Depression in marriage : a model for etiology and treatment
All practicing marital therapists and clinicians working with a depressed population see patients in whom depression and a dysfunctional relationship exist concurrently. Due to the unique problems they present, and the therapy process issues involved in seeing treatment through to successful completion, these cases are usually considered difficult. The first book to bring the relevant research literature to bear on this thorny clinical problem, "DEPRESSION IN MARRIAGE" views the marital relationship as a powerful point of therapeutic intervention for depression and offers step-by-step guidance to clinically flexible treatment.
By utilizing a marital discord model of depression, therapists can tap the power of the marital relationship to promote growth and healing rather than work against the powerful forces of the marital dyad. Offering precise guidelines for assessment, intervention, and management, "DEPRESSION IN MARRIAGE" provides useful clinical measurement tools and uses case vignettes to illustrate practical issues. Interventions are described in detail, with references to the relevant research literature. Whether marital therapy is the primary treatment modality, or an adjunct to individual or somatic interventions, "DEPRESSION IN MARRIAGE" will help identify useful, practical intervention strategies.
Providing a new understanding of the interpersonal aspects of depression, as well as ways in which this understanding can be put to work in therapy, "DEPRESSION IN MARRIAGE" will be of interest to a wide range of professionals working with depressed individuals or distressed couples. It can also be used as a text for graduate level courses in psychology, marriage and family therapy, and social work.
xiii, 242 pages : illustrations ; 24 cm.
9780898622058, 9780898622164, 0898622050, 0898622166
20993777
I. Understanding co-occurring depression and marital discord
1. Depression: The basic facts
Why should I learn about depression?
Why should I learn about marital discord?
Why should I learn about marital therapy for depression?
General definition
Prevalence and incidence
Symptoms of major depression
Conditions associated with major depressive disorder
Bereavement
Depression associated with organic disorders and psychotic features
Demographic risk factors for depression
Conclusions
2. Models of depression
A models approach to psychotherapy
Biological models of depression
Psychological models of depression
Macrosocial and cultural models of depression
Conclusions
3. The marital discord model of depression
Development and empirical background of the model
Initial conceptual concerns
Basic literature on marital discord; Implications for depression
An elaborated marital discord model of depression
Depression in the production and maintenance of marital discord
The role of cognition
The case of severe pathology
Translating theory into action
II. Treatment of co-occurring depression and marital discord
4. Overview of therapy: Assessment, process, and the therapist's role in marital therapy for depression
What is marital therapy for depression?
When is marital therapy for depression appropriate for a couple?
Process issues
The therapist's role in marital therapy for depression
What marital therapy for depression is not
A session-by-session outline of marital therapy for depression
5. The initial phase of therapy: gaining momentum for positive change
Increasing marital cohesions
increasing self-esteem support
Reducing or eliminating major stressors: An initial focus on negative patterns
Process issues in the initial phase of therapy
Case example: John and Marie
6. Restructuring the relationship; Themes and techniques of midtherapy
Increasing acceptance of emotional expression
Increasing the frequency and breadth of intimate exchanges
Enhancing perceived and actual coping assistance: A focus on problem-solving training
Enhancing the perception of spousal dependability
Decreasing stressors during the middle stage of therapy
Working on special problem areas
Process issues in midtherapy
Case example: Mary Jo and Michael
7. Ending therapy: Issues of maintenance, disengagement, and continued change
Fading out the directive role of the therapist
Narrowing the scope of therapy
Trouble-shooting
Problem solving: Mechanism for continued change
Booster sessions
Attitudes and expectations
Process issues in the final stage of therapy
Case example: Kathy and Sal
8. Outcome and future directions
Review of initial uncontrolled observations
Review of early outcome and analogue work on effects of marital therapy for depression
An initial pilot study
A larger-scale outcome study
Related ongoing outcome work
Future directions
Appendix: Marital therapy scale