Marriage and Couples Therapy: Course Module

What the module teaches

Module 10 of the PsychoPharmRef therapy course is a how-to for treating married and other committed couples in distress, and for using the couple as the unit of treatment when one partner has a disorder that a couple-based protocol addresses. It is written for clinicians and trainees. The Learn tab covers:

• What the outcome evidence supports, and how to read it
• Assessment: a conjoint session, then each partner alone, with attention to intimate partner violence, substance use, individual psychiatric illness and affairs
• Choosing a model: Gottman Method, emotionally focused couple therapy (Johnson), integrative behavioral couple therapy (Christensen and Jacobson), traditional behavioral and cognitive-behavioral couple therapy, and PREP and other brief or premarital programs
• A reasonable session course and common problems such as gridlock, infidelity, sexual problems, parenting stress and finances
• Couple-based treatment when one partner has depression, an alcohol or drug use disorder (behavioral couples therapy) or PTSD (cognitive-behavioral conjoint therapy)
• The psychopharmacology interface, the ethics of confidentiality, secrets and documentation, and what to measure

Interactive worksheets

• Assessment and Safety: a checklist that returns a decision. Fear of a partner, coercive control, recent injury or strangulation, weapons or stalking, or a partner who cannot meet privately makes ordinary conjoint therapy contraindicated. An ongoing secret affair or an unstabilized crisis puts change-oriented work on hold. The tool also checks that both individual sessions, a private IPV screen and a written secrets policy are complete.
• Formulation: the presenting problem, the negative cycle in words both partners would recognize, the model chosen, and a Four Horsemen observation (criticism, contempt, defensiveness, stonewalling) with antidotes.
• Session Tools: speaker–listener practice on one real topic and a behavior-exchange plan for positive behaviors each partner will increase.
• Plan and Outcomes: protocol, secrets policy, one functional goal, and a log of each partner's Couples Satisfaction Index (CSI-16, range 0–81).

The module notes that in Funk and Rogge (2007), CSI-16 scores under 51.5 fell on the distressed side of a Dyadic Adjustment Scale cut-point of 97.5, and that this is a research benchmark, not a diagnosis. Worksheets can be copied as plain text, and blank worksheets are available as a PDF download.

Who it is for

The module is a teaching resource for supervised skill development. The worksheets are practice aids, not validated instruments, and do not replace clinical judgment or supervision. References include Gottman's The Marriage Clinic, Johnson's The Practice of Emotionally Focused Couple Therapy (3rd ed.), Jacobson and Christensen's Acceptance and Change in Couple Therapy, and Baucom, Snyder and Gordon on affair recovery.