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Relationship Dysfunction Lecture Overview

Relationship Dysfunction Lecture Overview. Overview of the problem Theories of relationship dysfunction Empirically-supported treatments Traditional BMT Integrative couple therapy Efficacy data Class discussion. Significance of Marital Discord. Between 50-67% of married adults divorce

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Relationship Dysfunction Lecture Overview

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  1. Relationship DysfunctionLecture Overview • Overview of the problem • Theories of relationship dysfunction • Empirically-supported treatments • Traditional BMT • Integrative couple therapy • Efficacy data • Class discussion Treatments of Relationship problems

  2. Significance of Marital Discord • Between 50-67% of married adults divorce • Marital problems represent the single most frequent problem for which people seek out mental health services • Divorce and marital separations rank as one of the most significant stressors and has also been shown to increase people’s risk for physical and mental illness Treatments of Relationship problems

  3. Significance of Marital Discord • Admission to mental hospitals are the lowest among the married, and highest among the divorced • Motor vehicle accident rates among those undergoing divorce double during the six months before and after divorce • Marital distress, conflict, and disruption are associated with a wide range of deleterious effects on children Treatments of Relationship problems

  4. Significance of Marital Discord • Adults who experienced a divorce as children experience significantly more emotional problems in their adult life Treatments of Relationship problems

  5. What Predicts Marriages to End in Divorce? Treatments of Relationship problems

  6. Factors Associated with Marital Discord • Reinforcement loss (behavioral) • Positive affect loss (emotional) • Dysfunctional beliefs (cognitive) • Situational factors (environmental) Treatments of Relationship problems

  7. Factors that Predict Separation and Divorce • Parental disagreement about child rearing practices (Block, 1981) • Emotional stability (Kelly & Conley, 1987) Treatments of Relationship problems

  8. Gottman’s Balance Theory Gottman (1993) Treatments of Relationship problems

  9. Gottman Theory: Major Assumptions • The cascade toward marital dissolution can be predicted with just two variables Treatments of Relationship problems

  10. Gottman Theory: Major Assumptions • Not all negativity is equally corrosive Treatments of Relationship problems

  11. Gottman Theory: Major Assumptions • There is a process cascade that relates to the couple's perception of the relationship and that also predicts dissolution Treatments of Relationship problems

  12. Process Cascade Treatments of Relationship problems

  13. Gottman Theory: Major Assumptions • During marital conflict, the perception of positive affect is one dimensional, whereas the perception of negative affect is two dimensional Treatments of Relationship problems

  14. Gottman Theory: Major Assumptions • Flooding leads to emotional (escape) conditioning, which causes a state of hypervigilance to the cues conditioned to the flooding. Treatments of Relationship problems

  15. Gottman Theory: Major Assumptions • Physiological reactivity and chronically high levels of physiological arousal are related to separation and divorce Treatments of Relationship problems

  16. Gottman Model Treatments of Relationship problems

  17. Incompatibility As a Causal Factor in Relationship Discord Jacobson & Christensen (1996) Treatments of Relationship problems

  18. Development of Incompatibilities • Longitudinal research suggests that the likelihood of a person finding a mate whose preferences were compatible on just three separate dimensions was low (17%) Treatments of Relationship problems

  19. Development of Incompatibilities • Potentially conflictual differences and similarities are not likely to create problems early on in the relationship • Similarities and differences that were once a source of attraction may become a source of incompatibility Treatments of Relationship problems

  20. Development of Incompatibilities • Shared and individual life experiences may exacerbate existing incompatibilities or even create new ones Treatments of Relationship problems

  21. Incompatibility As a Causal Agent in Relationship Discord • Areas of incompatibility • Level of closeness • Extent of asymmetry Treatments of Relationship problems

  22. Incompatibility As a Causal Agent in Relationship Discord • Consequences of incompatibility • Coercion Treatments of Relationship problems

  23. Incompatibility As a Causal Agent in Relationship Discord • Consequences of incompatibility • Coercion • Vilification Treatments of Relationship problems

  24. Incompatibility As a Causal Agent in Relationship Discord • Consequences of incompatibility • Coercion • Vilification • Polarization Treatments of Relationship problems

  25. Incompatibility As a Causal Agent in Relationship Discord • Factors affecting how couples manage incompatibilities • Level of incompatibility • Attractions • Personality • Conflict resolution skills • Stressful circumstances Treatments of Relationship problems

  26. Assessment of Relationship Dysfunction • Partner’s beliefs that each hold about the relationship (marital satisfaction) • Lock-Wallace Marital Satisfaction Scale • Dyadic Adjustment Scale Treatments of Relationship problems

  27. Assessment of Relationship Dysfunction • What are the day-to-day interactions of the couple • Spouse Observational Checklist Treatments of Relationship problems

  28. Assessment of Relationship Dysfunction • What are the factors contributing to the central relationship problems? • Clinical interview with each partner • Self-monitoring Treatments of Relationship problems

  29. Assessment of Relationship Dysfunction • How do partners bring about change in their relationship e.g., conflict resolution skills)? • MICS (Marital Interaction Coding System) Treatments of Relationship problems

  30. Treatment of Relationship Problems Early Behavioral Marital Therapy Treatments of Relationship problems

  31. Behavioral Marital Therapy • History Treatments of Relationship problems

  32. Procedural Components of BMT • Increasing couples’ positive exchanges Treatments of Relationship problems

  33. Why Start with Increasing Couples Positive Exchanges • Changes in problems do not automatically increase positive exchanges • Negative spouse behaviors tend to diminish even if they are not the focus • May increases receptivity to tackle more demanding marital changes • The focus on the positive serves to reduce the spouses’ deprivation and thus may increase the perception that the relationship is worth the effort • Comparatively easy to implement Treatments of Relationship problems

  34. Strategies for Increasing Positive Exchanges • Giver-initiated positive exchanges • Have each spouse generate hypotheses about increasing partner’s daily satisfaction • Set target goals for increasing pleasing behaviors • Use of “love days” Treatments of Relationship problems

  35. Strategies for Increasing Positive Exchanges • Receiver-initiated positive exchanges • Teaching spouses to make specificrequests for pleasing behaviors • Exchange contracts • “Cookie jar” Treatments of Relationship problems

  36. Strategies for Increasing Positive Exchanges • Specification of mutual positive exchanges • Couple pleases • Companionship activities • Shared avocations Treatments of Relationship problems

  37. Procedural Components of BMT • Increasing couples’ positive exchanges • Communication training Treatments of Relationship problems

  38. Targets for Communication Training • Empathy and listening skills • Validation • Learning to talk about feelings • Learning to express negative feelings appropriately • Expression of positive feelings Treatments of Relationship problems

  39. Strategic Steps in Communication Training • Feedback • Coaching and modeling • Behavioral rehearsal Treatments of Relationship problems

  40. Cognitive Approaches to Communication Training • Teaching partners about sex differences in conversational style • Teaching partners about sex differences in the meaning of talk • Identifying dysfunctional beliefs • Correcting dysfunctional beliefs through communication Treatments of Relationship problems

  41. Considerations in the Choice of Positive Exchange Strategies • Have partners slacked off in their attempts to please one another? • Does one or both partners have difficulties with making requests from the other? • Are the partners ineffective in reinforcing each other even though positive behaviors are being emitted? Treatments of Relationship problems

  42. Procedural Components of BMT • Increasing couples’ positive exchanges • Communication training • Problem-solving training Treatments of Relationship problems

  43. Factors Contributing to Effective Problem-Solving • Setting • Attitude • Distinguishing between problem definition vs. problem solution Treatments of Relationship problems

  44. Guidelines for Defining Problems • Begin with something positive • Be specific • Express your feelings • Admit to your role in the problem • Be brief when defining problems • Discuss only one problem at a time • Paraphrase Treatments of Relationship problems

  45. Guidelines for Solution Phase • Focus on solutions that will work in the future • Brainstorm solutions • Solution should involve mutuality and compromise • Final change agreements should be specific • Final agreement should include cues reminding each of the changes they are to make • Final agreement should be recorded in writing Treatments of Relationship problems

  46. Therapist Behaviors Associated With a Positive Outcome • Structuring skills • Instigation skills • Teaching skills • Fostering positive expectancies • Provide emotional nurturance Treatments of Relationship problems

  47. Efficacy Data for BMT(Hahlweg & Markman, 1988) • Meta-analysis • 17 studies comparing BMT to either a wait-list group or placebo control group • Average effects size was .95 (83% of the BMT patients were better off than controls) • Chance of improving was 72% for BMT versus 28% for controls • Rate of improvement attributable to BMT is about 40% Treatments of Relationship problems

  48. Efficacy Data for BMT(Hahlweg & Markman, 1988) • Meta-analysis cont. • Trend toward a lower effect size for newer studies (.8 vs. 1.09) • Comparisons with other approaches showed no significant advantage of BMT • Measure of clinical significance revealed that few couples moved into the normal range Treatments of Relationship problems

  49. Meta-Analytic Review(Dunn & Schwebel, 1995) • Meta-analysis • 15 studies (558 couples) investigating effect sizes of three different treatments: (1) BMT (n = 13), (2) CBMT (n = 3), and (3) IOMT (n = 5) . • Each of the three treatment classes were compared to control couples • Behavior Change: Average effects size was .79 (BMT), .54 (CBMT), and .87 (IOMT) • Only CBMT led to significant change in cognitions • IOMT had largest effect size on general measures of the quality of the relationship Treatments of Relationship problems

  50. Moderators of Treatment Outcome for BMT • Commitment • Younger age (after controlling for duration of marriage) • Emotional engagement • Non-traditionality (peer marriage) • Convergent goals for the marriage Treatments of Relationship problems

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