Selected Essays And Book Reviews

COUN 612 - Theories and Techniques of Counseling I

Lessons 21. Marital Therapies: Psychoanalytic, Family Systems {809 words}

1. Discuss the need for marriage counseling. There is a need for pastoral counseling and secular private practice. Based on U.S. trends, Christians and non-Christians will have to do more: (a) premarital counseling and counseling immediately post-marriage (latter works best about 3 to 4 months following marriage), (b) counseling with cohabiting, unmarried couples (very popular but very risky for marriage), (c) divorce counseling (even fundamental Christians are divorcing; current divorce rate is around 55% to 60%), (d) pre-remarital counseling (65% to 70% divorced people remarry, despite the dangers; 4% of all adults have been married three times; remarriages fail most often because of the step-mother), and (e) marriage counseling with remarried couples.

2. Discuss the theories of marriage counseling. The theories, along with their key proponents, are:

A. psychoanalytically-informed (Nadelson (a nice simple approach) and Sager (marriage contracts)),

B. family systems theory (Bowen family systems theory by Phillip Gurin, Mental Research Institute where family systems therapy originated under Bateson (an anthropologist), structural family therapy by Minuchin, strategic family therapy by Haley and Madanes, emotion-focused therapy (Greenberg and Johnson), paradoxical (L'Abate), and Milton Erickson)

C. behavioral has a nice treatment program for marriages (Jacobson and Margolin and Stuart (also came up with Weight Washers).

D. cognitive (Baucom and Epstein, Aaron Beck, and Ellis (RET in marriage).

E. integrative with Sperry and Carlson.

F. Christian with Wright (behavioral and cognitive) and Worthington (cognitive-behavioral eclectic).

3. Discuss the psychoanalytically-informed marital therapy.

A. The causes of problems are developmental conflicts that are unresolved in each partner (I-A-D conflicts in each partner). These conflicts governed the choice of a mate who did not challenge these issues and conflicts. After marriage, each spouse's behavior comes to trigger the partner's issues and conflicts.

B. The goals of marital therapy are to solve marital problems through gaining insight into overt and unconscious reasons for behavior. The two types of couples are symptom relief (they want to stop the pain) and understanding their marriage (they want to understand why the problems are happening).

C. The process of therapy is: (a) begin with a discussion of symptoms or marital disagreement, (b) use a variety of communication strategies to help people straighten out their interactions, (c) interpret transference between spouses (rather than traditional transference between client and therapist; this involves having them act out problems with spouse), (d) phase two (this is for people who are interested in more in-depth understanding of their marriage; it includes insight through interpretations, confrontations, and dealing with resistances, goals are to neutralize and integrate aggressive and sexual needs so behavior is ego-controlled rather than impulse-controlled, and it involves an exploration of the past), (e) termination (set a date, deal with conflicts, and defenses that reemerge).

4. Discuss the family systems: emotion-focused therapy (Greenberg and Johnson). This theory sprang out of Gestalt thinking, but with families, it is more warm and compassionate.

A. Causes of problems: A person's experiences are organized so that some aspects are primary (figure) and others are secondary (background). The feeling or emotional system, which is being expressed through communication, is primary. In a troubled marriage, communication and thus the emotional valence of the relationship, is negative. Thus, each partner's perception is negative.

B. Goals: The goals are to reorganize each person's perception by changing the interactional system (the way couples communicate with each other) and each person's emotional experience of the relationship and to encourage people to make explicit statements of feelings and needs and to experience positive feelings toward the partner. Changed (better) communication is more a product of changed perception and feeling than a producer of changed perception and feeling.

C. Process of change: Reframe negative interactions in terms of primary emotions. Basically, people "believe" their emotions. Therefore, promote sincerely felt emotional expression and label it sensitively and positively. Note: Not all emotional expression is adaptive (good). The therapist labels emotional expression as facilitative or disruptive.

D. Process of therapy: Delineate conflict issues and themes in the core struggle. Identify the negative interaction cycle. Access unacknowledged feelings. Reframe the problem, getting the couples to interact and share feelings as they are experienced. Promote identification with disowned feelings and needs. Promote acceptance of the partner's experience (encourage disclosure of vulnerability and acceptance of the other's needs; deal with resistances). Facilitate the expression of needs and wants. Establish the emergence of new solutions. Consolidate new positions.

				Tom of Bethany

"He that hath the Son hath life; and he that hath not the Son of God hath not life." (I John 5:12)

"And ye shall seek me, and find me, when ye shall search for me with all your heart." (Jeremiah 29:13)

 

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Lesson 22. Marital Therapies: Behavioral and Cognitive

 

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