The effect of therapists' enactment interventions in promoting vulnerability sharing in emotion focused couple therapy.

OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSION: These findings suggest that therapists can facilitated vulnerability sharing using specific preparatory interventions.

Couples Therapists' Attitudes Toward Online Therapy During the COVID-19 Crisis.

The measures adopted by governments around the world to control the spread of the COVID-19 virus (e.g., social distancing) have propelled a rapid transition from face-to-face to online therapy. Studies on online individual therapy indicate that therapists often have favorable attitudes toward this modality. To date, there is scant work on couples therapists' attitudes, despite the fact that the provision of online couples' therapy poses unique challenges (e.g., dealing with escalating conflict remotely). To provide a snapshot, in real time, as to how therapists experience the transition to online therapy, we surveyed 166 Israeli couples' therapists during April 2020, when lockdown orders prevented therapists from seeing couples face-to-face. A few weeks later, when the stay-at-home policy was lifted, a subsample (N = 60) of these therapists completed a follow-up assessment. The results suggest that couples therapists had limited experience using the online modality prior to COVID. The therapists reported experiencing online couples' therapy as somewhat successful and that their experience of providing therapy during the COVID-19 crisis had an overall positive impact on their attitudes toward online work. Establishing a strong therapeutic bond with both partners, dealing with escalating conflict, and treatment dropout were identified as the issues of most concern when conducting online couples therapy. The perceived difficulties with online therapy prospectively predicted lower usage of online couples' therapy, as well as less intention to continue online treatment once the crisis is over.

Las medidas adoptadas por los gobiernos de todo el mundo para controlar la propagación del virus de la COVID-19 (p. ej.: el distanciamiento social) han impulsado una transición rápida de la terapia presencial a la terapia virtual. Los estudios sobre la terapia individual virtual indican que los terapeutas con frecuencia tienen actitudes favorables hacia esta modalidad. Hasta la fecha, los trabajos sobre las actitudes de los terapeutas de pareja son escasos, a pesar del hecho de que la práctica de la terapia de pareja virtual plantea desafíos únicos (p. ej.: manejar la intensificación del conflicto distancia). Para ofrecer un panorama en tiempo real sobre cómo viven los terapeutas la transición a la terapia virtual, encuestamos a 166 terapeutas de pareja israelíes durante abril de 2020, cuando las órdenes de confinamiento impidieron a los terapeutas ver a las parejas en persona. Algunas semanas después, cuando se levantó la orden de quedarse en casa, una submuestra (N=60) de estos terapeutas completó una evaluación de seguimiento. Los resultados sugieren que los terapeutas de pareja tenían poca experiencia en el uso de la modalidad virtual antes de la COVID-19. Los terapeutas informaron que vivieron la terapia de pareja virtual como bastante favorable y que su experiencia de ofrecer terapia durante la crisis de la COVID-19 tuvo un efecto general positivo en sus actitudes hacia el trabajo virtual. Los problemas identificados como los de mayor preocupación a la hora de ofrecer terapia de pareja virtual fueron los siguientes: la construcción de un vínculo terapéutico sólido con ambos integrantes de la pareja, el manejo de la intensificación del conflicto y el abandono del tratamiento. Las dificultades percibidas con la terapia virtual predijeron prospectivamente un menor uso de la terapia de pareja virtual, así como menos intenciones de continuar el tratamiento virtual una vez que termine la crisis.

The relationship between therapist interventions and couples' emotional injury resolution in emotion focused couples therapy.

The primary purported change process in emotion-focused couples therapy (EFT-C) occurs as therapists assist one partner to access and reveal vulnerable emotions and needs and promotes a subsequent compassionate responding from the other partner. This study aimed to examine the association between therapists' views regarding their interventions during a given session and the degree to which partners reported the session as helpful in resolving their unfinished business. Data from 22 couples who took part in the York Emotional Injury Project and received 10-12 EFT-C sessions were analyzed using multilevel models. The primary findings revealed that when therapists reported using interventions that promoted acceptance of feelings and needs in a given session, both partners reported higher resolution levels in relation to their partner. Our results suggest that interventions that facilitate responsiveness between partners are particularly important in EFT-C, and perhaps in couples therapy in general.