Silhouette Hall - Marinela

Cognitive-Behavioral Systems Approach for Couple Problems - Part I

One of every two to three marriages end up in divorce and many other negative consequences emerge following an unsuccessful marriage. This presentation will start by discussing the reasons why people insist to marry despite the high (45-50%) divorce rate and some catastrophic outcomes following unhappy marriages and divorce. Surprisingly, despite the trauma of divorce, the majority will choose to repeat the experience as the breakdown is seen as the other partner’s fault.The presentation will carry on by discussing whether the problem in a failing relationship is really the problematic partner and what makes the distinction between happy (successful) and unhappy marriages.

In cognitive behavioural systems approach the therapist attempts to reframe the problem as a result of interaction between the partners rather than arising from one of the partners. This is to shift the couple’s thinking from the illness model to the interactional model. In this approach, the focus of therapist attention is the relationship rather than the individual and thus communication training reciprocal negotiation and mutual problem solving become very important components of treatment. The workshop will progress by explaining how the therapist may at one moment be working behaviourally trying to help the couple solve their problem directly or working at a cognitive level to teach couple to identify automatic thoughts and distorted thinking and be working on a systematic level to explain their lack of co-operation and progress.

Different types of couple problems demand different therapeutic skills and responses. Whatever treatment approach is used, a good assessment and formulation is of great importance for a successful intervention, particularly in those couples presenting with relationship and sexual problems. Making conceptualizations, setting targets and homework assignments with the couple will also be discussed. It is generally considered inappropriate to offer sex therapy to couples with relationship problems, on the assumption that treatment is most likely to fail or remain uncompleted. However, some therapists question the validity of withholding sex therapy where relationship distress is present especially if the sexual dysfunction produces the secondary marital discord. The workshop will discuss the advantages of a combined sexual and couple therapy approach.