Couple therapy is a frequently sought domain by couples who experience problems in their relationships. Couple therapy has been researched intensively, but few studies incorporate a holistic account of the therapeutic process. This study aims to explore and integrate the therapist's and the couple's experiences of change in the context of couple therapy. The ecosystemic epistemology and the narrative metaphor forms the foundation from which the therapy and the research is approached. Qualitative research methods are employed from within a naturalistic paradigm which allows for personal and unique meanings to emerge. Rich descriptions of the therapist's and the participant's stories of change are provided. Multiple perspectives are offered in the stories which reveal the reciprocal motions between the therapist's and the couples' change processes. Recurring themes are extracted from the stories which punctuate the pivotal change processes that were experienced by the therapist and the couples during the therapy. / Psychology / M.A. (Clinical Psychology)

Text in English / As some criticism and hesitations have been expressed with regard to the implementation of provocation in psychotherapy, this study aimed to explore the experiences of clients and a therapist who participated in provocative psychotherapy. In order to do this, a concise theoretical description of the nature of provocative psychotherapy was provided along the lines of the work of Frank Farrelly and Maurizio Andolfi. Participants' experiences of provocation in psychotherapy were consequently presented by means of three case studies. A description of the experience of provocation in psychotherapy was co-created through the identifying of certain themes underlying of the three client groups' and the therapist's descriptions of their experiences. This was done by employing a qualitative research methodology to describe the experiences of clients and a therapist who participated in provocative individual-, couple- and family psychotherapy. / Psychology / M.A. (Clinical Psychology)

Inledning: Psykodynamisk parterapi handlar om interaktion mellan tre personer. Möten som syftar till förändring i samspel och att finna ny förståelse för varandras livsberättelse. Syftet med detta arbete var att undersöka psykodynamiska parterapeuters upplevelser och erfarenheter av förändring i parterapi. Frågeställningar: Vilka terapeutiska egenskaper är av betydelse för mötet i parterapin? Vilka terapeutiska egenskaper påverkar att parrelationens samspel förändras? Vilka möjligheter och svårigheter ställs en parterapeut inför? Metod: Fem terapeuter intervjuades utifrån en kvalitativ metod och en tematisk metod användes i analysen. Resultat: Det intersubjektiva mötet mellan terapeut och par var av betydelse för förändringsarbetet i psykodynamisk parterapi. Personlig hållning och receptiv förmåga att uppfatta kommunikativ allians skapade ett terapeutiskt rum där accepterande av olikheter och förmåga att stå ut med motsatser utvecklades. Diskussion: Den terapeutiska ramen, och informanternas simultanförmåga att upprätta och bevaka allians, var faktorer av särskild betydelse för parterapins tre parallellt pågående relationer. Informanternas samtidiga förmåga att uppfatta och undersöka kommunikativ allians var en faktor som påverkade den terapeutiska relationen positivt. Informanterna skapade sådana samspel att parets engagemang ökade. Genom att vara personliga och använda sig av primärt mjuka känslor engagerades paret till att vara personliga och nå djupare känslomässiga upplevelser. Dessa intersubjektiva möten ledde till en förändrad relation med tryggare emotionella band och en ökad psykisk närhet. / Introduction: Psychodynamic couple therapy is about the interaction in between three people. Meetings which aim to change the interaction and find new understanding of each other’s life experiences. The purpose of this study was to analyse psychotherapists’ understanding and experience of changes in couple therapy. Topics of discussion: Which therapeutic factors are relevant for couple therapy? Which therapeutic factors affect the interaction of the couple? What benefits or difficulties is a therapist posed to? Method: Five therapists were interviewed with respect to both qualitative and thematic methods. Conclusion: The intersubjective interaction between therapist and couples has relevance for implementing changes in psychodynamic couple therapy. Personal attitude and receptive ability to perceive communicative alliance created through a therapeutic environment in which acceptance of inequalities and difference of opinions was developed. Discussion: The therapeutic framework, and the informants’ simultaneous ability to establish and monitor the alliance, were factors of particular significance for the three parallel ongoing relationships of the couple therapy. The informants’ simultaneous ability to perceive and investigate communicative alliance was a factor that positively affected the therapeutic relationship. The therapists’ application of such interactions increased the couple's engagement in the therapy. By being personal and making use of primarily soft emotions, the couple became more open and were able to reach deeper emotional experiences. These intersubjective meetings led to a changed relationship with more secure emotional ties and an increased psychological presence.

Följande studie handlar om feedbackorienterad terapi på Familjerådgivningen. Syftet var att mäta parens upplevda förändring av livstillfredsställelse för att se om samtalen på Familjerådgivningen gör skillnad och om förändringen enligt skattningsinstrumenten ORS och SRS överensstämde med skattningen av klimatet i parrelationen/familjen samt om det fanns några könsskillnader. Undersökningsgruppen omfattades av 29 par, som sökte hjälp på Familjerådgivningen i södra Dalarna, i Mora och i Linköping under tiden januari 2016 till maj 2016. Paren fyllde i skattningsinstrumentet ORS (som mäter förändring) i början av varje samtal och SRS (som mäter alliansen) i slutet av varje samtal. Familjerådgivaren använde sig av den feedback som gavs och korrigerade behandlingen därefter. Vid första och tredje samtalet fyllde paren i skattningsinstrumentet "Familjeklimat". Resultatet efter tre samtal visade en liten förbättring av livstillfredsställelse för både män och kvinnor vilket överensstämde med skattningen av klimatet i familjen där närheten förbättrades och kaos minskade. / The following study is about feedback informed treatment in family councelling. The purpose was to measure the couples experienced change in life satisfaction, to see if treatment sessions of family councelling makes a difference and change according to the estimation instruments ORS and SRS and is consistent with the estimate of the atmosphere in the couple´s relationship/family atmosphere and if there were any gender differences. The study group included 29 couples who sought help at the Family councelling in southern Dalarna, Mora and Linköping during the period of January 2016 to May 2016. The couples filled in the instrument ORS (measuring change) at the beginning of each session and SRS (measuring alliance) at the end of each session. The family councellor used the received feedback and corrected treatment accordingly. In the first and third session the couples filled in the "Family climate" instrument. The outcome after three sessions showed a small improvement in the life satisfaction for both men and women which were consistent with the estimate of the atmosphere and the climate in the family. The vicinity improved and chaos decreased.

No description available.

Bakgrund: Digital otrohet är ett relativt nytt fenomen, som har uppstått via internet parallellt med den tekniska utvecklingen av sociala medier. Forskning på området är dock mycket begränsad i synnerhet i en terapeutisk kontext samtidigt är digital otrohet en problematik och utmaning som familjerådgivare möter i sin yrkesvardag. Syftet: Det övergripande syftet med studien är att skapa fördjupad kunskap om familjerådgivares erfarenheter av att möta par som upplevt digital otrohet. Mer specifikt avses att undersöka hur familjerådgivarna upplever att digital otrohet som fenomen påverkar den professionella arbetsprocessen.Metod: Studien är en kvalitativ intervjustudie med semistrukturerade frågor. Åtta familjerådgivare, fem kvinnor och tre män i åldrarna 45 - 66 år, intervjuades. Fem av intervjuerna skedde ansikte mot ansikte och tre över internet via Teams. Den insamlade data har analyserats genom tematisk analys. Resultat: Familjerådgivare beskriver att par de möter kan vara oense om det förekommit digital otrohet eller inte, till skillnad från fysisk otrohet där paren är överens om att det skett. Två familjerådgivare beskriver att digital otrohet kan gränsa till andra fenomen som svartsjuka och sexuella fantasier. En otydlig definition av vad som är digital otrohet och tvetydighet av hur beteendet/aktiviteten ska bedömas påverkar arbetsprocessen för familjerådgivare. Andra faktorer som påverkar arbetsprocessen är faktorer såsom parens tillgänglighet till internet och tillgång till digital teknik. / Background: Digital infidelity is a relatively new phenomenon that has emerged alongside the technological development of social media. Research in this area is, however, very limited, especially in a therapeutic context, while digital infidelity is a problem and challenge that family counsellors encounter in their professional practice.Aim: The overall aim of the study is to develop a deeper understanding of family counsellors´ experiences in working with couples who have encountered digital infidelity. More specifically, it intends to examine how family counsellors perceive digital infidelity as a phenomenon and how it affects their professional work process.Method: The study is a qualitative interview study with semi-structured questions. Eight family counsellors, five women and three men aged 45 - 66, were interviewed. Five of the interviews were conducted face-to-face, and three over internet via Teams. The collected data were analysed using thematic analysis.Results: Family counsellors describe that couples they meet may disagree on whether digital infidelity has occurred, unlike physical infidelity where the couples agree that it has taken place. Two family counsellors describe that digital infidelity could border on other phenomena such as jealousy and sexual fantasies. An unclear definition of what constitutes digital infidelity and ambiguity in how the behaviour/activity should be assessed impacts the work process for family counsellors. Other factors impacting the work process include the couples´ access to internet and digital technology.

This study replicated components from Babcock et al. (2013) by examining an Imago-based Safe Conversations (SC) workshop using Gottman's psychometrically established instruments for couple functioning. Participants were 28 married heterosexual couples (N = 56) with a mean age of 27.30 years (SD = 10.16), 89.3% non-Hispanic, 78.6% Black or African-American, 85.7% first time married, 75% with at least a bachelor's degree, and a median household income in the $100,000-150,000 range. Couples independently completed the online SC workshop, The Toolbox for Couples, within a 2-week timespan. For each of three variables regarding marital quality assessed at pre- and post-workshop—(a) marital friendship, (b) conflict management, and (c) marital adjustment—multilevel dyadic analysis was conducted for four outcomes: (a) overall Time*Gender interaction effect, (b) effect for women, (c) effect for men, and (d) interclass correlation between men and women. From pre- to post-test, participants improved on all three variables: Out of the 12 analyses, 11 yielded statistically significant improvement with one very large, six large, and five medium effects. Results suggested that women may benefit more or be more sensitive to the effect of marital friendship, conflict management may be more important to men, and whereas both distressed and non-distressed couples can benefit regarding marital friendship and conflict management, distressed couples may benefit more regarding marital adjustment.

While previous studies have demonstrated significant associations between partners' emotion regulation and overall well-being, few studies provide knowledge on emotion regulation in clinical couples, especially across couple therapy sessions. With 168 heterosexual couples who attended at least the initial eight sessions of couple therapy, the current study was designed to examine the intra- and inter-personal effects of emotion regulation difficulties (i.e., lack of awareness, nonacceptance, limited strategies, and impulsivity) on the development of relationship quality over the course of couple therapy. The results of the current study provide a few important findings. First, gender differences exist in emotion regulation and relationship quality. Second, across couple therapy sessions, relationship quality improves and partners change at a similar rate. Third, emotion regulation difficulties have intra- and inter-personal effects on the starting scores and rates of change of relationship quality in the process of couple therapy. For clinical implications of findings, I specifically discussed that clinicians working with couples may find it beneficial to utilize couple therapy modalities with a specific emphasis on the emotion regulation process, such as Greenberg's version of emotionally focused couple therapy. The need for future studies with more diverse samples was also discussed.

L’objectif général de cette thèse est d’examiner le lien entre l’attachement amoureux des conjoints, la satisfaction conjugale, le mandat thérapeutique et le résultat de la thérapie conjugale telle que conduite en milieu naturel. Afin d’atteindre cet objectif, des couples se présentant en thérapie conjugale ont d’abord complété une batterie de questionnaires comprenant l’Échelle d’ajustement dyadique (Spanier, 1976) et le Questionnaire sur les expériences d’attachement amoureux (Brennan, Clark, & Shaver, 1998). Les thérapeutes ont par la suite indiqué le mandat thérapeutique poursuivi avec chaque couple (réconciliation ou résolution de l’ambivalence), suivant la classification de Poitras-Wright et St-Père (2004). À la fin de la consultation, le jugement du thérapeute a été utilisé pour classer chacun des cas comme ayant abandonné ou complété le traitement. Les couples ayant complété la thérapie ont rempli l’Échelle d’ajustement dyadique au post-traitement. Dans le premier des articles composant cette thèse, le lien entre l’attachement amoureux et la satisfaction conjugale a été examiné auprès d’un échantillon de 172 couples en détresse débutant une thérapie conjugale, de même qu’auprès de 56 couples non en détresse débutant également une thérapie conjugale, pour fins de comparaison. Les résultats ont démontré que l’évitement de la proximité semble être une caractéristique distinctive des couples en détresse et que cette dimension de l’attachement est fortement liée à l’insatisfaction conjugale de ce même groupe. Dans le deuxième article, le mandat thérapeutique, l’attachement amoureux et la satisfaction conjugale ont été examinés en tant que prédicteurs de l’abandon de la thérapie conjugale, auprès de 141 couples. Les résultats ont notamment démontré qu’un mandat de résolution de l’ambivalence augmente les probabilités d’abandon de la thérapie conjugale. De plus, les prédicteurs du résultat de la thérapie ont également été examinés dans ce second article. Les résultats obtenus au moyen d’analyses acteur-partenaire ont démontré que la satisfaction conjugale pré-traitement apparaît comme le meilleur prédicteur de la satisfaction conjugale post-traitement, et ce, malgré l’inclusion de l’attachement amoureux parmi les variables investiguées. Considérés dans leur ensemble, les résultats de cette thèse suggèrent que l’insécurité d’attachement serait fortement associée à l’insatisfaction des couples en détresse, mais ne nuirait pas pour autant à l’obtention d’un résultat positif en thérapie conjugale. En somme, cette thèse contribue à l’avancement des connaissances en se penchant sur l’utilité de la théorie de l’attachement en thérapie conjugale et en soulignant la nécessité de tenir compte des mandats thérapeutiques dans les futures études en thérapie conjugale. Les implications cliniques des résultats et des recommandations pour la recherche clinique sont présentées dans la conclusion de l’ouvrage. / The aim of this thesis was to elucidate the link between adult romantic attachment, relationship satisfaction, therapeutic mandates and couple therapy outcome. Couples seeking therapy in a natural setting completed the Dyadic Adjustment Scale (Spanier, 1976) and the Experiences in Close Relationships Questionnaire (Brennan, Clark, & Shaver, 1998) at intake. Therapists classified the therapeutic mandate pursued in each case (i.e., alleviation of couple distress or ambivalence resolution) according to the Classification of Therapeutic Mandates Questionnaire (Poitras-Wright & St-Père, 2004). When treatment ceased, couples were classified as dropouts or completers according to therapists’ judgment, and completers were further assessed using the Dyadic Adjustment Scale. In the first of two articles, the association between adult romantic attachment and pre-treatment marital satisfaction was investigated in a sample of 172 distressed couples seeking therapy, as well as in a comparison sample of 56 nondistressed couples seeking therapy. Results showed that attachment avoidance was a distinctive characteristic of distressed couples and that it was a strong predictor of marital dissatisfaction among distressed couples seeking therapy. Based on a series of 141 couple therapy cases, the second article examined therapeutic mandates, romantic attachment orientations, and pre-treatment marital satisfaction as predictors of premature disengagement from couple therapy. The most striking result was that an ambivalence resolution mandate was strongly associated with increased chances of treatment discontinuation. Predictors of couple therapy outcome were also examined: actor-partner analyses revealed that the strongest predictor of post-treatment marital satisfaction was pre-treatment marital satisfaction, despite the inclusion of romantic attachment among the predictor variables. Overall, these results indicate that attachment insecurity is strongly related to distressed couples’ marital dissatisfaction, but that it might not impede the attainment of a positive outcome in couple therapy. In sum, this thesis contributed to the field of couple therapy by investigating the pertinence of attachment theory in couple treatment, and highlighting the need for further study of therapeutic mandates in couple therapy. Clinical implications for couple therapy are discussed, and recommendations for clinical research offered.

L’objectif général de cette thèse est d’examiner le lien entre l’attachement amoureux des conjoints, la satisfaction conjugale, le mandat thérapeutique et le résultat de la thérapie conjugale telle que conduite en milieu naturel. Afin d’atteindre cet objectif, des couples se présentant en thérapie conjugale ont d’abord complété une batterie de questionnaires comprenant l’Échelle d’ajustement dyadique (Spanier, 1976) et le Questionnaire sur les expériences d’attachement amoureux (Brennan, Clark, & Shaver, 1998). Les thérapeutes ont par la suite indiqué le mandat thérapeutique poursuivi avec chaque couple (réconciliation ou résolution de l’ambivalence), suivant la classification de Poitras-Wright et St-Père (2004). À la fin de la consultation, le jugement du thérapeute a été utilisé pour classer chacun des cas comme ayant abandonné ou complété le traitement. Les couples ayant complété la thérapie ont rempli l’Échelle d’ajustement dyadique au post-traitement. Dans le premier des articles composant cette thèse, le lien entre l’attachement amoureux et la satisfaction conjugale a été examiné auprès d’un échantillon de 172 couples en détresse débutant une thérapie conjugale, de même qu’auprès de 56 couples non en détresse débutant également une thérapie conjugale, pour fins de comparaison. Les résultats ont démontré que l’évitement de la proximité semble être une caractéristique distinctive des couples en détresse et que cette dimension de l’attachement est fortement liée à l’insatisfaction conjugale de ce même groupe. Dans le deuxième article, le mandat thérapeutique, l’attachement amoureux et la satisfaction conjugale ont été examinés en tant que prédicteurs de l’abandon de la thérapie conjugale, auprès de 141 couples. Les résultats ont notamment démontré qu’un mandat de résolution de l’ambivalence augmente les probabilités d’abandon de la thérapie conjugale. De plus, les prédicteurs du résultat de la thérapie ont également été examinés dans ce second article. Les résultats obtenus au moyen d’analyses acteur-partenaire ont démontré que la satisfaction conjugale pré-traitement apparaît comme le meilleur prédicteur de la satisfaction conjugale post-traitement, et ce, malgré l’inclusion de l’attachement amoureux parmi les variables investiguées. Considérés dans leur ensemble, les résultats de cette thèse suggèrent que l’insécurité d’attachement serait fortement associée à l’insatisfaction des couples en détresse, mais ne nuirait pas pour autant à l’obtention d’un résultat positif en thérapie conjugale. En somme, cette thèse contribue à l’avancement des connaissances en se penchant sur l’utilité de la théorie de l’attachement en thérapie conjugale et en soulignant la nécessité de tenir compte des mandats thérapeutiques dans les futures études en thérapie conjugale. Les implications cliniques des résultats et des recommandations pour la recherche clinique sont présentées dans la conclusion de l’ouvrage. / The aim of this thesis was to elucidate the link between adult romantic attachment, relationship satisfaction, therapeutic mandates and couple therapy outcome. Couples seeking therapy in a natural setting completed the Dyadic Adjustment Scale (Spanier, 1976) and the Experiences in Close Relationships Questionnaire (Brennan, Clark, & Shaver, 1998) at intake. Therapists classified the therapeutic mandate pursued in each case (i.e., alleviation of couple distress or ambivalence resolution) according to the Classification of Therapeutic Mandates Questionnaire (Poitras-Wright & St-Père, 2004). When treatment ceased, couples were classified as dropouts or completers according to therapists’ judgment, and completers were further assessed using the Dyadic Adjustment Scale. In the first of two articles, the association between adult romantic attachment and pre-treatment marital satisfaction was investigated in a sample of 172 distressed couples seeking therapy, as well as in a comparison sample of 56 nondistressed couples seeking therapy. Results showed that attachment avoidance was a distinctive characteristic of distressed couples and that it was a strong predictor of marital dissatisfaction among distressed couples seeking therapy. Based on a series of 141 couple therapy cases, the second article examined therapeutic mandates, romantic attachment orientations, and pre-treatment marital satisfaction as predictors of premature disengagement from couple therapy. The most striking result was that an ambivalence resolution mandate was strongly associated with increased chances of treatment discontinuation. Predictors of couple therapy outcome were also examined: actor-partner analyses revealed that the strongest predictor of post-treatment marital satisfaction was pre-treatment marital satisfaction, despite the inclusion of romantic attachment among the predictor variables. Overall, these results indicate that attachment insecurity is strongly related to distressed couples’ marital dissatisfaction, but that it might not impede the attainment of a positive outcome in couple therapy. In sum, this thesis contributed to the field of couple therapy by investigating the pertinence of attachment theory in couple treatment, and highlighting the need for further study of therapeutic mandates in couple therapy. Clinical implications for couple therapy are discussed, and recommendations for clinical research offered.