Common factors in therapy such as the therapeutic alliance and client motivation have been found to account for more change than therapy models. But common factors have been critiqued as only lists of variables that provide little practical guidance. Some researchers have demonstrated that certain common elements (e.g., the therapeutic alliance) account for more variance than others (e.g., techniques), suggesting that some factors should be emphasized over others. Such findings suggest the need for alternatives to model-based therapy, with one alternative being meta-models, or "models of models," that focus on how therapeutic factors interact with each other to produce change. The purpose of this article is to propose a meta-model describing the relationship between two specific common factors-the therapeutic alliance and interventions. We also propose a new factor-a therapist's way of being-that we believe is foundational to effective therapy. The model is proposed in pyramid format, with techniques on top, the therapeutic alliance in the middle, and therapist way of being as the foundation. The hierarchical relationships between these three concepts are discussed, along with implications for training, research, and therapy.
This article presents a unique clinical model of forgiveness developed specifically for use in the treatment of infidelity. The model focuses on forgiveness as a central component of the process of healing for couples who desire relationship reconciliation following an affair. Infidelity causes significant damage for couples and results in a loss of trust and relationship stability. However, couples can become reunified and trust may be restored as couples work through the process of forgiveness. Forgiveness is facilitated as therapists and clients focus on four unifying factors: empathy, humility, commitment and apology. Specific steps are outlined for therapists to help them guide clients through the process of forgiveness. The clinical application of the model is illustrated with a brief case example.
Infidelity is one of the most common and the most difficult problems to treat in couples therapy. In this article, the authors present an integrative approach to treating infidelity based on the intersystems approach developed by Weeks. The approach integrates theory and techniques from both individual and systemic psychotherapy and addresses the individual, relational, and intergenerational factors associated with infidelity. The treatment approach reflects the authors' view of infidelity as a systemic, intimacy-based problem. Treatment includes five interrelated phases: (a) crisis management and assessment, (b) systemic considerations, (c) facilitating forgiveness, (d) treating factors that contribute to infidelity, and (e) promoting intimacy through communication. Of particular importance is the development of unifying factors that facilitate healing, unite couples, and reduce their vulnerability to future betrayals.
In relationships characterized by control, abuse, or violence, many appraisal distortions occur including denial and minimization. However, the nature of the distortion varies depending on the individual's role in the relationship (i.e., abuser or victim). Reducing these distortions is an important component in treatment success and involves accepting responsibility for actions and attributions. This study used constructivist grounded theory methods to explore the following questions: (1) What are the types of distortions that are used by individuals who have been in violent or abusive relationships? (2) What are the gender and power differences in the appraisal distortions used? (3) What are the functions and interactions of the distortions in the relationship dynamics? Qualitative analysis of interviews with 29 individuals who had been in abusive relationships found that there were several types of distortions used by participants, but there were differences in the function of the distortion, depending on the individual's role in the abuse. These generally corresponded to power and gender, where the male as perpetrator used different distortions (or used similar distortions for different reasons) than did the female as victim. Suggestions for research as well as treatment implications for both offenders and survivors of abuse are given.
Forgiveness is a significant intervention for healing interpersonal injury. Yet therapists do not often use forgiveness intervention. Employing a semantic perspective and a survey design (n = 307), this study investigated whether the language used to rationalize forgiveness intervention (set at five levels: personal growth, relationship reconciliation, spiritual issue, others' growth, and pardoning/condoning) may affect its acceptability. Gender, problem type, and choice were also included in the analyses. Overall, forgiveness was found to be an acceptable intervention. A pardoning/condoning rationale led to significantly lower acceptability ratings. Other results are discussed. We conclude that therapists should be less apprehensive about using forgiveness, but need to inform themselves better concerning its purpose, process, and articulation.
Values have been shown to be a pervasive part of both marriage and family therapy (MFT) clinical practice and research. Yet, many therapists and researchers remain unclear about how values affect their work. This article examines the influence of Western philosophical assumptions and therapy traditions in light of current understandings of values in therapy. The influence of values in MFT research processes is similarly examined. Implications for how family therapy professionals can be more reflective and sophisticated in their understanding of values in clinical practice and scientific inquiry are discussed. Suggestions for addressing values in MFT training also are given.
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