Description
ASSIGNMENT OVERVIEW
After reading the assigned chapters for this week, my guess is that you are wondering how a therapist utilizes theory while working with a couple. That is a great question to have, and this assignment will help you to answer that question. In this paper, you are tasked with clearly articulating your clinical and personal assumptions of the couple and their situation based on the information provided. You will demonstrate your understanding of how to structure a couple’s therapy session to include the initial and ongoing assessment of the personal and interactive personality markers that influence relational engagement. You will then offer a case conceptualization in which you identify target behaviors that may be contributing to the challenges presented by the client unit. As a result of the assessment and conceptualization, you will articulate behavioral or integrative interventions (minimum of three) that will benefit the couple. As you share these interventions you will also clearly outline the clinical rationale for the selection of each of the interventions mentioned. You will also identify behavioral or integrative interventions that you believe would not clinically benefit the clients (minimum of two). In your response, make a case for why the selected interventions would not be of benefit to the client unit in question.
Please do not copy and paste the vignette as part of your paper. Failure to comply will result in a deduction of 10 points.
Vignette:
Abdul-Khabir and Hadiza come to see you for marital therapy. Abdul-Khabir is 37 years of age and works as a civil engineer. Hadiza is 36 years of age and was a nurse for many years. The couple have been married for 10 years and have two children ages six and three.
In the initial session and after the review of the informed consent and mandated reporting guidelines the couple talk about the presented challenges. Abdul-Khabir shared that after being married for 10 years he is having a tough time remembering how and why he fell in love with Hadiza. Arms folded and eyes full of tears, he slowly articulates how Hadiza has changed. He shared that she used to be energetic, engaging, and full of life. Now she hardly gets on his bed, struggles to help him take care of the kids, refuses to go out with him, the family, or with her friends. Whenever the topic of doing something other than sitting at home comes up it turns into a massive argument, and he is tired of having to argue constantly with his wife.
Hadiza sits patiently in the room as her husband shares his view of the challenges. As she is asked why the couple is here, in a confident and controlled tone she says, life would be much better if Khabir would learn how to relax. She says that earlier on in their marriage they would go out or be around family every weekend. It is the same scene, the same people, the same discussions, the same problems, just a different year and she is tired of it. She shared that her husband is neurotic, and any slight change in his world is made out to be a big earth-shattering problem. She indicates that she has the primary responsibility to care for the children and does not understand her husband’s perspective that she struggles to care for them.
As you author your paper, be sure to address all of the following questions. Do not cut and paste the questions into the text of your paper and do not use bullet points for any section of the paper. Failure to comply will result in a deduction of 10 points.
Paper Format:
Introduction:
Before delving into the main subject matter of your paper, please introduce your work and clearly explain what you plan to discuss in your paper.
Assumptions:
In this section, you are to identify your personal and professional assumptions based on the information shared within the vignette (a minimum of four). Clearly articulate how you reached the assumptions you have made regarding the client unit. It is important to note that personal and professional assumptions influence the way we work with our clients, and it is important that we identify those assumptions to create an accepting and growth-centered therapeutic environment.
Assessment:
After reading the vignette multiple times, address how you plan to structure the couple therapy session. Clearly identify and articulate theory specific assessment-based questions that would help you gather relevant information to help you assist the clients further (a minimum of five). It is important that you share the rationale for each of the questions you have identified. Specifically, share how the answers to the questions you have asked would benefit your understanding of the issues presented by the client unit.
Case Conceptualization:
In this section, you will write out a clinical conceptualization demonstrating your understanding of the presented issues using the language of the theory. For this assignment, you are employing the behavioral or the integrative approach. As a reminder, you should focus on the key factors shared by your client(s) and infer certain unspoken or unshared circumstances. Clearly support your hunches by referring to the information found in the vignette and stay away from simply summarizing the vignette. In addition, be sure to clearly outline structural or interactive nuances that help to maintain the presenting problem in place.
Behavioral or Integrative Interventions:
In this section, you will select one of the theories assigned to this week’s reading and articulate a minimum of three interventions you would use to help the client unit. As you share the specific interventions, please include the rationale for your selection and how the clients would benefit from the selected interventions. To demonstrate your ability to identify relevant interventions given the presence of specific issues and challenges, identify a minimum of two interventions that would not benefit the client unit.
Conclusion:
Summarize what you presented in the previous pages and draw a summative conclusion. In other words, this is where you get to share the highlights of your paper. Focus on the central theme of the paper and express your discoveries along the way.
Guidelines
Please submit your completed paper under the assignment link found in the week 1 tab. The assignment is due by Sunday at 11:59 pm of the same week (1).
The paper should be between 6 – 8 pages in length not including the title and reference page.
As outlined in the rubric, this paper should have a clear introduction and conclusion.
This paper should adhere to strict APA (American Psychological Association) guidelines (7th edition).
Punctuation and grammar count.
Font Style should be Times New Roman and font size should be the standard 12.
Page Margin should be the standard 1 inch.
Do not double space between paragraphs.
As a reminder, when you cite or quote any source, please be sure to cite that source and give credit in the body of the paper and on the reference page. If you paraphrase, you should still cite the source of the idea you are describing.
Unformatted Attachment Preview
Theory Application
Assignment Overview
After reading the assigned chapters for this week, my guess is that you are wondering
how a therapist utilizes theory while working with a couple. That is a great question to have, and
this assignment will help you to answer that question. In this paper, you are tasked with clearly
articulating your clinical and personal assumptions of the couple and their situation based on
information provided. You will demonstrate your understanding of how to structure a couple’s
therapy session to include the initial and ongoing assessment of the personal and interactive
personality markers that influence relational engagement. You will then offer a case
conceptualization in which you identify target behaviors that may be contributing to the
challenges presented by the client unit. As a result of the assessment and conceptualization, you
will articulate behavioral or integrative interventions (minimum of three) that will benefit the
couple. As you share these interventions you will also clearly outlines the clinical rationale for
the selection of each of the interventions mentioned. You will also identify behavioral or
integrative interventions that you believe would not clinically benefit the clients (minimum of
two). In your response, make a case for why the selected interventions would not be of benefit to
the client unit in question.
Please do not copy and paste the vignette as part of your paper. Failure to comply will
result in a deduction of 10 points.
Vignette:
Abdul-Khabir and Hadiza come to see you for marital therapy. Abdul-Khabir is 37 years
of age and works as a civil engineer. Hadiza is 36 years of age and was a nurse for many years.
The couple have been married for 10 years and have two children ages six and three.
In the initial session and after the review of the informed consent and mandated reporting
guidelines the couple talk about the presented challenges. Abdul-Khabir shared that after being
married for 10 years he is having a tough time remembering how and why he fell in love with
Hadiza. Arms folded and eyes full of tears, he slowly articulates how Hadiza has changed. He
shared that she used to be energetic, engaging, and full of life. Now she hardly gets on his bed,
Page 1|4
struggles to help him take care of the kids, refuses to go out with him, the family, or with her
friends. Whenever the topic of doing something other than sitting at home comes up it turns into
a massive argument, and he is tired of having to argue constantly with his wife.
Hadiza sits patiently in the room as her husband shares his view of the challenges. As she
is asked why the couple are here, in a confident and controlled tone she says, life would be much
better if Khabir would learn how to relax. She says that earlier on in their marriage they would
go out or be around family every weekend. It is the same scene, the same people, the same
discussions, the same problems, just a different year and she is tired of it. She shared that her
husband is neurotic, and any slight change in his world is made out to be a big earth-shattering
problem. She indicates that she has the primary responsibility to care for the children and does
not understand her husband’s perspective that she struggles to care for them.
As you author your paper, be sure to address all the following questions. Do not cut and paste
the questions into the text of your paper and do not use bullet points for any section of the
paper. Failure to comply will result in a deduction of 10 points.
Paper Format:
Introduction:
Before delving into the main subject matter of your paper, please introduce your work
and clearly explain what you plan to discuss in your paper.
Assumptions:
In the section you are to identify your personal and professional assumptions based on the
information shared within the vignette (a minimum of four). Clearly articulate how you reached
the assumptions you have made regarding the client unit. It is important to note that personal and
professional assumptions influence the way we work with our clients, and it is important that we
identify those assumptions to create an accepting and growth centered therapeutic environment.
Assessment:
After reading the vignette, multiple times, address how you plan to structure the couple
therapy session. Clearly identify and articulate theory specific assessment-based questions that
Page 2|4
would help you gather relevant information to help you assist the clients further (a minimum of
five). It is important that you share the rationale for each of the questions you have identified.
Specifically, share how the answers to the questions you have asked would benefit your
understanding of the issues presented by the client unit.
Case Conceptualization:
In this section, you will write out a clinical conceptualization demonstrating your
understanding of the presented issues using the language of the theory. For this assignment, you
are employing the behavioral or the integrative approach. As a reminder, you should focus on the
key factors shared by your client(s) and infer certain unspoken or unshared circumstances.
Clearly support your hunches by referring to the information found in the vignette and stay away
from simply summarizing the vignette. In addition, be sure to clearly outline structural or
interactive nuances that help to maintain the presenting problem in place.
Behavioral or Integrative Interventions:
In this section, you will select one of the theories assigned to this week’s reading and
articulate a minimum of three interventions you would use to help the client unit. As you share
the specific interventions, please include the rationale for your selection and how the clients
would benefit from the selected interventions. To demonstrate your ability to identify relevant
interventions given the presence of specific issues and challenges, identify a minimum of two
interventions that would not benefit the client unit.
Conclusion:
Summarize what you presented in the previous pages and draw a summative conclusion.
In other words, this is where you get to share the highlights of your paper. Focus on the central
theme of the paper and express your discoveries along the way.
Guidelines
1. Please submit your completed paper under the assignment link found in the week 1 tab.
The assignment is due by Sunday at 11:59 pm of the same week (1).
2. The paper should be between 6 – 8 pages in length not including the title and reference
page.
Page 3|4
3. As outlined in the rubric, this paper should have a clear introduction and conclusion.
4. This paper should adhere to strict APA (American Psychological Association) guidelines
(7th edition).
a. Punctuation and grammar count.
b. Font Style should be Times New Roman and font size should be the standard 12.
c. Page Margin should be the standard 1 inch.
d. Do not double space between paragraphs.
5. As a reminder, when you cite or quote any source, please be sure to cite that source and
give credit in the body of the paper and on the reference page. If you paraphrase, you
should still cite the source of the idea you are describing.
6. Save your paper as a doc or rtf with your name and the assignment name in the file, using
Last Name_Assignment. So, if your name is Alicia Jackson, and this is Essay 1, you
would title it Jackson_Essay 1.
Page 4|4
CLINICAL HANDBOOK OF COUPLE THERAPY
Also from Jay L. Lebow and Douglas K. Snyder
FOR PROFESSIONALS
Common Factors in Couple and Family Therapy:
The Overlooked Foundation for Effective Practice
Douglas H. Sprenkle, Sean D. Davis, and Jay L. Lebow
Couple-Based Interventions for Military and Veteran Families:
A Practitioner’s Guide
Edited by Douglas K. Snyder and Candice M. Monson
Helping Couples Get Past the Affair: A Clinician’s Guide
Donald H. Baucom, Douglas K. Snyder, and Kristina Coop Gordon
Treating Difficult Couples: Helping Clients
with Coexisting Mental and Relationship Disorders
Edited by Douglas K. Snyder and Mark A. Whisman
FOR GENERAL READERS
Getting Past the Affair: A Program to Help You Cope,
Heal, and Move On—Together or Apart
Douglas K. Snyder, Donald H. Baucom, and Kristina Coop Gordon
CLINICAL
HANDBOOK OF
COUPLE
THERAPY
SIXTH EDITION
edited by
Jay L. Lebow
Douglas K. Snyder
THE GUILFORD PRESS
New York London
Copyright © 2023 The Guilford Press
A Division of Guilford Publications, Inc.
370 Seventh Avenue, Suite 1200, New York, NY 10001
www.guilford.com
All rights reserved
No part of this book may be reproduced, translated, stored in a
retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, microfilming, recording,
or otherwise, without written permission from the publisher.
Printed in the United States of America
This book is printed on acid-free paper.
Last digit is print number: 9 8 7 6 5 4 3 2 1
The authors have checked with sources believed to be reliable in their efforts to provide
information that is complete and generally in accord with the standards of practice that
are accepted at the time of publication. However, in view of the possibility of human error
or changes in behavioral, mental health, or medical sciences, neither the authors, nor
the editors and publisher, nor any other party who has been involved in the preparation
or publication of this work warrants that the information contained herein is in every
respect accurate or complete, and they are not responsible for any errors or omissions or
the results obtained from the use of such information. Readers are encouraged to confirm
the information contained in this book with other sources.
Library of Congress Cataloging-in-Publication Data
Names: Lebow, Jay, editor. | Snyder, Douglas K., editor.
Title: Clinical handbook of couple therapy / edited by Jay L. Lebow,
Douglas K. Snyder.
Description: Sixth edition. | New York, NY : The Guilford Press, [2023] |
Includes bibliographical references and index.
Identifiers: LCCN 2022001583 | ISBN 9781462550128 (cloth)
Subjects: LCSH: Marital psychotherapy—Handbooks, manuals, etc.
Classification: LCC RC488.5 .C584 2022 | DDC 616.89/1562—dc23
LC record available at https://lccn.loc.gov/2022001583
Editors’ note. The case illustrations in this book are based on the authors’ research
and clinical practice. In all instances, names and identifying information have been
changed.
To our friends, colleagues, and precious loved ones
who have encouraged and sustained us over the years.
From the depth of our hearts—we thank you.
About the Editors
Jay L. Lebow, PhD, ABPP, LMFT, is Clinical Professor of Psychology at Northwestern University and
Senior Scholar at The Family Institute at Northwestern. He is also editor-in-chief of the journal Family
Process. Dr. Lebow has engaged in clinical practice, supervision, and research on couple and family
therapy since the 1970s, and is board certified in family psychology and an approved supervisor and
clinical fellow of the American Association for Marriage and Family Therapy (AAMFT). His numerous publications focus on the practice of couple and family therapy, the relationship of research and
practice, integrative practice, and intervention strategies with divorcing families. Dr. Lebow served as
president of Division 43 (Society for Couple and Family Psychology) of the American Psychological
Association (APA) and on the board of directors of the American Family Therapy Academy (AFTA).
He is a recipient of the Lifetime Achievement Award from AFTA and the Family Psychologist of the
Year Award from Division 43 of APA.
Douglas K. Snyder, PhD, is Professor of Psychological and Brain Sciences at Texas A&M University,
where he also served as Director of Clinical Training for 20 years. Dr. Snyder has engaged in clinical
practice and training of couple therapists since the 1970s, and is a clinical member of AAMFT. He
is coauthor or coeditor of several books, including Helping Couples Get Past the Affair and CoupleBased Interventions for Military and Veteran Families. Dr. Snyder has served as editor of the Clinician’s Research Digest and as associate editor of the Journal of Consulting and Clinical Psychology
and the Journal of Family Psychology. He is a recipient of the Distinguished Contribution to Research
in Family Therapy Award from AAMFT, the Distinguished Contribution to Family Psychology Award
from Division 43 of APA, and the Distinguished Psychologist Award from Division 29 (Society for the
Advancement of Psychotherapy) of APA.
vii
Contributors
Robert Allan, PhD, School of Education and Human Development, University of Colorado Denver,
Denver, Colorado
Samuel H. Allen, PhD, The Family Institute at Northwestern, Northwestern University, Evanston, Illinois
Christina Balderrama-Durbin, PhD, Department of Psychology, Binghamton University, State University
of New York, Binghamton, New York
Donald H. Baucom, PhD, Department of Psychology and Neuroscience, University of North Carolina
at Chapel Hill, Chapel Hill, North Carolina
Steven R. H. Beach, PhD, Center for Family Research and Department of Psychology, University of
Georgia, Athens, Georgia
Efrain Bleiberg, MD, The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College
of Medicine, Houston, Texas
Kristin Bolton, PhD, School of Social Work, University of North Carolina Wilmington,
Wilmington, North Carolina
Douglas C. Breunlin, MSSA, The Family Institute at Northwestern, Northwestern University,
Evanston, Illinois
Will H. Canu, PhD, Department of Psychology, Appalachian State University, Boone, North Carolina
Ryan G. Carlson, PhD, Department of Educational Studies, University of South Carolina, Columbia,
South Carolina
Anthony L. Chambers, PhD, The Family Institute at Northwestern, Northwestern University,
Evanston, Illinois
Andrew Christensen, PhD, Department of Psychology, University of California, Los Angeles,
Los Angeles, California
Aaron Samuel Cohn, PhD, The Family Institute at Northwestern, Northwestern University,
Evanston, Illinois
Gene Combs, MD, Evanston Family Therapy Center, Evanston, Illinois
Deb Coolhart, PhD, Marriage and Family Therapy Department, Syracuse University, Syracuse, New York
Joanne Davila, PhD, Department of Psychology, Stony Brook University, Stony Brook, New York
Sean Davis, PhD, California School of Professional Psychology, Alliant International University,
Sacramento, California
ix
x
Contributors
Sona Dimidjian, PhD, Crown Institute and Department of Psychology and Neuroscience,
University of Colorado Boulder, Boulder, Colorado
Brian D. Doss, PhD, Department of Psychology, University of Miami, Miami, Florida
Elizabeth E. Epstein, PhD, Department of Psychiatry, University of Massachusetts Chan Medical School,
Worcester, Massachusetts
Norman B. Epstein, PhD, Department of Family Science, School of Public Health, University of Maryland,
College Park, Maryland
Melanie S. Fischer, PhD, Department of Psychology, Philipps-Universität Marburg, Marburg, Germany
Mona DeKoven Fishbane, PhD, Chicago Center for Family Health, Chicago, Illinois
Peter Fonagy, PhD, Research Department of Clinical, Educational, and Health Psychology,
University College London, London, United Kingdom
Peter Fraenkel, PhD, Department of Psychology, The City College of New York, New York, New York
Cynthia Franklin, PhD, Steve Hicks School of Social Work, The University of Texas at Austin,
Austin, Texas
Steffany J. Fredman, PhD, Department of Human Development and Family Studies, The Pennsylvania
State University, University Park, Pennsylvania
Jill Freedman, MSW, Evanston Family Therapy Center, Evanston, Illinois
Elana B. Gordis, PhD, Department of Psychology, University at Albany, State University of New York,
Albany, New York
Kristina Coop Gordon, PhD, Department of Psychology, University of Tennessee, Knoxville, Tennessee
John Mordechai Gottman, PhD, The Gottman Institute, Seattle, Washington
Julie Schwartz Gottman, PhD, The Gottman Institute, Seattle, Washington
Kathryn S. K. Hall, PhD, private practice, Princeton, New Jersey
Cathryn Glanton Holzhauer, PhD, VA Central Western Massachusetts Healthcare System and Department
of Psychiatry, University of Massachusetts Chan Medical School, Worcester, Massachusetts
Sabrina Johnson, EdS, Department of Educational Studies, University of South Carolina, Columbia,
South Carolina
Susan M. Johnson, EdD, International Centre for Excellence in Emotionally Focused Therapy,
University of Ottawa, Ottawa, Ontario, Canada
Lana Kim, PhD, Graduate School of Education and Counseling, Lewis & Clark College, Portland, Oregon
Jennifer S. Kirby, PhD, Department of Psychology and Neuroscience, University of North Carolina
at Chapel Hill, Chapel Hill, North Carolina
Bob G. Knight, PhD, School of Psychology and Counselling, University of Southern Queensland,
Toowoomba, Queensland, Australia
Kayla C. Knopp, PhD, VA San Diego Healthcare System and Department of Psychiatry,
University of California, San Diego, La Jolla, California
Carmen Knudson-Martin, PhD, Graduate School of Education and Counseling, Lewis & Clark College,
Portland, Oregon
Jaslean J. LaTaillade, PhD, JBS International, Inc., North Bethesda, Maryland
Erika Lawrence, PhD, The Family Institute at Northwestern, Northwestern University, Evanston, Illinois
Jay L. Lebow, PhD, ABPP, LMFT, The Family Institute at Northwestern, Northwestern University,
Evanston, Illinois
Gayla Margolin, PhD, Department of Psychology, University of Southern California, Los Angeles,
California
Howard J. Markman, PhD, Department of Psychology, University of Denver, Denver, Colorado
Christopher R. Martell, PhD, Psychological Services Center, University of Massachusetts Amherst,
Amherst, Massachusetts
Barbara S. McCrady, PhD, Center on Alcohol, Substance Use, and Addictions
and Department of Psychology, University of New Mexico, Albuquerque, New Mexico
Contributors
Susan H. McDaniel, PhD, Departments of Psychiatry and Family Medicine, University of Rochester,
Rochester, New York
Erica A. Mitchell, PhD, College of Education, Health, and Human Sciences, University of Tennessee,
Knoxville, Tennessee
Candice M. Monson, PhD, Department of Psychology, Toronto Metropolitan University, Toronto,
Ontario, Canada
Leslie A. Morland, PsyD, VA San Diego Healthcare System and Department of Psychiatry,
University of California, San Diego, La Jolla, California
Patricia L. Papernow, EdD, Institute for Stepfamily Education, Hudson, Massachusetts
Hannah F. Rasmussen, MA, Department of Psychology, University of Southern California, Los Angeles,
California
Galena K. Rhoades, PhD, Department of Psychology, University of Denver, Denver, Colorado
Nancy Breen Ruddy, PhD, Department of Clinical Psychology, Antioch University New England,
Keene, New Hampshire
William P. Russell, MSW, The Family Institute at Northwestern, Northwestern University, Evanston,
Illinois
Ellen Safier, LCSW, The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College
of Medicine, Houston, Texas
Judith P. Siegel, PhD (retired), Silver School of Social Work, New York University, New York, New York
Douglas K. Snyder, PhD, Department of Psychological and Brain Sciences, Texas A&M University,
College Station, Texas
Alexandra H. Solomon, PhD, The Family Institute at Northwestern, Northwestern University,
Evanston, Illinois
Scott M. Stanley, PhD, Department of Psychology, University of Denver, Denver, Colorado
Daniel N. Watter, EdD, Morris Psychological Group, Parsippany, New Jersey
Carol A. Werlinich, PhD, private practice, Dayton, Maryland
Mark A. Whisman, PhD, Department of Psychology and Neuroscience, University of Colorado Boulder,
Boulder, Colorado
Stephanie A. Wiebe, PhD, School of Counselling, Psychotherapy, and Spirituality, Saint Paul University,
Ottawa, Ontario, Canada
Elizabeth R. Wrape, PhD, VA San Diego Healthcare System and Department of Psychiatry,
University of California, San Diego, La Jolla, California
Brian T. Wymbs, PhD, Department of Psychology, Ohio University, Athens, Ohio
Frances A. Wymbs, PhD, Department of Primary Care, Ohio University, Athens, Ohio
Helen Taylor Yates, PhD, School of Social Work, University of North Carolina Wilmington,
Wilmington, North Carolina
Anao Zhang, PhD, School of Social Work, University of Michigan, Ann Arbor, Michigan
xi
Contents
PART I. OVERVIEW AND GUIDING PRINCIPLES
CHAPTER 1
Couple Therapy in the 21st Century
3
Jay L. Lebow and Douglas K. Snyder
CHAPTER 2
Couple Assessment
22
Douglas K. Snyder and Christina Balderrama-Durbin
PART II. MODELS OF COUPLE THERAPY
BEHAVIORAL APPROACHES
CHAPTER 3
Cognitive-Behavioral Couple Therapy
53
Donald H. Baucom, Norman B. Epstein, Melanie S. Fischer,
Jennifer S. Kirby, and Jaslean J. LaTaillade
CHAPTER 4
Integrative Behavioral Couple Therapy
79
Andrew Christensen, Sona Dimidjian,
Christopher R. Martell, and Brian D. Doss
CHAPTER 5
Acceptance and Commitment Therapy for Couples
104
Erika Lawrence, Aaron Samuel Cohn, and Samuel H. Allen
EMOTION-CENTERED, PSYCHODYNAMIC, AND MULTIGENERATIONAL APPROACHES
CHAPTER 6
Emotionally Focused Couple Therapy
127
Susan M. Johnson, Stephanie A. Wiebe, and Robert Allan
CHAPTER 7
Object Relations Couple Therapy
Judith P. Siegel
xiii
151
xiv
Contents
CHAPTER 8
Mentalization-Based Couple Therapy
175
Efrain Bleiberg, Ellen Safier, and Peter Fonagy
CHAPTER 9
Intergenerational Factors in Couple Therapy
199
Mona DeKoven Fishbane
POSTSTRUCTURAL APPROACHES
CHAPTER 10
Narrative Couple Therapy
227
Jill Freedman and Gene Combs
CHAPTER 11
Solution-Focused Couple Therapy
250
Cynthia Franklin, Anao Zhang, Kristin Bolton,
and Helen Taylor Yates
CHAPTER 12
Socioculturally Attuned Couple Therapy
267
Carmen Knudson-Martin and Lana Kim
INTEGRATIVE APPROACHES
CHAPTER 13
Common Factors in Couple Therapy
295
Sean Davis
CHAPTER 14
Integrative Systemic Therapy for Couples
318
Douglas C. Breunlin, William P. Russell,
Anthony L. Chambers, and Alexandra H. Solomon
CHAPTER 15
Therapeutic Palette Integrative Couple Therapy
339
Peter Fraenkel
CHAPTER 16
Gottman Method Couple Therapy
362
John Mordechai Gottman and Julie Schwartz Gottman
PART III. APPLICATIONS OF COUPLE THERAPY
SPECIFIC RELATIONAL ISSUES AND POPULATIONS
CHAPTER 17
Couple Therapy for Partner Aggression
391
Norman B. Epstein, Jaslean J. LaTaillade, and Carol A. Werlinich
CHAPTER 18
Couple Therapy for Infidelity
Kristina Coop Gordon, Erica A. Mitchell,
Donald H. Baucom, and Douglas K. Snyder
413
Contents
CHAPTER 19
Couple Therapy and Sexuality
xv
434
Kathryn S. K. Hall and Daniel N. Watter
CHAPTER 20
Therapy with Older Adult Couples
454
Bob G. Knight
CHAPTER 21
Divorce Issues in Couple Therapy
472
Jay L. Lebow
CHAPTER 22
Therapy with Stepfamily Couples
492
Patricia L. Papernow
CHAPTER 23
Therapy with Queer Couples
512
Deb Coolhart
COUPLE-BASED THERAPY FOR INDIVIDUAL PROBLEMS
CHAPTER 24
Couple Therapy for Posttraumatic Stress Disorder
533
Candice M. Monson and Steffany J. Fredman
CHAPTER 25
Couple Therapy for Alcohol Problems
554
Barbara S. McCrady, Elizabeth E. Epstein,
and Cathryn Glanton Holzhauer
CHAPTER 26
Couple Therapy for Depression or Anxiety
576
Mark A. Whisman, Steven R. H. Beach, and Joanne Davila
CHAPTER 27
Couple Therapy with Parents of Youth
with Attention-Deficit/Hyperactivity Disorder
or Disruptive Behavior Disorders
595
Frances A. Wymbs, Brian T. Wymbs, and Will H. Canu
CHAPTER 28
Couple Therapy and Medical Issues
615
Nancy Breen Ruddy and Susan H. McDaniel
SPECIAL TOPICS
CHAPTER 29
Relationship Enhancement and Distress Prevention
Ryan G. Carlson, Galena K. Rhoades, Sabrina Johnson,
Scott M. Stanley, and Howard J. Markman
639
xvi
Contents
CHAPTER 30
Telehealth and Digital Couple Interventions
656
Brian D. Doss, Kayla C. Knopp, Elizabeth R. Wrape,
and Leslie A. Morland
CHAPTER 31
Ethical Issues in Couple Therapy
677
Gayla Margolin, Elana B. Gordis, and Hannah F. Rasmussen
Index
699
PA R T I
OVERVIEW AND
GUIDING PRINCIPLES
CHAPTER 1
Couple Therapy in the 21st Century
Jay L. Lebow and Douglas K. Snyder
Couple therapy is an evolving field, and this
Handbook, now in its sixth edition, reflects this
evolution. One transcendent fact is apparent in
even a cursory examination of the contents of the
current edition: Couple therapy is now an important, widely disseminated form of therapy. There
was a time when couple therapy was treated as an
afterthought in considerations of psychotherapy
and counseling, and seen as consisting of methods derived from individual or family therapy.
Today, couple therapy has emerged as a form
of treatment that stands on its own, is widely
practiced, and has its own distinct methods. The
largest international study of psychotherapists
found that 70% of psychotherapists treat couples (Orlinsky & Ronnestad, 2005). A survey of
expert psychotherapists’ predictions about future
practices in psychotherapy showed couple therapy to be the format likely to achieve the most
growth in the next decade (Norcross, Pfund, &
Prochaska, 2013).
Two key factors have driven the development
and widespread adoption of couple therapy as a
prominent therapeutic modality: the high prevalence of couple distress, and its adverse impact
on the emotional and physical well-being of
adult partners and their offspring. In the United
States, 40–50% of first marriages end in divorce
(Kreider & Ellis, 2011). Globally, across almost
all countries for which data are available, divorce
rates increased from the 1970s to the beginning of this century (Organization of Economic
Cooperation and Development, 2011). Indepen-
dent of divorce, many couple relationships experience periods of significant turmoil that place
partners at risk for developing symptoms of various emotional or physical health disorders. In a
U.S. survey, the most frequently cited causes of
acute emotional distress were couple relationship
problems (Swindle, Heller, Pescosolido, & Kikuzawa, 2000). Partners in a distressed relationship are significantly more likely to have a mood
disorder, anxiety disorder, or substance use disorder (McShall & Johnson, 2015) and to develop
more physical health problems (Waite & Gallagher, 2000). Moreover, couple distress has been
related to a wide range of deleterious effects on
children, including mental and physical health
problems, poor academic performance, and a
variety of other concerns (Bernet, Wamboldt, &
Narrow, 2016).
Many widely embraced principles of couple
therapy have emerged that transcend theoretical orientation, as well as several widely disseminated specific approaches to couple therapy
aimed at reducing couple distress and improving
relationship quality. Additional couple-based
interventions have been developed targeting
specific couple or individual problems (e.g., infidelity, partner aggression, mental health disorders) and populations (e.g., older adults, stepfamily couples). Although there remain threads
of both theoretical and technical connection to
various methods of individual and family therapy
(Lebow, 2014), the field now features a distinct
set of prominent approaches, builds on a large
3
4
I. OVERVIEW AND GUIDING PRINCIPLES
body of basic research focused on intimate relationships, and offers a substantial body of empirical evidence supporting the efficacy and effectiveness of its methods. It has become abundantly
clear that effective intervention with couples
requires its own set of theories, approaches, and
methods anchored in relational science. Furthermore, effective intervention for any psychological problem should include couple-based methods in the therapeutic arsenal.
A BRIEF HISTORY OF COUPLE THERAPY
Gurman and Fraenkel (2002) described four
stages in the development of couple therapy.
In the early 20th century, an atheoretical marriage counseling emerged, consisting of a pragmatic mix of psychoeducation and advice giving.
During this period, most of those working with
couples did not label themselves as psychotherapists; often they did not see spouses together.
The second phase that began in the 1930s built
on expanding the then predominant form of
therapy, psychoanalytic psychotherapy, to work
with couples. Initially, in this treatment, partners
tended to be seen separately by the same therapist in what was called concurrent therapy, but
eventually this approach segued into the beginnings of conjoint therapies in which both spouses
participated in sessions. Nonetheless, Michaelson (1963) estimated that in the 1940s, only 5%
of couples experienced counseling conjointly; by
the mid-1960s, this number had increased only
to about 15%. Phase 3 was sparked by the impact
of the family therapy revolution in the 1960s and
1970s, in which prominent models of therapy
emerged based in systems theory. Subvariations
of such core family systems therapies as experiential, strategic, psychoanalytic, and behavioral
therapies focused on couples and couple therapy
(Gurman & Kniskern, 1981). These therapies
almost invariably saw partners conjointly. In its
current phase, couple therapy has emerged as a
mature discipline that includes a wide array of
distinct treatments, a well-established underlying
set of theoretical percepts, a stronger evidence
base both in the efficacy of therapies and in its
foundation in the emerging body of relational
science, and an expanded conceptual framework
that includes feminism and multiculturalism,
and thus speaks to a broader diversity of couples.
This era also includes the flourishing of numerous integrative methods and the development of
couple therapy as a format for treating problems
of individual partners.
COUPLE THERAPY WORKS
Previous reviews affirm the effectiveness of
couple therapy in reducing relationship distress
(Bradbury & Bodenmann, 2020; Doss, Roddy,
Wiebe, & Johnson, 2022; Lebow, Chambers,
Christensen, & Johnson, 2012; Roddy, Walsh,
Rothman, Hatch, & Doss, 2020; Shadish &
Baldwin, 2003). The average person receiving
couple therapy is better off at termination than
70–80% of individuals not receiving treatment—
an improvement rate that rivals or exceeds the
most effective psychosocial and pharmacological
interventions for individual mental health disorders. A variety of couple treatments have also
garnered evidence supporting their effectiveness
for specific relationship problems including sexual difficulties, infidelity, and intimate partner
violence.
Separate from reducing either general or specific relationship difficulties, evidence from clinical trials supports the impact of couple therapies for coexisting emotional, behavioral, and
physical health concerns (Fischer, Baucom, &
Cohen, 2016; Goger & Weersing, 2022; Hogue,
Schumm, MacLean, & Bobek, 2022). For example, chapters included in this Handbook describe
evidence supporting couple-based interventions
for depression or anxiety, posttraumatic stress,
and alcohol problems of an adult partner, as well
as couple interventions with parents of youth with
attention-deficit/hyperactivity disorder (ADHD)
or related disruptive behavior disorders. Couplebased interventions for physical health problems
constitute a rapidly expanding application—with
evidence supporting the benefits of couple therapy for a broad spectrum of conditions including cancer, chronic pain, cardiovascular disease,
anorexia nervosa, or type 2 diabetes (Shields,
Finley, Chawla, & Meadors, 2012). Common
components of couple-based interventions for
individual mental and physical health problems
emphasize partner support, improved communication, and increased attention to the disorder’s
adverse impact on the couple relationship. The
extension of couple-based treatments to individual disorders reflects one of the most important
developments of couple therapy in this century.
A VIEW OF COUPLE THERAPY TODAY
Editing this Handbook has been a privilege.
Since the inaugural volume edited by Neil Jacobson and Alan Gurman (Jacobson & Gurman,
1986), it has long been a definitive guide to the
1. Couple Therapy in the 21st Century
couple therapy of the time. Over the past 40
years, authors of chapters in this Handbook have
been a “who’s who” in the field of couple therapy, and the approaches covered have provided
a snapshot into the Zeitgeist of couple therapy at
the time of each edition. In this first chapter, we
look to extrapolate from the various chapters in
this sixth edition to discern broad trends in the
field since the prior edition. Moving beyond the
obvious observation that this Handbook offers
a rich and effective set of approaches, we look
to articulate general trends in the field, as well
as commonalities and continuing major points of
difference and controversy across approaches. As
we have read the various chapters in this edition,
clear trends have emerged. So, in looking at the
approaches in this book, what then can we say of
couple therapy?
Foundation in Relational Scie
