The Effect of Psychotherapy on the Spouse

Some ethical concerns regarding the individual psychotherapy of the married client.

“…Since the time of Freud, relatives of clients have been viewed as a nuisance and as potential saboteurs of treatment. It may also be that therapists have simply been reluctant to consider that they may create, as well as resolve, their client's problems (Fox, 1968). Lehrman (1962) suggests that the tendency on the part of the mental health profession to avoid issues concerning the significant others involved is due primarily to the individualistic orientation of therapy.…”

“…Given a theoretical model which sees the individual as a member of a system of significant relationships, an alternative to individual psychotherapy emerges: the spouse, as the client's most intimate "significant other", should be a part of the therapy from the beginning. Conjoint therapy can enable clients to change in a way which is not at their own or someone else's expense -particularly someone else with whom the client is involved in an important reciprocal role relationship (Fox, 1968). If the improvement of the client seen in therapy is of foremost concern, and is seen as inextricably linked to the interpersonal situation, the clinician must be aware of how changes in the client will effect the other family members, and can be guided by such information by involving the family in treatment (Fox, 1968;Grosser & Paul, 1964;Hines & Hare-Mustin, 1978).…”

Effects of psychotherapy on significant others.

“…Their results, which were based on data derived from interviews and projective tests, showed that a patient's improved functioning may, among other things, serve as a model for other family members, freeing them to behave in new ways. As Fox (1968) pointed out, however, the results of this study must be interpreted cautiously: first, because of the difficulties inherent in interpreting projective test material and, second, because only the families of those patients who had shown significant improvement were referred for study. Kohl (1962), in a study of 39 spouses of inpatients treated with psychotherapy over a ten-year period, focused on the adverse reactions of spouses to the patients' improved functioning.…”

“…Kohl (1962), in a study of 39 spouses of inpatients treated with psychotherapy over a ten-year period, focused on the adverse reactions of spouses to the patients' improved functioning. Here again, the generalizability of results is limited because Kohl studied only those partners whose adverse reactions attracted the therapist's attention (Fox, 1968). Furthermore, Kohl gathered no data regarding the nature of the couples' interaction over time; this makes it difficult to attribute the partners' adverse reactions to the therapy per se (Fox, 1968).…”

“…Here again, the generalizability of results is limited because Kohl studied only those partners whose adverse reactions attracted the therapist's attention (Fox, 1968). Furthermore, Kohl gathered no data regarding the nature of the couples' interaction over time; this makes it difficult to attribute the partners' adverse reactions to the therapy per se (Fox, 1968).…”