Dropout is a problematic phenomenon which wastes community, clinician, client, and researcher resources. Clients who dropout from therapy end up the same, or worse than, those who did not seek out therapy at all. While there is a relatively deep and broad understanding of dropout from individual therapy, an exhaustive review of couple therapy dropout literature reveals a very inconsistent and non-conclusive body of research. This may stem from a lack of a consistently used theory to guide research endeavors in this important realm. Primarily, this seems to stem from treating dropout as a static event rather than a process occurring across time. This study seeks to remedy this and shed new light on dropout from couple therapy by using a growth mixture model analysis to tease out which trajectories of change of predictor variables across time are more likely to predict dropout from couple therapy. While the results of this study did not reveal any significant relationships between class membership and dropout (likely due to a too small sample size), the study did find that there were distinct classes (trajectories of change) among the predictor variables across time.

Despite the strong efficacy of couple therapy, many couples still do not benefit from treatment. Marriage and family therapy scholars have argued that therapists play a crucial role in the delivery of successful couple therapy, yet little research has documented that the therapist in couple therapy has a significant impact on outcomes. Known as the study of therapist effects, this study sought to assess the amount of variance attributed to the therapist in couple therapy outcomes. Using dropout as the outcome variable, this study analyzed data from 1192 couples treated by 90 therapists at a university-based training clinic. Results from multilevel analysis indicated that therapists in the sample accounted for 9.5% of the variance in couple dropout while controlling for initial couple impairment. Therapist gender and therapist experience did not significantly predict the effectiveness of therapists. These findings give promise to future research on therapist effects in couple therapy and encourage exploration into which therapist characteristics and behaviors contribute to successful clinical outcomes.

Recent literature in couple therapy has demonstrated the effects of physical health on some common presenting problems; however, few studies have considered progress as a construct on its own, irrespective of client-identified presenting problem. The current study used an Actor-Partner Interdependence Mediated Model to determine the connection between each partner's physical health and their own and their partner's self-reported progress in couple therapy, mediated by each partner's emotional regulation. Physical health was measured every four sessions using the Health-Related Quality of Life scale, and progress was measured by the Presenting Problem Progress Questionnaire given each time a couple attended therapy. Emotional regulation was measured by the Difficulties in Emotion Regulation scale. The research questions asked whether healthier people and/or their partners would be more emotionally regulated and therefore experience more progress. Results indicated a significant predictive relationship between individual health and presenting problem progress for males and females; however, neither association was mediated by emotional regulation. Additional results suggested that health may predict emotional regulation for both male and female clients, with female health also predicting variation in male emotional regulation. Clinicians are encouraged to consider client health as a predictor of emotional regulation and create treatment goals that facilitate improvements to client health.

The therapeutic alliance is a core element of successful treatment in therapy. Recent literature has explored variables that predict the alliance at various time points during therapy, but few studies have explored how the alliance develops over time and the factors that influence its rate of change. The current study addresses these questions by estimating latent growth-curve models to analyze how male and female partners' alliance scores develop over time and how adverse childhood experiences (ACEs) impact the development of the alliance during the first six sessions of therapy. Results from these analyses show that neither men nor women's ACEs had a significant effect on the rate of change in the alliance. A discussion of the attachment implications of these findings, as well as the limitations of this study and potential directions for future research are then presented.

Over the years, many interventions have been used to ameliorate couple distress and increase relationship satisfaction. These interventions have been getting shorter in duration. The purpose of this pilot study was to test the feasibility and impact of a brief intervention using a solution-focused approach (SFBT) for couples. The brief intervention included two two-hour consultations. Data were collected from 30 couples and were analyzed using a repeated measures design. The analyses yielded mixed results. There were statistically significant improvements in the areas of individual well-being and relationship knowledge. There were no significant differences in terms of marital satisfaction, communication skills, and readiness to change, although positive trends were observed in this pilot phase. Implications for future research and development are discussed.

No description available.

The therapeutic alliance, a construct representing agreement and collaboration on therapy goals, therapy tasks, and the emotional bond between client(s) and therapist, is a robust predictor of therapy outcomes in individual, couple, and family therapy. One way to track the therapeutic alliance is through ruptures and repairs. Ruptures are breaks, tensions, or tears in the therapeutic alliance. Ruptures and repairs influence the therapeutic alliance and consequently therapeutic outcomes. Currently, there is a lack of research addressing ruptures and repairs in couple therapy. The first step in researching alliance ruptures is to have a reliable way to assess alliance ruptures. This study will describe the development of the Coding Rupture Indicators in Couples Therapy (CRICT). The CRICT is an observational coding scheme that measures ruptures in couple therapy. The CRICT was developed through collaboration with researchers in marriage and family therapy, creation of items, adaptation of items from established coding schemes from individual therapy, and input and feedback as the CRICT was used and tested by undergraduates in a coding class. This paper will review foundational research of ruptures and repairs as well as the construction and use of the CRICT coding scheme.

No description available.

Listening is a fundamental and deceptively complicated component of talk therapy that has received very little specific research attention. The work of Carl Rogers and others promotes the importance of empathic listening to create safety and process client experiences, and several models identify its importance in processing and regulating client emotions (especially in couple therapy, where empathic listening can disrupt rigid conflict cycles and model coregulation skills). Much of the dysregulation and resistance we see in therapy may be related to a perceived lack of safety caused by persistent conflict or previous trauma, explained by the unconscious processes of the autonomic nervous system and polyvagal theory. Polyvagal research also supports the relationship between empathic listening and emotional safety: demonstration of genuine interest, care, acceptance, and validation are perceived as evidence of safety that encourage emotional connection. These behaviors are accessible to novice therapists who are still learning specific models and interventions. This study seeks to illustrate this relationship by conducting a task analysis on empathic listening behaviors by therapists in training in a therapy-as-usual environment. Observation of emotional inquiries in therapy leading to increased perceptions of safety demonstrate that empathic listening requires a sustained balancing of safety-promoting and exploratory behaviors. Therapist directiveness, possibly rooted in anxiety, was a common observation across segments where client safety was not achieved. Our observations also highlight the importance of therapist attunement, or neuroception, to determine whether to use safety-promoting behaviors or exploratory questioning. It is my hope that this research can lend illustration and clarity to the theoretical underpinnings of empathic listening to guide therapist interventions and training.

Meta-analytic reviews of decades of comparative efficacy psychotherapy research consistently reveal that all tested models of marriage and family therapy (MFT) work, and they generally work equally well. Researchers have hypothesized that this may be due to factors common across models responsible for change. Despite a sizable body of common factors literature in psychology, such research in MFT is still in its infancy. The purpose of this study is to contribute to the development of a theory of common factors responsible for change in MFT. Semi-structured, open-ended qualitative interviews were conducted with three different MFT model developers (i.e., Dr. Susan M. Johnson, Emotionally Focused Therapy; Dr. Frank M. Dattilio, Cognitive Behavioral Therapy; and Dr. Richard C. Schwartz, Internal Family Systems Therapy), Dr. Johnson and Dr. Schwartz's former students, and each of their former clients who had terminated therapy successfully. Transcripts were coded using the grounded theory techniques of open coding, axial coding, and relational statements. Coding was done utilizing a constant comparative method in which data were simultaneously analyzed and coded. Common factors fell into two main categories of model-dependent factors and model-independent factors. Factors within the model-dependent category include those aspects of therapy directly informed by the therapist's model. Model-dependent categories include common conceptualizations, common interventions, and common outcomes. Factors within the model-independent category include general aspects of therapy that are not directly related to the therapist's model. Model-independent categories include client variables, therapist variables, the therapeutic alliance, therapeutic process, and expectancy and motivational factors. Each model-dependent and model-independent category has several subcategories. Results are discussed in both model-specific and common factors conceptualizations. A sequential model outlining how model-dependent factors appear to combine to produce therapeutic change while being mediated by model-independent variables is proposed. The findings are integrated with the current common factors literature in psychology and MFT. Clinical, training, and research implications are discussed. / Ph. D.