1
|
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.
Collapse
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
| |
Collapse
|
2
|
Zahl-Olsen R, Thuen F, Bertelsen TB. The effectiveness of the in-person and online Gottman Seven Principles Couple Enhancement Program: A propensity score matching design. JOURNAL OF MARITAL AND FAMILY THERAPY 2024. [PMID: 38961585 DOI: 10.1111/jmft.12726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024]
Abstract
This study investigates the effectiveness of the 12-h Gottman Seven Principles couple enhancement program delivered in person and online. In Norway, we recruited 490 participants and 242 people for a control group. All were in close relationships. The revised dyadic adjustment scale (RDAS) was used to assess the quality of their relationships before and after program participation, and at 6-month follow-up. Repeated measures ANOVA, t tests, reliable change, and multilevel multiple regression using propensity score matching to control for confounders were used to investigate the effectiveness of the course. The results demonstrate that the Gottman Seven Principles course improves couple relationships and is equally effective whether delivered in person or online. Furthermore, it does not matter whether there are therapists with a clinical background delivering the course, suggesting that the material itself is sufficient.
Collapse
Affiliation(s)
- Rune Zahl-Olsen
- Department of Child and Adolescent Mental Health, Clinic of Mental Health, Sorlandet Hospital, Kristiansand, Norway
| | - Frode Thuen
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Bergen, Hordaland, Norway
| | - Thomas Bjerregaard Bertelsen
- Department of Child and Adolescent Mental Health, Clinic of Mental Health, Sorlandet Hospital, Kristiansand, Norway
| |
Collapse
|
3
|
Lebow JL. Another editor's farewell. FAMILY PROCESS 2023; 62:1273-1280. [PMID: 38055997 DOI: 10.1111/famp.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 12/08/2023]
Affiliation(s)
- Jay L Lebow
- Family Process and Family Institute at Northwestern, Evanston, Illinois, USA
| |
Collapse
|
4
|
Haase CM. Emotion Regulation in Couples Across Adulthood. ANNUAL REVIEW OF DEVELOPMENTAL PSYCHOLOGY 2023; 5:399-421. [PMID: 38939362 PMCID: PMC11210602 DOI: 10.1146/annurev-devpsych-120621-043836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Intimate relationships are hotbeds of emotion. This article presents key findings and current directions in research on couples' emotion regulation across adulthood as a critical context in which older adults not only maintain functioning but may also outshine younger adults. First, I introduce key concepts, defining qualities (i.e., dynamic, coregulatory, bidirectional, bivalent), and measures (i.e., self-report versus performance-based) of couples' emotion regulation. Second, I highlight a socioemotional turn in our understanding of adult development with the advent of socioemotional selectivity theory. Third, I offer a life-span developmental perspective on emotion regulation in couples (i.e., across infancy, adolescence and young adulthood, midlife, and late life). Finally, I present the idea that emotion regulation may shift from "me to us" across adulthood and discuss how emotion regulation in couples may become more important, better, and increasingly consequential (e.g., for relationship outcomes, well-being, and health) with age. Ideas for future research are then discussed.
Collapse
Affiliation(s)
- Claudia M Haase
- School of Education and Social Policy and (by courtesy) Department of Psychology, Northwestern University, Evanston, Illinois, USA
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Chen S, Yu P, Fang Y, Xin M, Yu FY, Ip M, Mo PKH, Wang Z. Patterns and Factors of the Sexual Agreement for Extra-Dyadic Sex Among Men Who Have Sex with Men in Hong Kong, China: A Cross-Sectional Survey. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:303-314. [PMID: 37981896 DOI: 10.1080/0092623x.2023.2279096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
This study investigated patterns of sexual agreement for extra-dyadic sex and their associations with sexual risk behaviors among men who have sex with men (MSM) having a regular male sex partner (RP) in China. A cross-sectional telephone survey was conducted among 530 MSM recruited through multiple sources in Hong Kong, China, between April and December 2020. This study was based on a subsample of 368 participants who had an RP in the past 6 months. Logistic regression models were fitted. Among the participants, 27.2%, 13.0%, and 3.0% had a closed agreement, an in-between agreement, and an open agreement, respectively. Compared to no agreement, a closed agreement was associated with fewer extra-dyadic partners and fewer instances of condomless sex with extra-dyadic partners. Those who had more positive attitudes toward a closed agreement, perceived more support from significant others to create a closed agreement, and perceived higher behavioral control of refraining from sex with extra-dyadic partners were more likely to have a closed agreement with RP. Those who were concerned that a closed agreement would impair freedom and sexual desire were less likely to have such an agreement. A closed agreement is a potentially useful risk reduction strategy for Chinese MSM with an RP.
Collapse
Affiliation(s)
- Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Peishi Yu
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong, China
| | - Meiqi Xin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, the Hong Kong Polytechnic University, Hong Kong, China
| | - Fuk-Yuen Yu
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Mary Ip
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
7
|
Lebow JL. Welcoming Melanie M. Domenech Rodríguez. FAMILY PROCESS 2023; 62:1-5. [PMID: 36914426 DOI: 10.1111/famp.12860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Jay L Lebow
- Family Process and Family Institute at Northwestern, Evanston, Illinois, USA
| |
Collapse
|