[pt] Este trabalho teve como objetivo avaliar o papel da terapia de casal no tratamento e na prevenção da violência quando ela ocorre de forma recorrente no casal. Para tanto foram entrevistados quatro psicólogos, terapeutas de família e casal, que realizaram a especialização nesta área em instituições de formação da cidade do Rio de Janeiro. Das entrevistas emergiram cinco categorias de análise: Compreensão sobre a dinâmica da violência; Fatores associados à emergência da violência; A questão do enquadre terapêutico; O problema da identificação dos diversos tipos de violência; Recursos disponíveis disponíveis para o trabalho com violência. Os profissionais entrevistados romperam com uma concepção disjuntiva e reducionista da violência, que procura identificar os agressores e as vítimas, para em seguida responsabilizar os primeiros por seus atos violentos. Como alternativa a essa concepção, os terapeutas se apropriaram da perspectiva sistêmica para compreender a dinâmica da violência no casal. Sob a influência dessa perspectiva o foco recai sobre as relações cujas interações possibilitam a manutenção da violência. Os processos anestésicos que reduzem a sensibilidade à violência e que se encontram presentes nas famílias onde ocorrem abusos de toda ordem, a escolha do enquadre terapêutico e os procedimentos para se identificar os diferentes tipos de violência foram outros temas que se mostraram relevantes para o tratamento de casais em situação de violência. A análise das entrevistas demonstrou que a terapia de casal, pelo menos sob a ótica dos profissionais entrevistados, demonstra ser um importante recurso para lidar com a problemática em questão. / [en] This work has the goal to evaluate the role of couples therapy in the treatment and prevention of recurrent violence among couples. Four psychologists - family and couples therapists - who had specialized in this area in educational institutions in Rio de Janeiro were interviewed. Five analytical categories emerged from the interviews: Understanding violence dynamics; Factors associated to the emergence of violence; The question of therapeutic framing; The problem of identifying various kinds of violence; Available resources to work with violence. The interviewed professionals deconstructed a disjunctive and reductionist conception of violence, which aims to identify perpetrators and victims to hold the latter responsible for their violent acts. As an alternative to this conception, therapists had appropriated a systemic perspective to understand the dynamics of violence among couples. From this perspective the focus is on the relationships marked by interactions that elicit the maintenance of violence. The anesthetic processes that diminish the sensitivity to violence and that are present in families where different forms of abuse take place, the choice for the therapeutic framing and the procedures to identify the different forms of violence were other themes that turned out relevant in treating couples in violent situations. The analysis of interviews showed that couples therapy, at least from the perspective of the interviewed professionals, is an important resource to deal with the problem in question.

A number of studies have examined variables associated with medical use. However, most of the studies deal with samples that are not easily generalizable to other populations. In particular, no study is known to have looked at general medical use among people seeking services for marital and family problems. In this study, medical use of participants from the marriage and family therapy services at Brigham Young University Comprehensive Clinic was investigated to determine the best predictors of general medical use. Best subsets multiple linear regression showed that the best overall predictors of general medical use were anxiety and hostility.

This study evaluated the therapy process for married couples recovering from addictive use of pornography. The author's proposal was that in conjoint couple therapy, clinicians are able to help organize the relationship to sponsor recovery while helping both members of the relationship heal individually. The prevalence and effects of pornography are discussed through a review of the current literature. Six couples were interviewed following the termination of their treatment in marital therapy to gain a holistic view of the process of recovery and gain groundwork for future development of a concise model of treatment. Results demonstrated that an increase in understanding of each other's position in the sexual addiction and recovery process (i.e., emotional, cognitive and behavioral) increases a) marital trust and faith in the future, b) softening towards each other, c) the ability to discern key points of intervention in helping the other spouse during recovery, and d) client-perceived marital enhancement. These preliminary findings suggest that couples perceive that conjoint marital therapy is a useful component in treating addiction to pornography.

The Marriage Checkup (Cordova, Warren & Gee, 2001) was introduced as a brief intervention targeting couples at risk for severe marital distress. The purpose of this study was to examine married couples who participated in The Marriage Checkup for levels of individual and relational stress and severity of presenting problems recorded at intake. Differences were investigated between couples who, though initially requesting the brief Marriage Checkup, elected to continue with traditional marital therapy and couples who only participated in traditional marital therapy. The group means were compared using a structural equation model in order to account for the non-independence of distress within a relationship. Results showed that Marriage Checkup couples reported lower distress levels than couples who received traditional marital therapy even if they transitioned from the Marital Checkup into marital therapy. Additional analyses compared levels of distress and presenting problems for the two Marriage Checkup groups: couples who only completed the Marriage Checkup and couples who also transitioned into traditional marital therapy. Couples who only participated in the Marriage Checkup had lower levels of individual distress for husbands and lower levels of relational distress than did couples who participated in the Marriage Checkup and then transitioned into traditional marital therapy. Clinical implications are discussed.

This thesis explores why the divorce rate has remained relatively stable over the past few decades, even in the face of rapidly growing social sciences – particularly the branch associated with the study and treatment of marriage – through an analysis of the work of John Gottman. This thesis chiefly claims that divorce is not addressed in marital research. It is argued, however, that far from being intentional on the part of researchers, the disregard for divorce in the marital research is actually due to underlying, unrecognized assumptions. Specifically, this thesis analyzes the most fundamental assumptions – the ontological assumptions – upon which the investigation of marriage is conceptualized. The body is divided into three parts: First, the apparent absence of divorce in the marital literature is discussed, providing a starting point for the ontological analysis. Second, a section on ontology sets up the analysis. It begins with an introduction to two categories of ontological assumptions. These assumptive frameworks are used to guide the analysis of the marital literature. The final part analyzes John Gottman's research as a case example of the marital literature, uncovering the ontological assumptions of his work and demonstrating that many of his assumptions are potentially problematic for addressing divorce. After briefly wrapping up the arguments herein contained, the thesis discusses an alternative ontology which provides a framework whereby, if employed, marital researchers can begin to more adequately address the divorce epidemic.

This study is an empirical investigation of 35 clinically distressed therapy seeking couples receiving sequential sessions of both therapist-centered and, alternatively, couple- centered, enactment-based therapy processes. Using a mixed-level longitudinal analysis with a repeated measure design, analysis of secure attachment, and the interrelated dimensions of attachment anxiety and attachment avoidance were examined demonstrating that couple- centered, enactment-based sessions produced higher levels of post-session and within-session attachment gains than therapist-centered process for both males and females. Couple-centered, enactment-based process was observed to have a unique treatment effect after the second session, where both partners experienced higher levels of attachment followed by levels returning to pre-experiment levels. Clinical implications and future research considerations are suggested.

Enactments consist of episodes of direct couple engagement being carefully monitored and coached by the therapist. Enactments have been identified and studied as a potential common factor in marriage and family therapy. Attachment security is considered to be a foundational marker of marital health. This study explored what role enactments play in promoting attachment-related outcomes in therapy. A qualitative group hermeneutic approach was used to analyze the interviews of twelve participants (six couples) who had participated in six experimental sessions: three sessions with a preponderance of therapist-centered process and three of enactment-based process. The results of this analysis provide a general profile of participants' experiences of these two approaches in therapy and contribute to an emerging framework to inform potential best practice of enactments for helping couples work towards more secure attachment. Major findings include the importance of therapeutic alliance and sequencing of interventions for promoting positive attachment-related outcomes.

Depression is a major societal health problem with individual, familial, social, and economic costs. Cross sectional research has linked depression and marital discord, with women frequently having a higher association between variables. Several longitudinal research studies have linked marital satisfaction to subsequent depression. The Marital Discord Model of Depression states that marital discord is an important antecedent in the development of depression. While some empirical evidence exists supporting this premise, no research has been done with Latinos. The purpose of this study was to test the longitudinal relationship between marital satisfaction and depression among Latina women. The data was conducted in two waves, 2 years apart, from a Brazilian sample of 99 females. The data were analyzed using Structural Equation Modeling (SEM) procedures. The results indicated that there was a strong association between marital satisfaction and depression. Marital satisfaction at time-1 was a significant predictor of, not only time-1 depression, but also time-2 depression. Marital satisfaction and depression at time-1 predicted 59% of the time-2 depression scores. These results provide evidence that the Marital Discord Model of Depression is an appropriate theoretical model for the conceptualization of marital discord and depression with Latina women. With previous research already having established the effectiveness of Behavioral Marital Therapy of Depression (BMT-D) for treating depression among Caucasian couples, these results suggest that BMT-D might also an appropriate treatment for depression among Latinos. Further BMT-D effectiveness research needs to be done to test the utility of interventions with the Latino population. Further research also needs to be done to test the longitudinal association of marital distress and depression among Latinos living in the United States.

Extra-marital affairs are the main reason for divorce in western society. Pastoral therapists usually operate within a modernistic theology and use their 'expert' knowledge of theological ethics to confront the unfaithful spouse - a pastoral therapeutic approach that neither delivers the desired results, nor honours the client's expertise and freedom. This study endeavoured to socially construct pastoral therapy using the principles of postmodernistic social construction discourse with couples/spouses where one spouse is or was engaged in an extramarital affair. The relation between a modernistic epistemology and a postmodernistic epistemology, and how this relation affects theology, practical theology and pastoral therapy were explored. The propium of pastoral therapy in a postmodemistic paradigm and the implications of a narrative approach in pastoral therapy for theological ethics were reflected upon. A narrative description of extra-marital affairs was constructed and some of the cultural discourses which co-constitute extra-marital affairs were discussed. The pastoral therapist and clients were simultaneously in conversation with ethical discourses and relational, personal and emotional discourses, thus co-constructing new alternatives and possibilities. During these multiple reflexive conversations, some of the cultural discourses (eros; self-fulfilment; extra-marital sex and hedonism) which co-constitute extra-marital affairs were deconstructed. In the light of the usual limitations of the life-span of an extra-marital affair, the pastoral therapist and faithful spouses socially constructed alternatives and possibilities for their lives to enable them to outstay the extra-marital affair of the unfaithful spouse. Multiple reflexive conversations with (un)faithful spouses co-constructed, with relational and ethical discourses, a narrative approach in pastoral therapy. The use of externalisation and ritualisation in a narrative approach in pastoral therapy concerning extra-marital affairs was explored. A sense of guilt and secrets were also themes in multiple reflexive conversations with unfaithful spouses. This prompted reflection on the use of Scripture in a narrative approach in pastoral therapy. The relation between the biological-psychological aspects of extra-marital affairs and narrative therapy are also briefly explored. / Philosophy, Practical & Systematic Theology / D. Th. (Practical Theology)

[pt] O objetivo deste trabalho é propor, em uma perspectiva sistêmica construcionista social, um modelo de terapia de casal orientado pelos padrões interacionais do casal em terapia, tomados como marcadores e preditores da formação e dissolução do laço conjugal. É apresentada uma formulação metodológica para a construção do modelo psicoterapêutico que contempla a explicitação dos aspectos epistemológicos, teóricos, morfológicos e técnicos, em relação à inserção nos campos epistêmico, doxológico, axiológico, e no de demanda social. Dentro desta proposta, são revistos estudos sobre temas relevantes para construção deste modelo terapêutico, tais como padrões da conjugalidade na pós-modernidade; características emergentes dos estudos sobre psicoterapia de casal, enfocando a eficácia e eficiência terapêutica; estudos sobre marcadores e preditores da formação e dissolução da conjugalidade; o processo de mudança em psicoterapia, com o aumento da autonomia e complexidade, como produção de novas subjetividades. O modelo apresentado ressalta, além do enfoque sistêmico na relação psicoterapêutica, a construção social da subjetividade e do significado da conjugalidade, sendo que o terapeuta é coparticipante, provocando, através do seu discurso, perturbações que levem a mudanças de segunda ordem, favorecendo aspectos de criatividade na conjugalidade, dentro do espaço social de construção intersubjetiva. Algumas questões técnicas e éticas são apontadas, assim como são sugeridas novas direções de exploração. / [en] The aim of this paper is to propose, in a social constructionism systemic perspective, a model of marital therapy, oriented by couple`s interactional patterns in therapy, as markers and predictors of the conjugal ties formation and dissolution. It is proposed a methodological formulation, for the construction of a psychotherapeutic model that contemplates the explicitness of the epistemological, theoretical, morphological and technical aspects, concerning the insertion in the epistemic, doxological and axiological fields, and of social demand. Within this proposal, studies on subjects relevant to the construction of this therapeutic model, such as conjugality patterns in post-modernity; characteristics emerging from the studies on couple psychotherapy, focused on therapeutic efficiency and efficacy; studies on markers and predictors of the conjugality formation and dissolution; the changing process in psychotherapy like the increase of autonomy and complexity as the production of new subjectiveness are reviewed. The presented model emphasizes, besides the systemic focus on the psychotherapeutic relation, the social construction of subjectivity and the meaning of conjugality, in which the therapist is a co- participant, stimulating, though his speech, disturbances that take to 2nd level changes, favoring creative aspects in the conjugality, within the social space of intersubjective construction. Some technical and ethical issues are pointed out. New directions of exploration are proposed.