Call me maybe? In-person vs. teletherapy outcomes among married couples.

ABSTRACTObjective: The objective of this study was to investigate the effectiveness of teletherapy compared to in-person couple therapy in outcomes such as couple satisfaction, sexual satisfaction, and the therapeutic alliance.Method: Data from 1157 married clients seeking couple therapy were examined. Individual growth curve models were used to analyze changes in the aforementioned outcomes, with teletherapy as a predictor. The study also examined client age and clinic type as moderators.Results: The results indicated that overall, teletherapy is as effective as in-person therapy in improving outcomes. However, there were notable differences in the development of the therapeutic alliance. The alliance improved at twice the rate in in-person therapy as in teletherapy. Clinic type was also found to be a moderator of changes in sexual satisfaction. Clients in group and private practices reported improvements in sexual satisfaction; whereas clients seen in training clinics reported decreases in sexual satisfaction.Conclusion: The study concludes that although teletherapy may be a viable alternative to in-person couple therapy, there are nevertheless differences in the development of the therapeutic alliance that warrant care and further investigation. The setting of the therapy also plays a role in the effectiveness of therapy, although not specific to therapy modality.

Emotion dysregulation and couple relationship satisfaction of clinical couples: An actor-partner interdependence model.

Despite the pivotal role that emotion regulation is thought to occupy for individual and relational wellbeing, emotion regulation in couples has been surprisingly understudied. With a clinical sample consisting of 275 couples starting therapy from 2017 to 2022, this study sought to clarify the actor and partner effects of clinical couples' emotion dysregulation on relationship satisfaction. Our results showed that, for partners' emotion dysregulation dimensions, while impulse control difficulties, lack of emotional awareness, and limited emotion regulation strategies were negatively predictive of couple relationship satisfaction, nonacceptance of negative emotions had a positive association with relationship satisfaction. Further, compared with other dimensions of emotion dysregulation, female limited emotion regulation strategies were greater predictors of decreased female relationship satisfaction. We also found significant gender differences in partners' emotion dysregulation dimensions and relationship satisfaction. These results show the significance of addressing emotion dysregulation for both partners at intra- and inter-personal levels simultaneously in couple therapy. Notably, the 275 couples in our sample did not report a clinically distressed relationship, though they attended at least one couple therapy session. Clinical implications and directions for future study are discussed.

Resource loss, gain, and traumatic stress in couples during COVID-19.

OBJECTIVE: This study was designed to understand how resource losses and gains during the early months of COVID-19 pandemic-related shutdowns in the United States longitudinally predicted variation in posttraumatic stress symptoms (PTSS) in couples by examining actor and partner effects. METHOD: A dyadic sample was recruited through the panelist company "Forthright" to complete an online survey asking about experiences with COVID-19 and PTSS. The sample included 535 heterosexual couples from several U.S. states who responded to the survey in April, July, and October of 2020. RESULTS: Actor-partner interdependence modeling (Kenny et al., 2006) was used to explore longitudinal associations within and between partners. Results showed that higher PTSS at Wave 1 significantly, positively predicted both loss and gain at Wave 2 within and between partners. Loss at Wave 2 was a significant predictor of PTSS at Wave 3 within partners. Furthermore, indirect actor and partner effects from Wave 1 to Wave 3 PTSS are discussed. CONCLUSIONS: Greater loss, within and between partners, was a predictor of greater posttraumatic stress over time in this study. Further, PTSS were connected over time across partners. While gains have an important role in understanding the effects of the pandemic, loss may be pivotal for clinical focus in addressing posttraumatic stress in dyadic treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Residuum of Childhood Physical and Sexual Abuse: Coming to Terms in Couple Relationships.

Childhood exposure to physical violence and sexual abuse is a public health concern and is empirically connected to poor outcomes in adulthood. The present study was designed to assess dyadic associations between exposure to childhood physical violence and sexual abuse, and resolution, or a sense that one has "come to terms" with events in one's family of origin. The study was also aimed at assessing whether attachment behaviors mediated associations between abuse, violence, and resolution. The study was carried out using data from a community sample of 3,836 heterosexual couples who completed the Relationship Evaluation Questionnaire inventory. Actor-Partner Interdependence Modeling was employed within a structural equation model to examine associations. Results suggested inverse, direct actor associations for both men and women between physical violence and sexual abuse, and coming to terms. The results also showed inverse, direct partner associations for both men and women between sexual abuse and coming to terms. Furthermore, findings indicated the presence of inverse, indirect actor and partner effects for men and women between physical violence and coming to terms. Examination of these specific indirect partner and actor effects from physical violence to coming to terms implies partial mediation carried through one's own rating of attachment behaviors. Finally, actor (but not partner) associations were noted between attachment behaviors and coming to terms. In aggregate, the findings support the potential benefit of enhancing investment in attachment behaviors as a resource to aid in the resolution process of exposure to physical violence and sexual abuse in childhood.

Longitudinal anxiety in couples during a global pandemic: Considering loss, attachment behaviors, and trauma coping self-efficacy.

The COVID-19 (SARS-COV-2) pandemic has had a significant impact on multiple domains of daily functioning in communities, families, and couples. Research on couple dynamics amid mass stress events using dyadic data is still limited. As such, the current study employed a cross-lagged panel design with 535 cisgender, heterosexual couples to explore longitudinal paths between pandemic-related loss, attachment behaviors, trauma coping self-efficacy, and anxiety symptoms. Data were collected at three time points between April and October 2020. The findings demonstrated the potentially mobilizing nature of loss. Higher levels of loss associated with higher levels of attachment behaviors in partners later and higher levels of trauma coping self-efficacy for men in a partner effect at one lag. Higher levels of attachment behaviors generally associated with improved trauma coping self-efficacy at the next wave within and across partners, and higher levels of trauma coping self-efficacy appeared to offset later anxiety within partners. On the other hand, within partners, greater loss is associated with lower levels of attachment behaviors within partners across time. Furthermore, higher anxiety is associated with lower levels of TCSE and higher levels of loss within partners across most lags. Finally, higher trauma coping self-efficacy is associated with less loss within men at one lag, and greater loss within men at the later lag, which may demonstrate stress and efforts to mobilize to meet it. Indirect effects were found implying the intermediary nature of anxiety and trauma coping self-efficacy in explaining wave 3 anxiety. Implications for practice and further research are discussed.

La pandemia de la COVID-19 (SARS-COV-2) ha tenido un efecto significativo en varios aspectos del funcionamiento diario de las comunidades, las familias y las parejas. Las investigaciones sobre la dinámica de pareja en medio de situaciones de estrés masivo usando datos diádicos aún son escasas. Por lo tanto, en el presente estudio se utilizó un diseño de panel de retardo cruzado con 535 parejas cisgénero heterosexuales a fin de analizar las pautas longitudinales entre la pérdida, las conductas de apego, la autoeficacia para afrontar el trauma y los síntomas de ansiedad relacionados con la pandemia. Se recogieron datos en tres intervalos de tiempo entre abril y octubre de 2020. Los resultados demostraron la índole posiblemente movilizadora de la pérdida. Los niveles más altos de pérdida se asociaron con niveles más altos de conductas de apego en las parejas posteriormente, y con niveles más altos de autoeficacia para afrontar el trauma en los hombres en un efecto de la pareja durante un periodo. Los niveles más altos de conductas de apego se asociaron generalmente con una mejor autoeficacia para afrontar el trauma en la fase siguiente dentro y entre los integrantes de la pareja, y los niveles más altos de autoeficacia para afrontar el trauma parecieron compensar la ansiedad posterior dentro de los integrantes de la pareja. Por el otro lado, dentro de los integrantes de la pareja, una mayor pérdida se asoció con niveles más bajos de conductas de apego dentro de los integrantes de la pareja a lo largo del tiempo. Además, los niveles más altos de ansiedad se asociaron con niveles más bajos de autoeficacia para afrontar el trauma y con niveles más altos de pérdida dentro de los integrantes de la pareja durante la mayoría de los periodos. Finalmente, los niveles más altos de autoeficacia para afrontar el trauma se asociaron con una menor pérdida dentro de los hombres en un periodo, y con una mayor pérdida dentro de los hombres en el periodo posterior, lo cual puede demostrar estrés y esfuerzos para movilizarse y ocuparse. Se hallaron efectos indirectos, los cuales indicaron la índole intermediaria de la ansiedad y la autoeficacia para afrontar el trauma a la hora de explicar la ansiedad de la tercera fase. Se comentan las consecuencias para la práctica y las investigaciones futuras.

Family Adversity and Relationship Quality for Pacific Islanders and the Mediating Role of Coming to Terms, Self-Esteem, and Depression.

This study investigated the association between family of origin (FOO) adversities and relationship quality for Pacific Islanders as well as the potential intermediary role of coming to terms (CTT), depression, and self-esteem. The sample consisted of 226 self-identified Pacific Islanders who completed the RELATE assessment (see www.relate-institute.org). Results indicated that greater levels of FOO adversity predicted lower levels of CTT. However, higher levels of CTT in turn associated with higher self-esteem, and lower levels of depression. Results also indicated that greater FOO adversity associates with lower relationship quality indirectly. The clinical implications of these findings and directions for future research are discussed.

The stigma of widowhood in war and disaster affected communities of Sri Lanka: Contextual paths between trauma exposure and mental health distress.

To add to the dialogue regarding the long-term recovery and wellbeing of war and tsunami-affected women in Sri Lanka, we utilised the Conservation of Resources Theory (COR, Hobfoll, 2009) to inform an investigation of direct and indirect effects. The study was specifically designed to assess how traumatic exposure may represent a form of loss which may associate with related losses in the form of external and internal stigma which may then associate with poor mental health outcomes. The data for this study were collected in 2016 from a sample of 379 widowed women in Eastern Sri Lanka; participant spouses died in the civil war, in the tsunami, or from health or other problems. Our analyses yielded a model suggesting associations between remembered trauma event exposure from war and disaster, external stigma, internalised stigma and mental health symptom distress. Results further yielded direct and indirect effects suggesting that trauma may represent a form of loss, and potentially lead to distress through the weight and challenges of stigma.

Pressure to Attend Therapy, Dyadic Adjustment, and Adverse Childhood Experiences: Direct and Indirect Effects on the Therapeutic Alliance in Couples Therapy.

In this study we examine the role that pressure to attend therapy, dyadic adjustment, and adverse childhood experiences (ACEs) play in developing the therapeutic alliance. A total of 351 couples received treatment as usual at three family therapy training clinics. Participants rated predictor variables at intake and alliance at the fourth session. Results of a path analysis indicate that each partner's dyadic adjustment is directly associated with the quality of her or his own alliance. In addition, when male partners report more ACEs and pressure to attend treatment, their own alliance scores decrease. Additionally, when one partner reports feeling pressure to attend therapy, the other partner's alliance decreases. Finally, for males, there is an indirect effect of dyadic adjustment on alliance through pressure to attend therapy. These results suggest that clinicians should routinely assess relationship adjustment, how pressured each partner is feeling to attend treatment, and ACEs; as these may impact alliance quality.

Subjective reactions to international research participation: An illustration of ethical considerations with women heading households in Sri Lanka.

There are unique ethical considerations in conducting international research with war and disaster-affected populations that are important for ensuring adequate protection of participants. Of particular importance is the distress that participants may experience as a result of being asked about traumatic stressors, psychological symptoms, and life problems. In this study, trauma-affected Tamil women in Eastern Sri Lanka were asked to report on their research-participation experience after taking part in a larger study on risk and resiliency. Results indicated that most participants experienced emotional upset as a result of taking part in the study. However, the degree of distress was generally not more than they anticipated, and most participants reported they would have participated had they known in advance how they would feel. Most participants perceived some benefit as a result of participating and agreed that items were personally relevant. Emotional distress from participation positively correlated with culturally specific symptoms of anxiety and depression. Contextual stressors and social support were not associated with participation-related distress. We discuss these findings as well as general issues that might arise in international research with trauma-affected populations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Long Arm of Trauma During Childhood: Associations with Resources in Couple Relationships.

Traumatic experiences within and outside the family of origin in childhood may disrupt couple functioning later in life. Using a sample of 3,958 couples assessed through the Relationship Evaluation Questionnaire (RELATE), an actor-partner independence model was fit to test direct and indirect associations between negative impact from one's family of origin (accounting for physical violence and sexual abuse) and resources in couple relationships. Resources were defined using intervention principles derived from the Conservation of Resources (COR) theory. Actor and partner effects suggested negative family impact associates with relationship instability and is mediated through negative couple communication. Actor effects suggested negative family impact associates with less calmness in one's self and is also mediated through negative couple communication.

Adult Attachment Security and Different Types of Relational Violence Victimization Among College-Age Couples.

This study aims to understand the associations between adult attachment security and different types of intimate partner violence victimization including that of emotional abuse, physical violence, and sexual coercion among heterosexual couples. Participants included 87 couples with the mean age 22.3 years. An actor-partner interdependence model was fit to the data. Findings indicated that adult attachment security accounted for 15% of the variance in the emotional abuse victimization of females, 9% of the variance in the sexual coercion victimization of females, and 7% of the variance in minor physical victimization of males. This may significantly impact risk factor assessment, and contribute to improved therapeutic intervention and increased understanding of the development and progression of relationship violence.

War and disaster in Sri Lanka: Depression, family adjustment and health among women heading households.

BACKGROUND: The civil war, lasting from 1983 to 2009, and the tsunami that struck Southeastern Asia in 2004 were major stressors that changed the demographic landscape of the northern province of Sri Lanka. The composition of families changed dramatically, with an increase in female-headed households, largely due to casualties. The conservation of resources (COR) model was applied in this study to examine relationships between risk and resiliency factors among women heading households, including women widowed by war or disaster. AIMS: This study represents an investigation of the association between predictive risk and resiliency factors (i.e. war damage and loss, social support, economic status, religious participation and discrimination) and outcomes representing well-being (depressive symptoms, family adjustment and a rating of physical health). METHODS: Data from 514 women heading households living in the Kilinochchi district of Sri Lanka were collected through face-to-face interviews in 2013, and associations among the data were estimated using path analysis. RESULTS: Results suggest that resiliency factors that are representative of greater resources generally predicted lower levels of distress and vice versa. CONCLUSION: Further study informing intervention development with women heading households in Sri Lanka is warranted to better understand which individual, family and community resources are most important to mobilize for sustainable recovery efforts to be successful in the decades following war and natural disaster.