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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 dr

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.

aws 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 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 Schema

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