate, the participants demonstrated high satisfaction with the online coaching blended intervention and reported that it was helpful and easy to use. Both husbands and wives showed significant differences over time in depression, couple satisfaction, and healthy relationships between spouses. This feasibility study demonstrated the successful reach, acceptability, and potential effectiveness of this preventive intervention. Additionally, we suggest the importance of culturally tailored and online coaching blended couple-oriented intervention for preventing depression and promoting healthy couple relationships.
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Affiliation(s)
- Minji Gil
- College of Nursing, Ewha Womans University, Seoul, South Korea
- Department of Nursing, Gangneung-Wonju National University, Wonju, South Korea
| | - Suk-Sun Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Daeun Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Sunhai Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
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Tseng CF, Miller DL, Huerta P, PettyJohn ME, Yzaguirre MM, Agundez JC, Wittenborn AK. Recruitment strategies in couple intervention studies: A systematic review of recruitment methods and sample characteristics in the United States from 2015 to 2020. FAMILY PROCESS 2023; 62:880-898. [PMID: 37086013 DOI: 10.1111/famp.12885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Abstract
Including diverse participants in couple intervention studies is critical for developing an evidence base that informs best practices for all potential clients. Research has shown that subgroups of clients respond differently to different interventions and that interventions that have been adapted to fit the needs of a given population are more effective than non-adapted interventions. Unfortunately, couple intervention samples often exclude participants with marginalized identities and culturally adapted couple intervention research is limited. The lack of information about best practices for diverse client subgroups perpetuates mental and relational health disparities. We conducted a systematic review to examine recruitment strategies and sampling characteristics of diverse races/ethnicities, incomes, ages, and sexual identities. We reviewed articles published between January 2015 and December 2020. Articles were eligible for inclusion in our review if they implemented an intervention with couples in the United States. Of 4054 articles identified, 54 articles were eligible for our review. Findings suggest that couple intervention studies lack diversity across multiple identity domains (i.e., races/ethnicities, incomes, ages, and sexual identities). Further, descriptions of recruitment strategies are often vague, limiting opportunities to better understand methods used to recruit diverse samples.
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Affiliation(s)
- Chi-Fang Tseng
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Debra L Miller
- Community Mental Health for Central Michigan, Mt. Pleasant, Michigan, USA
| | - Patricia Huerta
- Human Development and Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Morgan E PettyJohn
- Center for Violence Prevention, University of Texas Medical Branch, Galveston, Texas, USA
| | - Melissa M Yzaguirre
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - J C Agundez
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Andrea K Wittenborn
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
- Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, Michigan, USA
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Chamorro PP, Pino MJ, Casas-Rosal JC, Herruzo J. A longitudinal comparative study of a multicouple group and single-couple psychosocial intervention while experiencing infertility. FAMILY PROCESS 2023; 62:557-575. [PMID: 36175066 DOI: 10.1111/famp.12820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 06/08/2023]
Abstract
This is a quasi-experimental, nonequivalent design study investigating the efficacy of multicouple group and single-couple intervention formats aimed at diminishing the psychosocial impact of infertility. The review studies carried out to date that have assessed this subject do not show consistent findings and although increasing the efficacy and efficiency of intervention formats more than justifies their analysis, there are no studies making this particular comparison. Eighty-seven infertile couples who were in assessment for their infertility and/or were close to undergoing some kind of assisted reproductive technology process participated in a psychosocial intervention either under the multicouple group or single-couple subconditions, or acted as controls. The variables of depression, anxiety, and fertility quality of life were used for evaluating psychosocial impact. Comparisons were made: (a) between the intervention condition and controls and (b) between the two subconditions. The results support the efficacy of the intervention both in the dyadic latent growth curve models analysis carried out and in the treatment effect calculation. Although in the comparison between the multicouple and single-couple format, some differences generally favoring the single format one were found, they were not conclusive. Therefore, the results are in line with review studies that did not find the group format to be more effective. Although this study provides valuable information, its limitations mean that further research needs to be carried out. When selecting the intervention format, therapists should also weigh up others aspects, such as the intervention goal, patient's needs and characteristics, reproductive history, and current stage of infertility.
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13
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Shariatpanahi M, Faramarzi M, Barat S, Farghadani A, Shirafkan H. Acceptability, feasibility, and effectiveness of internet-based emotion-focused cognitive behavior therapy with husband participation for Iranian pregnant women with anxiety disorder. INTERNATIONAL JOURNAL OF SYSTEMIC THERAPY 2023. [DOI: 10.1080/2692398x.2023.2174773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Mojgan Shariatpanahi
- Psychology, Department of Psychology, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Mahbobeh Faramarzi
- Psychology, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shahnaz Barat
- Obstetrics and Gynecology, Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Azadeh Farghadani
- Department of Psychology, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Hoda Shirafkan
- Biostatistics, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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14
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McKee LG, Yang Y, Highlander A, McCall M, Jones DJ. Conceptualizing the Role of Parent and Child Emotion Regulation in the Treatment of Early-Onset Behavior Disorders: Theory, Research, and Future Directions. Clin Child Fam Psychol Rev 2023; 26:272-301. [PMID: 36385585 DOI: 10.1007/s10567-022-00419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
Behavior disorders (BDs) are common and costly, making prevention and early-intervention a clinical and public health imperative. Behavioral Parent Training (BPT) is the standard of care for early-onset (3-8 years old) BDs, yet effect sizes vary and wane with time suggesting the role of underlying factors accounting for variability in outcomes. The literature on emotion regulation (ER), which has been proposed as one such underlying factor, is reviewed here, including a brief overview of ER, theory and research linking ER, externalizing symptoms, and/or BDs, and still largely preliminary work exploring the role of parent and child ER in BPT outcomes. Research to date provides clues regarding the interrelationship of ER, BDs, and BPT; yet, determining whether adaptations to BPT targeting ER are necessary or useful, for whom such adaptations would be most important, and how those adaptations would be implemented requires addressing mixed findings and methodological limitations. To guide such work, we propose a conceptual model elucidating how standard BPT may impact ER and processes linked to ER, which we believe will be useful in organizing and advancing both basic and applied research in future work.
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Affiliation(s)
- Laura G McKee
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Yexinyu Yang
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - April Highlander
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Madison McCall
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Deborah J Jones
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA.
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15
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Lebow J, Snyder DK. Couple therapy in the 2020s: Current status and emerging developments. FAMILY PROCESS 2022; 61:1359-1385. [PMID: 36175119 PMCID: PMC10087549 DOI: 10.1111/famp.12824] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/10/2022] [Accepted: 08/23/2022] [Indexed: 06/16/2023]
Abstract
This paper provides a critical analysis and synthesis of the current status and emerging developments in contemporary couple therapy. Its narrative centers on the evolution of couple therapy into a prominent intervention modality and coherent body of practice. The review begins with the consideration of the field's strong empirical underpinnings derived from research on couple therapy and basic relational science. Couple therapy comprises the widely accepted method for reducing relationship distress and enhancing relationship quality. Moreover, both as a stand-alone intervention and in conjunction with other treatment formats, couple-based interventions have garnered considerable empirical support for their effectiveness in addressing a broad spectrum of specific relational dysfunctions as well as individual emotional and physical health problems. We highlight the convergence of methods through common factors, shared strategies, and remarkably similar arrangements across approaches. Our review also points to key differences among approaches, the importance of recognizing respective strengths and limitations linked to these differences, and building on differences across models when selecting and tailoring interventions for a given couple. The discussion concludes with a consideration of recent trends in the field including the impact of telehealth and related digital technologies, the expansion of specific treatments for specific problems and diverse populations, the interface of couple therapy with relationship education, and enduring challenges as well as new opportunities addressing broader systemic and global dynamics.
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Affiliation(s)
- Jay Lebow
- Family Institute of NorthwesternNorthwestern UniversityEvanstonIllinoisUSA
| | - Douglas K. Snyder
- Department of Psychological and Brain SciencesTexas A&M UniversityCollege StationTexasUSA
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16
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Wawrziczny E, Picard S, Buquet A, Traversac E, Puisieux F, Pasquier F, Huvent-Grelle D, Doba K. Hypnosis Intervention for Couples Confronted with Alzheimer’s Disease: Promising Results of a First Exploratory Study. J Alzheimers Dis 2022; 89:1351-1366. [DOI: 10.3233/jad-220430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Dementia has a negative impact on the quality of life of the person with dementia and their spouse caregivers, as well as on the couple’s relationship, which can lead to high levels of distress for both partners. Hypnosis has been shown to be effective in managing distress and increasing the quality of the relationship. Objective: The aim was to develop a standardized hypnosis intervention for couples confronted with Alzheimer’s disease and evaluate its feasibility, acceptability, and helpfulness in managing the distress of both partners and increasing the quality of the relationship. Methods: In a single-arm study, sixteen couples received the 8-week intervention. Qualitative and quantitative assessments were conducted pre- and post-intervention as well as three months after. Results: 88.9% of couples (n = 16) of the final sample (n = 18) completed the intervention. Despite the negative representations of hypnosis, several factors led couples to accept to participate in this study: positive expectations, professional endorsement, medical application, non-drug approach, home-based, free, flexible, and couple-based intervention. The results showed a significant decrease in distress for both partners. These effects were maintained three months after the intervention. Couples felt more relaxed, had fewer negative emotions, accepted difficulties more easily, were more patient, and reported better communication and more affection in the relationship. Conclusion: Overall, this pilot study shows the feasibility and acceptability of hypnosis with couples confronted with Alzheimer’s disease. Although measures of the preliminary pre- and post-intervention effects are encouraging, confirmatory testing with a randomized controlled trial is needed.
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Affiliation(s)
- Emilie Wawrziczny
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
| | - Sandrine Picard
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
| | - Amandine Buquet
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
| | - Elodie Traversac
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
| | - François Puisieux
- Department of Geriatrics, Memory consultation, CHU Lille, Lille, France
| | - Florence Pasquier
- Department of Neurology, Memory Research and Resources Clinic, CHU Lille, Lille, France
| | | | - Karyn Doba
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
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17
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Smith TW. Intimate Relationships and Coronary Heart Disease: Implications for Risk, Prevention, and Patient Management. Curr Cardiol Rep 2022; 24:761-774. [PMID: 35380384 PMCID: PMC8981884 DOI: 10.1007/s11886-022-01695-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Research and clinical services addressing psychosocial aspects of coronary heart disease (CHD) typically emphasize individuals, focusing less on the context of intimate relationships such as marriage and similar partnerships. This review describes current evidence regarding the role of intimate relationships in the development, course, and management of CHD. RECENT FINDINGS Having an intimate partner is associated with reduced risk of incident CHD and a better prognosis among patients, but strain (e.g., conflict) and disruption (i.e., separation, divorce) in these relationships are associated with increased risk and poor outcomes. These associations likely reflect mechanisms involving health behavior and the physiological effects of emotion and stress. Importantly, many other well-established psychosocial risk and protective factors (e.g., low SES, job stress, depression, and optimism) are strongly related to the quality of intimate relationships, and these associations likely contribute to the effects of those other psychosocial factors. For better or worse, intimate partners can also affect the outcome of efforts to alter health behaviors (physical activity, diet, smoking, and medication adherence) central in the prevention and management CHD. Intimate partners also influence-and are influenced by-stressful aspects of acute coronary crises and longer-term patient adjustment and management. Evidence on each of these roles of intimate relationships in CHD is considerable, but direct demonstrations of the value of couple assessments and interventions are limited, although preliminary research is promising. Research needed to close this gap must also address issues of diversity, disparities, and inequity that have strong parallels in CHD and intimate relationships.
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Affiliation(s)
- Timothy W Smith
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.
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18
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Embedding the silver thread in all-age psychological services: training and supervising younger therapists to deliver CBT for anxiety or depression to older people with multi-morbidity. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract
Providers of cognitive behavioural therapy (CBT) in adult mental health services in the UK are expected to deliver therapy suitable for adults of all ages. However, older people commonly present with co-morbidities that challenge delivery of single-diagnosis CBT protocols. Added to this, the difference in age between therapy-provider and service-user can compromise collaboration. In this paper, I consider two key areas of relevance for training and supervising CBT therapists for work with older people, namely multi-morbidities and intergenerational relations. The evolving evidence base for CBT with older people is summarised and a commentary provided on previous ‘old age’ case studies from the Cognitive Behaviour Therapist (tCBT). Strategies for collaborative relationships are discussed, as are strategies for ‘embedding the silver thread’. I conclude with recommendations for future directions for CBT training and supervision.
Key learning aims
(1)
To be aware that any differences in working with older people are not due to age per se, but factors such as cohort differences and multi-morbidity.
(2)
To reflect on case examples of CBT with older people.
(3)
To learn strategies for developing collaborative relationships across an intergenerational divide.
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19
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Rabey M, Buldo B, Duesund Helland M, Pang C, Kendell M, Beales D. Significant other interactions in people with chronic low back pain: Subgrouping and multidimensional profiles. Br J Pain 2021; 16:326-340. [DOI: 10.1177/20494637211062045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Back pain is complex. Social support and significant other interactions influence the pain experience. Purpose: To statistically derive subgroups of people with chronic low back pain based upon their interactions with significant others, and profile subgroups across multidimensional variables. Research Design: Longitudinal cohort study. Study Sample: People with chronic axial low back pain ( n = 262). Data Collection and Analysis: Latent class analysis of significant other interaction data was used to derive subgroups of people with chronic low back pain. Subgroups were profiled across baseline multidimensional variables and one-year follow-up pain intensity, disability and bothersomeness. Results: Three clusters were identified: Cluster 1 (7.6%) characterised by the lowest distracting, punishing and solicitous interactions. Cluster 2 (16.0%) characterised by the highest distracting and solicitous responses and social support. Cluster 3 (76.3%) characterised by the highest punishing and lowest social support. Cluster 1 reported less disability than Clusters 2 and 3. Mindfulness was significantly different across all subgroups with Cluster 1 being most mindful and Cluster 3 least mindful. Depression, anxiety and stress were significantly higher in Cluster 3 than Cluster 1. Pain catastrophising was higher for Cluster 2 than Clusters 1 and 3. Cluster 2 had lower pressure pain threshold than Clusters 1 and 3. Conclusions: These results support the association between significant other interactions and the experience of back pain. Considering significant other interactions in clinical practice may be important for managing some people’s presentation.
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Affiliation(s)
- Martin Rabey
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
- Thrive Physiotherapy, Guernsey
| | - Brendan Buldo
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
| | - Magnus Duesund Helland
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
| | - Courtenay Pang
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
| | - Michelle Kendell
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
| | - Darren Beales
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
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20
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Wagner AC. Couple Therapy With MDMA-Proposed Pathways of Action. Front Psychol 2021; 12:733456. [PMID: 34858270 PMCID: PMC8631777 DOI: 10.3389/fpsyg.2021.733456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/05/2021] [Indexed: 12/03/2022] Open
Abstract
MDMA's first identified potential as a therapeutic catalyst was for couple therapy. Early work in the 1970s and 1980s explored its potential amongst seasoned psychotherapists and their clients. With the completion of the first pilot trial of MDMA-assisted psychotherapy with couples for PTSD, and as the possibility of conducting MDMA-assisted psychotherapy trials expands due to new regulatory frameworks, we have an opportunity to explore and investigate how and why MDMA-assisted couples therapy works. This theoretical paper will explore the neurobiological and neurochemical effects of MDMA in a relational context, the emotional, behavioral, cognitive and somatic effects within a dyadic frame, and how empathy, communication, perception of social connection/support, non-avoidance, openness, attachment/safety, bonding/social intimacy and relationship satisfaction, are all impacted by MDMA, and can be harnessed to facilitate systems-level and interpersonal healing and growth. A model to support MDMA-assisted couple therapy is introduced, and future directions, including implications for intervention development and delivery, will be elucidated.
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21
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Pentel KZ, Baucom DH, Weber DM, Wojda AK, Carrino EA. Cognitive-behavioral couple therapy for same-sex female couples: A pilot study. FAMILY PROCESS 2021; 60:1083-1097. [PMID: 34325480 DOI: 10.1111/famp.12696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 06/13/2023]
Abstract
Despite comparable levels of relationship satisfaction and intimacy, same-sex couples break up faster and more often than different-sex couples, highlighting a need for quality couple therapy. Research suggests that culturally tailored services are desired by same-sex couples and may be more effective and better received. Although efficacious couple therapies exist to treat relationship distress, they have been overwhelmingly studied with different-sex couples. Sexual minority (SM) affirming couple therapies have not been systematically developed or evaluated. The current study involved developing and pilot testing a couple therapy tailored for distressed same-sex female couples. This treatment integrates the SM stress model with the empirically supported cognitive-behavioral couple therapy framework and is the first culturally tailored couple therapy for same-sex couples to be empirically evaluated. Therapists delivered the treatment in an open-trial format to a pilot sample of 11 same-sex female couples experiencing relationship distress and SM stress. Treatment was delivered with high adherence to the treatment manual. Participants reported high treatment satisfaction. As hypothesized, participants experienced significant decreases in relationship distress and improvements in couple coping with SM stress from pre- to post-therapy. Limitations precluded clear conclusions regarding anticipated improvements in individual mental health. Participants experienced comparable or stronger improvements in relationship functioning compared to couples in a similar benchmark study. Given this is a small pilot study, results are interpreted with caution. Implications for culturally tailoring evidence-based couple therapy for marginalized groups are discussed.
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Affiliation(s)
- Kimberly Z Pentel
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Danielle M Weber
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alexandra K Wojda
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily A Carrino
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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22
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Wood AW, Martin JL, Bruns K. An Integrative Counseling Approach for African American Couples With Prostate Cancer. ADULTSPAN JOURNAL 2021. [DOI: 10.1002/adsp.12113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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23
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Khalifian CE, Leifker FR, Knopp K, Wilks CR, Depp C, Glynn S, Bryan C, Morland LA. Utilizing the couple relationship to prevent suicide: A preliminary examination of Treatment for Relationships and Safety Together. J Clin Psychol 2021; 78:747-757. [PMID: 34559895 DOI: 10.1002/jclp.23251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 07/29/2021] [Accepted: 09/09/2021] [Indexed: 11/12/2022]
Abstract
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.
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Affiliation(s)
- Chandra E Khalifian
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | | | - Kayla Knopp
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | | | - Colin Depp
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Shirley Glynn
- Veterans Affairs Los Angeles Healthcare System, Los Angeles, California, USA
| | - Craig Bryan
- College of Medicine, Ohio State University, Columbus, Ohio, USA
| | - Leslie A Morland
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, California, USA.,National Center for PTSD-Pacific Islands division, Honolulu, Hawaii, USA
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24
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Drieves AA. Case Examples and Process-Oriented Questions in Teletherapy with Couples and Families. FAMILY PROCESS 2021; 60:1048-1061. [PMID: 34189727 DOI: 10.1111/famp.12680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This paper shares learned experiences in teletherapy (also called tele-mental-health, remote video therapy, and virtual therapy) with couples and families. It aims to enhance teletherapy practice with couples and families by providing tools for screening and coaching. The paper describes common pitfalls in teletherapy with couples and families and how to avoid or address them, describes the opportunities for added insight when engaging couples and families in teletherapy from their homes, provides concrete interventions in the form of process-focused questions which therapists can draw from, and provides case examples. The case examples and process-oriented questions focus on four areas: screening, logistical coaching of technology, using the family's meeting place to learn about the family, and avoiding pitfalls.
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25
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Winter F, Steffan A, Warth M, Ditzen B, Aguilar-Raab C. Mindfulness-Based Couple Interventions: A Systematic Literature Review. FAMILY PROCESS 2021; 60:694-711. [PMID: 34114656 DOI: 10.1111/famp.12683] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Over the past decades, mindfulness-based interventions have been shown to improve individual health and well-being in clinical and nonclinical settings. More recently, secular contemplative trainings were adapted to the couple context as research showed satisfying couple relationships to be one of the strongest predictors of physical and mental health. Mindfulness-based interventions hence seem to be a promising treatment in couple counseling and therapy in both clinical and nonclinical settings. Therefore, we conducted a systematic review to provide an overview of the emerging literature in the field of mindfulness-based interventions for couples and other dyads. Overall, sixteen studies met the inclusion criteria. To summarize the heterogeneous quantitative literature regarding individual outcomes, mindfulness interventions for couples seem to increase mindfulness, self-compassion, well-being, and quality of life. Additionally, we found initial evidence of beneficial effects on relieving psychopathological symptoms and psychobiological stress measures. Measures of relationship quality were the predominant dyadic outcome. Based on these studies, we cautiously conclude that mindfulness trainings can enhance relationship quality. Practitioners should be aware that mindfulness-based interventions for couples can potentially improve the perceived relationship quality between partners and the individual burden. Future studies should expand the field, particularly with regard to other contemplative practices for couples such as compassion interventions.
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Affiliation(s)
- Friederike Winter
- Institute of Medical Psychology, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Antonia Steffan
- Institute of Medical Psychology, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Marco Warth
- Institute of Medical Psychology, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Corina Aguilar-Raab
- Institute of Medical Psychology, Medical Faculty, Heidelberg University, Heidelberg, Germany
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26
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Tseng CF, PettyJohn ME, Huerta P, Miller DL, Agundez JC, Fang M, Wittenborn AK. Representation of Diverse Populations in Couple and Family Therapy Intervention Studies: A Systematic Review of Race/Ethnicity, Sexual Orientation, Age, and Income in the United States from 2014 to 2019. FAMILY PROCESS 2021; 60:424-440. [PMID: 33434313 DOI: 10.1111/famp.12628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Disparities in mental health care among marginalized populations have been well-documented. Without research designed to study interventions for diverse populations, disparities in the quality of services will persist. A systematic review of articles evaluating couple and family therapy (CFT) interventions was conducted to evaluate the representation of diverse populations. More specifically, researchers sought to examine race/ethnicity, sexual orientation, income level, and age of sample participants. One hundred ninety-six studies evaluating CFT interventions in the United States in ten journals were included in the analysis. Findings indicate that family therapy research is more representative of racial minority and low-income participants compared with studies of couple interventions. Couple therapy research is often still conducted with predominately white, middle- to high-income samples. Following whites, African Americans and Hispanic/Latinos were the most common racial/ethnic groups included in both couple therapy research and family therapy research. Participants in same-sex relationships were absent from family intervention research and under-researched in couple intervention studies. Only one couple therapy study recruited a sample in which the average age was late adulthood. These findings are cause for concern given the widening mental health disparities in the United States.
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Affiliation(s)
- Chi-Fang Tseng
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Morgan E PettyJohn
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Patricia Huerta
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Debra L Miller
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Juan Carlos Agundez
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Meng Fang
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Andrea K Wittenborn
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
- Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA
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27
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Fitzpatrick S, Liebman RE, Monson CM. The borderline interpersonal-affective systems (BIAS) model: Extending understanding of the interpersonal context of borderline personality disorder. Clin Psychol Rev 2021; 84:101983. [PMID: 33517245 DOI: 10.1016/j.cpr.2021.101983] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 12/16/2020] [Accepted: 01/19/2021] [Indexed: 01/10/2023]
Abstract
Prominent explanatory models for borderline personality disorder (BPD) are intrapersonal in nature and hold that it is an emotional disorder. However, the empirical support for emotional models of BPD is mixed. Refinements to BPD explanatory models are needed to increase the precision with which BPD can be understood and treated. Drawing on existing theoretical and empirical research in BPD, this manuscript presents the Borderline Interpersonal-Affective Systems (BIAS) model. The BIAS model purports that harmful early life relationships and subsequent conflictual relationships lead individuals with BPD to develop a sensitivity to interpersonal threat in the form of attentional and appraisal biases. Individuals with BPD are posited to 1) experience heightened emotional reactivity specifically to perceived interpersonal threat and 2) engage in destructive behaviors both to regulate increasing emotion and to meet interpersonal needs. We review the empirical support for each component of the BIAS model, along with the role of the cognitions, emotions, and behaviors of significant others in influencing BIAS model processes in individuals with BPD over time. The BIAS model highlights a novel way of understanding and integrating interpersonal and emotional components of the disorder. Key directives for future research and clinical implications are discussed.
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Affiliation(s)
- Skye Fitzpatrick
- Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
| | - Rachel E Liebman
- Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada; Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
| | - Candice M Monson
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
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The development and evaluation of a brief intervention for male partners of women hospitalized for perinatal distress. J Affect Disord 2021; 280:26-33. [PMID: 33202335 DOI: 10.1016/j.jad.2020.10.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/24/2020] [Accepted: 10/31/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Perinatal distress (PD) is a term used to describe mood and anxiety disorders experienced during pregnancy or in the postpartum period. In acute cases of PD, inpatient hospitalization may be indicated. Although hospitalization tends to result in improved immediate safety outcomes, many patients are discharged when they are still experiencing acute symptomology. Interpersonal and environmental factors, particularly those that exist within intimate relationships, can significantly help or hinder patient progress. Partners are also affected by the patient's symptoms and often lacks the skills or knowledge to offer support. METHODS The aim of the present investigation is to address PD through a dyadic lens by integrating partners into treatment. In this feasibility study, 20 partners of women hospitalized for PD were recruited to participate in an individually delivered, 90-minute intervention designed to improve partner understanding and support behaviors. RESULTS Qualitative feedback from partners suggests that the intervention was acceptable and the high recruitment rates demonstrate strong feasibility. Additionally, partners reported significant gains in the context of their support self-efficacy for assisting patients to cope with distress. Patients reported that they were significantly more satisfied with the support that their partners were providing. LIMITATIONS This was a feasibility study and as such, there was no control group, thereby limiting causal inferences about the intervention. CONCLUSIONS These findings suggest that this intervention may serve to enhance the recovery of women hospitalized for PD by empowering partners through offering psychoeducation and skills for offering support.
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D'Arrigo-Patrick E, Samman SK, Knudson-Martin C. Moving from "I" to "We": A Grounded Theory Analysis of Couple Therapy with Liver Patients and Their Partners. FAMILY PROCESS 2020; 59:1517-1529. [PMID: 32097502 DOI: 10.1111/famp.12528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Prior research indicates that couples who cope with chronic illness from a relational "we" orientation experience more positive outcomes than couples that cope individually; however, little prior research identifies clinical processes that promote reciprocity or how societal gender processes are involved. This grounded theory analysis of 25 videotaped therapy sessions with six heterosexual couples coping with chronic liver disease (LD) used a feminist-informed relational lens to focus on the clinical processes involved in shifting from an individual to a relational orientation. Findings identified three contextual barriers to attaining a "we orientation": (a) autonomy discourse, (b) illness-related power, and (c) gendered power. Analysis detailed therapist actions that decreased the impact of barriers to reciprocity and fostered relational coping. Clinical implications attend to complex intersections among gender, caregiving, and contextual barriers to reciprocity.
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30
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Lucier-Greer M, Quichocho D, Frye-Cox N, Sherman H, Burke B, Duncan JM. Coping and Mental Health Differences among Active Duty Service Members and Their Spouses with High and Low Levels of Marital Warmth. MILITARY PSYCHOLOGY 2020; 32:425-431. [PMID: 38536387 PMCID: PMC10187028 DOI: 10.1080/08995605.2020.1803724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/28/2020] [Indexed: 10/22/2022]
Abstract
This study examined the relationship between marital warmth (e.g., openly expressing affection, supportive behaviors) and assessments of coping (i.e., challenges coping with military life and self-efficacy in the context of stress) and mental health (i.e., depressive symptoms and anxiety symptoms) in a sample of active duty men and their spouses/romantic partners (N = 234 military couples). Results from a series of multivariate analysis of variance tests indicate that service members and spouses who reported higher levels of marital warmth also reported better coping skills and mental health compared to individuals in couple relationships that demonstrated lower levels of marital warmth. Intervention and prevention implications targeting social support and marital warmth are provided.
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Affiliation(s)
| | - Davina Quichocho
- Human Development and Family Studies, Auburn University, Auburn, Alabama
| | - Nicky Frye-Cox
- Human Development and Family Studies, Auburn University, Auburn, Alabama
| | - Haley Sherman
- Human Development and Family Studies, Auburn University, Auburn, Alabama
| | - Benjamin Burke
- Human Development and Family Studies, Auburn University, Auburn, Alabama
| | - James M. Duncan
- Human Development and Family Sciences, University of Arkansas, Fayetteville, Arkansas
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31
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Franz MR, Kaiser AP, Phillips RJ, Lee LO, Lawrence AE, Taft CT, Vasterling JJ. Associations of warzone veteran mental health with partner mental health and family functioning: Family Foundations Study. Depress Anxiety 2020; 37:1068-1078. [PMID: 32805764 PMCID: PMC8252135 DOI: 10.1002/da.23083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Warzone participation is associated with increased risk of stress-related psychopathology, including posttraumatic stress disorder (PTSD) and depression. Prior research suggests that the mental health of spouses of warzone veterans (WZVs) is linked to that of their partners. Additionally, PTSD among WZVs has been associated with marital dysfunction. Less is known about the effects of depression among WZVs on partner mental health and family relationships. We sought in this study to examine associations between WZV PTSD and depression and partner mental health and relationship outcomes. METHODS Using a nationally dispersed sample of Iraq and Afghanistan veterans and their married and unmarried intimate partners, 245 dyads completed structured psychiatric interviews and psychometric surveys assessing family functioning and relationship aggression. RESULTS Adjusted regression analyses indicated that depression among WZVs was associated with partner depression and anxiety disorders. WZV PTSD and depression were also associated with partner-reported relationship dysfunction, dissatisfaction, and communication issues, and higher rates of intimate partner aggression victimization and perpetration. CONCLUSIONS Mental health consequences of war extend beyond WZVs to the mental health of their intimate partners and their relationships with intimate partners.
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Affiliation(s)
- Molly R. Franz
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Anica Pless Kaiser
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts,Psychology Service, VA Boston Healthcare System, Boston, Massachusetts
| | | | - Lewina O. Lee
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts,Psychology Service, VA Boston Healthcare System, Boston, Massachusetts
| | - Amy E. Lawrence
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts,Psychology Service, VA Boston Healthcare System, Boston, Massachusetts
| | - Casey T. Taft
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts,Psychology Service, VA Boston Healthcare System, Boston, Massachusetts
| | - Jennifer J. Vasterling
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts,Psychology Service, VA Boston Healthcare System, Boston, Massachusetts
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Cognitive-behavioral and emotion-focused couple therapy: Similarities and differences. CLINICAL PSYCHOLOGY IN EUROPE 2020; 2:e2741. [PMID: 36398146 PMCID: PMC9645475 DOI: 10.32872/cpe.v2i3.2741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 06/21/2020] [Indexed: 11/25/2022] Open
Abstract
Background Couples and families often seek therapy to deal with relational distress, which is a result of external or internal factors of the relationship. Two approaches are acknowledged to be most effective in dealing with relationship distress or psychological disorders in couples: (a) cognitive behavioral couple therapy with new directions (CBCT) and (b) emotion-focused couple therapy (EFCT). In this article we investigate how much CBCT and EFCT really differ with regard to working with emotions, which is claimed to be a major focus of EFCT, and whether there exist significant differences in efficacy between these two approaches. Method This article critically reviews the theoretical background, process, techniques and outcomes associated with CBCT and EFCT in an effort to challenge the assumptions noted above. Results There is no evidence that EFCT is more emotion-focused than CBCT. Both approaches were repeatedly examined with RCT studies with follow-ups. In sum, no significant differences in effect size were found between CBCT and EFCT. Conclusion CBCT and EFCT are both effective in reducing couples’ distress. CBCT and EFCT are both effective in helping couples deal with relationship distress. Both are similarly effective in helping couples to better understand and cope with their presenting concerns. Both approaches address the importance of personal schema, triggering relevant cognitions and emotions. Both approaches help couples wherein one partner has been diagnosed with a clinical disorder.
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33
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A Social Blow: The Role of Interpersonal Relationships in Mild Traumatic Brain Injury. PSYCHOSOMATICS 2020; 61:518-526. [DOI: 10.1016/j.psym.2020.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 12/22/2022]
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Voils CI, Shaw R, Adler R, Jeanes E, Lewis MA, Sharp W, Cronin KA, Hetzel S, Mao L, Johnson HM, Elwert F, Pabich S, Gavin KL, Yancy WS, Porter LS. Protocol for Partner2Lose: A randomized controlled trial to evaluate partner involvement on long-term weight loss. Contemp Clin Trials 2020; 96:106092. [PMID: 32750431 PMCID: PMC7395658 DOI: 10.1016/j.cct.2020.106092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/23/2020] [Accepted: 07/26/2020] [Indexed: 11/25/2022]
Abstract
Background Behavioral interventions produce clinically significant weight reduction, with many participants regaining weight subsequently. Most interventions focus on an individual, but dietary and physical activity behaviors occur with, or are influenced by, domestic partners. According to interdependence theory, couples who approach behavior change as a problem to be tackled together versus independently are more likely to utilize communal coping processes to promote behavior change. We utilized interdependence theory to develop a partner-assisted intervention to increase long-term weight loss. Methods Community-dwelling individuals (index participants) cohabitating with a partner with 1) overweight and at least one obesity-related comorbidity or 2) obesity are randomized to participate in a standard weight management program alone or with their partner. The weight management program involves biweekly, in-person, group sessions focusing on weight loss for six months, followed by three group sessions and nine telephone calls focusing on weight loss maintenance for twelve months. In the partner-assisted arm, partners participate in half of the group sessions and telephone calls. Couples receive training in principles of cognitive behavioral therapy for couples, including sharing thoughts and feelings and joint problem solving, to increase communal coping. The primary outcome is participant weight loss at 24 months, with caloric intake and moderate-intensity physical activity as secondary outcomes. Partner weight and caloric intake will also be analyzed. Mediation analyses will examine the role of interdependence variables and social support. Discussion This trial will provide knowledge about effective ways to promote long-term weight loss and the role of interdependence constructs in weight loss. Clinical trials identifier: NCT 03801174.
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Affiliation(s)
- Corrine I Voils
- University of Wisconsin-Madison School of Medicine & Public Health, Department of Surgery, 600 Highland Ave, K6/100 CSC, Madison, WI 53792-1690, USA; William S Middleton Memorial Veterans Hospital, 2500 Overlook Terrace (151), Madison, WI 53705, USA.
| | - Ryan Shaw
- Duke University School of Nursing, 307 Trent Dr., 1055 Clipp, Durham, NC 27710, USA
| | - Rachel Adler
- Center for Surgery and Public Health, Brigham and Women's Hospital, One Brigham Circle, 1620 Tremont Street Suite 2-016, Boston, MA 02120, USA
| | - Elizabeth Jeanes
- University of Wisconsin-Madison School of Medicine & Public Health, Department of Surgery, 600 Highland Ave, K6/100 CSC, Madison, WI 53792-1690, USA
| | - Megan A Lewis
- RTI International, 119 S. Main St., Union Trust Bldg., Suite 220, Seattle, WA 98104, USA
| | - Whitney Sharp
- University of Wisconsin-Madison School of Medicine & Public Health, Department of Surgery, 600 Highland Ave, K6/100 CSC, Madison, WI 53792-1690, USA
| | - Kate A Cronin
- University of Wisconsin-Madison School of Medicine & Public Health, Department of Surgery, 600 Highland Ave, K6/100 CSC, Madison, WI 53792-1690, USA
| | - Scott Hetzel
- University of Wisconsin-Madison School of Medicine & Public Health, Department of Biostatistics and Bioinformatics, 610 Walnut St, WARF 201, Madison, WI 53726, USA
| | - Lu Mao
- University of Wisconsin-Madison School of Medicine & Public Health, Department of Biostatistics and Bioinformatics, 610 Walnut St, WARF 201, Madison, WI 53726, USA
| | - Heather M Johnson
- Boca Raton Regional Hospital, Christine E. Lynn Women's Health & Wellness Institute, 690 Meadows Road, Boca Raton, FL 33486, USA
| | - Felix Elwert
- University of Wisconsin-Madison Department of Sociology, 11800 Observatory Dr, Madison, WI 53706, USA
| | - Samantha Pabich
- University of Wisconsin-Madison School of Medicine & Public Health, Department of Medicine, 1685 Highland Ave Madison, WI 53705-2281, USA
| | - Kara L Gavin
- University of Wisconsin-Madison School of Medicine & Public Health, Department of Surgery, 600 Highland Ave, K6/100 CSC, Madison, WI 53792-1690, USA
| | - William S Yancy
- Duke University School of Medicine, Department of Medicine, 501 Douglas St., Durham, NC 27705, USA
| | - Laura S Porter
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Box 90399, Durham, NC 27708, USA
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Roesler C. Effectiveness of Couple Therapy in Practice Settings and Identification of Potential Predictors for Different Outcomes: Results of a German Nationwide Naturalistic Study. FAMILY PROCESS 2020; 59:390-408. [PMID: 30865295 DOI: 10.1111/famp.12443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Even though couple therapy is efficacious, there is no improvement in up to 50% of the couples. Also effect sizes found in effectiveness studies in real-world settings are considerably lower than those found in efficacy studies. There is a need to understand more about couple therapy effectiveness in practice settings and the factors responsible for different outcomes. A German nationwide study on the effectiveness of couple counseling including 554 couples applied the same methodology as two earlier studies in the same field. A remarkable consistency was found over the three independent studies in the burden with individual and relationship distress as well as in the rates of improvement. This supports the insight that the improvements reached through couple therapy in practice settings are only about half of the effect sizes reached in efficacy trials. Additionally this study investigated 64 factors, which were found to be influential for relationship quality and stability in earlier studies, for their impact on outcome. Factors present at initiation and termination of therapy were found, which correlate significantly with outcome and with separation of the couple in the follow-up. These factors could be included in prediction models for improvement and separation of the couple. The implications for the practice of couple therapy and for future research are discussed.
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Affiliation(s)
- Christian Roesler
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
- Department of Psychology, University of Basel, Basel, Switzerland
- Graduate School of Education, Kyoto University, Kyoto, Japan
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Georgia Salivar EJ, Rothman K, Roddy MK, Doss BD. Relative Cost Effectiveness of In-Person and Internet Interventions for Relationship Distress. FAMILY PROCESS 2020; 59:66-80. [PMID: 30537091 DOI: 10.1111/famp.12414] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
While the efficacy of couple therapy has been repeatedly demonstrated, most distressed couples do not seek treatment. To improve reach and overcome barriers to therapy, Integrative Behavioral Couple Therapy (IBCT) was translated into a web-based program, OurRelationship (OR). While both IBCT and OR have been shown to improve relationship and individual functioning, the goal of the present study was to compare the relative cost effectiveness of these two treatment modalities. In IBCT, 74% of couples experienced reliable improvement, compared to 55% of couples in OR. Within-group Cohen's d effect sizes during treatment for relationship satisfaction were d = 0.87 for IBCT and d = 0.96 for OR. Relative cost effectiveness analyses revealed that even at the highest expense estimates for OR and the lowest expense estimates for IBCT, OR was more cost effective in creating reliable improvement once at least 229 couples were served and was more cost effective in creating large-size effects once at least 153 couples were served. Cost-effectiveness increases for both IBCT and OR as more couples are served; however, this cost savings occurs at a much more rapid rate for OR. These findings demonstrate that despite higher initial development costs, Internet programs are a cost-effective option for dissemination either as a stand-alone service or as an initial intervention in a stepped care model with more intensive in-person services.
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Affiliation(s)
| | - Karen Rothman
- Department of Psychology, University of Miami, Coral Gables, FL
| | | | - Brian D Doss
- Department of Psychology, University of Miami, Coral Gables, FL
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Abstract
Because relationship discord and dissolution are common and costly, interventions are needed to treat distressed couples and to prevent distress among vulnerable couples. We review meta-analytic evidence showing that 60-80% of distressed couples benefit from behavioral and emotion-focused approaches to couple therapy, but we also note that treatment effects are weaker in actual clinical practice than in controlled studies, dissipate following treatment for about half of all couples, and may be explained by factors that are common across models. Meta-analyses of prevention programs reveal reliable but smaller effects, reflecting a need to know more about whether and how communication mediates effects, about how risk and diversity moderate effects, and about how technology-enabled interventions can reduce attrition in vulnerable populations. Interventions for couples are improving and expanding, but critical questions remain about how and for whom they work.
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Affiliation(s)
- Thomas N Bradbury
- Department of Psychology, University of California, Los Angeles, California 90095-1563, USA;
| | - Guy Bodenmann
- Department of Psychology, University of Zurich, CH-8050 Zurich, Switzerland;
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Tankha H, Caño A, Corley A, Dillaway H, Lumley MA, Clark S. A Novel Couple-Based Intervention for Chronic Pain and Relationship Distress: A Pilot Study. COUPLE & FAMILY PSYCHOLOGY 2020; 9:13-32. [PMID: 34017649 PMCID: PMC8132556 DOI: 10.1037/cfp0000131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Chronic pain contributes to psychological and relationship distress in individuals with pain as well as their partners. Prior pain interventions have addressed this important social context by engaging partners in treatment; however, partners have not been considered co-participants who can benefit directly from therapy, but rather incorporated as pain management coaches or guides. This manuscript assesses the feasibility, acceptability, and preliminary outcomes of a novel intervention which targets both partners and focuses on improving well-being in couples in which one or both partners experiences chronic pain and relationship distress. Fifteen couples participated in Mindful Living and Relating, a 6-session in-person intervention, and completed baseline and post-treatment outcome measures. Both quantitative and qualitative methods were used to evaluate participants' engagement in and experiences of the intervention, as well as preliminary outcomes. Results suggest that couples were engaged in, and reported satisfaction with, the treatment. Participants who completed the therapy (N = 28; 14 couples) reported reductions in depressive symptoms and improvements in relationship satisfaction and partner responsiveness, and individuals with pain reported reductions in pain interference. In post-treatment interviews, couples reported their preference for couple therapy over individual therapy for pain and relationship distress. Although the conduct of the therapy was feasible for couples who enrolled in the trial, initial recruitment difficulties suggested feasibility challenges. Recommendations are made for researchers who are interested in designing psychological interventions to improve quality of life in the context of chronic illness.
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Affiliation(s)
- Hallie Tankha
- Wayne State University, Department of Psychology 5057 Woodward Avenue, Detroit, Michigan, 48202, USA
| | - Annmarie Caño
- Wayne State University, Department of Psychology and Office of the Provost, 656 W. Kirby, 4228 FAB, Detroit, Michigan, 48202, USA
| | - Angelia Corley
- Wayne State University, Department of Psychology 5057 Woodward Avenue, Detroit, Michigan, 48202, USA
| | - Heather Dillaway
- Wayne State University, Department of Sociology, 2237 Faculty Administration Building, Detroit, Michigan, 48202, USA
| | - Mark A. Lumley
- Wayne State University, Department of Psychology 5057 Woodward Avenue, Detroit, Michigan, 48202, USA
| | - Shannon Clark
- Wayne State University, Department of Psychology 5057 Woodward Avenue, Detroit, Michigan, 48202, USA
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Brock R, Franz M, O’Bleness J, Lawrence E. The Dynamic Interplay Between Satisfaction With Intimate Relationship Functioning and Daily Mood in Low-Income Outpatients. FAMILY PROCESS 2019; 58:891-907. [PMID: 30357806 PMCID: PMC6483892 DOI: 10.1111/famp.12402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Substantial research supports bidirectional links between intimate relationship discord and individual psychopathology, including depressive symptoms. However, few studies have utilized daily diary methods to capture the micro-level processes underlying the association between couple discord and depression, particularly among populations that are at elevated risk for both interpersonal and individual dysfunction. To address this gap, we examined whether daily changes in satisfaction with relationship functioning were associated with daily changes in negative affect and positive affect over the span of 2 weeks among mental health outpatients of low socioeconomic status. Participants were 53 low-income outpatients from community mental health clinics who completed a semi-structured interview about the quality of their intimate relationships followed by 14 daily reports of positive and negative mood and satisfaction with relationship functioning across several domains. Growth curve analytic techniques revealed the hypothesized bidirectional relations. Decline in satisfaction with relationship functioning predicted escalation in negative affect and deterioration in positive affect over 2 weeks, and deterioration of mood predicted declining satisfaction with relationship functioning. This study extends existing knowledge about couple dysfunction and individual psychopathology by highlighting the immediate nature of this dynamic process as it unfolds over time.
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Affiliation(s)
- Rebecca Brock
- University of Nebraska-Lincoln, Psychology, 238 Burnett Hall, Lincoln, Nebraska, United States
- Corresponding author
| | - Molly Franz
- University of Nebraska-Lincoln, Psychology, 238 Burnett Hall, Lincoln, Nebraska, United States
| | | | - Erika Lawrence
- Northwestern University, The Family Institute, 618 Library Place, United States
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Weber DM, Fischer MS, Baucom DH, Baucom BRW, Kirby JS, Runfola CD, Matherne CE, Bulik CM. The Association between Symptom Accommodation and Emotional Coregulation in Couples with Binge Eating Disorder. FAMILY PROCESS 2019; 58:920-935. [PMID: 30229890 DOI: 10.1111/famp.12391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Intense negative emotions and maladaptive behavioral strategies to reduce emotional distress occur not only in patients with various forms of psychopathology but also in their committed partners. One common strategy to reduce distress is for partners to accommodate to the symptoms of the disorder, which reduces distress short term but maintains symptoms long term. Accommodation is believed to be motivated by the partner reacting behaviorally to the patient's emotions, but the emotions of the partner in this context have yet to be examined. This pilot study examined how partner accommodation related to specific patterns of emotional coregulation between patients with binge eating disorder (BED) and their partners, before and after a couple-based intervention for BED. Vocally encoded emotional arousal was measured during couples' (n = 11) conversations about BED. As predicted, partners' emotional reactivity to patients' emotional arousal was associated with high accommodation before treatment. Thus, partners may use accommodation as a strategy to reduce both the patients' and their own distress. After treatment, partners' arousal was no longer associated with the patients' emotional arousal; instead, partners showed greater emotional stability over time, specifically when accommodation was low. Additionally, patients were less emotionally aroused after treatment. Therefore, treatment may have decreased overall emotionality of patients and altered the association between accommodation and partners' emotional reactivity. If replicated, this understanding of the emotional context associated with accommodation in BED can inform couple-based treatment by targeting specific emotional precipitants of behaviors that maintain symptoms.
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Affiliation(s)
- Danielle M Weber
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Melanie S Fischer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian R W Baucom
- Department of Psychology, University of Utah, University of Utah, Salt Lake City, UT
| | - Jennifer S Kirby
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Cristin D Runfola
- Department of Psychiatry, University of North Carolina at Chapel Hill
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
| | - Camden E Matherne
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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41
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Ditzen B, Eckstein M, Fischer M, Aguilar-Raab C. Partnerschaft und Gesundheit. PSYCHOTHERAPEUT 2019. [DOI: 10.1007/s00278-019-00379-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Lebow JL. Editorial: Integration in Couple and Family Therapy. FAMILY PROCESS 2019; 58:527-531. [PMID: 31486073 DOI: 10.1111/famp.12476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Jay L Lebow
- Family Institute at Northwestern, Evanston, IL
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43
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Roddy MK, Rothman K, Cicila LN, Doss BD. Why do couples seek relationship help online? Description and comparison to in-person interventions. JOURNAL OF MARITAL AND FAMILY THERAPY 2019; 45:369-379. [PMID: 29607520 DOI: 10.1111/jmft.12329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Couples are increasingly utilizing newly developed online adaptations of couple therapy; however, different presenting problems could drive couples to seek either online or in-person services. This study compared the presenting problems of 151 couples seeking an online couple intervention for relationship distress (OurRelationship) with responses from 147 couples seeking in-person couple therapy. Presenting problems were generally consistent across gender and whether or not the respondent was the initial help-seeker. Online and in-person samples frequently endorsed difficulties with communication and emotional intimacy; however, they differentially endorsed trust, time together, and child/parenting difficulties. Therefore, while basing online interventions on existing couple therapies is generally supported, efforts should be made to tailor online services to meet the unique needs of this population.
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Grov EK, Dahl AA. Golf as Therapy for Individuals With Mental Health or Substance Use Disorders. J Psychosoc Nurs Ment Health Serv 2019; 57:44-51. [PMID: 31188463 DOI: 10.3928/02793695-20190528-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/04/2019] [Indexed: 11/20/2022]
Abstract
The current study was undertaken to explore the experiences of individuals with mental health problems or substance use when introduced to systematic golf activities. The study examined the perceived impact of golf activities on participants' physical and mental health, social contact, and daily activities, as well as their overall evaluation of involvement in a Golf as Therapy group. This qualitative, cross-sectional study gathered data from 12 individual interviews. Qualitative content analysis based on the information from meaning units, subcategories, categories, and themes determined the interpretation of manifest and latent concepts. The findings revealed a positive influence on health and social well-being in addition to positive changes in daily activities. The main theme that arose from the data was Shaping a New Direction in Life, elaborated by the categories of ameliorated physical fitness, creation of a social meeting place, improved focus and concentration, practical help and support, and reduced mental symptom burden. [Journal of Psychosocial Nursing and Mental Health Services, 57(10), 44-51.].
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Scott SB, Whitton SW, Buzzella BA. Providing Relationship Interventions to Same-Sex Couples: Clinical Considerations, Program Adaptations, and Continuing Education. COGNITIVE AND BEHAVIORAL PRACTICE 2019. [DOI: 10.1016/j.cbpra.2018.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Halder S, Mahato AK. Cognitive Behavior Therapy for Children and Adolescents: Challenges and Gaps in Practice. Indian J Psychol Med 2019; 41:279-283. [PMID: 31142932 PMCID: PMC6532387 DOI: 10.4103/ijpsym.ijpsym_470_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Susmita Halder
- Department of Clinical Psychology, Amity University, Kolkata, West Bengal, India
| | - Akash Kumar Mahato
- Department of Clinical Psychology, Amity University, Kolkata, West Bengal, India
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Abstract
AbstractThis invited paper is a review of the significance of couple relationships to the practice of all therapists. The article begins with a summary of the evidence on the centrality of committed couple relationships to the lives and wellbeing of adults, and the association of the quality of the parents’ couple relationship on the wellbeing of children. We argue that the well-established reciprocal association between individual problems and couple relationship problems means that all therapists need to pay attention to how a couple relationship might be influencing a client's functioning, even if the relationship is not the presenting problem. There is an outline the evolution of current approaches to behavioural couple therapy, and the current state of the art and science of couple therapy. We present an analysis of the evidence for couple therapy as a treatment for relationship distress, as well as couple-based treatments for individual problems. This is followed by a description of the distinctive challenges in working with couples and how to address those challenges, and recommendations about how to address the needs of diverse couple relationships. Finally, we propose some core therapist competencies needed to work effectively with couples.
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Abstract
Digitally delivered interventions aim to make psychological treatments more widely accessible and minimize clinician input. Although their clinical efficacy against wait-list, control conditions is well established, comparative outcome studies are a much better way to examine if psychotherapies are equally effective. Such reviews are still relatively lacking. The aim of this review was therefore to evaluate the effectiveness of digitally delivered psychological therapies over traditionally delivered (face-to-face) ones to alleviate symptoms in adults experiencing sub-threshold and clinical depression. Findings showed that digital interventions produced consistently clinically significant improvements in depressive symptoms. Moreover, the level of therapist contact or expertise did not affect much treatment effectiveness. Future research is pertinent to investigate further the influence of therapist input, the reasons for dropout, how to improve users' experience and therapeutic engagement and maintain improvements at post-treatment.
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Coop Gordon K, Roberson PNE, Hughes JA, Khaddouma AM, Swamy GK, Noonan D, Gonzalez AM, Fish L, Pollak KI. The Effects of a Couples-Based Health Behavior Intervention During Pregnancy on Latino Couples' Dyadic Satisfaction Postpartum. FAMILY PROCESS 2018; 57:629-648. [PMID: 29603202 PMCID: PMC6436102 DOI: 10.1111/famp.12354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Many couples tend to report steadily decreasing relationship quality following the birth of a child. However, little is known about the postpartum period for Latino couples, a rapidly growing ethnic group who are notably underserved by mental and physical health caregivers in the United States. Thus, this study investigated whether a brief couples' intervention focused on helping couples support each other while increasing healthy behaviors might improve dyadic functioning postpartum. This study presents secondary analyses of data regarding couple functioning from a larger randomized controlled trial with 348 Latino couples to promote smoking cessation. Portions of the intervention taught the couple communication and problem-solving skills to increase healthy behavior. Couples participated in four face-to-face assessments across 1 year starting at the end of the first trimester. Latent growth curve analyses revealed that the treatment group reported an increase in relationship satisfaction and constructive communication after the intervention, which diminished by 1-year follow-up, returning couples to their baseline levels of satisfaction. Results suggest that incorporating a brief couple intervention as part of a larger health intervention for Latinos may prevent postpartum decreases in relationship satisfaction.
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Affiliation(s)
| | | | - Jessica A Hughes
- Department of Psychology, University of Tennessee, Knoxville, TN
| | | | - Geeta K Swamy
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
| | - Devon Noonan
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
| | - Alicia M Gonzalez
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
| | - Laura Fish
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
| | - Kathryn I Pollak
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
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Lebow JL. Editorial: The Impact of the Trump Administration on Families in the United States. FAMILY PROCESS 2018; 57:589-593. [PMID: 30178884 DOI: 10.1111/famp.12387] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jay L Lebow
- Family Process, and The Family Insitute at Northwestern, Evanston, IL
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