1. Marital & Family Therapies
Dr. Anisha Shah
Department of Clinical Psychology
NIMHANS

2. Marital/couple therapy research “possibly efficacious”
Agoraphobia/panic disorder: couple communication training
Depression: behavioral marital therapy
Marital Discord: behavioral marital therapy, Cognitive behavior therapy, cognitive therapy, emotion focused couple therapy, insight- oriented marital therapy
Sexual dysfunction: reduce sexual anxiety and improve communication

3. Family therapy research
Obsessive-compulsive disorders: family assisted ERP & relaxation
Bipolar disorder: family therapy
Anorexia: behavioral family systems therapy, family therapy
Schizophrenia: behavioral family therapy, family systems therapy, supportive long-term family therapy

4. …with children & adolescents
ADHD: behavioral parent training
Anxiety disorders: CBT & family anxiety management training
Conduct disorders: functional family therapy, multisystemic therapy, parent-child interaction therapy, parent-training based on living with children, videotape modeling parent training

5. …. Disruptive disorders: structural family therapies
Psychophysiological disorders: family therapy

6. Guidelines for conducting couple & family therapy
Develop systemic perspective
Consider context
Various viewpoints of members
Circular causality maintains problems
Respect family diversity
Ethical considerations
Assessment and intervention from first contact
clarify participants
Engagement and alliance building
Influence of FOO on present family

7. Guidelines… Brief format Improve relationships
Promote solutions, coping, family health
Negotiate goals
Move family from habitual patterns
Use individual, biological, couple, family and macrosystemic interventions
Empathy, communication, reinforcements, structure

8. Guidelines…
Promote individuals to take responsibility of own behaviour
Conjoint sessions for couples
Address criticisms, contempt, defensiveness, stonewalling
Psychoeducational approaches for severe mental illness
Create stabilizing rituals
Safety when violence and abuse
Maintenance of change & termination

9. Theoretical models marital/couple therapy
Behavioral Jacobson, Margolin, Stuart, Weiss, Hops, Patterson Cognitive Baucom, Epstein, Waring Sex therapy LoPiccolo, Friedman
Emotion-focused Greenberg, Johnson, Prevention/enrichment /enhancement Markman, Floyd, Stanley, Lewis MT & Ind psychopathology Beach, Oleary, Jacobson

10. In therapy: focus on communication, problem solving, analysis of sequences, contingencies, reciprocities
Alter consequences, allow spouses to choose freely in order to prevent resistance, modify antecedents
Practice, feedback, modeling, instructions, + and – communication styles, feelings, define problems without blaming, active listening

11. Cognitive interventions: beliefs & expectations
Relabel negative attributions
Modify unrealistic expectations
Create positive expectancies
Diminish negative emotions
Avoid extreme statements/interpretations
Maximize +ve/realsitic expectations
Predict expected relapses
Cheerleading and TA, enthusiasm, humor
Learn to prevent future problems with collaboration and mutual responsibility

12. Suggested reading
Chambless, D.L. & Oliendick, T.H. (2001) Empirically supported psychological interventions; Controversies and evidence, Annual Review of Psychology, 52,
Snyder, D.K., Castellani, A. M. & Whisman, M. A. (2006) Current status and future directions in couple therapy, Annual Review of Psychology, 57,