Chronic pain impacts individuals with pain as well as their loved ones. Yet, there has been little attention to the social context in individual psychological treatment approaches to chronic pain management. With this need in mind, we developed a couple-based treatment, "Mindful Living and Relating," aimed at alleviating pain and suffering by promoting couples' psychological and relational flexibility skills. Currently, there is no integrative treatment that fully harnesses the power of the couple, treating both the individual with chronic pain and the spouse as two individuals who are in need of developing greater psychological and relational flexibility to improve their own and their partners' health. Mindfulness, acceptance, and values-based action exercises were used to promote psychological flexibility. The intervention also targets relational flexibility, which we define as the ability to interact with one's partner, fully attending to the present moment, and responding empathically in a way that serves one's own and one's partner's values. To this end, the intervention also included exercises aimed at applying psychological flexibility skills to social interactions as well as emotional disclosure and empathic responding exercises to enhance relational flexibility. The case presented demonstrates that healthy coping with pain and stress may be most successful and sustainable when one is involved in a supportive relationship with someone who also practices psychological flexibility skills and when both partners use relational flexibility skills during their interactions.
These findings demonstrate that the interpersonal context is independently related to acute pain and may also alter the effect of threatening information on acute pain.
Chronic pain contributes to psychological and relationship distress in individuals with pain as well as their partners. Previous pain interventions have addressed this important social context by engaging partners in treatment; however, partners have not been considered coparticipants who can benefit directly from therapy, but rather incorporated as pain management coaches or guides. This article assesses the feasibility, acceptability, and preliminary outcomes of a novel intervention that targets both partners and focuses on improving well-being in couples in which one or both partners experiences chronic pain and relationship distress. Fifteen couples participated in Mindful Living and Relating, a 6-session in-person intervention, and completed baseline and posttreatment outcome measures. Both quantitative and qualitative methods were used to evaluate participants’ engagement in and experiences of the intervention, as well as preliminary outcomes. Results suggest that couples were engaged in, and reported satisfaction with, the treatment. Participants who completed the therapy (N = 28; 14 couples) reported reductions in depressive symptoms and improvements in relationship satisfaction and partner responsiveness, and individuals with pain reported reductions in pain interference. In posttreatment interviews, couples reported their preference for couple therapy over individual therapy for pain and relationship distress. Although the conduct of the therapy was feasible for couples who enrolled in the trial, initial recruitment difficulties suggested feasibility challenges. Recommendations are made for researchers who are interested in designing psychological interventions to improve quality of life in the context of chronic illness.
Peer group supervision is a commonly integrated component of predoctoral psychology training. However, much of the supervision literature has focused on individual supervision. The predominant focus on individual supervision has left a gap in the literature in regard to peer group supervision at the predoctoral internship level. In particular, little is known about the aspects of peer group supervision that are necessary to engage supervisees in group supervision or the processes that facilitate positive growth in supervisees during peer group supervision. This article uses a case example of peer group supervision that was conducted at a predoctoral internship site to examine the parallels between group psychotherapy and group supervision. Notably, Yalom's group psychotherapy curative factors resemble the same beneficial processes that occur within peer group supervision. Therefore, a series of vignettes was presented to illuminate how these processes unfold and the impact that these processes have on supervisee professional development. In the case example, peer group supervision impacted training positively and promoted supervisee growth in self-reflective practice, attention to interpersonal process within therapy, integration of different theoretical orientations, case conceptualization, and self-care. A primary implication of this work is that peer group supervision can be a unique professional development experience that, when implemented with attention to therapeutic alliance and group process, can result in profound supervisee growth.
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