Category:

Cognitive-Behavioral Therapy with Couples and Families

Course Outline

From a leading expert in cognitive-behavioral therapy (CBT) and couple and family therapy, this highly practical work combines cutting-edge research and clinical wisdom. Frank M. Dattilio shows how therapeutic techniques originally designed for individuals have been successfully adapted for use with couples and families struggling with a wide range of relationship problems and stressful life transitions.

The volume integrates the latest CBT knowledge with ideas and findings on family systems, attachment, neurobiology, and emotional regulation. Dattilio draws out the real-worrld implications of the research for understanding the difficulties that bring couples and families to therapy, and how therapeutic change occurs. Focusing on the “whys,” “whats,” and “how-tos” of intervention, the book describes effective ways to help clients:

  • Identify and modify automatic thoughts.
  • Restructure dysfunctional schemas in the family context.
  • Address problems involving emotional regulation.
  • Improve their communication and problem solving.
  • Make mutually agreed-on behavioral changes.
  • Practice and consolidate their new skills.

Assessment and treatment techniques are clearly explained and illustrated with vivid case examples featuring couples and families of all ages and developmental stages. Strategies for overcoming common roadblocks are discussed. Special topics include working with couples considering divorce, getting through to challenging adolescents and their parents, dealing with mental illness or substance abuse in the family, and more. Cultural diversity issues are woven throughout.

This authoritative guide provides essential tools for all clinicians who treat couples and families, including couple and family therapists and counselors, clinical psychologists, social workers, pastoral counselors, and psychiatrists. Graduate students and trainees will find it an invaluable text.

About the Authors

Frank M. Dattilio, PhD., ABPP, holds faculty positions with the Department of Psychiatry at Harvard Medical School and the University of Pennsylvania School of Medicine. He is also in the private practice of clinical and forensic psychology and marital and family therapy in Allentown, Pennsylvania. With more than 250 professional publications in the areas of couple and family problems, anxiety and behavioral disorders, and forensic and clinical psychology, Dr. Dattilio has presented extrensively on CBT throughout the world. His works have been translated into more than 27 languages and are used in over 80 countries. He serves on the editorial boards of a number of professional journals, including the Journal of Marital and Family Therapy and Contemporary Family Therapy. Dr. Dattilio is a recipient of several awards for outstanding achievement in the fields of psychology and psychotherapy.

Learning Objectives

After completing this course you’ll be able to:

  1. Discuss several learning theory principles.
  2. Discuss cognitive therapy principles.
  3. Describe the advent of cognitive-behavioral therapy.
  4. Discuss the five cognitive processes by Baucom, Epstein, Sayers, and Sher (1989).
  5. List briefly several cognitive distortions seen in couple and family interactions.
  6. Discuss expectancies, assumptions and standards.
  7. Discuss the four attachment styles of Bartholamew and Horowitz.
  8. Define abandonment schema, subjugation schema, and dependence/independence schema.
  9. Describe emotionally focused therapy.
  10. Define a negative frame.
  11. Describe the social exchange theory.
  12. Compare reciprocity by behaviorists and systems theorists.
  13. Discuss schema therapy.
  14. Describe the family schema.
  15. State when schemas should be addressed during therapy.
  16. Compare the vulnerable core schema and the protective coping schema.
  17. Discuss the limbic brain.
  18. Discuss emotional memory.
  19. List the goals of assessment.
  20. Discuss the interview.
  21. Discuss the use of questionnaires to gather information.
  22. Describe several assessment tools.
  23. Describe a genogram.
  24. Discuss Socratic questioning and the technique of the downward-arrow.
  25. Define core belief and schema.
  26. Define negative framing as introduced by Abrahms and Spring (1989).
  27. Describe the Dysfunctional Thought Record.
  28. List “the Four Horsemen of the Apocalypse.”
  29. Discuss communication problems in relationships.
  30. List the five steps from Epstein and Schlesinger (1996) as guidelines for problem solving.
  31. Describe several paradoxical interventions and when they are best used.
  32. Discuss the value of homework assignments.
  33. List the steps for relapse (O’Farrell, 1993).
  34. Discuss several roadblocks for change.
  35. Describe the enhanced CBT approach.
  36. Compare the behavior of a husband or wife when the other spouse is depressed.
  37. Discuss the frequency of extramarital affairs.
  38. Discuss the work of Andrew Christensen regarding empathic joining, unified detachment, and tolerance building.
  39. List several limitations and contraindications of the cognitive-behavioral approach.
  40. Discuss mindfulness.

Course Contents

  1. Introduction
    • Overview of Contemporary Cognitive-Behavioral Therapy with Couples and Families
    • Learning Theory Principles
    • Cognitive Therapy Principles
    • The Integrative Potential of Cognitive-Behavioral Therapy
  2. The Mechanics of Change with Couples and Families
    • Cognitive Processes
    • Attachment and Affect
    • The Role of Behavioral Change
  3. The Schema Component in Cognitive-Behavioral Therapy
    • The Concept of Schemas
    • Automatic Thoughts and Schemas
    • Underlying Schemas and Cognitive Distortions
    • Identifying Schemas from the Family of Origin and Their Impact on Couple and Family Relationshps
    • Cognitions and Transgenerational Schemas
  4. The Role of Neurobiological Processes
    • The Role of the Amygdala
    • Cognition versus Emotion
  5. Methods of Clinical Assessment
    • Initial Joint Interviews
    • Consultation with Previous Therapists and Other Mental Health Providers
    • Inventories and Questionnaires
    • Additional Psychological Testing and Appraisals
    • Genograms
    • Ongoing Assessment and Case Conceptualization throughout the Course of Therapy
    • Specific Difficulties with the Assessment Process
    • Behavioral Observations and Change
    • Structured Family Interaction
    • Assessment of Cognitions
    • Individual Interviews
    • Identification of Macro-Level Patterns and Core Relationship Issues
    • Assessing Motivation to Change
    • Feedback on the Assessment
    • Identifying Automatic Thoughts and Core Beliefs
    • Differentiating Core Beliefs from Schemas
    • Negative Framing and How to Identify It
    • Identifying and Labeling Cognitive Distortions
    • Translating Thoughts, Emotions, and Behaviors in the Process of Conceptualization
    • Attribution and Standards and Their Role in Assessment
    • Targeting Maladaptive Behavioral Patterns
    • Testing and Reinterpretting Automatic Thoughts
    • Formulating a Plan of Treatment
  6. Cognitive-Behavioral Techniques
    • Educating and Socializing Couples and Family Members about the Cognitive-Behavioral Model
    • Identifying Automatic Thoughts and Associated Emotions and Behavior
    • Addressing Schemas and Schema Restructuring
    • Instituting Enactment through Reframing and Rehearsal
    • Behavioral Techniques
    • Addressing the Potential for Relapse
    • Handling Roadblocks and Resistance to Change
    • Partners’ Negativity and Hopelessness about Change
    • Differences in Agendas
    • Anxiety about Changing Existing Patterns in the Relationship
    • Relinquishing Perceived Power and Control
    • Issues of Taking Responsibility for Change
    • Roadblocks
  7. Special Topics
    • Divorce
    • Cultural Sensitivity
    • Depression, Personality Disorder, and Other Mental Illnesses
    • Extramarital Affairs
    • Substance Abuse
    • Domestic Abuse
    • Contraindications and Limitations of the Cognitive-Behavioral Approach
    • Couples and Families in Crisis
    • Same-Sex Couples and Their Children
    • Atypical Couple and Family Consultations
    • Cotherapy with Couples and Families
    • Multilevel Treatment
  8. Enhancements to Cogntive-Behavioral Therapy
    • Acceptance-Based Techniques
    • Mindfulness
  9. Case Examples
    • The Retirement Trap
    • Family of Gluttons
  10. Epilogue

Appendix A: Questionnaires and Inventories for Couples and Families

Appendix B: Dysfunctional Thought Record

References

Index