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Indian Journal of Psychiatry Feb 2018Substance abuse is a family disease that adversely impacts both the user and the user's family. The family can act as a risk factor for the development of substance... (Review)
Review
Substance abuse is a family disease that adversely impacts both the user and the user's family. The family can act as a risk factor for the development of substance abuse among children and adults. The family can also be involved in therapy to either help the recovery process or prevent substance abuse. Marital and family therapy have been found to be effective in reducing the severity of substance use, lowering marital and family conflict, improving family communication and cohesion as well as effective parenting practices. Behavioural Couples Therapy has been found to have good empirical support for bringing about the desired changes in both substance abuse and marital relationship. While targeting entire families, the most common evidenced based family interventions are Brief Strategic Family Therapy, Multidimensional Family Therapy, Family Behaviour Therapy, Functional Family Therapy and Community Reinforcement Programme. Marital and family therapy have to be sensitive to gender and culture. Effective use of marital and family therapy requires adequate training to equip practitioners in adequately treating not only substance use disorders and family pathology, but also in treating co-morbid mental health conditions.
PubMed: 29540921
DOI: 10.4103/psychiatry.IndianJPsychiatry_19_18 -
Psychological Medicine Apr 2023Depression during pregnancy and after the birth of a child is highly prevalent and an important public health problem. Psychological interventions are the first-line... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Depression during pregnancy and after the birth of a child is highly prevalent and an important public health problem. Psychological interventions are the first-line treatment and, although a considerable number of randomized trials have been conducted, no recent comprehensive meta-analysis has evaluated treatment effects.
METHODS
We used an existing database of randomized controlled trials of psychotherapies for adult depression and included studies aimed at perinatal depression. Random effects models were used in all analyses. We examined the effects of the interventions in the short and long term, and also examined secondary outcomes.
RESULTS
Forty-three studies with 49 comparisons and 6270 participants between an intervention and control group were included. The overall effect size was = 0.67 [95% confidence interval (CI) 0.45~0.89; numbers needed-to-be-treated = 4.39] with high heterogeneity ( = 80%; 95% CI 75~85). This effect size remained largely unchanged and significant in a series of sensitivity analyses, although some publication bias was found. The effects remained significant at 6-12 months follow-up. Significant effects were also found for social support, anxiety, functional limitations, parental stress and marital stress, although the number of studies for each outcome was low. All results should be considered with caution because of the high levels of heterogeneity in most analyses.
CONCLUSIONS
Psychological interventions are probably effective in the treatment of perinatal depression, with effects that last at least up to 6-12 months and probably also have effects on social support, anxiety, functional impairment, parental stress, and marital stress.
Topics: Adult; Child; Female; Pregnancy; Humans; Depression; Psychotherapy; Depressive Disorder; Anxiety; Anxiety Disorders
PubMed: 37310303
DOI: 10.1017/S0033291721004529 -
Family Process Jun 2022This article describes the treatment framework and core therapeutic principles of the integrative brief systemic intervention (IBSI), a manualized six-session...
This article describes the treatment framework and core therapeutic principles of the integrative brief systemic intervention (IBSI), a manualized six-session intervention intended for parents seeking couple therapy. IBSI aims to work on the couple's presenting problem, considering its specific impact in the marital and coparenting domains. The basic premise of IBSI is to consider that, when working with couples who have children, therapeutic work on their coparenting alliance may be used as a lever, as both parents may be particularly motivated to improve their relationship for their children's benefit. Increasing the coparenting alliance may then facilitate work on deeper conflicts within the marital relationship. The core therapeutic principles of IBSI are: (1) joining with the couple as romantic partners and a coparenting team from the start of the therapeutic process; (2) supporting the parents in increasing their awareness regarding their children's behavior and emotional experiences when facing their parents' conflicts; and (3) working on the spill- and cross-over effects between marital and coparenting relationships (i.e., exploring how conflict or positivity spills over from one relationship to the other or crosses over from one partner to the other). Therapeutic work following these main therapeutic principles is expected to improve the quality of both relationships. A clinical case is provided to illustrate the core therapeutic principles of IBSI.
Topics: Child; Couples Therapy; Emotions; Humans; Marriage; Parenting; Parents
PubMed: 35394059
DOI: 10.1111/famp.12773 -
The effectiveness of reality therapy on sexual satisfaction and marital intimacy of infertile women.Journal of Education and Health... 2022Infertility is one of the most important challenges in the modern life that can damage the sexual satisfaction and marital intimacy of couples. The present study was...
BACKGROUND
Infertility is one of the most important challenges in the modern life that can damage the sexual satisfaction and marital intimacy of couples. The present study was aimed to investigate the effectiveness of reality therapy on sexual satisfaction and marital intimacy of infertile women.
MATERIALS AND METHODS
This quasi-experimental study was conducted with a pretest-posttest design and follow-up. The statistical population was infertile women who were referred to Imam Sajjad Shahriyar Hospital in 2019-2020. 15 infertile women selected by purposive sampling and underwent reality therapy (8 sessions of 90 min). Data were collected using index sexual satisfaction (ISS) and marital intimacy questionnaire. Data analysis was performed using SPSS-24 software, analysis of variance with repeated measures and Bonferroni test.
RESULTS
The results of analysis of variance showed that there was a significant difference between the scores of sexual satisfaction and marital intimacy in posttest and follow-up stages compared to pretest ( < 0.05).
CONCLUSIONS
Based on the results, reality therapy can be used as an effective intervention to improvement sexual satisfaction and marital intimacy of infertile women.
PubMed: 36325233
DOI: 10.4103/jehp.jehp_1106_21 -
Journal of Marital and Family Therapy Jan 2012This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We... (Review)
Review
This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.
Topics: Adaptation, Psychological; Alcoholism; Attitude to Health; Behavior Control; Counseling; Evidence-Based Practice; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Marital Therapy; Outcome Assessment, Health Care; Patient Compliance; Research Design; Self Efficacy; Sex Factors
PubMed: 22283384
DOI: 10.1111/j.1752-0606.2011.00242.x -
The Cochrane Database of Systematic... Jun 2018Couple therapy for depression has the twofold aim of modifying negative interaction patterns and increasing mutually supportive aspects of intimate relationships,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Couple therapy for depression has the twofold aim of modifying negative interaction patterns and increasing mutually supportive aspects of intimate relationships, changing the interpersonal context of depression. Couple therapy is included in several guidelines among the suggested treatments for depression.
OBJECTIVES
1. The main objective was to examine the effects of couple therapy compared to individual psychotherapy for depression.2. Secondary objectives were to examine the effects of couple therapy compared to drug therapy and no/minimal treatment for depression.
SEARCH METHODS
The Cochrane Common Mental Disorders Group Controlled Trials Register (CCMDCTR), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid) and PsycINFO (Ovid) were searched to 19 February 2018. Relevant journals and reference lists were checked.
SELECTION CRITERIA
Randomised and quasi-randomised controlled trials examining the effects of couple therapy versus individual psychotherapy, drug therapy, or no treatment/minimal treatment for depression were included in the review.
DATA COLLECTION AND ANALYSIS
We considered as primary outcomes the depressive symptom level, the depression persistence, and the dropouts; the relationship distress level was a secondary outcome. We extracted data using a standardised spreadsheet. Where data were not included in published papers, we tried to obtain the data from the authors. We synthesised data using Review Manager software version 5.3. We pooled dichotomous data using the relative risk (RR), and continuous data calculating the standardised mean difference (SMD), together with 95% confidence intervals (CIs). We employed the random-effects model for all comparisons and also calculated a formal test for heterogeneity, the natural approximate Chi test.
MAIN RESULTS
We included fourteen studies from Europe, North America, and Israel, with 651 participants. Eighty per cent of participants were Caucasian. Therefore, the findings cannot be considered as applicable to non-Western countries or to other ethnic groups in Western countries. On average, participants had moderate depression, preventing the extension of results to severely depressed patients. Almost all participants were aged between 36 and 47 years.There was no evidence of difference in effect at the end of treatment between couple therapy and individual psychotherapy, either for the continuous outcome of depressive symptoms, based on nine studies with 304 participants (SMD -0.17, 95% CI -0.44 to 0.10, low-quality evidence), or the proportion of participants remaining depressed, based on six studies with 237 participants (RR 0.94, 95% CI 0.72 to 1.22, low-quality evidence). Findings from studies with 6-month or longer follow-up confirmed the lack of difference between the two conditions.No trial gave information on harmful effects. However, we considered rates of treatment discontinuation for any reason as a proxy indicator of adverse outcomes. There was no evidence of difference for dropout rates between couple therapy and individual psychotherapy, based on eight studies with 316 participants (RR 0.85, 95% CI 0.51 to 1.41, low-quality evidence).Few data were available for the comparison with drug therapy. Data from a small study with 12 participants showed no difference for the continuous outcome of depressive symptoms at end of treatment (SMD -0.51, 95% CI -1.69 to 0.66, very low-quality evidence) and at 6-month follow-up (SMD -1.07, 95% CI -2.45 to 0.31, very low-quality evidence). Data on dropouts from two studies with 95 participants showed a clear advantage for couple therapy (RR 0.31, 95% CI 0.15 to 0.61, very low-quality evidence). However, this finding was heavily influenced by a single study, probably affected by a selection bias favouring couple therapy.The comparison between couple therapy plus drug therapy and drug therapy alone showed no difference in depressive symptom level, based on two studies with 34 participants (SMD -1.04, 95% CI -3.97 to 1.89, very low-quality evidence) and on dropouts, based on two studies with 45 participants (RR 1.03, 95% CI 0.07 to 15.52, very low-quality evidence).The comparison with no/minimal treatment showed a large significant effect favouring couple therapy both for depressive symptom level, based on three studies with 90 participants: (SMD -0.95, 95% CI -1.59 to -0.32, very low-quality evidence) and persistence of depression, based on two studies with 65 participants (RR 0.48, 95% CI 0.32 to 0.70, very low-quality evidence). No data were available for dropouts for this comparison.Concerning relationship distress, the comparison with individual psychotherapy showed that couple therapy appeared more effective in reducing distress level at the end of treatment, based on six studies with 187 participants (SMD -0.50, CI -0.97 to -0.02, very low-quality evidence) and the persistence of distress, based on two studies with 81 participants (RR 0.71, 95% CI 0.51 to 0.98, very low-quality evidence). The quality of evidence was heavily affected by substantial heterogeneity (I = 59%). In the analysis restricted to studies including only distressed couples, no heterogeneity was found and the effect in distress level at the end of treatment was larger (SMD -1.10, 95% CI -1.59 to -0.61). Very few data on this outcome were available for other comparisons.We assessed the certainty of the evidence using the GRADE system. The results were weakened by the low quality of evidence related to the effects on depressive symptoms, in comparison with individual psychotherapy, and by very low quality evidence for all other comparisons and for the effects on relationship distress. Most studies were affected by problems such as the small number of cases, performance bias, assessment bias due to the non-blinding outcome assessment, incomplete outcome reporting and the allegiance bias of investigators. Heterogeneity was, in particular, a problem for data about relationship distress.
AUTHORS' CONCLUSIONS
Although there is suggestion that couple therapy is as effective as individual psychotherapy in improving depressive symptoms and more effective in improving relations in distressed couples, the low or very low quality of the evidence seriously limits the possibility of drawing firm conclusions. Very few data were available for comparisons with no/minimal treatment and drug therapy. Future trials of high quality should test in large samples with a long follow-up of the effects of couple therapy in comparison to other interventions in discordant couples with a depressed partner, considering the role of relationship quality as a potential effect mediator in the improvement of depression.
Topics: Adult; Antidepressive Agents; Depression; Humans; Interpersonal Relations; Marital Therapy; Middle Aged; Patient Dropouts; Randomized Controlled Trials as Topic; Sex Factors
PubMed: 29882960
DOI: 10.1002/14651858.CD004188.pub3 -
Cancer Epidemiology Dec 2023Lung cancer is associated with high mortality, and significant health burden. Marital status has been associated with lung cancer survival. This systematic review and... (Meta-Analysis)
Meta-Analysis Review
Lung cancer is associated with high mortality, and significant health burden. Marital status has been associated with lung cancer survival. This systematic review and meta-analysis set out to investigate the association between marital status and treatment receipt in lung cancer. The search was conducted across three databases: Medline (OVID), Embase and CINAHL, from inception to June 2022. Retrospective or prospective observational studies that quantified treatment receipt by marital status were eligible for inclusion. Study quality was assessed via a modified checklist for retrospective databased-based studies. Meta-analysis using a random effects model was undertaken by chemotherapy, radiotherapy, surgery, and any treatment relative to married or not married. Pooled unadjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated for each type of treatment. 837 papers were screened and 18 met the inclusion criteria with eight being eligible for inclusion in the meta-analysis. Studies were excluded from meta-analysis due to overlap in the data reported in papers; the mean quality score of the 18 included papers was 12/17. Being married was associated with increased odds of overall treatment OR 1.43 (95 % CI 1.14-1.79; I = 82 %; Tau = 0.07; six studies) and also increased receipt of: chemotherapy 1.40 (95 % CI 1.35-1.44; I2 = 82 %; Tau = 0.00); radiotherapy 1.29 (95 % CI 0.96-1.75; I = 100 %; Tau= 0.09; four studies) and surgery (95 % CI 1.31-1.52; I = 86 %; Tau = 0.00; five studies). The results indicate that those who are married are more likely to receive treatment for lung cancer compared to those who are not married. This requires further investigation to better understand the explanations behind this finding and how we can work to combat this inequality.
Topics: Humans; Retrospective Studies; Lung Neoplasms; Marital Status; Cognition; Marriage; Observational Studies as Topic
PubMed: 37992417
DOI: 10.1016/j.canep.2023.102494 -
Family Process Dec 2022This paper provides a critical analysis and synthesis of the current status and emerging developments in contemporary couple therapy. Its narrative centers on the... (Review)
Review
This paper provides a critical analysis and synthesis of the current status and emerging developments in contemporary couple therapy. Its narrative centers on the evolution of couple therapy into a prominent intervention modality and coherent body of practice. The review begins with the consideration of the field's strong empirical underpinnings derived from research on couple therapy and basic relational science. Couple therapy comprises the widely accepted method for reducing relationship distress and enhancing relationship quality. Moreover, both as a stand-alone intervention and in conjunction with other treatment formats, couple-based interventions have garnered considerable empirical support for their effectiveness in addressing a broad spectrum of specific relational dysfunctions as well as individual emotional and physical health problems. We highlight the convergence of methods through common factors, shared strategies, and remarkably similar arrangements across approaches. Our review also points to key differences among approaches, the importance of recognizing respective strengths and limitations linked to these differences, and building on differences across models when selecting and tailoring interventions for a given couple. The discussion concludes with a consideration of recent trends in the field including the impact of telehealth and related digital technologies, the expansion of specific treatments for specific problems and diverse populations, the interface of couple therapy with relationship education, and enduring challenges as well as new opportunities addressing broader systemic and global dynamics.
Topics: Humans; Couples Therapy
PubMed: 36175119
DOI: 10.1111/famp.12824 -
International Journal of Environmental... Jan 2022Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health...
Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health effect of marriage or divorce is age-dependent and differs between women and men. The study aimed to identify the age and sex-related associations between marital status with PA and TV time. We used data from Vigitel, an annual telephone survey started in 2006 in Brazil. We applied a complex sample logistic regression model to estimate the odds for PA and TV time comparing marital statuses according to age and sex subgroups, independent of obesity, hypertension, diabetes, self-assessed poor health, and smoking. Our sample included 561,837 individuals from 18 to 99 years, with a TV time > 3 h/day (prevalence = 25.2%) and PA > 150 min/week (prevalence = 35%). Later, we divided our sample in seven age groups by marital status and sex. Compared to single individuals, married men and women were less likely to watch TV more than 3 h/day in participants >30 years old. When compared to single, married participants were less likely to do more than 150 min of PA/week at younger age groups. Married women older than 40 years were more likely to do more than 150 min of PA/week than the single ones, while there were no differences among married men by age group. In conclusion, our study suggests that the investments in public policies to encourage the practice of PA and reduction of TV time could be based on the marital status, sex, and age, prioritizing less active groups.
Topics: Adult; Divorce; Exercise; Female; Humans; Male; Marital Status; Marriage; Obesity
PubMed: 35010761
DOI: 10.3390/ijerph19010502 -
Heliyon Jul 2020Having sexual relations plays a very important role in the success and scope of procreation. Understanding sexual function can lead to sexual satisfaction and ultimately...
BACKGROUND
Having sexual relations plays a very important role in the success and scope of procreation. Understanding sexual function can lead to sexual satisfaction and ultimately to marital satisfaction and reconciliation of spouses.
OBJECTIVE
The aim of this study was to evaluate the effectiveness of a psychoeducational programme on sexual function and marital satisfaction of Iranian couples.
MATERIALS AND METHODS
This is a semi-experimental pre-test and post-test study with control group. The statistical population included all couples diagnosed with sexual dysfunction referred to Bahar Consulting Center in Mashhad in 2019. A total of 40 individuals were randomly assigned to the two treatment conditions which were experimental (n = 20) and control (n = 20) forming two groups. The individuals assigned to experimental condition experienced a 10 session psychoeducational program and the control condition comprised of Treatment As Usual (TAU) which was based on medical and general counseling regime. The data collection tool was marital satisfaction and sexual function questionnaire. Data was analyzed using SPSS version 22 software.
RESULTS
there is a significant difference between the amount of sexual function and marital satisfaction before and after the test in experimental group (p < 0.01). The results of this study showed that Psychoeducational Group Therapy improved the sexual performance and improved marital satisfaction.
CONCLUSION
Psychoeducational Group Therapy helps to increase marital satisfaction and sexual functioning of married couples. Therefore, this intervention is recommended as an effective program for improving marital satisfaction and sexual performance of couples. It can help to strengthen the foundation of the family.
PubMed: 32775734
DOI: 10.1016/j.heliyon.2020.e04586