Summary
Research consistently suggests that couples therapy is an effective treatment modality (Carr, 2019). However, little is known about how change occurs in couples therapy. Although studies have examined the mechanisms of change in therapy generally, few studies have focused on couples therapy specifically. This study examined the process of change in couples therapy from the therapist’s perspective. To accomplish this, we used constructivist grounded theory to analyze semi-structured interviews. Our results indicate that the three interrelated processes of (1) taking action, (2) noticing action and changes, and (3) reflection resulted in pivotal changes occurring. The complete model of change indicates that both therapists and clients play an important role in the process of change and that changes occur both inside and outside of the therapeutic environment. This study is part of a larger project where couples and their therapists were interviewed about the process of change in couples therapy.

Objectives

• Attendees will learn how therapists conceptualize the process of change in couples therapy
• Attendees will learn to apply the presented grounded theory to their own work with couples in therapy
• Attendees will identify what aspects of their clinical work contribute to therapeutic change, from the perspective of therapists

Subject Codes: relationships, relationship quality, interpersonal relationships
Population Codes: couples/coupled
Method and Approach Codes: grounded theory

Summary
Research consistently suggests that couples therapy is an effective treatment modality (Carr, 2019); however, little is known about how change occurs in couples therapy. While studies have examined the mechanisms of change in therapy generally, few studies have focused on couples therapy and even fewer have considered the client’s perspective. This study examined the process of change in couples therapy from the couple’s perspective. We used constructivist grounded theory to analyze semi-structured interviews. Our results indicate that the two interrelated processes of making space and expanding interactions resulted in pivotal changes occurring in therapy. The complete model of change indicates that both therapists and clients play an important role in the process of change and that change was not isolated to the therapy room. This study is part of a larger project where couples and their therapists were both interviewed about the process of change in couples therapy.

Objectives

• Attendees will learn how couples conceptualize the process of change in couples therapy
• Attendees will learn to apply the grounded theory of change in couples therapy to their own work with couples
• Attendees will identify what aspects of their clinical work contribute to therapeutic change, from the perspective of couples

Subject Codes: relationships, relationship quality, interpersonal relationships
Population Codes: couples/coupled
Method and Approach Codes: grounded theory

Summary
Early discontinuance is pervasive across psychotherapies, and is associated with important costs to clients, society, and therapist. Despite these costs, little research has been done to understand the reasons couples decide to discontinue treatment, especially from the client’s perspective. The purpose of this presentation is to begin to understand the complexity of dropout in couple therapy by asking former clients of couple therapy to identify the reasons they decided to stop attending. One hundred sixty participants were recruited through a Qualtrics panel and completed a brief survey about the reasons they stopped attending therapy without discussing the decision with their therapist. This presentation will discuss their responses, including better understanding the context of dropout, the reasons participants gave for ending treatment, and the reasons they said were the most important. Particular attention will be given to the systemic issues that precipitate discontinuation.

Objectives

• Understand the reasons couples give for discontinuing treatment without discussing the decision with their therapist.
• Understand the context in which discontinuance occurs during treatment.
• Understand the systemic factors associated with discontinuance in couple therapy.

Subject Codes: mental health, relationships, family processes
Population Codes: Family Scientists, couples/coupled, U.S.
Method and Approach Codes: family therapy, therapy, research (general)

Summary
The goal of this study is to investigate how clients’ pretherapy relationship goal and perceptions of therapy (e.g., importance of attending therapy) are associated with one’s own and their partners’ couple therapy outcomes using the Actor-Partner Interdependence Model. Participants were 156 heterosexual couples (61.6% married) who sought couple therapy at four outpatient mental health clinics. Results showed that male partners’ goal of figuring out whether to stay in the relationship (rather than wanting the relationship to improve) or feel pressure to attend therapy were negatively associated with their own and their female partners’ relational outcomes posttreatment. Female partners’ perception that many of their problems are caused by other people was positively related to their positive treatment progress in the relationship domain. The findings may inform the design of evidence-based couple therapy treatments and yield practical clinical implications for couple and family therapists.

Objectives

• To investigate how clients’ pretherapy factors are associated with one’s own and their partners’ couple therapy outcomes
• To provide practical clinical implications for couple and family therapists
• To inform research and the design of evidence-based couple therapy treatments

Subject Codes: relationships, mental health
Population Codes: couples/coupled, heterosexual
Method and Approach Codes: actor-partner interdependence model (APIM), family therapy, dyadic analysis