Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL.
The Chicago Institute for Psychoanalysis, Chicago, IL.
Fam Process. 2017 Sep;56(3):540-557. doi: 10.1111/famp.12300. Epub 2017 Jun 13.
Couple therapy is a complex undertaking that proceeds best by integrating various schools of thought. Grounded in an in-depth review of the clinical and research literature, and drawing on the author's 40-plus years of experience, this paper presents a comprehensive, flexible, and user-friendly roadmap for conducting couple therapy. It begins by describing "Couple Therapy 1.0," the basic conjoint couple therapy format in which partners talk to each other with the help of the therapist. After noting the limitations of this model, the paper introduces upgrades derived from systemic, psychodynamic, and behavioral/educational approaches, and shows how to combine and sequence them. The most important upgrade is the early focus on the couple's negative interaction cycle, which causes them pain and impedes their ability to address it. Using a clinical case example, the paper shows how all three approaches can improve couple process as a prerequisite for better problem solving. Additional modules and sequencing choice points are also discussed, including discernment counseling and encouraging positive couple experiences.
夫妻治疗是一项复杂的任务,最好通过整合各种思想流派来进行。本文基于对临床和研究文献的深入回顾,并借鉴作者 40 多年的经验,为进行夫妻治疗提供了全面、灵活、易用的路线图。它首先描述了“夫妻治疗 1.0”,这是一种基本的联合夫妻治疗模式,伴侣在治疗师的帮助下相互交谈。在指出该模型的局限性之后,本文介绍了源自系统、心理动力学和行为/教育方法的升级,并展示了如何组合和排序它们。最重要的升级是早期关注夫妻的负面互动循环,这会给他们带来痛苦并阻碍他们解决问题的能力。本文通过一个临床案例示例展示了这三种方法如何改善夫妻关系过程,这是更好地解决问题的前提。本文还讨论了其他模块和排序选择点,包括辨别咨询和鼓励积极的夫妻体验。