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Feldman T. The elusive nature of neutrality: The role of values in couple therapy. FAMILY PROCESS 2024. [PMID: 38424739 DOI: 10.1111/famp.12984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 03/02/2024]
Abstract
This paper will explore the role of the therapist's values in couple therapy and the challenge these values pose to therapeutic neutrality. It will illuminate how the therapist's values shape what is considered healthy and unhealthy, functional and dysfunctional, and hence frame the problem the couple therapist seeks to treat. Values have particular relevance for couple treatment because the conversations the couple therapist facilitates may unwittingly privilege one partner's needs and wishes over the other's, creating the potential for therapeutic misalliances. This paper will explore common values and their impact on treatment, including the values of monogamy, gender equity, and talk intimacy (emotional expression as a path to intimacy). It will conclude by discussing how couple therapists can avoid partisanship with one partner and maintain a balanced approach in their couple work.
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Affiliation(s)
- Tamara Feldman
- The Psychodynamic Couple and Family Institute of New England, Needham, Massachusetts, USA
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2
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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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3
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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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Rossman SM, Lerner RE, Córdova JV. Disentangling acceptance: Direct and indirect effects of partner acceptance on felt acceptance and relationship satisfaction. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:378-384. [PMID: 34197160 PMCID: PMC8720111 DOI: 10.1037/fam0000900] [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: 06/13/2023]
Abstract
Acceptance in intimate relationships predicts relationship satisfaction, as well as positive treatment outcomes in some couple interventions. However, little research has attempted to disentangle the dyadic effects of husbands' and wives' partner acceptance (i.e., acceptance of one's partner) and felt acceptance (i.e., felt sense of being accepted by one's partner) on relationship satisfaction. This study utilized a modified actor-partner interdependence mediation model (APIMeM) to examine whether the associations between acceptance of one's partner and each partner's relationship satisfaction are mediated by each partner's felt acceptance. We analyzed baseline self-report data from 209 heterosexual married couples who participated in a brief marital intervention in the United States. The final model supported the prediction that a person's acceptance of their partner would relate to their partner's relationship satisfaction through their partner's felt acceptance (i.e., an "accuracy effect") and to their own relationship satisfaction through their own felt acceptance (i.e., a "projection effect"). In all, the study demonstrates the utility of examining partner acceptance and felt acceptance as distinct, but related, constructs. Researchers and clinicians working with couples may consider conceptualizing, assessing, and even targeting partners and felt acceptance separately. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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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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Megale A, Peterson E, Friedlander ML. How Effective is Online Couple Relationship Education? A Systematic Meta-Content Review. CONTEMPORARY FAMILY THERAPY 2021; 44:294-304. [PMID: 34025019 PMCID: PMC8127847 DOI: 10.1007/s10591-021-09585-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 12/24/2022]
Abstract
Due to logistical and financial barriers that keep many distressed couples from seeking psychotherapy, online relationship education is a more accessible alternative. In the decade since a web-based program showed equivalent effectiveness to traditional marriage education (Duncan et al., 2009), several fully online programs have been developed and evaluated. We reviewed nine studies of four different programs that sampled 2,000 + couples. Specifically, we rated each study's experimental rigor and compared research designs, theoretical and empirical grounding, average post-intervention and follow-up effect sizes, and differential effectiveness. Across studies, measured outcomes included relational (improved satisfaction, quality, confidence, commitment, communication; reduced conflict and aggression) and individual functioning on various indices of mental and physical health, emotional expression, and quality of life. Finally, we discuss the strengths and limitations of the research evidence, describe the two most evidence-based programs (ePREP and OurRelationship) in some detail and make recommendations for future study of these promising kinds of interventions.
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Affiliation(s)
- Allison Megale
- Department of Educational & Counseling Psychology, University At Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222 USA
| | - Emily Peterson
- Department of Educational & Counseling Psychology, University At Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222 USA
| | - Myrna L Friedlander
- Department of Educational & Counseling Psychology, University At Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222 USA
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Integrative Behavioral Couple Therapy for Intercultural Couples: Helping Couples Navigate Cultural Differences. CONTEMPORARY FAMILY THERAPY 2021. [DOI: 10.1007/s10591-020-09560-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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8
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Yasmin N, Riley GA. Psychological intervention for partners post-stroke: A case report. NeuroRehabilitation 2020; 47:237-245. [DOI: 10.3233/nre-203173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Following a brain injury, caregiving spouses/partners differ in their perceptions of relationship continuity/discontinuity (i.e. whether the relationship is experienced as similar or different to the pre-injury relationship). Perceptions of continuity are associated with better psychological wellbeing and a better relationship. OBJECTIVE: To conduct a pilot test of an intervention aimed at exploring the possibility of supporting caregiving partners to experience greater continuity within their relationship post-stroke. METHODS: A post-stroke couple was provided with integrated behavioural couples therapy for three months, which aimed to increase relationship continuity alongside addressing individual goals identified by the couple. Before and after measures were taken using a battery of six questionnaires evaluating changes in perceptions of continuity, relationship quality, and stress. RESULTS: Quantitative and qualitative data showed post-therapy improvement in all the measures. CONCLUSIONS: The study suggested that perceptions of relationship continuity can be improved by therapy, and that such an improvement might have a beneficial impact in terms of relationship quality and psychological wellbeing. The intervention is currently being further developed and evaluated.
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Affiliation(s)
- Natasha Yasmin
- School of Psychology, University of Birmingham, Birmingham, UK
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Couture N, Villeneuve P, Éthier S. Five Functions of Art Therapy Supporting Couples Affected by Alzheimer’s Disease. ART THERAPY 2020. [DOI: 10.1080/07421656.2020.1726707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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10
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Lebow JL. Editorial: The Systemic in Couple and Family Research and Couple and Family Therapy. FAMILY PROCESS 2020; 59:3-9. [PMID: 32119753 DOI: 10.1111/famp.12529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Jay L Lebow
- Family Institute at Northwestern, Evanston, IL
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11
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Lebow JL. Current Issues in the Practice of Integrative Couple and Family Therapy. FAMILY PROCESS 2019; 58:610-628. [PMID: 31334847 DOI: 10.1111/famp.12473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This paper provides an overview of current issues in integration in couple and family therapy. It summarizes the evolution of integration in couple and family therapy, the various traditions in integration, the strengths of integrative approach, and the possible pitfalls involved. It highlights the extent to which most couple and family therapy is now integrative practice. It concludes with a consideration of an emerging trend toward methods of practice centered on modules of intervention that have been identified as effective with certain presenting phenomena. The example of therapy for high conflict divorce is utilized to illustrate how various components can be brought together to create a maximally effective intervention.
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Affiliation(s)
- Jay L Lebow
- Family Institute at Northwestern University, Evanston, IL
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12
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Kugler J, Andresen FJ, Bean RC, Blais RK. Couple‐based interventions for PTSD among military veterans: An empirical review. J Clin Psychol 2019; 75:1737-1755. [DOI: 10.1002/jclp.22822] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Jordan Kugler
- Department of PsychologyUtah State University Logan Utah
| | | | - Ron C. Bean
- Department of PsychologyUtah State University Logan Utah
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13
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Lebow JL. Editorial: Effectiveness Research in Couple and Family Therapy. FAMILY PROCESS 2018; 57:271-274. [PMID: 29786133 DOI: 10.1111/famp.12367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jay L Lebow
- Family Process, and Family Institute at Northwestern, Evanston, IL
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14
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Lebow JL. Editorial: The Multidisciplinary World of Couple and Family Therapy and Family Science. FAMILY PROCESS 2017; 56:795-798. [PMID: 29205341 DOI: 10.1111/famp.12324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Jay L Lebow
- Family Institute at Northwestern, Evanston, IL
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15
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Borcsa M, Pomini V. Virtual Relationships and Systemic Practices in the Digital Era. CONTEMPORARY FAMILY THERAPY 2017. [DOI: 10.1007/s10591-017-9446-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Smith Slep AM, Heyman RE, Mitnick DM, Lorber MF, Beauchaine TP. Targeting couple and parent-child coercion to improve health behaviors. Behav Res Ther 2017; 101:82-91. [PMID: 29108651 DOI: 10.1016/j.brat.2017.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/29/2017] [Accepted: 10/09/2017] [Indexed: 02/07/2023]
Abstract
This phase of the NIH Science of Behavior Change program emphasizes an "experimental medicine approach to behavior change," that seeks to identify targets related to stress reactivity, self-regulation, and social processes for maximal effects on multiple health outcomes. Within this framework, our project focuses on interpersonal processes associated with health: coercive couple and parent-child conflict. Diabetes and poor oral health portend pain, distress, expense, loss of productivity, and even mortality. They share overlapping medical regimens, are driven by overlapping proximal health behaviors, and affect a wide developmental span, from early childhood to late adulthood. Coercive couple and parent-child conflict constitute potent and destructive influences on a wide range of adult and child health outcomes. Such interaction patterns give rise to disturbed environmental stress reactivity (e.g., disrupted sympathetic nervous and parasympathetic nervous systems) and a wide range of adverse health outcomes in children and adults, including dental caries, obesity, and diabetes-related metabolic markers. In this work, we seek to identify/develop/validate assays assessing coercion, identify/develop and test brief interventions to reduce coercion, and test whether changes in coercion trigger changes in health behaviors.
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Lebow JL. Editorial: Emerging Principles of Practice in Couple and Family therapy. FAMILY PROCESS 2017; 56:535-539. [PMID: 28862336 DOI: 10.1111/famp.12309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Jay L Lebow
- Family Process, and Family Institute at Northwestern, Evanston, IL
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18
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Nielsen AC. From Couple Therapy 1.0 to a Comprehensive Model: A Roadmap for Sequencing and Integrating Systemic, Psychodynamic, and Behavioral Approaches in Couple Therapy. FAMILY PROCESS 2017; 56:540-557. [PMID: 28608399 DOI: 10.1111/famp.12300] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Couple therapy is a complex undertaking that proceeds best by integrating various schools of thought. Grounded in an in-depth review of the clinical and research literature, and drawing on the author's 40-plus years of experience, this paper presents a comprehensive, flexible, and user-friendly roadmap for conducting couple therapy. It begins by describing "Couple Therapy 1.0," the basic conjoint couple therapy format in which partners talk to each other with the help of the therapist. After noting the limitations of this model, the paper introduces upgrades derived from systemic, psychodynamic, and behavioral/educational approaches, and shows how to combine and sequence them. The most important upgrade is the early focus on the couple's negative interaction cycle, which causes them pain and impedes their ability to address it. Using a clinical case example, the paper shows how all three approaches can improve couple process as a prerequisite for better problem solving. Additional modules and sequencing choice points are also discussed, including discernment counseling and encouraging positive couple experiences.
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Affiliation(s)
- Arthur C Nielsen
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- The Chicago Institute for Psychoanalysis, Chicago, IL
- The Family Institute at Northwestern University, Evanston, IL
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Lebow JL. Editorial: Empirically Supported Treatments in Couple and Family Therapy. FAMILY PROCESS 2016; 55:385-9. [PMID: 27619908 DOI: 10.1111/famp.12240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- Jay L Lebow
- Family Process and Family Institute at Northwestern.
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