Couples are frequently unhappy for about _ years before they seek therapy.
6.
If handled improperly, ___ can be the source of relationship distress.
Anything.
What is the most common problem?
Communication.
What is the most damaging problem?
Physical abuse.
What is the most difficult problem to treat?
Lack of loving feelings.
Psychodynamic Models
Focus on early experiences and unconscious processes that stem from these experiences.
Object Relations Couples Therapy is a ___ model.
Psychodynamic.
Object Relations Couples Therapy
Focuses on people’s early experiences with, and mental models of, caregivers. Project their expectations onto their partner.
The process of their partner’s response to projection (in object relations couples therapy) is known as ___ ___.
Projective identification.
What is the goal of object relations therapy?
Minimize or eliminate possible harm that can come from projection.
How does one minimize harms come from projection?
- Encourage partner to identify with the other’s projections.
- Encourage protector to accept partner’s response.
- Recognize role of early experience in current behaviour.
Systems Models
Focus on unspoken rules and expectations within the relationship.
Systems models says that relationship problems occur when…
Unspoken rules and expectations have too much rigidity.
What is the goals of systems models?
Enable partners to articulate the unspoken rules and expectations of their relationship.
Systems models help partners to develop new, more adaptive rules and expectations for the relationship by…
Re-lablling behaviours and reframing problems.
Outcome Research
Examines the effectiveness of interventions.
Efficacy Studies
Couples are randomly assigned to a control group or to a type of therapy. The “pure intervention” is delivered according to a manual that details what is to be done at every session.
Effectiveness Studies
Study of therapy outcomes in real world settings.
About ___ of couples who underwent therapy were recovered and over __% improved.
Half, 20%.
Were changes maintained for recovered couples?
Yes.
Do different types of therapy have different levels of efficacy?
No.
Effectiveness studies show ___ success rates than efficacy studies.
Lower.
Effectiveness studies show that large numbers of couples ___ ___ of therapy.
Drop out.
Effectiveness studies show that treatments for ___ difficulties are more effective than treatments for ___ difficulties.
Individual, couple.
Behavioural exchanged examine how partners’ behaviours are followed by…
Rewards or punishments.
Rewards
Increase the likelihood of the behaviour in the future.
Punishments
Decrease the likelihood of that behaviour in the future.
What theory is behavioural models related to?
Social learning theory.
What are the 3 types of treatment under behavioural models?
- Behavioural exchanges.
- Communication training.
- Problem-solving training.
How does CBT modify the behavioural model?
Says that thoughts (interpretations) also matter, and identifies maladaptive thoughts.
Communication Training
- Advice on how to listen to each other.
- Advice on how to talk productively.
Problem-Solving Training
Help to apply skills from communication training to the discussion of specific problems.
CBT specifically addresses:
- Selective attention.
- Attributions.
- Expectations.
- Assumptions.
- Standards.
What is the goal of CBT?
Help couples to interpret their partner’s behaviour in a positive light.
What does Integrative Behavioural Couples Therapy add to behavioural therapy?
Teaching that some behaviours and aspects need to be tolerated.
The focus in Integrative Behavioural Couples Therapy is to help one partner ___ the other’s behaviour, instead of changing the other’s behaviour.
Accomodate.
With Integrative Behavioural Couples Therapy, when an individual was given permission to stay the way they were…
The more likely they were to change.
What is the goal of Integrative Behavioural Couples Therapy?
- Empathic joining.
- Unified detachment.
- Tolerance building.
Empathic Joining
Adopting each others’ perspective.
Unified Detachment
Help partner view their problems with less emotion.
Tolerance Building
Help partners accept that not all problems can be solved.
Emotionally Focused Couples Therapy
Focuses on partners’ feelings.
Emotionally Focused Couples Therapy divides emotions into:
Primary and secondary emotions.
Primary Emotions
Focus on feelings related to security and abandonment.
Secondary Emotions
Feelings that may surprise primary emotions.
Give an example of a secondary emotion.
Anger.
Emotionally Focused Couples Therapy aims to help partners see through their secondary emotions to their primary emotions through:
- De-escalation of negative cycles.
- Shaping new cycles of responsiveness and accessibility.
- Consolidation and integration.