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Background: Aphasia impacts communication and relationships. While counselling is increasingly recognised as a component of the speech‐language therapy role, the success of conversation partner training is typically measured in terms of communication alone. This scoping review aimed to describe how successful conversation is currently measured with couples—with and without aphasia, to inform the development of an ecologically valid measure for couples with aphasia. Methods and Procedures: The scoping review was reported in alignment with the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis Extensions for Scoping Reviews (PRISMA‐SCR). MEDLINE, EMBASE, CINAHL and PsycINFO databases were searched for conversation treatment studies for couples with and without aphasia. Patient‐reported outcome measures (PROMs) were extracted from included studies and screened against the three‐tier model of situated language to shortlist those that measure everyday communication. Items within shortlisted PROMs were further described using the refined International Classification of Functioning, Disability and Health linking rules. Results: Following screening and full‐text review, 46 studies were included, consisting of 24 studies conducted with couples with aphasia and 22 studies conducted with couples without aphasia. For couples with aphasia, 13 PROMs were identified that measured everyday communication. Of these, 23% were dyadic (i.e., measured from the perspectives of both members of the couple); however, they usually only appraised the communication behaviours of the person with aphasia. For couples without aphasia, eight PROMs were identified that measured everyday communication; all were dyadic and measured both attitudes and communication behaviours of both partners. Conclusion: Conversation relies on the interaction of two people, and success in conversation is best rated by those having the conversation. The use of PROMs is recommended as part of person and relationship‐centred practice; however, there is currently no validated PROM for conversation in aphasia that considers the perspectives and behaviours of both the person with aphasia and their communication partner. The PROM items identified in this study will form the basis of future research to develop a PROM for couples' conversations in aphasia. WHAT THIS PAPER ADDS: What is already known on the subject: Communication partner training (CPT) for couples, where one person has aphasia, can improve conversation skills and enhance relationships. Clinician‐rated measures, such as conversation analysis, have been used to measure the outcomes of CPT. However, there is a lack of person‐centred or self‐rated outcome measurement instruments. that is, patient‐reported outcome measures (PROMs) for couples' conversations in aphasia. What this paper adds to existing knowledge: We have identified outcome measurement instruments used in conversation treatment studies for couples with and without aphasia. We found that most PROMs used in aphasia treatment studies were not dyadic, that is, they did not include the self‐report of both communication partners. In contrast, the PROMs used with couples without aphasia were dyadic and contained items that measured a more complex range of both partners' emotions, behaviours and attitudes. What are the potential or actual clinical implications of this work?: This study provides insights into the content and characteristics of PROMs for couples' conversation therapy and may assist clinicians in selecting outcome measurement instruments in their practice. [ABSTRACT FROM AUTHOR]

This article provides a comprehensive review of how the field of family therapy has evolved, tracing its roots from early practices influenced by eugenics to its current diverse theoretical frameworks, which are ever-expanding. In the mid-20th century, family therapy expanded beyond its eugenic roots, embracing diverse theoretical frameworks and giving rise to various therapeutic modalities like behavioral and emotionally focused family and couples therapy. However, due to cultural disparities, these concepts and models cannot holistically capture the essence of family therapy in India. They do not compute the central role of the intergenerational subsystem or understand hierarchical dynamics. What is deemed "okay" in the Western context does not hold true in the Indian context. Postmodern approaches show a marked improvement in dealing with these problems in cultural adaptations of family and couples therapy by integrating diverse therapeutic practices, technological advances, and cultural and diversity-sensitive practices. However, despite these advancements, the adapted modalities have a scope for improvement, posing a pressing need for research that bridges this gap. Moving forward research should focus on family change mechanisms, symptom improvement factors, and prioritizing culturally sensitive approaches to meet the unique needs of Indian families. [ABSTRACT FROM AUTHOR]

Much has been written about the need for greater integration between the fields of sex therapy and couples therapy, as sex is an integral part of many intimate relationships. Sexual desire discrepancy (SDD) is a common relationship issue that couples therapists are likely to encounter; however, they receive limited and varying degrees of training on how to approach and treat sexual issues like SDD. Emotionally focused therapy (EFT) is an empirically supported approach to couples therapy that offers a structure for strengthening relational bonds. The current literature on using EFT for sexual issues in general, and desire discrepancy specifically, focuses on adapting EFT to treat sexual issues by mapping out the sexual cycle and using an attachment lens to increase emotional safety. The PLISSIT model and its extension the Ex-PLISSIT model are multi-pronged approaches commonly used in sex therapy that provide a guide for how to initiate and progress therapeutic treatment of sexual issues. This article explores how incorporating the PLISSIT and Ex-PLISSIT models into EFT can offer additional benefits to clients and practitioners alike. [ABSTRACT FROM AUTHOR]

The literature provides an incomplete picture of gender dynamics in later-life domestic work. This couple-level study examines the division of female-typed, gender-neutral, and male-typed housework among middle-aged and older Chinese couples, comparing working and non-working couples. It also explores the different relationships between education, income, and the division of housework in these two groups of couples. The findings derived from national time-use data reveal that, first, non-working couples exhibit a smaller gender gap in household labor compared to working couples, primarily because wives take on more gender-neutral tasks, while husbands assume more female-typed tasks. Second, female-typed housework exhibits the largest gender disparity, followed by gender-neutral housework. Third, educational and economic resources play distinct roles in shaping the division of household chores in the two groups. Furthermore, the time spent on paid work is a more significant factor in explaining gender differences in housework among working couples than education and income. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between five subconscious psychological factors and marital quality with data collected from 799 married adults in Iran. Participants completed two questionnaires assessing their subconscious factors and the quality of their marriages; questionnaires were based on the Imago theory and developed specifically for this study. Analysis of the data revealed a negative relationship between all five factors and quality of one's marital life. The presence of these factors could lower the quality of marital life. Additionally, among all five factors, defenses had the largest influence on overall marital quality. Therefore, subconscious factors significantly impact marriage quality. [ABSTRACT FROM AUTHOR]

This quasi-experimental study investigated the effects of a telehealth Marriage Checkup on improvement of marital quality among 98 newly married couples. We assigned couples to either an intervention) telehealth Marriage Checkup program (or a control group.The participants completed the Quality of Marriage Index (QMI), and the NEO Five-Factor Inventory (NEO-FFI) at baseline, post-intervention, and three-month follow-up. The telehealth Marriage Checkup significantly increased marital satisfaction and this effect persisted at the three-month follow-up. Our study demonstrates the importance of early preventive interventions for enhancing and maintaining marital satisfaction in the initial stages of marriage. [ABSTRACT FROM AUTHOR]

This article is written to help therapists who are not clinical researchers assess the quality of experimental studies that are designed to compare the relative merits of different approaches to treating distressed couples. To illustrate some of the major difficulties encountered in conducting comparative research with couples (instrumentation, pretreatment assessment, internal validity, external validity, reliability of treatments, outcome evaluation, etc.) hypothetical examples are presented. Suggestions for addressing some of the salient methodological issues identified in the article and implications for determining best practices are offered for consideration. [ABSTRACT FROM AUTHOR]

Experiences of change from the perspective of both chronically conflictual couples and their therapist has not been explored, thus inhibiting current understanding of what is important for in-session change. The present study examines couple and therapist experiences of therapy for chronically conflictual couples. Sixteen interviews from four couples (n = 8) and their therapists (n = 4) were analyzed using Colaizzi's method of phenomenological inquiry. Results highlight environmental, couple, and therapist factors that are integral to experiencing change in session. Results show the importance of therapists facilitating intentional, non-conflictual, and connecting couple interactions. We discuss clinical implications of the findings. [ABSTRACT FROM AUTHOR]

Integrative Behavioral Couple Therapy (IBCT) posits that couple distress can, in part, be attributed to four factors labeled with the acronym DEEP: natural Uifferences between partners in their perspectives, beliefs, interests, and personalities, partner's Emotional sensitivities related to these differences, the External, contextual stressors that often exacerbate their differences and sensitivities, and the resultant Patterns of distressed interaction. Although an extensive assessment process captures these four components and thus tailors targets for intervention based on the unique characteristics of each couple, it does not explicitly consider the uniqueness of African American couples. Given the historical and contemporary realities that African American couples face (e.g., anti‐Black racism), the purpose of this article is to help clinicians use IBCT with African American couples in a culturally responsive way. We begin this article by highlighting the unique needs of African American couples. We then provide a broad overview of the benefits of adopting a multicultural lens of awareness, knowledge, and skills in clinical work, present an atheoretical overview of IBCT, and offer specific recommendations to attend to the unique cultural experiences of African American couples. Finally, we present a case study to exemplify our suggestions and highlight implications of using IBCT with African American couples in a culturally responsible way. [ABSTRACT FROM AUTHOR]

Background: Improvement of the knowledge of pregnant mothers and their partners related to low birth weight (LBW) is a vital factor in preventing LBW and reducing its prevalence. Objectives: Implement and evaluate the effectiveness of a community based health promotion intervention on pregnant mothers and their partners to increase knowledge on birth weight and its determinants. The second objective is to determine the difference of the birth weight after implementing the intervention. Methods: A quasi experimental study design was used, and the setting was 806 pregnant mothers, 403 each in two districts. In 26 ANCs, twenty six initial training sessions were conducted as a group, with an average of three hours for each session. Three follow up sessions were conducted in each ANC over 04 months (in total 104 sessions). All sessions were conducted in groups of 10 to 20 antenatal couples. The pregnant mothers and their partners completed interviewer-administered questionnaires. Pre and post data were analysed based on four major knowledge categories using statistical methods. The McNemar's Chi Square test; Chi Square test, Fisher's Exact test, Paired t test, Student's independent sample t test, Wilcoxon Signed Ranks test and Mann Whitney U test methods were applied as appropriate. Results: Both mothers and their partners in the intervention group (IG) reached significantly higher gains in knowledge than in the comparison group (CG). The participants who got the lowest scores for knowledge, at the pre assessment, in IG, also improved more than the CG {mothers (p = 0.002) and partners (p = 0.007)}. The mean birth weight shows that the IG has significantly improved for both mothers (p < 0.001) and partners (p = 0.013) with low knowledge scores (< 50% of total). Conclusions: Knowledge about birth weight and its determinants among pregnant mothers and their partners improved significantly. [ABSTRACT FROM AUTHOR]

Background: Data from a two‐arm randomized controlled trial of emotionally focused therapy (EFT) compared to usual care were used to examine whether baseline emotion regulation influences relationship satisfaction for female and male partners. This is clinically relevant as clinicians have debated whether clients' initial emotion regulation skills predict positive outcomes in EFT. Methods: Dyadic multilevel modeling was used to determine whether baseline emotion regulation predicted both initial levels and change in relationship satisfaction and whether that relationship differed by treatment group (i.e., EFT or usual care). Results: Baseline emotion regulation difficulties were associated with lower initial relationship satisfaction. However, baseline emotion regulation difficulties were not associated with change in relationship satisfaction over the course of treatment and this relationship did not differ by treatment group. Conclusions: Results demonstrate that partners with diverse presentations of emotion regulation at baseline may benefit from couple therapy. [ABSTRACT FROM AUTHOR]

This paper will explore the role of the therapist's values in couple therapy and the challenge these values pose to therapeutic neutrality. It will illuminate how the therapist's values shape what is considered healthy and unhealthy, functional and dysfunctional, and hence frame the problem the couple therapist seeks to treat. Values have particular relevance for couple treatment because the conversations the couple therapist facilitates may unwittingly privilege one partner's needs and wishes over the other's, creating the potential for therapeutic misalliances. This paper will explore common values and their impact on treatment, including the values of monogamy, gender equity, and talk intimacy (emotional expression as a path to intimacy). It will conclude by discussing how couple therapists can avoid partisanship with one partner and maintain a balanced approach in their couple work. [ABSTRACT FROM AUTHOR]

A new measure for assessing an individual's perception of the dyadic difficulties in emotion regulation with a romantic partner is tested. The Difficulties in Emotion Regulation Scale–Dyadic (DERS‐D) was obtained by adapting some items of the previous Difficulties in Emotion Regulation Scale (DERS) to the dyadic context. The scale was administered both to a sample of university students (N = 835) to explore its factorial structure and to a convenience sample (N = 833) together with the DERS, the DERS‐Positive, the Emotion Beliefs Questionnaire (EBQ), and the Emotion Regulation Questionnaire (ERQ) to confirm the factorial structure and to explore its construct validity. Results highlight that DERS‐D measures two distinct features, namely the lack of dyadic awareness and the lack of dyadic clarity, and that configural invariance across genders was met. DERS‐D subscales' internal consistency was high. The correlations between the DERS‐D and the other measures demonstrated its construct and criterion validity. The promising nature of these results is discussed in light of the potential clinical and empirical uses of the DERS‐D. [ABSTRACT FROM AUTHOR]

Objective: Couples' joint coping is important in managing the impact of breast cancer. However, measures assessing couples' communication as a way of coping are insufficient. This study aimed to generate a self-report valid and reliable measure of couples' coping with a particular focus on communication. Method: We used baseline data of 343 couple dyads who participated in a randomized clinical trial targeting marital communication. Women were diagnosed with early-stage breast cancer in the past eight months; couples were married or in an intimate relationship for at least six months, could read and write English, and lived within 100 miles of the study center. An expert panel selected items with conceptual fit from the Mutuality and Interpersonal Sensitivity Scale (MIS) that was originally designed to evaluate marital communication about breast cancer. Results: Exploratory and confirmatory factor analyses supported a 12-item measurement model with four factors: Keeping the communication open with each other about breast cancer (4 items), Sharing a positive outlook on breast cancer (2 items), Avoiding discussion of negative thoughts and feelings about breast cancer (3 items), and Spending sufficient time together talking about breast cancer (3 items). Reliability ranged from 0.76 to 0.87 for women and 0.70 to 0.83 for spouses. Conclusion: This new measure has potential application in clinical practice and future research to assess couple's joint coping efforts especially through communication. [ABSTRACT FROM AUTHOR]

The Middle East and North Africa, of which the southern and eastern Mediterranean sub-region constitutes the bulk of the population and territory, is the world's most securitized region. It is also the leading recipient of security assistance but provides the least security of any global region. A related paradox is that this region, the states of which are the world's least democratic, receives the bulk of its security assistance from democracies. This article draws upon the causes and consequences of these two paradoxes to investigate relationships between securitization, security systems, and insecurity in the Mediterranean and broader MENA region. These paradoxes are products of historical legacies and limited access orders that characterize the region's political economies. They are key drivers of 'Faustian Bargains' between providers and recipients of security assistance and the costs of those relationships. The article concludes with a review of proposals to improve the balance of costs and benefits of SA, recommending a dual strategy of seeking to reform recipients' civil–military relations while changing military roles and responsibilities of both partners in security assistance relationships. [ABSTRACT FROM AUTHOR]

Background: Marital distress is a risk factor for a panoply of mental and physical health disorders. One of the causes of marital distress that is increasingly gaining relevance is attachment injuries in the marital relationship. Emerging from the confluence of adult attachment theory and emotionally focussed couples therapy, attachment injuries refer to tears in the relationship bond caused by abandonment or betrayal in the marriage, especially at times of critical need when attachment needs are salient. Objective: The objective of this study was to investigate how therapists in India conceptualise and assess attachment injuries in marital relationships. Method: A qualitative design was used, whereby in‐depth interviews were conducted with 13 therapists and the transcripts were analysed using thematic analysis. Results: The analysis resulted in two overarching themes. The first was 'Attachment Injuries are a Common Phenomenon in Couples undergoing Marital Distress', which included themes related to markers of attachment injuries, injurious events, the gendered nature of attachment injury experiences and the impact of attachment injuries. The second overarching theme was 'Therapists Utilize Diverse Methods for the Crucial Process of Identification of Attachment Injuries', which included themes related to the methods used for assessment, the significance of attachment lens, the role of early experiences and the utility of identifying attachment injuries. Conclusion: The results highlighted how attachment injuries, originating from various injurious events, are often a component of marital distress in couples accessing therapy. The findings also pointed towards the need for therapists to develop competency in assessing and addressing attachment injuries, irrespective of their primary therapy orientation. [ABSTRACT FROM AUTHOR]

Improving intimate partner violence interventions requires understanding pathways to change among couples participating in these interventions. This article presents qualitative data from 18 males and 16 females who participated in a combined behavioral economics (contingency management) and cognitive behavioral therapy alcohol and violence reduction intervention trial in Bengaluru, India. Results confirmed several theorized pathways of change, as well as identified further mechanisms through which the intervention supported the change. These included the emotional impacts of incentives, perceived and actual accountability via breathalyzers and family involvement, and enhanced support gained through counseling skills. Findings reveal critical insights into intervention design for future implementation. [ABSTRACT FROM AUTHOR]

This article aims to apply structural family therapy to working with family and intimate partner violence in after-violence context, where risks and safety issues have been addressed. This practice research study uses case analyses based on the work done with a Chinese couple and a Chinese family in Singapore, respectively. It identifies the salient therapeutic focus and healing processes in after-violence context with Chinese families. Reflections and feedback of social workers and clients during and after the conjoint sessions were included systematically. Practice implications to apply Structural family therapy in working with Chinese couples and families in after-violence are highlighted. [ABSTRACT FROM AUTHOR]

We examined the prevalence of relationship undermining statements by therapists treating couples, as reported by clients, and the association of these statements with outcomes. Participants (n = 270) reported on recollections of their therapist saying that they were incompatible, that therapist could not help them, that the relationship was beyond repair, that divorce was the best or most realistic option, or told one of partners that the other had a personality problem, or proposed individual therapy instead of couple therapy. Findings showed a prevalence rate of 10-28% across these five undermining statements; 40% of clients reported at least one statement. Undermining statements were associated with poorer outcomes and shorter duration of couple therapy. We suggest that some therapists treating couples lack a systemic/relationship framework and set of skills, which leads them to become frustrated and pessimistic with difficult couple cases. We offer implications for the training of couple therapists. [ABSTRACT FROM AUTHOR]

When lovers sense anxiousness in their bodies—and want to "bite each other's heads off," they might go to couples counseling for help with communication. Like parents trying to help siblings "use their words," counselors try to help lovers talk. In couples dance/movement therapy, it is helpful to look at the physiology of language with awareness provided by the method called Chi for Two. Chi for Two—The Energetic Dance of Healthy Relationship was originated by a long-time dance/movement therapist. It synthesizes knowledge of nervous system functioning, infant development, and trauma patterning, which is passed down over generations, plus how the therapeutic relationship shifts attachment styles. Dance/movement therapists who have this knowledge can help lovers recognize when their interactions awaken unfinished infant/parent dances involving the "biting/snapping" rhythm from the Kestenberg Movement Profile system, adapted for Chi for Two. (The authors use the word "lovers" to name people who are engaging in mutually consensual sexual sharing with one another.) The biting/snapping rhythm is key in articulating language. When lovers can recognize what is happening in their bodies during their efforts to use words, they can learn to bring the bite/snap infant movement expressions to dance/movement therapists to work through those moves. When lovers work through the infant movement patterns with the dance/movement therapist in the presence of a romantic partner, but not acted out with the romantic partner, lovers can celebrate their partners' bravery in doing their individual healing and relational re-patterning. [ABSTRACT FROM AUTHOR]

Objective: This research delved into the experiences of couples and therapists in online couples therapy with an emphasis on therapeutic boundaries. Background: Although the popularity of online therapy has surged, limited understanding exists about the meanings and experiences tied to therapeutic boundaries in this context, underscoring the need for its examination to enhance online therapy's effectiveness. Method: A purposive sample of 51 participants, including 36 individuals (comprising 18 couples who underwent separate interviews), and 15 couple and family therapists were interviewed in four online focus groups. Constructivist grounded theory guided the data analysis to discern therapeutic boundary dimensions. Results: The analysis identified three dimensions of therapeutic boundaries: (a) boundaries between the therapist and couple, (b) boundaries between the couple and their family, and (c) boundaries between the therapists and their own families. Conclusion: The study offers insights into the nuanced concept of liminality within therapists' and couples' transition to online couples therapy, particularly emphasizing disruptions in conventional therapeutic paradigms. Implications: To uphold the integrity and bolster the therapeutic alliance in online couples therapy, there is a compelling need for therapists to transition toward novel means of establishing boundaries, moving away from traditional constructs. [ABSTRACT FROM AUTHOR]

This study examined the development of the therapy alliance over the first six sessions of couple therapy using a dyadic latent growth curve. The role of relationship adjustment, symptom distress, and attachment to alliance development were also examined. Participants were 165 couples in a treatment-as-usual setting. The alliance increased over the first six therapy sessions for males and females with males following a curvilinear pattern of growth. Additionally, female relationship adjustment was related to initial alliance levels for females while symptom distress was related to female alliance development. Male attachment avoidance and female attachment anxiety were related to male initial alliance. Couple therapists need to pay attention to intake level of female adjustment, symptom distress, and attachment—along with male attachment, as these are related to alliance development. Therapists should also be mindful that female and male alliance follow a different developmental trajectory. [ABSTRACT FROM AUTHOR]

In Gottman Couple Therapy (GCT), the intervention of Dreams-within-Conflict (DWC) helps break down a gridlocked issue between couples through deeper emotional expression and experiencing (in-counseling exploration of emotions). The current study examined experiencing in a single session of DWC for N = 30 individuals (15 couples) using multiple methods such as self-assessment questionnaires, observation rating and coding of the video recording, and feedback interviews. The before and during DWC best experiencing video segments were selected and rated by two raters independently on the experiencing scale (ES) for partners. The changes in experiencing mode and peak scores (ESM and ESP) during DWC were investigated in the presence of individual characteristics of attachment (anxiety and avoidance) and relationship mindfulness traits. A paired-samples t-test showed a significant increase in experiencing for both partners. Hierarchical linear modeling analysis indicated that gender (women) significantly and positively predicted ESM. ESP was predicted positively by gender (women) and negatively by avoidance, though the results were not conclusive. Thematic analysis was used to look at the Indian couples' experiencing as shared by them in order to better grasp the therapeutic implications. The qualitative findings confirm the quantitative results that couples outside of intervention utilized experiencing levels 1–3 predominantly and moved to 3–4 levels during best experiencing segments of intervention. Couples reviewed positively to the emotional experiencing techniques used during the DWC intervention. [ABSTRACT FROM AUTHOR]

Background: Social problems related to infertility are associated with a significant psychological burden for the involved couple. Previous studies have shown the positive effects of couple interactions on the psychological health of these couples; however, the specific conditions of participating in assisted reproductive treatments (ART) might influence the effect of couple collaboration. Therefore, the present study aimed to evaluate the relationship between couple collaboration, well-being during infertility, and the psychological indicators of infertile couples undergoing fertility treatment. Methods: This cross-sectional study was conducted on 200 ART volunteer couples. Couple collaboration and well-being during infertility were evaluated using a validated researcher-made questionnaire, and the level of depression, anxiety, and stress was evaluated using the DASS-21 questionnaire in both couples. Statistical analysis was performed using the plug-in application PROCESS macro for SPSS and AMOS software. Results: The results showed that couple collaboration was correlated with the level of depression, anxiety, and stress. Moreover, depression, anxiety, and stress levels were correlated with well-being during infertility. The direct and indirect effect of couple collaboration on the depression level was significant; however, the direct effect of couple collaboration on the level of anxiety and stress was not significant, and the effect of couple collaboration on these indicators was mediated by well-being during infertility. The fit index of the equation modelling showed a good fit of the relationship path between the variables of couple collaboration, well-being during infertility, and psychological indicators (CMIN = 4.196, p = 0.260). Conclusion: The results of this study show that the specific conditions of participating in ART may affect the direct effects of couple interaction on an infertile couple's levels of anxiety and stress. These results suggest that in order to develop mental health programs for infertile couples, strategies based on couple collaboration that are associated with higher well-being during infertility should be developed and presented. Plain English Summary: Social problems related to infertility are associated with a significant psychological burden for the involved men and women. Previous studies have shown the positive effects of couple interactions on the psychological health of these couples. However, the specific conditions of participating in assisted reproductive treatments (ART) might influence the effect of couple collaboration. Therefore, the present study aimed to evaluate the relationship between couple collaboration, well-being during infertility, and the psychological indicators of infertile couples undergoing fertility treatment. This cross-sectional study was conducted on 200 ART volunteer couples. Couple collaboration, well-being during infertility and the level of depression, anxiety, and stress were evaluated using validated questionnaires. The results showed that the direct and indirect effect of couple collaboration on the depression level was significant; however, the direct effect of couple collaboration on the level of anxiety and stress was not significant, and the effect of couple collaboration on these indicators was mediated by well-being during infertility. The results of this study show that the specific conditions of participating in ART may affect the direct effects of couple interaction on an infertile couple's levels of anxiety and stress. These results suggest that in order to develop mental health programs for infertile couples, strategies based on couple collaboration that are associated with higher well-being during infertility should be developed and presented. [ABSTRACT FROM AUTHOR]

Infidelity is a relationship betrayal that can lead to multiple negative individual and relational outcomes. Multiple clinicians have developed practice-based models of couple healing from infidelity; however, few of these models have been systematically examined. One such model is Butler et al.'s clinical model, grounded in attachment theory and the concept of relational ambivalence. In the present study, we sought to systematically examine and refine Butler et al.'s model of couple healing from infidelity using deductive qualitative analysis of seven publicly available online blogs written by non-straying partners. Informed by the clinically based model, we generated sensitizing constructs and engaged in open, focused, and theoretical coding. Our results support several key components of the original model, while also suggesting refinements to the concept of ambivalence for straying partners as well as couple-level responses. Our results suggest that a meaningful expansion to the original model is non-straying partners' efforts to heal individually throughout the entire healing process. We suggest clinical implications and opportunities for future research based on our analysis. Infidelity is a relationship betrayal that can lead to individual distress and relationship disruption. In this article, we evaluated an existing descriptive model of couple healing from infidelity using seven online blogs. Our results suggest that the existing model of couple healing can be improved by incorporating non-straying partners' individual healing. [ABSTRACT FROM AUTHOR]

Background: Research has predominated among the therapeutic application of psychedelics for varied psychopathologies and yet remains limited when supporting sexual behaviour intimacy among couples; particularly those who micro-dose. Method: Using semi-structured interviews, this qualitative study explored the micro-dosing sexual experiences of four partnered men and women aged 20–35 years. Interviews examined the effect of micro-dosing on confidence, openness, sexuality, inhibition and perceived relationship satisfaction. Results: Thematic analysis identified three key narratives: increased sexual self-efficacy; sexual exploration; and heightened relationship satisfaction. From the participant's perspective, the use of micro-dosing psychedelics had a positive effect on sexual and physical well-being by reducing stress and performance-related anxiety. This, in turn, elevated sexual desire, exploration, communication and enhanced sensory and sexual experience, thus potentially supporting emotional and physical connection. In terms of erectile functioning and orgasm, participants attributed this to being micro-dose and psychedelic choice dependent. Whilst higher doses of MDMA hindered sexual functioning this did not negatively impact the emotional and sensory experiences. Conclusion: These findings point to micro-dosing psychedelics as offering a potentially beneficial adjunct to psychosexual and couple's therapy; potentiating relationship and sexual satisfaction. Further research might wish to gravitate quantitatively towards a larger and varied micro-dosing populace in supporting sexual self-efficacy and intimacy. [ABSTRACT FROM AUTHOR]

Sexual activities changes between partners is a common issue during pregnancy because of physical and psychological transformation. Moreover, couples who have infertility problems have more doubts and uncertainties about sexual life during pregnancy. This longitudinal study sought to understand the differences of sexual activities, information source and health status during gestation between married couples who underwent In Vitro Fertilization (IVF) and who conceived without IVF (NI). Within three time points, we mailed questionnaires to 75 couples who conceived without IVF and 70 couples with IVF. The questionnaires were completed separately by the husband and the wife. The proportion of couple's sexual activity in the IVF group was significantly lower than that in the NI group (p < 0.05) during the first trimester. Most couples seek sexual health information from unprofessional resources. For preventing the misunderstanding of the information which may lead to inaccurate interpretations, healthcare professionals should take sexual health–related issues into considerations during the fertility treatment. More than 90% of married couples have sexual activity during pregnancy, hugging is the top activity, and sexual intercourse frequency decreases. The sexual activities are similar between women who conceived with IVF or not in most trimesters. Couples seeking sexual health information from healthcare providers were less than 30%. [ABSTRACT FROM AUTHOR]

Much of the research on mindfulness training has focused on individuals and little has evaluated mindfulness training and education in the context of romantic relationships. Mindfulness practiced by committed partners has been linked to greater empathy, perspective taking, and overall marital satisfaction. However, no relationship education program includes training on how mindfulness may benefit a couple's sexual relationship. Sexual mindfulness is a new area of research that preliminarily has shown that sexual mindfulness may benefit individuals and couples above and beyond mindfulness alone. To build on the small amount of research that indicates mindfulness and sexual mindfulness may benefit romantic relationships, we compared heterosexual couples in a mindfulness-only intervention comparison group (n = 66 individuals) to couples in a sexual-mindfulness intervention treatment group (n = 83 individuals). Couples in both groups were taught about mindfulness, communication, and effective problem solving. Participants in the treatment group were given addition information about sexual mindfulness. The two-session, six-hour intervention found that both groups improved in all metrics. The sexual-mindfulness group made greater improvements in sexual mindfulness awareness. Implications about how sexual mindfulness may benefit relationship education programs and therapists' practice are discussed. This intervention two-treatment design compared the use of mindfulness only and sexual mindfulness. Both treatments showed positive results. The sexual mindfulness treatment showed higher sexual awareness than mindfulness alone. Participants reported that the classes were fun, interesting, and taught several skills that were valuable and improved their relationships. [ABSTRACT FROM AUTHOR]

In the context of a couples cohort established to evaluate an optimised couples-focused behavioural intervention in rural South Africa, we examined: (1) Is couples' relationship quality (RQ) associated with couples HIV testing and counselling (CHTC) uptake? (2) Does CHTC uptake or the intervention components uptake improve subsequent RQ? Enrolled couples, (n = 218), previously naïve to couples HIV testing, were invited to two group sessions and offered four couples counselling sessions (CS1-CS4), as part of the intervention and administered a questionnaire individually at baseline, four weeks, and four months, which included item-scales to measure RQ: satisfaction, intimacy, dyadic trust, conflict, and mutual constructive communication. Logistic models indicated that no baseline RQ measures were significantly associated with CHTC uptake. Linear regression models showed that CHTC uptake before four weeks assessment significantly improved couples' satisfaction and trust at four weeks, and intimacy at four months. Attending at least one CS was associated with increased satisfaction, intimacy, and decreased conflict within couples at four weeks; the improvement in intimacy was sustained at four months. Consistent with the theoretical interdependence model, our findings suggest that CHTC and CS seemed to strengthen aspects of relationship quality, possibly leading to further collaboration in managing lifestyle changes and treatment adherence. [ABSTRACT FROM AUTHOR]

The primary purported change process in emotion-focused therapy for couples (EFT-C) involves partners accessing and revealing their underlying vulnerable emotions and responding empathically when their partners disclose their vulnerable emotions. One main intervention to facilitate vulnerability sharing is enactment – guiding partners to interact directly with each other. The objective of the current study was to identify interventions therapists can use to help partners share vulnerability in the context of enactment. The primary hypothesis of this study was that promoting these interventions would lead to more vulnerability expressions during enactments. One hundred and five vulnerability enactment events were identified from videod therapy sessions of 33 couples dealing with a significant emotional injury who received 12 sessions of EFT-C. Four therapists' interventions were coded: setting a meaningful systemic context, promoting the revealing partner's emotional engagement, preparing the revealing partner for enactment, and promoting the listening partner's emotional engagement in the enactment. In addition, vulnerability expression was coded. Multilevel regression models showed that two interventions were significantly associated with greater levels of expressed vulnerability: setting a meaningful systemic context, and preparing the revealing partner for enactment. These findings suggest that therapists can facilitated vulnerability sharing using specific preparatory interventions. [ABSTRACT FROM AUTHOR]

This article explores the integration of creativity into relational-cultural therapy (RCT) with couples, emphasizing the potential for creative interventions to enhance clients' understanding of self and others while promoting relational growth. RCT, rooted in the acknowledgment of chronic disconnection as a source of human suffering, focuses on meaningful interdependence and connection as essential for well-being. Despite the documented benefits of creative techniques in couples therapy, there is a gap in the literature regarding the use of creative interventions within RCT couples counseling. The article argues that incorporating creativity within RCT couples counseling facilitates the development of a common language and understanding of RCT concepts among couples. It provides an overview of RCT concepts, discusses the rationale and research supporting the integration of creativity with RCT and couples work, and offers five creative RCT-based interventions: Reflecting on the relationship, creating a context constellation, honoring strategies of disconnection, visualizing relational images, and exploring shame and authenticity. Each intervention is designed to align with RCT principles, encouraging clients to explore their identities, relational dynamics, and strategies of disconnection in a creative and experiential manner. The article emphasizes the importance of creating a safe and non-judgmental therapeutic space, where clients and counselors can collaboratively engage in these creative activities. Overall, the integration of creativity into RCT couples counseling aims to promote vulnerability, mutual empathy, and strengthened connection within the therapeutic relationship and the couple's dyad. [ABSTRACT FROM AUTHOR]

Given the history of discrimination and increased mental health risks surrounding LGBTQIA+ service members, group counseling is a practical approach for practitioners to mitigate effects in a therapeutic setting. This article synthesizes the Positive Relational Couples Therapy (PRCT) model, incorporating concepts of the Multicultural and Social Justice Counseling Competencies (MSJCC), Relational-Cultural Theory (RCT), the PERMA model, and Gottman's Method Couples Therapy as a group process to provide a conceptual framework. An outline of the PRCT model and case illustration are provided for practitioners for group counseling with LGBTQIA+ military couples. Practical group considerations and implications for this work are discussed. [ABSTRACT FROM AUTHOR]

The following case study demonstrates the potential of a culturally sensitive, integrated model of marital therapy intervention designed and developed using data from and research done in India. This integrated approach utilizes humanistic-existential approaches as the base frame of reference and techniques from the approaches falling within the theoretical frame of systemic and social constructionist approaches have been assimilated into it. The model is called the Indian model for Attunement To Tackle Active Conflict And Helplessness with married couples (I-ATTACH). This case demonstrates the application of the approach with a couple married for 2 years who saw an escalation of marital problems leading to talks of separation post the birth of their child 6 months ago. The couple completed both pre-treatment and post-treatment assessment measures that included a self-reported standardized questionnaire, a 5 point scaled questionnaire designed by the authors and a semi-structured questionnaire to assess for the couple's assessment regarding the effectiveness of the intervention. After the pre-treatment assessment, the couple engaged in 16 joint and 2 individual intervention sessions of I-ATTACH. A description of the model and the stage-wise progress of the couple is discussed and the assessment data presented for both pre-treatment and post-treatment. [ABSTRACT FROM AUTHOR]

We examined relationship quality of couples as a mediator between therapy progression and reduced individual distress in short-term systemic couple therapy. Participants evaluated relationship-quality (EVOS), therapy progress (STEP), and individual distress (OQ45) before therapy and one month after therapy. Clients' evaluation of the therapeutic process predicted a reduction of individual distress. Hierarchical mediation-analysis revealed that the effect was completely mediated by the change in the relationship quality over the course of the therapy. Results highlight the importance of relationship quality for each individual's health. Specifically in systemic couple therapy, improving relationship quality is the core ingredient that drives its effectiveness. [ABSTRACT FROM AUTHOR]

Social comparison may weaken one's sense of self and limit satisfaction in romantic relationships. Using a sample of adults in committed relationships (n = 421), we examine whether engaging in social comparison is associated with relationship satisfaction and whether this association is mediated by sense of self. Results indicated that more social comparison is associated with a weaker sense of self but having a strong sense of is positively associated with relationship satisfaction. Given the pervasiveness of social comparison, this may be a helpful consideration for clinicians and educators to address with individuals and couples in strengthening relationships. [ABSTRACT FROM AUTHOR]

This article is intended for therapists who do not ordinarily use standardized assessment measures in their work with couples but who would like to consider doing so. A systematic procedure for selecting, administering, and interpreting such measures is described. The issue of potential negative effects on both a couple's relationship and partners' motivation for treatment when certain instruments are used is discussed. The question of social desirability affecting partners' responses to assessment instruments is raised and suggestions are offered for dealing with this concern. [ABSTRACT FROM AUTHOR]

Grounded in the socio-ecological model of health, this study aims to understand the broader impact of adult attention deficit hyperactivity disorder (ADHD) on the family system. With a notable gap in knowledge concerning the impact of adult ADHD on spouses' well-being, this research explores the lived experiences of women in relationships with partners diagnosed with ADHD. Using a descriptive qualitative phenomenological approach, we conducted semi-structured interviews with thirteen women without ADHD, to gain insights into their experiences. Three main themes were identified- ADHD in Everyday Life, Burden Experience, and Women's Coping Strategies for managing ADHD within relationships. The findings suggest that partners' ADHD symptoms involve a burden on women. In response, women developed coping strategies such as learning about ADHD, setting limits, and cultivating partnership by creating bridges to compensate for ADHD-related barriers. This study highlights the substantial burden experienced by women in a relationship with partners diagnosed with ADHD, suggesting they should be recognized as caregivers and a potentially vulnerable group at risk. However, the homogeneous nature of our sample, focusing on white, heterosexual women, underlines the need for further research to better understand the impact of adult ADHD on diverse partners' functioning and health, as well as pathways to support them. Women partners of adults with attention deficit hyperactivity disorder (ADHD) often fulfill a caregiving role that can create a substantial burden. Healthcare providers working with adults diagnosed with ADHD are encouraged to recognize the broader social context of their patients and validate the burden experienced by both partners living with the implications of this health condition. Healthcare providers can offer supportive measures for both partners, such as education and counseling to facilitate a deeper understanding of the unique challenges posed by ADHD, and to provide guidance on effective coping strategies. Interventions are needed to support women in relationships with adults with ADHD. Future interventions might include peer support groups, individual counseling, or couples therapy that specifically addresses the unique challenges of living with ADHD in a relationship. [ABSTRACT FROM AUTHOR]

Objective: The increasing prevalence of marital conflicts in contemporary society, the risk of separation, and its negative impact on the mental health of couples and their children is one of the most significant issues, sometimes affecting even three generations of a family. The effectiveness of Gottman's Systemic Cognitive Couple Therapy on marital conflicts, communication patterns, and alexithymia in couples with marital conflict was examined. Methods and Materials: This study utilized an applied and quasi-experimental design with a pre-test, post-test, and follow-up, accompanied by a control group. The statistical population of this study included all couples who referred to counseling clinics in District 1 of Tehran from June to September 2023. Among them, 30 couples were selected through convenience sampling and randomly assigned to experimental and control groups. The interventions included seven sessions of Gottman's Systemic Cognitive Couple Therapy (2008) administered to the experimental group. Data were collected using the Christensen and Sullaway (1984) Communication Patterns Questionnaire, the Bagby, Parker, and Taylor (1994) Alexithymia Scale, and the Barati and Sanai (1996) Marital Conflict Questionnaire. The data were analyzed using repeated measures ANOVA and SPSS-22 software. Findings: The results of data analysis indicated that systemic cognitive couple therapy was effective on marital conflicts (F=40.30, P<0.001), communication patterns (F=13.53, P<0.001), and alexithymia (F=3.59, P=0.036) in couples with marital conflict (P<0.01). Conclusion: It can be concluded that couple therapy can be utilized to improve marital conflicts, communication patterns, and alexithymia in couples experiencing marital conflict. [ABSTRACT FROM AUTHOR]

Objective: Background and Objective: Couples face numerous challenges in marital life, particularly in areas of family cohesion and emotional selfregulation. Implementing psychological interventions to enhance these characteristics is essential. This study aimed to determine the effectiveness of couples therapy using the Gottman method on family cohesion and emotional self-regulation among couples. Methods and Materials: This quasi-experimental research was conducted using a pre-test and post-test design. The study population consisted of couples seeking divorce at counseling centers in Tehran in the year 2023. The sample comprised 50 couples, selected through convenience sampling and randomly assigned into two equal groups (each group containing 25 couples). The intervention group underwent eight 36-minute sessions (two sessions per week) of couples therapy using the Gottman method. Research tools included questionnaires on family cohesion and emotional self-regulation, completed by both groups during pretest and post-test phases. Data were analyzed using multivariate analysis of covariance. Findings: Results indicated significant differences between the experimental and control groups in the post-test stage for the variables of family cohesion (F=54.29, p<0.001) and emotional self-regulation (F=11.40, p<0.001). Conclusion: The findings underscore the importance of couples therapy using the Gottman method in enhancing family cohesion and emotional self-regulation among couples. Consequently, clinical psychologists and therapists can utilize this method to improve psychological characteristics, particularly improving family cohesion and emotional self-regulation. [ABSTRACT FROM AUTHOR]

Objective: Autism spectrum disorders, being neurodevelopmental, present with serious difficulties in social interactions, verbal and non-verbal communication, repetitive behaviors, and restricted interests. This research aimed to investigate the efficacy of couples therapy with a cognitive-behavioral approach on the marital satisfaction of parents and the externalized behavioral problems of students with autism spectrum disorder. Methods and Materials: The current research design was quasi-experimental, utilizing a pre-test, post-test, and follow-up with a control group. The population for this study consisted of all parents of male students aged 10 to 15 with autism in Mashhad in the year 2023. Sampling was conducted through a convenience method, including 58 qualified parents of children with internalized behavioral problems, selected from the parents at the Tabbasum public center and the Mehr Amin private clinic, and were divided into experimental and control groups. Data were collected using the Spouses' Marital Satisfaction Questionnaire, the Child Behavior Checklist, and the Gilliam Autism Rating Scale-2, and analyzed using repeated measures ANOVA with SPSS software version 22. Findings: The results indicated that implementing couples therapy with a cognitivebehavioral approach significantly affected mothers' marital satisfaction (F=38.98, P<0.001), fathers' marital satisfaction (F=65.25, P<0.001), and the externalized behavioral problems (F=61.80, P<0.001) of children with autism spectrum disorder. Conclusion: It can be concluded that couples therapy with a cognitive-behavioral approach is effective in enhancing the marital satisfaction of parents and addressing the externalized behavioral problems of children with autism spectrum disorder. This approach can be utilized to reduce the psychological issues of children with autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Desire discrepancies are a common source of relationship conflict and one reason adults may seek couples counseling. Within romantic relationships, adults individually experience sexual and affectionate desire, but also experience desire relative to their partner. If desire discrepancies exist, partners may attempt to resolve these discrepancies. Thus, we examined adults' strategies for managing sexual and affectionate desire discrepancies. Our sample consisted of 300 adults (45% women; Mage = 29.5; 86.3% LGBTQ+) who were in a romantic relationship and reported a desire discrepancy. Thematic analysis revealed five strategies for managing desire discrepancies: alternative behaviors, communication, doing nothing, engaging in behaviors anyway, and giving control to a specific partner. Adults reported similar strategies for resolving sexual and affectionate desire discrepancies. Perceived effectiveness and strategies varied by whether adults thought that their discrepancies were problematic. Our findings hold implications for clinicians approaching problematic desire discrepancies, and suggest strategies that may promote effective resolutions. [ABSTRACT FROM AUTHOR]

Introduction: Incarcerated couples face a variety of concerns and barriers in their relationships, with infidelity being a major problem. This study sought to research incarcerated individuals' intimate relationships and experiences of anger and fidelity for both partners. Methods: Using data from the Multi-site Family Study on Incarceration, Parenting, and Partnering we utilized Actor-Partner Interdependence Modeling (APIM) to examine fidelity and anger management for incarcerated men and their non-incarcerated female partners. Results: The findings showed that the actor effect was not statistically significant, but the partner effect was statistically significant for both the incarcerated male partner and non-incarcerated female partner. There was no statistical significance for the control variable of education, which is contrary to previous correlational studies of anger management and education levels. Discussion: Based on these results, it is recommended that incarcerated individuals receive anger management training to strengthen fidelity. [ABSTRACT FROM AUTHOR]

Institutional analysis typically assumes professional newcomers use strategic isomorphism to craft a legitimation project. A qualitative study of 31 tutors and their respective clients and managers in Beijing indicates how this project is continually in flux, predicating the life stages of its practitioners. Using the dyad theory of legitimacy, we find that tutors' professional legitimacy is anchored to their ability to meet the immediate expectations of clients when they regard performance boosting as a single-dimensional priority. The tutor–parent relationship is purely market-based and reputation-driven. A tutor's professional knowledge plays a minor role in winning parents' approval as it has been routinized by and embedded in the techno-managerial tutoring agencies. Faced with uncertainty in teaching, tutors are increasingly resorting to ancillary services to retain clients. From this perspective, tutors are being reduced to replaceable service workers. The legitimation project is transient and beyond the grasp of individual tutors. [ABSTRACT FROM AUTHOR]

The current study reports intervention from the perspective of abused South Asian women in the United States (U.S.) aligning with the Center for Disease Control (CDC's) ecological model. In-depth telephonic interviews were conducted with a convenience sample of 20 South Asian women in the U.S. The interviews were analyzed using thematic analysis. Utilizing the CDC's ecological model, the following themes emerged for prevention at the individual level: walk away the first-time abuse occurred; at the relationship level: pre-marital counseling and at the societal level: act on the red flags before the wedding, address the stringent gender roles, socialization, and blame. For protection, the following themes emerged at the individual level: self-determination and strength, protection of children, and financial independence. At the relationship level, the theme of marital counseling emerged and at the community level, the theme of community resources emerged. The South Asian natal family or family members in positions of power can recognize red flags, raise their voice, take constructive action to address misogyny, rigid patriarchal attitudes, and prevent abuse before it occurs. There is an urgent need to recognize and work at both preventative and protective levels to address the abuse among South Asian women in the U.S. [ABSTRACT FROM AUTHOR]

Nurses are at high risk of burnout and subsequent mental health concerns due to problems with overstaffing, immense workload volume, and personal health risks associated with the job. Effective mental health treatments are available but potential barriers to receiving care may prevent nurses from benefiting. The Emotional Health and Well-Being Clinic (EHWC) at Houston Methodist is an outpatient mental health clinic offering therapy and medication management services for employees and employee dependents of our institution. The EHWC is uniquely positioned to observe how nurses utilize mental health services and to address barriers to effective care for this vital group of healthcare professionals. This paper provides descriptive data on the utilization of mental health services by nurses in the EHWC and a discussion of possible challenges faced by this group when seeking care. Based on these data, we propose potential solutions to ensure that nurses can achieve maximum benefit from outpatient mental health services. [ABSTRACT FROM AUTHOR]