Couples Therapy

夫妻治疗
  • 文章类型: Journal Article
    抑郁症是青少年疾病和残疾的主要原因,近年来,抑郁症的发病率和未经治疗的年轻人数量有所增加。对这些年轻人进行有效的干预可以降低青春期前和青春期的疾病负担和自杀或自我伤害风险。
    验证全身性夫妻团体疗法(SCGT)对青少年抑郁症的改变和青少年抑郁症家庭的短期疗效。
    该研究是一项自我对照试验;仅评估了组内变化。参与者是有一个抑郁孩子的夫妇,他们对心理治疗有抵抗力;他们是通过方便的抽样非随机招募的。采用配对样本t检验和Wilcoxon符号秩检验比较干预前后的差异。还使用Cohen的d.Spearman的相关性分析来评估效应大小。
    治疗后抑郁症状呈下降趋势,科恩的d为0.33(p=0.258)。青少年认为父母间的冲突较少,对于感知的冲突频率,效应大小是中等的(0.66,p=0.043),冲突强度(0.73,p=0.028),冲突解决方案(0.75,p=0.025),应对效能(0.68,p=0.038),和感知威胁(0.57,p=0.072)。对于父母来说,全球通信质量,建设性的沟通模式,干预后主观婚姻满意度显著提高,具有较大的效应大小(分别为1.11、0.85和1.03;所有p<0.001)。其他破坏性的沟通模式,如需求/撤回(p=0.003)和相互回避(p=0.018),以及言语攻击(p=0.012)等沟通策略,石墙(p=0.002),回避-投降(p=0.036),儿童参与(p=0.001)也减少了,具有中等效应大小(分别为0.69、0.52、0.55、0.71、0.46和0.79)。同时,抑郁的变化与父母间冲突的变化(p<0.001)和婚姻满意度(p=0.001)之间存在显著的关联.
    SCGT为不愿寻求治疗的抑郁儿童家庭提供了治疗的可能性。帮助父母改善沟通和婚姻质量可能对儿童的抑郁症状有益。
    UNASSIGNED: Depression is a primary cause of illness and disability among teenagers, and the incidence of depression and the number of untreated young people have increased in recent years. Effective intervention for those youths could decrease the disease burden and suicide or self-harm risk during preadolescence and adolescence.
    UNASSIGNED: To verify the short efficacy of the systemic couple group therapy (SCGT) on youths\' depression changes and families with depressed adolescents.
    UNASSIGNED: The study was a self-control trial; only within-group changes were evaluated. Participants were couples with a depressed child who was resistant to psychotherapy; they were recruited non-randomly through convenient sampling. The paired-sample t-test and Wilcoxon signed-rank test were used to compare differences before and after interventions. The effect sizes were also estimated using Cohen\'s d. Spearman\'s correlation analysis was used to examine associations between changes.
    UNASSIGNED: A downward trend was seen in depressive symptoms after treatment, and Cohen\'s d was 0.33 (p = 0.258). The adolescents perceived fewer interparental conflicts, and the effect sizes were medium for perceived conflict frequency (0.66, p = 0.043), conflict intensity (0.73, p = 0.028), conflict solutions (0.75, p = 0.025), coping efficacy (0.68, p = 0.038), and perceived threat (0.57, p = 0.072). For parents, global communication quality, constructive communication patterns, and subjective marital satisfaction significantly improved after interventions, with large effect sizes (1.11, 0.85, and 1.03, respectively; all p < 0.001). Other destructive communication patterns such as demand/withdraw (p = 0.003) and mutual avoidance (p = 0.018) and communication strategies like verbal aggression (p = 0.012), stonewalling (p = 0.002), avoidance-capitulation (p = 0.036), and child involvement (p = 0.001) also reduced, with medium effect sizes (0.69, 0.52, 0.55, 0.71, 0.46, and 0.79, respectively). Meanwhile, the associations between depression changes and changes in interparental conflicts (p < 0.001) and marital satisfaction (p = 0.001) were significant.
    UNASSIGNED: The SCGT offers the possibility for the treatment of families with depressed children who are unwilling to seek treatment. Helping parents improve communication and marital quality may have benefits on children\'s depressive symptoms.
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  • 文章类型: Journal Article
    我们调查了在线SensateFocus练习的有效性,作为一系列11个动画视频在线交付,在改善参与者的性功能和增强亲密关系方面,关系和性满意度。我们研究了35对中国异性恋夫妇,在测试前评估他们,测试后,和三个月的随访。与waitlist控制组相比,实验组女性的性高潮有所改善,这在后续行动中得到了保持。此外,对于那些在预测测试中函数较低的人来说,干预措施可能有效改善男性的勃起功能,以及女性的整体性功能和疼痛。这些改进在后续行动中也得到了保持。当前研究的结果表明,在线SensateFocus干预在治疗中国异性恋夫妇的性功能障碍方面具有潜力。它也可以作为阶梯式护理方法的第一部分或与其他药物或认知行为疗法治疗整合。
    We investigated the effectiveness of online Sensate Focus exercises, delivered online as a series of 11 animation videos, in improving participants\' sexual functioning and enhancing intimacy, relationship and sexual satisfaction. We studied 35 Chinese heterosexual couples, assessed them at pretest, post-test, and a three-month follow-up. Compared to the waitlist control group, the experimental group showed improvement in orgasm in women, and this was maintained at follow-up. Also, for those with a lower function at pretest, the intervention was possibly effective in improving erectile function among men, as well as overall sexual function and pain among women. These improvements were maintained at follow-up as well. Findings from the current study suggest that online Sensate Focus intervention has potential in treating sexual dysfunction of Chinese heterosexual couples. It may also serve as the first part of a stepped care approach or be integrated with other medication or cognitive behavioral therapy treatment.
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  • 文章类型: Journal Article
    性亲密,表征为个人之间的经验分享一般的感情和性活动与彼此在个人评估亲密关系清单内,与关系满意度和稳定性呈正相关。然而,许多关于夫妻治疗的研究表明,它只会导致小尺寸的(通常是不显著的)性亲密关系的改善。此外,有许多金融,后勤,夫妻治疗的心理障碍。因此,本研究旨在研究两种简短的在线关系教育计划(OurRelationship和epREP)是否能够克服这些障碍,并产生与更密集的夫妻治疗相似的效果.在两个独立收集的低收入夫妇样本中(NSample1=742对;MAgeSample1=33.19;NSample2=671对;MAgeSample2=33.48),当前的研究发现:OurRelationship(d=0.24-0.28)和epREP(d=0.26-0.34)在两个样本中相对于等候名单控制条件的性亲密关系产生了小范围的变化,在第二个样本中复制的效应大小的大小,除了罕见的例外,这些变化通常不受感兴趣的关键变量的调节.鉴于基于网络的关系教育明显缩短,更便宜,比面对面的夫妻干预更容易获得,基于网络的关系教育可以被认为是一个可行的候选人,为夫妇经历性亲密关系的问题。
    Sexual intimacy, characterized as the experience between individuals of sharing general affection and sexual activity with one another within the Personal Assessment of Intimacy in Relationships inventory, is positively related to relationship satisfaction and stability. However, many studies of couple therapy have shown that it only results in small-sized (and often non-significant) improvements in sexual intimacy. Furthermore, there are numerous financial, logistical, and psychological barriers to couple therapy. Thus, the current study sought to examine whether two brief online relationship education programs (OurRelationship and ePREP) could overcome these barriers and yield similar-sized effects to more intensive couple therapy. In two independently collected samples of low-income couples (NSample 1 = 742 Couples; M AgeSample 1 = 33.19; NSample 2 = 671 Couples; M AgeSample 2 = 33.48), the current study found that: OurRelationship (d = 0.24-0.28) and ePREP (d = 0.26-0.34) produced small-sized changes in sexual intimacy relative to a waitlist control condition in both samples, the magnitude of the effect size replicated in a second sample and, with rare exception, these changes were generally not moderated by key variables of interest. Given that web-based relationship education is significantly shorter, less expensive, and more accessible than in-person couple interventions, web-based relationship education could be considered a viable candidate for couples experiencing concerns with sexual intimacy.
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  • 文章类型: Journal Article
    这项初步研究检查了七对夫妇的复杂创伤发育夫妇疗法(DCCT)的过程和结果。DCCT是一种新型的夫妻疗法,旨在解决创伤幸存者及其伴侣的复杂创伤后应激障碍症状和夫妻级困扰。这些夫妇在整体创伤症状方面表现出统计学上的显着改善,情绪调节能力,和减少依恋相关的焦虑。这些结果表明,DCCT可能是一种有希望的干预方法。未来的方向包括序贯护理模式的发展,因为资源限制可能不允许所有夫妇在40周内接受完整的治疗模式;解决与心理相关的测量问题也很重要,允许在整个治疗过程中进行观察性编码。
    This pilot study examined the process and outcome of Developmental Couple Therapy for Complex Trauma (DCTCT) with seven couples. DCTCT is a novel form of couple therapy designed to address complex posttraumatic stress disorder symptomatology and couple-level distress in trauma survivors and their partners. These couples showed statistically significant improvements in overall trauma symptoms, emotion regulation capacities, and reductions in attachment-related anxiety. These results suggest that DCTCT may be a promising approach to intervention. Future directions include the development of a sequential care model, because resource limitations may not allow for all couples to receive the full treatment model over 40 weeks; it will also be important to address measurement issues in relation to mentalizing, to allow for observational coding across the course of therapy.
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  • 文章类型: Journal Article
    使用以夫妇为中心的方法,本研究旨在了解(a)寻求帮助的夫妇在他们的关系满意度如何随时间变化的具体方式。(b)在干预开始时,关系特征是否存在重要差异,以及(c)具有不同关系特征的夫妇是否从有效的在线关系计划中同样受益。寻求帮助的混合性别低收入夫妇(Ncouple=659)被随机分配到两个在线关系计划(n=432)或等待名单对照组(n=227)之一。进行潜在轮廓分析,以确定(a)在基线时评估的双方关系满意度的轨迹轮廓,during,和postprogram,并在2个月和4个月的随访中;(b)基线配对概况与基线通信指标,承诺,情感支持,和双方报告的性满意度。确定了四个独特的满意度轨迹:女性-小男性-中等改善(39%),仅男性下降(25%),大幅改善(19%),只有女性改善(17%)。确定了五个独特的基线夫妇简介:冲突激情(30%),陪伴(22%),男性承诺萎靡不振(22%),满意(16%),和萎靡不振(10%)。与控制夫妇相比,干预夫妇遵循大改善轨迹的几率增加,遵循男性单下降轨迹的几率降低;遵循其他两个中间轨迹的几率因干预状态而没有差异.此外,基线资料较差的夫妇更有可能遵循以满意度增加为特征的轨迹,而不管他们的干预状态如何.然而,程序效果根据基线夫妇配置文件没有差异,这表明通用方法可能足以提供在线关系计划,以提高该人群的关系满意度。
    Using a couple-centered approach, the current study seeks to understand (a) the specific ways in which help-seeking couples vary in how their relationship satisfaction changes over time, (b) whether there are important differences in relationship characteristics at the beginning of the interventions, and (c) whether couples with distinct relationship characteristics benefit equally from effective online relationship programs. Mixed-gender low-income couples (Ncouple = 659) seeking help for their relationship were randomly assigned to one of two online relationship programs (n = 432) or the wait-list control group (n = 227). Latent profile analyses were conducted to identify (a) trajectory profiles with both partners\' relationship satisfaction assessed at baseline, during, and postprogram, and at 2- and 4-month follow-ups; and (b) baseline couple profiles with indicators of baseline communication, commitment, emotional support, and sexual satisfaction reported by both partners. Four unique satisfaction trajectories were identified: women-small-men-medium improvement (39%), men-only decline (25%), large improvement (19%), and women-only improvement (17%). Five unique baseline couple profiles were identified: conflictual passionate (30%), companionate (22%), men-committed languishing (22%), satisfied (16%), and languishing (10%). Compared to control couples, intervention couples\' odds of following the large improvement trajectory increased and their odds of following the men-only decline trajectory decreased; the odds of following the other two intermediate trajectories did not differ by intervention status. Moreover, couples with more distressed baseline profiles were more likely to follow trajectories characterized by greater satisfaction gains regardless of their intervention status. However, program effects did not differ based on baseline couple profiles, suggesting that a universal approach may be sufficient for delivering online relationship programs to improve relationship satisfaction in this population.
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  • 文章类型: Journal Article
    背景:在治疗期间利用退伍军人的亲密关系有可能同时改善创伤后应激障碍(PTSD)症状和关系质量。认知-行为联合治疗(CBCT)和8次简短的认知-行为联合治疗(bCBCT)是手动治疗,旨在同时改善PTSD和夫妻的关系功能,其中一个伴侣患有PTSD。虽然在改善创伤后应激障碍方面有效,CBCT对关系满意度的影响很小,尤其是退伍军人。鼻内催产素,以创伤后应激障碍和关系质量的机制为目标,可增强bCBCT的疗效。
    方法:这项为期4年的临床试验的目的是比较鼻内催产素增强bCBCT(bCBCT+OT)与bCBCT加安慰剂(bCBCT+PL)的结果。我们还将探索潜在的行动机制:自我报告沟通技巧,同理心,和信任。我们将招募120个二元组合(即,患有创伤后应激障碍的老兵和他们的亲密伴侣)来自[蒙面同行评审]。退伍军人将在通过远程医疗提供的8bCBCT会话之前30分钟给予40国际单位的催产素(n=60)或安慰剂(n=60)。临床和功能结果将在五个时间点进行评估(基线,中期治疗,治疗后,以及3个月和6个月的随访)。
    结论:研究结果将揭示催产素辅助的短暂夫妇治疗创伤后应激障碍的疗效,这可以作为夫妻应对创伤后应激障碍的高度可扩展的选择,以及提供初步证据的人际机制的变化。
    结果:govIdentifier:NCT06194851。
    Leveraging military veterans\' intimate relationships during treatment has the potential to concurrently improve posttraumatic stress disorder (PTSD) symptoms and relationship quality. Cognitive-Behavioral Conjoint Therapy (CBCT) and an 8-session Brief Cognitive-Behavioral Conjoint Therapy (bCBCT) are manualized treatments designed to simultaneously improve PTSD and relationship functioning for couples in which one partner has PTSD. Although efficacious in improving PTSD, the effects of CBCT on relationship satisfaction are small, especially among veterans. Intranasal oxytocin, which targets mechanisms of PTSD and relationship quality, may enhance the efficacy of bCBCT.
    The purpose of this 4-year clinical trial is to compare the outcomes of bCBCT augmented with intranasal oxytocin versus bCBCT plus placebo. We will also explore potential mechanisms of action: self-reported communication skills, empathy, and trust. We will recruit 120 dyads (i.e., veteran with PTSD and their intimate partner) from the VA San Diego Healthcare System. Veterans will be administered 40 international units of oxytocin (n = 60) or placebo (n = 60) 30 min before each of 8 bCBCT sessions delivered via telehealth. Clinical and functioning outcomes will be assessed at five timepoints (baseline, mid-treatment, post-treatment, and 3- and 6-month follow-up).
    Study findings will reveal the efficacy of oxytocin-assisted brief couple therapy for PTSD, which could serve as highly scalable option for couples coping with PTSD, as well as provide preliminary evidence of interpersonal mechanisms of change.
    govIdentifier:NCT06194851.
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  • 文章类型: Journal Article
    随着美国多样性的增加,婚姻和家庭治疗师在治疗中遇到了更多的多重遗产夫妇。最近的研究表明,大约11%的成年人与来自不同种族或族裔的人结婚,在新婚姻中上升到19%。多重遗产夫妇包含种族的固有差异,种族,宗教,性别,性取向,国家起源,和文化。本文探讨了多元遗产夫妇在治疗中面临的独特挑战,并探讨了适合其需求的现有评估工具的优缺点。该研究强调了数量有限的现有工具,可用于与多遗产夫妇一起工作的治疗师。因此,这篇文章提出了未来的方向,以加强开发适合多遗产夫妇具体需求的评估工具。
    As diversity in the United States increases, marriage and family therapists are encountering more multi-heritage couples in therapy. Recent research shows that around 11% of adults are married to someone from a different racial or ethnic group, rising to 19% among new marriages. Multi-heritage couples encompass inherent differences in race, ethnicity, religion, gender, sexual orientation, national origin, and culture. This article addresses the unique challenges faced by multi-heritage couples in therapy and explores the strengths and weaknesses of existing assessment tools suitable for their needs. The study highlights a limited number of existing tools that are available for therapists working with multi-heritage couples. Consequently, the article suggests future directions to enhance the development of assessment tools tailored to the specific needs of multi-heritage couples.
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  • 文章类型: Journal Article
    在过去的50年中,技术的扩散呈指数级加速。同时,研究人员探索了技术使用对个人和人际关系的影响。诸如这对夫妇之类的理论框架,家庭,和技术(CFT)框架已应用于承诺关系中的个人和夫妇,以更好地理解在此关系子系统中采用和使用技术的含义。调查技术对夫妻关系的影响的研究认识到技术使用对关系有帮助或无益的潜力,但未能全面检查技术使用的有用方面。这项研究通过建立基于N=45对夫妇(n=90个人)在承诺关系中的数据的理论来解决这一差距。结果表明,夫妻使用技术可以增强关系中的情感联系和团结,因为夫妻以关系上有益的方式管理技术的影响。
    The proliferation of technology has accelerated exponentially over the past 50 years. Contemporarily, researchers have explored the influences technology use is having on individuals and relationships. Theoretical frameworks such as the couple, family, and technology (CFT) Framework have been applied to individuals and couples in committed relationships to better understand the implications of technology adoption and use within this relational subsystem. Research examining technology\'s impact on couple relationships recognizes the potential for technology use to be either helpful or unhelpful to the relationship but fails to fully examine the helpful aspects of technology use. This study addresses this gap with the creation of a theory grounded in data from N = 45 couples (n = 90 individuals) in committed relationships. Results indicate couples\' technology use can augment emotional connection and unity within the relationship as couples manage the influence of technology in a way that is relationally helpful.
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  • 文章类型: Journal Article
    在整个治疗过程中监测治疗联盟可以改善客户结果并导致改善的护理。个人,夫妇,和家庭版本的会话间联盟措施(IAM)的开发,以促进日常监测扩大的治疗联盟。使用临床样本检查了三种版本的IAM的心理测量特性。参与者来自美国参加婚姻和家庭治疗实践研究网络的诊所。使用此示例,结果表明,每个IAM版本上的项目在一个因素上加载,在性别上是不变的,每个版本都有很好的内部一致性,测试-重测可靠性,和并发有效性。IAM-C和IAM-F也具有良好的预测有效性,而IAM-I对其预测有效性的证据更有限。这些结果表明,IAM是有效且可靠的措施,可以促进对心理治疗中扩大的治疗联盟的常规监测。
    Monitoring the therapeutic alliance throughout treatment can improve client outcomes and lead to improved care. The individual, couple, and family versions of the intersession alliance measure (IAM) were developed to facilitate routine monitoring of the expanded therapeutic alliance. Psychometric properties of the three versions of the IAM were examined using a clinical sample. Participants were drawn from clinics in the United States participating in the Marriage and Family Therapy Practice Research Network. Using this sample, results indicate that items on each version of the IAM load on one factor, are invariant across sex, and that each version has good internal consistency, test-retest reliability, and concurrent validity. The IAM-C and IAM-F also have good predictive validity, while the IAM-I has more limited evidence for its predictive validity. These results suggest that the IAMs are valid and reliable measures that can facilitate the routine monitoring of the expanded therapeutic alliance in psychotherapy.
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  • 文章类型: Journal Article
    PTSD的认知行为联合治疗(CBCT)已证明在退伍军人经历PTSD的军事夫妇中有效。然而,迄今为止,尚无研究调查在线提供CBCT.这份简短的报告旨在描述向英国军事夫妇在线提供CBCT的可行性。六名退伍军人和他们的伙伴接受了CBCT,使用在线视频平台交付。他们在治疗开始和结束时以及12周的随访中完成了心理健康措施。数据趋势表明,退伍军人和伴侣的心理困扰和创伤症状减少,幸福感增加。在个人层面上,大多数退伍军人(83.3%)表现出PTSD症状的临床显著减轻.治疗师的思考建议客户接受治疗,并强调了在线提供CBCT的注意事项。讨论了在线交付CBCT的临床意义和进一步实证研究的必要性。
    Cognitive-Behavior Conjoint Therapy (CBCT) for PTSD has demonstrated efficacy among military couples in which the veteran is experiencing PTSD. Yet, no studies to date have investigated delivering CBCT online. This brief report aims to describe the feasibility of delivering CBCT online to UK military couples. Six military veterans and their partners received CBCT, delivered using an online video platform. They completed mental health measures at the start and end of treatment as well as 12-weeks follow-up. Data trends suggested reduced psychological distress and trauma symptoms as well as increased wellbeing of veterans and partners. On the individual level, most veterans (83.3%) demonstrated clinically significant reductions in PTSD symptoms. Therapist reflections suggested client acceptability of treatment and highlighted considerations for delivering CBCT online. Clinical implications and the need for further empirical investigation of online-delivered CBCT are discussed.
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