Save Your Marriage

Save The Marriage

Lee Baucom, Ph. D. shows couples with marriage troubles a new way to save their marriage that is far more effective than any marriage counselor in this marriage course. In 4 easy-to-read modules, Dr. Baucom shows the step by step way to save a marriage that is in danger of ending any day. These show the top 5 mistakes that most people make in marriage, the REAL secrets to a happy marriage, why marriage counseling can actually HURT your marriage more, and how to move beyond your emotions into action. This module can actually have you saving your marriage in less than an hour, sometimes even 10 minutes. This book also comes with 4 bonus gifts free: Coping With a Midlife Marriage Crisis, Recovering from an Affair, 5 Rules for Fighting Fair, and an eBook written by a couple who was on the edge of divorce and the methods they used to get a happy marriage back. Marriage can be hard, but divorce is harder, on you and your children. Why risk it? Read more...

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Highly Recommended

The author presents a well detailed summery of the major headings. As a professional in this field, I must say that the points shared in this ebook are precise.

As a whole, this e-book contains everything you need to know about this subject. I would recommend it as a guide for beginners as well as experts and everyone in between.

Divorce Rates and Demographics

Divorce rates in the United States showed an upward trend from the late nineteenth century to the late twentieth century, rising from 0.3 divorces per 1,000 people in 1867, the first year for which national data are available, to a peak of 5.3 per 1,000 people during the period from 1979 to 1981. In the 1980s the divorce rate stabilized and began trending downward, with a figure of 4.4 divorces per 1,000 people recorded for 1995. It is projected that approximately one-half of the first marriages of the baby boom generation will end in divorce but that the rate will decline to 40 percent for the generations that followed the baby boomers. The median length of a first marriage that ends in divorce is eight years, and three out of four men and two out of three women remarry. Divorce is a more likely outcome for second marriages approximately 60 percent end in divorce after a median length of five to six years. Several factors increase the probability of divorce. Briefly, divorce rates...

Family Therapy Combined with Individual Therapy

Jacobson, Dobson, Fruzetti, Schmaling, and Salusky (1991) compared behavioral couple therapy, CT, or their combination in depressed (but not necessarily maritally distressed) women. In terms of depression outcomes, they found that the combined treatment performed as well as CT in both maritally distressed and nondistressed women, and that CT was superior to behavioral couple therapy in nondistressed couples. In terms of marital outcomes, there were no significant differences between groups. This was surprising Jacobson et al. had hypothesized that the combined treatment would be superior to either treatment alone. They have suggested that the reason for the lack of findings was that couples in the combined treatment received suboptimal doses of both behavioral couple therapy and CT (Addis & Jacobson, 1991). Another possibility is that the treatment approach and rationale for the two modalities needed to be more truly integrated. Finally, Miller et al. (2005) examined the impact of...

Marital Stability Marital Satisfaction and Divorce

During the first testing session in the 1930s, acquaintances provided ratings o each participant's personality on a wide variety of dimensions. Three aspects of personality proved to be strong predictors of marital dissatisfaction and divorce the neu-roticism of the husband, the lack of impulse control of the husband, and the neuroticism of the wife. High levels of neuroticism proved to be the strongest predictors. Neuroticism was linked with marital dissatisfaction of both the men and the women in the 1930s, again in 1955, and yet again in 1980. Furthermore, the neuroticism of both the husband and the wife, as well as the lack of impulse control of the husband, were strong predictors of divorce. The three major aspects of personality accounted for more than half of the predicable variance in whether or not the couples split up. This is a particularly strong ef fect in personality research. The couples who had a stable and satisfying marriage had neuroticism scores that were roughly...

Family therapy

Most professionals in the field of eating disorders in young people will agree that family therapy is one of the most important ways of treating the disease. Family therapists are trained to help the members of the family unit to Depending on the stage of the patient's illness the family might be asked to try and take responsibility for feeding their child, or at least to take a central role in supporting their child's efforts to eat. Ideas about how to improve things might flow easily from the discussion, although not many families find family therapy easy. The therapist might have to take a pro-active role in encouraging all the members of the family to speak up. Certainly in our first session Joe only spoke when spoken to and then his answers were monosyllabic. His younger brother Tom, who was only nine years old at the time, spent the entire session drawing pictures and basically ignored the therapist when she tried to speak to him. Subsequent sessions were easier and we all got...

Stability of Temperament2

Initial evidence showing how changes in individual temperament are associated with the nature of the child's environment typically involved assessment of negative emotionality during the first year of life. Specifically, Belsky, Fish, and Isabella (1991) have shown that infants who shifted from low to high negative emotionality during the first year of life had fathers who were both less involved with them early in infancy and who had greater feelings of marital dissatisfaction, as compared to infants whose level of negative emotionality remained low during this time period. In contrast, infants whose level of high negative emotionality declined over the first year of life had parents who had better marital relations and whose mothers displayed greater sensitivity, as compared to infants whose level of negative emotionality remained high during this time period. Similarly, Fish (1997) has reported that infants whose level of negative emotionality declined over the first year of life...

Talking things over with a buddy

Talking to your partner about how you feel is all well and good, but if you're both hurting badly, your partner can't give you all the support you need. Having someone outside your relationship to confide in someone you trust and feel can provide ongoing support may be immensely helpful. A good buddy is happy to lend you a shoulder to cry on. Perhaps this person may be your mum, or your sister, or your best pal from work. Set aside time to meet up with your buddy and give vent to your feelings. Opening up may be hard at first, but after you've broached the subject the going usually gets easier.

The Sense of Merger and Transcendence

Lovers may go beyond a sense of joint identity, may feel that they have in fact merged. Charles Williams said, Love you I am you, perhaps echoing Cathy's famous declaration, Nelly, I am Heathcliff. Lovers play on merging their names as a symbol of soulful merging. The Duke and Duchess of Windsor, in their love letters written before their marriage, referred to themselves as WE, the W standing for Wallis

Clinical Vignettes

A 21-year-old female college student decides to go on a date with her boyfriend of 2 years. She consumes a large volume of alcohol while out. When they return to her dorm room, the boyfriend tries to coerce her into having sex with him. She passes out without agreeing. Since they've had had sex before, he cites their long-term relationship as proof of consent. Would this incident be considered sexual assault Yes a long-term relationship (or even marriage) does not substitute or replace consent. Even if the woman agreed to intercourse, an intoxicated person is unable to give consent and the act would still be considered sexual assault.

Longterm Effects Of Cancer Diagnosis And Treatment On Survivors Family Members

The literature on the effect of cancer diagnosis and treatment on family members is sparse.74 Of studies in this area, most have focused on the impact of cancer soon after diagnosis, during recurrence, or at the terminal phase of the disease.75-77 One study shows that partners of men with prostate cancer, generally from small convenience samples, report more distress than their sick partners, but also believe that their partners are more distressed. The only reviewed study of long-term prostate cancer survivors found that couples' health-related QOL was associated with marital satisfaction.61 Distress was inversely related to levels of family support. The men's focus of concern, on their sexual functioning (i.e., impotence), was not shared to an equal degree by their non-sick partners.78,79 The most relevant study included

Finding Professional Help

Social workers, marriage and family therapists, and caseworkers, who hold degrees such as MSW, MFT, or LCSW, also receive specialized training in working with people with mental illness diagnoses. They can offer therapy and support and can also help with navigating government and community services.

Strengths And Weaknesses

Stance use with minor modifications, and are compatible with a wide range of other treatment approaches, including family therapy and pharmacotherapy. Another advantage is that these approaches have emphasized clear specification of treatment and a variety of manuals are available, thus allowing a high level of technology transfer. Disadvantages of this group of approaches include

Treatment For Abusers

Shame, guilt, and denial are powerful emotions that impede both the recognition of problems and the admission of the need for help. It is popularly believed that perpetrators enter treatment only under coercion and with considerable reluctance. Given the strong association between substance abuse and marital violence in some individuals, questions arise as to whether treatment of alcohol or drug abuse alone will concomitantly diminish violent acts. Behavioral marital therapy teaches improved communication skills and has been used to improve the marital relationships of patients as their drinking abates (O'Farrell & Murphy, 1995). This treatment modality, however, does not directly address the problem of violence. A comparison was made between eighty-eight couples with a newly abstinent husband and a nonalcoholic control sample of eighty-eight couples undergoing marital therapy. The study covered the year before treatment and the year after it. Acts of domestic violence occurred...

Interdependent skills

Chapter 6 helped you to assess whether making physical changes to your home environment and enlisting the help of volunteer play helpers would be beneficial to your relationship with your child, as well as increase his ability to interact and relax around people. Assuming that your home environment is in peak condition and that you found volunteers to befriend your child, your remaining steps are

Supporting each other

Your greatest supporter is your partner. The two of you have the same goal and have decided to give it your all to have a baby together. However, at times you may both be feeling down and have trouble giving each other support. If that's the case it may be better to turn to someone else for support and focus on nurturing your relationship with your partner instead Have fun together, go to the movies, eat out, see your friends, go for walks, do anything you like to take a break from the 'IVF job' and to remind yourselves that there's more to your relationship than surviving IVF.

Marriage and identity

Marriage or its equivalent long-term relationship brings about a huge change in ways of life. Whatever form a marriage takes, it must involve a sorting out of roles, that is, who does what and when. Where do the responsibilities lie This may seem a minor matter, but to anyone who has experienced it, it is not. To settle into living with another person, in an intimate relationship, requires considerable adjustment. To take the USA as an example (although it may be the extreme example), one half to two-thirds of American marriages end in divorce and some other enduring marriages are unhappy. What is it, then, that makes marriages or long-term relationships happy Why do some succeed and others fail This is a description of some of the behaviours of happy couples in successful long-term relationships. Turning the coin over, these ways of behaving in a relationship could be seen as prescriptions for happiness, actions to aim at if one wishes to develop a satisfactory and enduring...

Questions and possibilities

Compare your own long-term relationship(s) with those of your friends and family. What types of division of roles characterise them Why do you think that different patterns develop of the sharing of labour in enduring relationships To some extent, long-term relationships and small family circles are a product of the present time within Western society. What are your views on alternative social structures Do small nuclear families necessarily represent the best background for development across the lifespan

Joes fourth weekly review

Joe's therapeutic programme was gradually being built up. This week Joe's care team decided it was time to book a family therapy consultation and to consider cognitive behavioural therapy. Joe's care team were still concerned about Joe's ritualistic behaviour. Joe claimed he carried on with his rituals because he was so bored and frustrated with the lack of physical activity. He also claimed that he was unable to sleep properly because of this.

Lisa A Uebelacker Marjorie E Weishaar Ivan W Miller

Depression and family problems frequently co-occur. In this chapter, we describe an integrated approach that a cognitive therapist may use to conceptualize and manage depression and family problems in adults and older adolescents. Although we do not describe how to conduct full-scale family therapy per se, we do focus on (1) how to conceptualize depression from an integrated cognitive and interpersonal viewpoint and (2) a menu of interventions that are consistent with cognitive therapy and include the family. These interventions, which range from a one-session family meeting to concurrent family and individual therapy, allow the clinician to develop an integrative case conceptualization and then act on it.

Family Problems Predict Onset Delayed Recovery and Relapse of Major Depression

Humiliating events, such as infidelity or threats of divorce, may leave people particularly vulnerable to major depression (Cano & O'Leary, 2000). These data are supported by retrospective studies in which large portions of depressed individuals reported that marital problems occurred before the onset of their depression (e.g., Kendler, Karkowski, & Prescott, 1999), and that they believed marital problems had a causal role in the onset of the depression (O'Leary, Riso, & Beach, 1990).

General Issues Regarding Inclusion of a Family Members in Treatment

First, whenever multiple family members are involved in a session, even if it is not for formal family therapy, it is useful for the therapist to keep a few principles in mind. It is important to acknowledge that everyone in the room is having different thoughts and reactions, not just the identified patient. All family members need a chance to talk about their reactions and to feel understood. If someone has a lot of reactions, the therapist might ask him her to write them down to avoid interrupting other people as they talk. Also, in terms of pacing, it is important to move with the slowest person and to check continuously to make sure that everyone understands the information being presented. Finally, it is ideal if the family members finish the session with a common understanding of the problem, or at least agree on ways to manage the problem. Second, one or two family meetings can be useful even if the therapist believes more extensive family intervention is indicated. Some...

Identifying the Pros and Cons of Sharing

The benefits of disclosing your illness will differ depending on whom you're telling and what you're hoping to achieve. Here are some examples, but make sure the benefits you list are appropriate to your unique experiences, the person you're thinking of telling, and your relationship.

Nonverbal Communication

Yalom (1985) suggests that, in general, structured exercises are of more value in brief specialized groups than in long-term outpatient groups. However, this particular intervention has been used in the working phase of insight-oriented groups that focus on long-term relationship building and learning from the responses of and interactions with others. I have found it most useful when working with a client who has doubts about his or her membership in group, particularly when that doubt has grown out of a sense of shame or concern about rejection following misbehavior (in or outside of group) or revelation of what the client perceives as shameful historical material.

New And Improved Treatments

Because behavioral interventions are the most common, and sometimes the only, treatments administered to individuals with drug addiction, NIDA also has a robust behavioral therapies development program to complement its medications portfolio. Researchers are working to develop new behavioral treatments for drug abuse and addiction and enhance the efficacy of existing ones. Psycho-therapies, behavior therapies, cognitive therapies, family therapies, and counseling strategies are among the approaches currently being studied under this program. Once these treatments are proven to be safe and effective in small trials, they will be tested in larger and more diverse populations through NIDA's new National Drug Abuse Treatment Clinical Trials Network. This network will enable the rapid, concurrent testing of a wide range of promising science-based medications and behavioral therapies across a spectrum of real-life

Economic And Occupational Illness Burden

Likely effects of treatment on indirect illness-related costs are illustrated by a survey of 500 patients with bipolar disorder conducted by the National Depressive and Manic-Depressive Association, which reported that after receiving effective treatment, patients were significantly less likely to commit minor crimes, experience financial difficulties, become divorced or encounter marital difficulties, injure themselves or others, gamble excessively, or abuse alcohol or drugs 18 . This portrait of the composite expense of bipolar disorder suggests that it is far more costly not to treat than to treat.

The Importance Of Matching Treatment To Client Needs

National Academy Press. KAUFMAN, E. (1985). Family systems and family therapy of substance abuse An overview of two decades of research and clinical experience. International Journal of the Addictions, 20 (6& 7), 897-916. ONKEN, L. S., & J. D. Blaine (1990). Psychotherapy and counseling in the treatment of drug abuse. Rockville, Maryland National Institute on Drug Abuse. Wilkinson, D. A., & Garth W. Martin (1991). Intervention methods for youth with problems of substance abuse. In Helen M. Annis & Christine Susan Davis (Eds.). Youth and drugs Drug use by adolescents Identification, assessment and intervention. Toronto Addiction Research Foundation

Developing a Support Agreement

Each support agreement will probably be different, depending on the person and your relationship. And although many people find this approach useful, it doesn't work for everyone it depends on how comfortable you are with involving friends or family members in your treatment plan.

Childhood Bipolar Disorder

Increasing attention has been paid in the literature to the recognition of bipolar illness that may develop during childhood 46 , although its frequent non-prototypical features or comorbid presentation with other conditions (such as attention deficit hyperactivity disorder) hinder accurate and timely diagnoses. Little information is available on the psychosocial impact of juvenile-onset bipolar disorder with regard to school performance, social development, or longitudinal outcomes. However, data from the National Depressive and Manic-Depressive Association membership survey 18 point to a number of differences in psychosocial outcome following child adolescent onset (before age 20, approximate n 295) and adult onset (after age 20, approximate n 205) bipolar disorder. Notably, child-adolescent onset bipolar disorder was more often associated with school dropout (55 of respondents), financial difficulties (70 of respondents), divorce or marital problems (73 of respondents), alcohol or...

An Integrated Approach To A Workable System Of Family Treatment

Accurate diagnosis is as important a cornerstone of family therapy as it is in individual therapy. Family diagnosis looks at family interaction and communication patterns and relationships. In assessing a family, it is helpful to construct a map of the basic alliances and roles, as well as to examine the family rules, boundaries, and adaptability. Family Treatment Techniques. Each system of family therapy presently in use is briefly summarized below, with an emphasis on the application of these techniques to substance abusers. They are classified into four schools structural-strategic, psychodynamic, Bowen's systems theory, and behavioral. Any of these types can be applied to substance abusers if their common family patterns are kept in mind and if a method to control substance abuse is implemented. Structural-Strategic Therapy. These two types are combined because they were developed by many of the same practitioners, and shifts between the two are frequently made...

Family And Caregiver Burden

Marital conflict, separation and divorce are frequent occurrences among individuals with bipolar disorder, such that some studies report intact marital relationships in less than one-fifth of bipolar cohorts 2, 75 . Interpersonal problems with spouses or romantic partners have also been associated with elevated suicide risk in at least one bipolar cohort based in Taiwan 76 . These latter observations are consistent with findings by Miklowitz et a 83 that emotional overinvolvement by family members of bipolar patients may reflect one aspect of negative expressed emotion (EE), in turn heightening relapse risk. To that end, family-therapy based efforts to reduce EE levels may be of value not only as a means for improving medication compliance and individual patient outcomes, but also as an aid to reduce subjective caregiver burden aggravated by illness misperceptions.

Do Race Differences In Iq Imply That Immigration To The United States Will Lead To More Social Problems

IQ and some outcome, the relationship is not large, and IQ certainly does not account for most of the variation. We can be sure that many other factors than IQ are related to poverty, crime, and marital breakdown. The design of the study does not in fact permit us to draw the conclusion that IQ is a cause of these outcomes. This is a correlational study, which can demonstrate an association, but not a casual link.

Use of Psychodynamic Psychotherapy With Other Treatment Approaches

Psychodynamic psychotherapy can be integrated fairly readily with other treatments, including medication, cognitive-behavioral therapy (CBT), and couples therapy. Patients treated with psychodynamic therapy for depression frequently also take antidepressant or mood-stabilizing medications for their symptoms, which is sometimes essential for a full exploration of their conflicts. When medication treatments are so complex as to limit time available for psychotherapy, or when the therapist is not a physician, a psychopharmacologist can manage the patient's medications. The use of medication and the therapist's role in employing this modality (whether the therapist or another health professional is prescribing) can often be important areas for exploration. For additional discussion of the issues involved in combining psychodynamic psychotherapy with other treatments, see Beitman and Klerman (1991), Riba and Balon (2001), and Kay (2001).

Review Of Efficacy Research

Brent and colleagues (1997) compared individual CT to systems behavioral family therapy (SBFT) and nondirective supportive therapy (NST) with 107 adolescents with MDD. Treatment was weekly for 12-16 weeks. Remission was defined as at least 3 consecutive weeks of normal scores on self-reported depression and absence of MDD. Remission was higher for CT (60 ) than for SBFT (38 ) or NST (39 ). Parents also perceived CT as more credible than the other treatments.

Recognizing Dualities And Resilience

From literature and nonfiction, good luck bad luck tales, and proverbs of many cultures, the reality that problems can directly or indirectly lead to paradoxically positive outcomes, self-knowledge, and resiliencies has long been part of human awareness. The concept of reframing, originally developed in family therapy contexts, has been broadened and utilized in other therapies, including resiliency interventions (Wolin, S.J. & Wolin, S., 1993). With longitudinal developmental research such as that reported by Valliant (1995) and the Kauai studies (Werner & Smith, 2002), reporting unexpectedly positive life trajectories for multiply stressed subjects, and further stimulated by the influence of positive psychology, the realities of adaptive lifelong functioning are being incorporated into theoretical perspectives (see Fredrickson, Mancuso, Branigan, & Tugade, 2000 Fred-rickson, 2001). As Hemingway, in his semi-autobiographical novel, A Farewell to Arms (1929) wrote The world...

Finding Meaning at Your Funeral

We are gathered here today to say goodbye to our friend and family member, Roland. Roland was a wonderful father and husband. He loved and enjoyed spending time with his family Roland's children grew up to be successful and happy He loved and cherished his wife throughout their marriage. He was careful to keep the romance alive, even until the end. Roland was a true friend to many of us here today When someone needed help, Roland was the first to offer His door was always open. Whether or not people needed his time or even his money, Roland was generous. Roland also gave to his community he organized members of his congregation to pick up seniors who were unable to drive so that they could attend church services and functions. Truly, he made the world a little better place.

Description Of Interventions

Family-of-origin or transference work Did this experience feel familiar to you How did something like this play out in your own family Jane, how you are feeling about Andrew right now sounds an awful lot like what you've told us your relationship with your mother was like.

The afterlife in the Japanese myth of creation

Finally, Izanami herself came in pursuit of Izanagi. He pulled a huge boulder across the pass to separate Yomi from the land of the living. As Izanagi and Izanami stood facing each other on either side of the boulder, she said 'O my beloved husband, if you do thus, I will each day strangle to death 1,000 of the populace of your country.' He replied 'O my beloved spouse, if you do this, I will each day build 1,500 parturition huts, meaning that 1,500 people will be born.'6 Finally, she told him that he must accept her death. Izanagi promised not to visit her again. Then, they formally declared their marriage over.

Cynthia M Bulik and Sara E Trace

Providing accurate information for parents and family members regarding the biology of BED is also critical. Parents and family members frequently have a great deal of influence on a patient's views and beliefs about their disorder. As parents and family members are often exposed to the same misleading messages from the media regarding the genetics of eating disorders, it is important that these topics are discussed within a family therapy context or that psychoe-ducational materials are provided to family members. An added benefit to educating parents and family members about the genetic contribution to BED is that it may reduce misguided guilt and self-blame. Historically, in the case of children or adolescents, parents have been held responsible for their children's eating problems. Educating parents on genetics may reduce guilt based on these inaccurate stereotypes.

Think I am a good candidate for gastric bypass surgery What do I need to do to obtain insurance coverage for this

If you do not have a long-term relationship with your doctor you should bring detailed notes to give her or him. These should include information on specific diets you have been on, when you were on the diet, and how successful you were. If you did lose weight during any of your weight loss attempts, you should supply your doctor with information on how long you were able to maintain it. Your primary care doctor should be aware of your obesity-related conditions, but if you have seen specialists for various problems, he or she might not have all the details of treatments you have received. If you want your procedure to be approved quickly, I suggest you draft a sample letter for your physician. (See Appendix B for an example of a sample letter.)

Contributors To Group Therapy

Tal-Li Cohen, MA, is a clinical and educational psychologist, family therapist, and riding instructor practicing in Israel. In the past year, she has developed a unique therapy approach using horses in her therapeutic paradigm. Michael P. Frank, MA, MFT, CGP, FAGPA, is a licensed marriage and family therapist and certified group psychotherapist who has been leading therapy groups in his private practice in Los Angeles, California, since 1984. He is a Fellow of the American Group Psychotherapy Society and a past president of the Los Angeles Group Psychotherapy Society. Jondra Pennington, MS, is a marriage and family therapist in private practice in La Quinta, California. She is an associate clinical member of the American Group Psychotherapy Association whose clinical interests include dialectical behavior therapy, the treatment of eating disorders and trauma. Sheila Sazant, MS, is a registered mental health counselor intern specializing in individual, group, and family therapy.

Adaptation of Standard CT for Depression

Second, therapists need to assess how the patient's sexual orientation fits into the case conceptualization. This is extremely important to prevent the therapist from assuming that sexual orientation is a major factor in the patient's presenting problem when it is not, or alternatively, not seeing a relationship between the patient's sexual orientation and his her presenting problem when clearly there is one. For example in the case of a male patient having unsafe sex with multiple male and female partners both sexual orientation and sexual behavior may be important considerations in the case conceptualization. On the other hand, in the case of a male patient in a long-term relationship who is open and out to his family, friends, and cowork-ers, and who presents with reactive depression following the death of his father, sexual orientation may play a negligible role in the case conceptualization.

L Oriana Linares Nicole A Morin

Ritchie, 1991 Osofsky et al., 1993 Jaffe, Wolfe, Wilson, & Zak, 1986 McCloskey, Figueredo, & Koss, 1995 Jouriles, Murphy, & O'Leary, 1989 Crockenberg & Covey, 1991). For example, in nonclinical samples, preschool children exposed to marital discord showed more externalizing behavior problems, including aggression and noncompliance (Crockenberg & Covey, 1991). A recent meta analysis examining 118 studies of children exposed to interparental violence indicate a low-to-moderate effect size (d -.29) on child problems (Kitzmann, Gaylord, Holt, & Kenny, 2003), with greater exposure risk shown among preschoolers.

Approaches To Treatment

There are many options for integrating family interventions into individually based CT for depression. The integrative case conceptualization, as well as pragmatics, guides the choice of family intervention level and the specific strategies used. Options include (1) treating an individual alone (2) including family members in a few sessions for the purpose of assessment (3) providing psychoeducation to family members (4) brief problem solving with family members (5) including a family member as a therapy coach and (6) conducting full-scale family therapy in addition to (or in lieu of) individual therapy. We describe what may lead a therapist and patient to choose a particular option, what may be accomplished in the context of that option, and any caveats or limitations of that option.

Diabetes In The Bedroom

Research about women, diabetes, and sexuality. It appears as it is not as much about the complications or the blood sugar-blood pressure relationship that affects sexuality. It is shaped much more by confidence in yourself and by depression, and your relationship with your partner.

The Impact Of Cancer On Relationships

Several studies have compared relationship quality in cancer survivors to various control groups, both population-based and other. With few exceptions, the outcome of focus has been the partner relationship. In one of the earliest studies of this type, no differences in satisfaction with relationships with family or friends, or marital status were found between a mixed sample of 339 long-term (more than 3 years post-treatment), disease-free cancer survivors compared to national age-adjusted data.30 In a more recent study specific to long-term testicular cancer survivors, no differences were found in separation or divorce rates compared to matched controls, and cancer survivors reported fewer negative changes in friendships compared to controls.31 In an older study, also conducted with testicular cancer survivors, levels of satisfaction with the partner relationship were higher in survivors compared to age-matched controls.32 Breast cancer survivors (between 6 and 57 months...

The Well Being of Children Raised in Single Parent Homes

Families that attain their single-parent status through marital dissolution are disproportionately more likely to experience both residential instability and higher rates of interparental conflict (both prior and subsequent to marital disruption). Children who are exposed to interparental conflict are more likely to experience difficulties with regard to psychological and behavioral adjustment and academic achievement. Again, once levels of interparental conflict are taken into account, differences in well-being for children from single-parent families versus two-parent families are reduced.

Childrens and Adolescents Adjustment in Stepfamilies

Children and adolescents in stepfamilies tend to develop more problems than children and adolescents in intact families. Children in stepfamilies are more likely than children in intact families to have academic problems, to have externalizing or internalizing disorders, to be less socially competent, and to have problems with parents, siblings, and peers. About a third of adolescents become disengaged from their stepfamilies and consequently may be more like ly to become sexually active at an early age, to be involved in delinquent activities, to be involved with drugs or alcohol, and to drop out of high school. When children or adolescents raised in stepfamilies reach adulthood, they are more likely to divorce than children raised in intact families. But it is important to note that although children in stepfamilies are more likely to have problems than children in intact families, the majority of children in stepfamilies are normally adjusted.

Substance Abuse And Family Life

Disrupted family dynamics can occur irrespective of socioeconomic status and ethnic group membership. Research involving a large cross-sectional sample found that offspring of substance abusers were more likely to experience marital instability and psychiatric symptoms, especially if they had experienced physical and sexual abuse (Greenfield etal., 1993), and it has also been found that alcohol abuse often co-occurs with domestic violence (Fagan, Barnett, & Patton, 1988 Dinwiddie, 1992). Construction of family trees,'' or genograms, are now in common use as clinical tools to depict the degree to which abuse of various substances has had effects on several generations in a family, the extent that support is available from family members, and the emotional valence of kinship relationships (Lex, 1990). Background factors significant for women include childhood violence experiences, violence from a cohabiting partner, and presence of concurrent antisocial and or borderline personality...

How Mediation Affects Parents and Children

Sales. Family Mediation Facts, Myths and Future Prospects. Washington, DC American Psychological Association, 2001. Dillon, Peter A., and Robert E. Emery. Divorce Mediation and Resolution of Child Custody Disputes Long-Term Effects.'' American Journal of Orthopsychiatry 66 (1996) 131-140. Emery, Robert E. Renegotiating Family Relationships Divorce, Child Custody, and Mediation. New York Guilford Press, 1994. Emery, Robert E. Sage Developmental Clinical Psychology and Psychiatry Series, Vol. 14 Marriage, Divorce, and Children's Adjustment. Thousand Oaks, CA Sage, 1999. Emery, Robert E., and Melissa M. Wyer. Divorce Mediation.'' American Psychologist 42 (1987) 472-480. Emery, Robert E., Sheila G. Matthews, and Melissa M. Wyer. Child Custody Mediation and Litigation Further Evidence on the Differing Views of Mothers and Fathers.'' Journal of Consulting and Clinical Psychology 59 (1991) 410-418. Hahn, Robert A., and David M. Kleist. Divorce Mediation...

The Prevalence of Single Parent Families in America

Such increases are accounted for by rising divorce rates (5.7 of first-time marriages ended in divorce in 1970, while 18.5 of such marriages ended in divorce in 1998) and an increase in the number of women who give birth to or adopt children outside of marital relationships. Women giving birth outside of marital relationships include adolescent mothers and increasing numbers of older, more affluent (and predominantly white) women, who have elected to become single parents through either out-of-marriage births or adoption. Such women are called single mothers by choice. There are ethnic differences in the prevalence of single-parent families. In 1999 the rate of single-parent families among black families was 56 percent among Hispanic families, 32 percent and among white families, 20 percent. Higher rates of black single-parent families result from higher rates of out-of-marriage adolescent childbearing within this group and higher divorce rates among black women.

Diagramming The Cognitive Case Conceptualization And Presenting It To The Patient

Cognitive Conceptualization Diagram

In addition to providing hypotheses about relationships among the patient's problems, the case conceptualization should ultimately provide information regarding selection of an appropriate treatment modality (e.g., individual, couple, or family therapy) and specific intervention strategies, and the pacing of therapy. Case conceptualization may also provide information about other contextual factors that are relevant to treatment (e.g., the therapeutic relationship). Finally, it should be noted that case conceptualization is not fixed at the beginning (or at any stage) of therapy. Although it begins

Brief Problem Solving and Goal Setting

To conduct problem solving, the therapist explains to the family the standard steps of problem solving (e.g., defining a problem, brainstorming possible solutions, discussing the pros and cons of these solutions, deciding upon a solution, and evaluating the solution). The therapist can assist the family in walking through these steps to manage a specific problem. Because this is not full-scale family therapy, the focus is less on learning the process of problem solving (although the process should be explained) and more on solving a particular problem. The limitation of this strategy is that because it is not full-scale therapy, the number and complexity of problems that can be considered are circumscribed.

Types of Self Help for Sexual Dysfunctions

All participants increased in orgasmic capacity during masturbation (65 posttreatment 77 follow-up) and manual and oral partner stimulation (33 posttreatment 27 follow-up) couples therapy and BT superior to group therapy in percentage orgasmic by manual partner stimulation van Lankveld, Leusink, van Diest, Slob, and Gijs (2004) recently conducted a pilot study to gauge the possible efficacy of sex therapy through the Internet for heterosexual men with sexual dysfunctions. A relatively homogeneous sample was investigated, from which men with hypersexual-ity and problems with gender identity or sexual orientation were excluded, as were men with depressive symptoms, psychotic comorbidity, substance abuse disorder, and major marital problems. The study had a pre-post participants-as-own-control design. After completing a Web-based questionnaire, participants were offered 3 months of sex therapy with e-mail contact only. Three experienced therapists provided treatment. Treatment followed a...

But everyone else can have a baby

You're certain to feel sad and worried about the future ('Will I ever have a baby ') and you may also wonder if your relationship with your partner will survive or crumble under the pressure of it all. The burden of being the partner with the fertility problem can affect the dynamics of a relationship too. The infertile partner may become withdrawn and feel inferior because she or he is 'causing the problem', and may even offer to end the relationship so that the fertile partner can find someone else to have a family with. This then places pressure on the fertile partner to bend over backwards to be reassuring and understanding. Talking openly about your feelings is the best way to avoid damaging your relationship.

Table 135 Questions about Intimacy and Infertility to Ask Your Doctor

Cologists, urologists, endocrinologists, psychiatrists, psychologists, and clinical social workers. Sex therapy, another option, usually involves working as a couple with a mental health professional for a specific period of time (usually around ten to twenty visits). The goal of sex therapy is to treat issues specifically related to intimacy. Underlying marital problems are better addressed in traditional couples therapy. For more information on resources, see the Appendix.

HOME and Socio Emotional Development

Findings by Bakeman and Brown (1980) Lamb et al. (1988) Erickson, Stroufe, and Egeland (1985) Mink and Nihira (1987) Bradley, Caldwell, Rock, Barnard, Gray, et al. (1989), Caughy, DiPietro & Strobino, 1994, and Bradley and Corwyn (2000, 2001) suggested that particular parenting practices may interact with both particular child characteristics (e.g., quality of attachment, difficult temperament, self-efficacy beliefs, level of disability) and broader ecological factors (e.g., marital quality, support from extended family, participation in day care, family conflict, overall family style) to affect the course of social development. Moreover, the study by Plomin, Loehlin, and DeFries (1985) showing little relation between HOME and behavior problems in adopted children but a significant, yet small (.23), relation for nonadopted children suggests that genetic factors may play a role. A child's reaction to a particular parent action also is a function of the overall ambiance or style...

As a caregiver how can I cope with my partners PD

Balance of your relationship is shifting you will be challenged emotionally, spiritually, and physically. A partner who mowed the lawn and kept the garden may no longer be able to perform these tasks. A partner who shopped and cooked and cleaned the house may have to share those tasks with his or her mate. At times, the responsibility for the home combined with caregiving for the ill partner can become so burdensome that you feel pushed beyond your abilities to cope.

Challenges With Disclosure

Answer Just because you have an illness doesn't mean it's the most important thing about you or that you need to share this information as soon as possible. Use the tips we provided earlier to test the waters and determine whether new people in your life are understanding and accepting about mental illness. Because bipolar disorder is a chronic illness, someone who isn't open to learning about it probably won't turn out to be a good fit for a long-term relationship. You'll know when the timing feels right. If

Your partners reaction to your pregnancy

Encourage your partner to identify his doubts and worries and be honest about what he's feeling, both the good and the bad. You do the same. Discussing your feelings honestly and openly will strengthen your relationship with your partner and help the two of you start the important work of preparing a home for your baby.

Sicklecell disease 455

In a few families, the conflict between siblings is so severe that the help of a mental health professional may be required. Signs that a family may need outside help in solving the problem include conflict that is causing marital problems, creates a real danger of physical harm, or that is hurting a child's self-esteem or psychological well-being.

Obsessive Compulsive Foundation OCF An

Oppositional defiant disorder (ODD) A behavior disorder characterized by uncooperative, defiant, negative, irritable, and annoying behavior toward parents, teachers, and other authority figures in children and teens. Oppositional defiant disorder (ODD) is reported to affect between 2 and 16 percent of children and adolescents in the general population, usually appearing by age eight. ODD is more common in boys than in girls and may be more common among those children whose parents are having marital problems. Oppo-sitional defiant disorder often coexists with other mental health disorders such as mood disorders, anxiety disorders, conduct disorder, and attention Treatment may include individual therapy, family therapy, peer group therapy, or medication. Family therapy Family therapy is often focused on making changes within the family system, such as improving communication skills and family interactions. Parenting children with ODD can be very difficult and trying for parents....

Case examples and scoring sheets

In the course of their marriage it also became clear that she was not able to get pregnant. She therefore visited an infertility clinic about 2 years ago. After all kinds of investigations the doctors concluded that, because of her illness, she could not be admitted to a fertilization program her chances of becoming pregnant were regarded as minimal. Although she asked the doctors to discuss this issue with her nephrologist, no action was taken, and she was afraid of being perceived as difficult and did not ask again. As a consequence of the diagnostic confusion in the past she does not really trust doctors, although she trusts her nephrologist and is inclined to follow his advice.

Augmenting Standard CT for Depression

Adapting standard CT for depression with supplemental interventions generally proceeds in one of two directions. First, a therapist might use additional clinical techniques in targeting other problems in a sequential fashion. For example, a clinician working with a patient who presents with comor-bid depression and a substance use disorder might first decide to treat the depression, then the substance use disorder, in a sequential fashion. In deciding upon the order of treatment, the clinician may want to begin with the problem that is most distressing to the patient. Another approach to sequencing of treatment strategies is to begin with the problem that is seen as primary (i.e., occurring prior to other problems) and subsequently moving to secondary problems once the primary problem is successfully treated. For example, if a patient has developed an addiction to a medication prescribed to help with insomnia he she experiences as part of depression, it may be most useful to treat the...

Impact of Family Problems on Cognitive Therapy for Depression

Although one might speculate that the presence of serious family problems decreases the efficacy of cognitive therapy (CT) for depression, there is actually very little research on this topic. Individuals in CT who reported that relationship problems were a cause of their depression (relative to those who did not) were less likely to complete homework and showed a poorer response to treatment (Addis & Jacobson, 1996). Beach and O'Leary (1992) also found that depressed married women with negative marital environments had more residual depression symptoms after CT than after behavioral couple therapy. Finally, depressed women treated with an antidepressant and either CT or supportive therapy were less likely to remit if they had reported having low support from their husband before beginning treatment (Bromberger, Wisner, & Hanusa, 1994). In summary, the small amount of existing evidence suggests that relationship problems may interfere with response to individual CT.

Ameliorating the Impact of Divorce on Children

Access to therapeutic interventions, especially school-based support programs, is associated with improved postdivorce adjustment. Perhaps the greatest effort to help children has occurred through programs targeted at parents. A growing number of states are offering (or mandating) education or mediation programs for divorcing parents. Divorce mediation leads to speedier dispute resolution, greater compliance in payment of child support, and greater involvement of the father in the children's lives. Although parties who participate in mediation and in education programs tend to be satisfied with them, there is little evidence to suggest that they benefit children. But absence of evidence is not equivalent to evidence of absence. Evaluation research is acutely needed to improve the efforts to help children whose parents separate. Allison, Paul, and Frank Furstenberg. ''How Marital Dissolution Affects Children Variations by Age and Sex.'' Developmental Psychology 25 (1989) 540-549....

Methodological Limitations

Couples in lengthy partnerships have likely endured other hardships and challenges throughout the course of their duration as a couple, which may make them better equipped to manage the stressors associated with cancer as well, and they may be more committed to the relationship given their investment in it. Not only does the fact that most research is conducted with individuals and couples in long-term relationships reporting high levels of relationships satisfaction and few problematic relationship behaviors threaten the generalizability and external validity of findings, but also this issue is problematic because it leads to restriction of variance, which ultimately reduces statistical power and ability to detect significant effects.

Psychiatric Treatment

This firm understanding should engage the patient in a treatment alliance with the team. Remember that many of these patients are very polite and 'out to please you' at least superficially, and many times their initial acceptance hides deeper feelings of isolation and resentment. Psychotherapy is of help for some patients, usually accompanied by behavior modification and family therapy.

Impact of Divorce on Children

Various theories of child development suggest that children younger than age five or six are particularly vulnerable to the effects of parental separation. The disruption of attachment relations, combined with the child's limited cognitive abilities to understand divorce, is central to this vulnerability. Although most children are young when their parents separate because divorce risk is greater earlier in marriage (of all children who experience divorce by age twelve, 66 experience it by age six), preschoolers and infants are the least studied groups in the divorce literature. In fact, data on developmental differences in response to parental separation are surprisingly limited. It is common for children to experience sadness, anxiety, anger, sleep disturbances, and other symptoms in the months following a parental separation. Indeed, for the first one to two years after divorce both boys and girls tend to show subclinical behavioral and emotional distress and are likely to be more...

Disruptive or Externalizing Behavior Disorders

The development of ODD or CD is likely to have origins in multiple factors associated with diverse pathways. Researchers have found evidence that several factors are related to the development of ODD, CD, or both genetically based, early temperament difficulties (e.g., having lower frustration tolerance), neurobiological factors (e.g., low psychophysiological arousal), social-cognitive factors (e.g., cognitive distortions), family patterns of interaction (e.g., inadequate monitoring of the child's behavior), and family environmental stress and adversity (e.g., marital discord).

Sibling Relationships in the Family System

However, marital problems and parental depression are far less likely to affect sibling relationship quality. The same is true for parents' relationships with impatient children. Parents who are able to form positive relationships with such children, even though the children's temperaments make it difficult to deal with them, may be able to smooth out the problems these children experience in their sibling relationships. Children with difficult temperaments who experience positive relationships with their parents will learn how to treat others positively, including their siblings.

Helpful Parenting Strategies

The limits you set, and enforce them in a firm but nonaggressive and nonconfrontational manner. If possible, involve your child in solving issues to teach him or her problem-solving skills. Remember that parents serve as models for child behavior, so, as much as possible, work to provide your child with frequent examples of step-by-step problem solving and conflict resolution (family therapy may help to a great degree here). If arguments become aggressive, implement strategies to de-escalate tension (e.g., a family time-out until all parties have calmed down). If parents disagree about how to handle a problem, avoid arguing or discussing this in front of your child.

Coping With Msrelated Changes In Sexual Response

Restore the special nature of your relationship by showing your partner how important he or she is to you. Loving gestures are often forgotten under the pressure of coping with MS and other stresses. when you treat your partner as a special person, you set the stage for increased intimacy, which can sometimes stimulate libido. Read books and watch educational videos with your partner. Set aside time to talk about what you are learning, whether or not it applies to your relationship. Make regular dates, free from the responsibilities of work, caregiving, and childrearing, to rediscover your partner. Try to recreate the feeling of romance that characterized your relationship before it was swept away by the burdens of career, parenthood, and MS.

What happens at an adolescent unit

Fiona explained that each patient has an individual therapeutic programme consisting of individual and group therapy and family work. The appropriate programme for Joe would be worked out once he had settled in and was a little stronger. Families are expected to be actively involved in the therapeutic programme, this may involve structured Family Therapy sessions, informal meetings or family mealtimes.

Effects on the family

Anorexia is a very manipulative illness, and families that try to ignore its existence can soon find that the anorexia is controlling the lives of all the individuals within the family. By working together, a family unit can be very successful in taking control of the anorexia and helping the sufferer overcome his difficulties with eating. I mention later on that family therapy often forms a key part of a successful treatment programme.

Our second parentscarers meeting

The other two girls had still not reached their target weight and their parents fully expected their daughters to be at The Great Barn for some time to come. We talked about several things during the course of the meeting, but the two issues I found most useful that we discussed were the anger and aggression of anorexia, and family therapy.

Psychotherapy and Weight Change

When weight gain or loss is considered to be a psychological illness rather than a behavioral aberration, very different approaches are used. Certainly, the use of talk-therapy, whether in the form of classic psychoanalysis or short-term psychotherapy, has a long history. Indeed, family therapy remains a mainstay for the treatment of eating disorders such as bulimia and anorexia nervosa, but it is used relatively rarely as a treatment for obesity. Alternative psychoanalytic explanations, such as libido theory, have been offered to explain the presence of obesity (Friedman 1972 364-83). The effectiveness of interpersonal psychotherapy has been claimed by Christopher Fairburn as an answer to the lack of long-term effectiveness of behavioral therapy (Fairburn 1997). One large-scale study in i977 tracked the treatment of eighty-four obese patients (paired with sixty-three normal-weight patients) treated with a wide range of psychoanalytic approaches. The resultant (short-term) weight loss...

Suggestions for Parents in Stepfamilies

Children's and adolescents' adjustment in step-families can be encouraged several ways. First, parents can help children and adolescents adjust to stepfamilies by taking into account issues related to gender and age. The most successful stepfamilies have parents who are flexible and able to adjust to the varying demands that children's gender, age, and individual differences place on parents. Parents should have realistic expectations of new family relationships and should not expect close bonds immediately. Parents also should be aware that fathers and mothers in stepfamilies face different challenges and try to provide support for their partner's parenting. A strong marriage is the foundation of a successful new step-family. Finally, parents should work together to create warm, supportive relationships with their children and stepchildren. One technique for doing so is to create new family traditions to add to the traditions of the original families. In conclusion, although...

Directions For Future Research

There also is clearly a need for research with more ethnically and culturally diverse populations. The few culture-specific studies that are available suggest that there are few differences between ethnic and nonethnic samples on standardized measures of marital functioning, however qualitative data suggest that the cultural norms related to expression and gender role expectations may contribute to relationship quality.98 Data that evaluate the impact of cancer on nonmarital relationships

Illness Related Variables

More invasive surgery (mastectomy versus lumpectomy) has been linked to poorer marital adjustment in breast cancer patients and their husbands61 and more relationship problems between breast cancer patients and their children.50 Results of a meta-analysis that examined the impact of breast conserving surgery versus mastectomy on marital and sexual functioning suggest that mastectomy may be associated with worse functioning, however the effect size was small.78 Higher levels of marital dissatisfaction have also been observed in the spousal caregivers of patients who underwent more intensive HSCT regimens (allogeneic versus autologous transplants).40 Treatment regimens that are more physically debilitating, or are associated with prolonged caregiving (such as stem cell transplant) may be more disruptive to the couple's relationship as roles and responsibilities are altered for extended periods of time. Data indicate that patient functional impairment may restrict the spouse's ability to...

Interpersonal Problems in Bipolar Disorder and Their Psychotherapeutic Treatment

Couples therapy techniques commonly employ many of the suggestions that are included in Bauer's review of other psychosocial therapeutic approaches. There is certainly a strong element of educational input to the couple regarding the nature of bipolar illness. There may also be psycho-dynamic aspects that need to be explored (as in any marriage) in order to determine why there are misinterpretations by the patient of the spouse's behaviour (or, if the spouse is, indeed, attempting to exert inappropriate behavioural control). Cognitive-behavioural techniques regarding irritability, sleep schedules, and inappropriate behaviours may also need to be employed. patient couples work with patient and marital or significant partner. It has been my experience that without couples work, treatment of the seriously and recurrently ill bipolar patient may be seriously impaired by treatment noncompliance, distortions, and misunderstanding of each person's communication and behaviour, and ultimately...

Restoring Relationships

Discovering the connection between emotions and relationships Examining your relationship Enhancing your relationship with positive actions Dealing with endings Numerous studies indicate that good relationships and social support improve both mental and physical health. Humans apparently are social animals that are biologically programmed to function better when in supportive relationships. Like gorillas, birds, and ants, we thrive in close-knit colonies. Therefore, working to improve your relationships can help boost your moods, increase your ability to handle stress, and create a sense of well-being. Yet, distressing emotions can get in the way of your attempts to improve your relationships. Such emotions can harm friendships, intimate relationships, and even relationships with co-workers or relative strangers. So, along with the obvious ways of working to alleviate your anxiety or depression, shoring up your relationships will also improve your moods.

Family Readjustment After Cessation

Once the substance abuse has stopped, the family may enter a honeymoon phase in which major conflicts are denied. They may maintain a superficial harmony based on relief and suppression of negative feelings. When the drug-dependent person stops using drugs, however, other family problems may be uncovered, particularly in the parents' marriage or in other siblings. These problems, which were present all along but obscured by the IP's drug use, will be ''resolved'' by the IP's return to symptomatic behavior if they are not dealt with in family therapy. In the latter case, the family reunites around their problem person, according to their old, familiar pathological style. Too many treatment programs in the substance-abuse field focus their efforts on brief, high-impact treatment, neglecting aftercare. Many of these programs include a brief, intensive family educational and therapeutic experience, but have even less focus on the family in aftercare than on the IP. These intensive,...

Treatment Alternatives

Dual-diagnosis programs are usually based in psychiatric hospitals and are designed to treat patients with both serious psychiatric illnesses and substance-use disorders. Treatment may include individual, group, and family therapy, phar-macotherapy, relaxation techniques, and education. Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) groups may also be offered. Individuals may reside in these hospital units from several weeks to several months. Rehabilitation units are usually free-standing facilities that are often based on the AA Twelve-Step model of treatment. Some carry out uncomplicated pharmacologic detoxifications, but many patients are already detoxified at entry. Some rehabilitation programs are staffed to offer psychiatric evaluation or treatment (or both). Therapy usually consists of education, group therapy, individual meetings, and at times, specialized groups (e.g., a women's group), usually provided by drug or alcohol counselors. Social workers may provide family...

Efficacy Of 12step Based Treatment

This section contains the following articles An Overview Acupuncture Approaches based on Behavioral Principles Aversion Therapy Behavior Modification Cognitive Therapy Contingency Management Family Therapy Group Therapy Hypnosis Long-Term versus Brief Minnesota Model Nonmedical Detoxification Outpatient versus Inpatient Pharmacotherapy, An Overview Psychological Approaches Self-Help and Anonymous Groups Therapeutic Communities Traditional Dynamic Psychotherapy and Twelve Steps, The.

The Number of Children in Custody Allocations

The exact number of children involved in custody allocations is not known. Reporting is not uniform, consistent, or comprehensive within and across states. Based on figures from the National Center for Health Statistics, at a divorce rate of 4.1 per 1,000 population in the United States in 1999 (amounting to 1.1 million divorces) and an average rate of 0.9 children per divorce decree, approximately one million children were affected by divorce. It should be noted, however, that divorce data do not provide complete estimates of the total number of children involved in custody allocations, because one out of three children in the United States is born to unmarried parents. More informative estimates stem from the reports of household living arrangements compiled by the U.S. Bureau of the Census. The majority (85 ) of children who lived with a single parent in 1998 lived with their mother. About 40 percent of these children lived with mothers who had never been married.

Personality Change

The notion of personality development in the sense of change over time also requires elaboration. To start with, not all change qualifies as development. For instance, i you walk from one classroom to another , your relationship to your surroundings has changed. But we do not speak of your development in this case, since the change is external to you and not enduring.

Case Example

L was a married surgeon in his 40s with two children who was referred for psychotherapy for recurrent, moderately severe depressive episodes. Although he was a man who loved feeling decisive and strong, his therapy had revealed considerable self-hatred whenever he felt as if he were behaving in a weak or indecisive fashion. At times, he was also contemptuous of his wife, when he saw her as passive or confused about something. This caused turmoil in their marriage, and his critical outbursts were inevitably followed by self-punishing behavior and by a tormenting sense of guilt. In the transference, his therapist noted that Dr. L became contemptuous of her and disinclined to work at his treatment when he was actually feeling vulnerable himself. Their exploration of his contempt helped to illuminate his marital difficulties considerably.

Do I tell my boss

This depends on several factors and especially on what kind of job you have and your relationship with your boss. Will PD affect your job performance An airline pilot or a surgeon will have to tell his or her employer sooner than someone who works in sales. How your boss responds may not be predictable either. Although PD is a disability and federal law prohibits firing a person because of a disability, you could be reassigned to a different job or be pressured into taking early retirement. Then again, an employer might be willing to make accommodations to keep you or even allow you to work from home. For many people, their job helps them to feel defined what they do is who they are. Finding yourself without your occupational definition of self regardless of how gently you are let go or with what allowances can be a terrible blow. Finding another way to use your skills and knowledge will lead to new ways of being productive and can restore your sense of identity. Other people may be...

Family Support

Family and marital therapy can also be useful, especially if your family is experiencing significant stress related to the raising of your child. Parents may have significant anxiety or depression about their child's diagnosis or future, irrational guilt about having in some way caused the problem, anger and frustration about the availability of services, resentment about the effects of a difficult child on the family, and so forth. A skilled family or marital therapist can help you work through these feelings, learn to cope with the needs of your child, and still maintain some semblance of a life. If there are significant disagreements about discipline, other parenting issues, or treatment, a family therapist can be invaluable in constructively and adaptively addressing them, helping sort out the different choices, and disentangling personal or marital issues from the needs of your child with AS-HFA.

Psychotherapy

Family therapy can be an especially important component of treatment. Parents may benefit from learning different ways of interacting and parenting children with bipolar disorder. They may also benefit from learning strategies to help children manage their mood symptoms, address behavior problems, and decrease stress and conflict in the family. Recent research suggests that family conflict and stress can precipitate relapse of bipolar disorder in adults and adolescents, suggesting that decreasing these problems may be important in managing bipolar symptoms. In addition, it is important for parents to obtain support because it can often be very stressful and isolating to have a child who is experiencing this illness. Finally, siblings may benefit from the opportunity to learn about bipolar disorder and talk about their concerns.

Relationship Quality

The perceived quality of the couple's relationship prior to cancer appears to be a strong predictor of marital satisfaction following cancer.66 Couples who recall having experienced higher levels of marital satisfaction prior to diagnosis tend to endorse higher levels of satisfaction following diagnosis and treatment.61 The quality of the marital relationship in the early stages of the illness experience also appears to predict future problems. In one study, low marital satisfaction identified within the first 3 months of diagnosis predicted both marital dissatisfaction and marital dissolution at later time points.36 Not only does relationship dissatisfaction predict later relationship quality, but also it is a significant predictor of concurrent and future psychological distress.39 Thus, couples experiencing relationship problems prior to the cancer experience may be at increased risk for difficulties during and following the cancer experience.

Mediation

When a marriage is dissolving, the spouses must reach agreement on property division, spousal support, child custody, and parental visitation. With the advent of no-fault divorce laws, the process of reaching a settlement between the divorcing spouses has become increasingly private. The high costs associated with the more public and formal legal processes has led many divorcing spouses to seek a low-cost alternative divorce mediation. Much has been written about the reasons for this trend toward the privatization of divorce, including the increase in no-fault divorce and the elimination of the tender years'' presumption, which used to influence judges to award child custody to the mother. When divorce For these reasons, divorce mediation has emerged in recent years as a more suitable alternative to court-ordered approaches. Mediation holds the promise of being cheaper, takes less time to reach settlement, and can effectively prevent many custody disputes from going to court. By...

How Mediation Works

Mediation is defined as any strategy or approach to resolving conflict that arrives at a settlement agreeable to the parties. In divorce mediation, the spouses meet with an impartial third party to reach an agreement regarding child custody and other issues. Two forms of divorce mediation are generally recognized. Child custody mediation is specific to the issues of each parent's right to custody and visitation of their children. Comprehensive divorce mediation deals with other issues such as property distribution and spousal support. Some mediation programs involve an average of two or three sessions, whereas others may use as many as ten sessions. to make their own decisions. Although some forms of mediation may address underlying interpersonal or individual problems, mediation is unlike marriage therapy because it does not aim for reconciliation. The goal of mediation is for the couple to reach a fair settlement that allows the marriage to be dissolved. In addition to court-based...

Frustrations abound

Weight but he couldn't bear going back to The Great Barn. Once again I was emotionally torn in two. I desperately wanted to take him home but I knew how dangerous that would be. Eventually I persuaded Joe to get back in the car and we returned to the Great Barn. Joe seemed to manage to pull himself together and chatted with his friend in the lounge while I reported back to the care worker on duty. She wasn't at all surprised that Joe had been tense and upset. Joe was making fantastic progress but there was still an awfully long way to go. I was feeling very tearful by this stage and the care worker asked me if I ever let Joe see how upset I was. I said I tried to be strong in front of him, otherwise I feared he might try and manipulate me into letting him come home. She fully understood this but suggested that this was an issue that could be explored in family therapy. Our family therapy sessions were due to start in a couple of weeks. She also suggested that we could discuss this...

Dealing with stress

Been through many definitions over the years. This is, perhaps, because it is something that is both within and without the person. Certainly, some circumstances (such as losing one's job, a marriage break-up, moving house, having a child with a chronic illness, retiring, etc.) are stressful to many people. But all of these events are not necessarily stressful to everyone and nor are they stressful to the same degree in everyone. So, there are large individual differences in stress reactions. Stress is the result of an interaction between the individual and the environment, and for a highly readable analysis of stress, see Overton (2005).

Psychoeducation

One caveat about psychoeducation Although increased knowledge may help family members to modify negative cognitions about the patient or therapy, it does not guarantee that behavior change will occur. More intensive family therapy may be needed to help family members change established negative behavior patterns.

Family Meetings

No research of which we are aware compares CT with one or two family meetings to CT alone. Group Individual Family Therapy for Depression (GIFT Friedman et al., 2005) involves 10-14 sessions of cognitive-behavioral group therapy, as well as three individual sessions and two family meetings used primarily for assessment and psychoeducation purposes. Data from an open trial of GIFT indicate that the pre- to posttreatment effect size is similar to that seen with other group treatments for depression. Similarly, CT interventions for adolescents have involved a few conjoint family sessions and or psychoeducation for parents (Treatment for Adolescents with Depression Study TADS Team, 2004).

Phases Of Treatment

In addition to standard treatments provided in most rehabilitation programs, such as the twelve-step program, group and family therapy, there have been studies using specific manual-driven psychotherapy and behavioral therapy. A recent report of a large-scale multi-center study demonstrated superior results with individual drug counseling. Furthermore, the effectiveness of individual drug counseling correlated highly with attendance in twelve-step group meetings.

Discussion

Dr Davis, Joe's community consultant psychiatrist stated that he had a cognitive behavioural therapist and a family therapist on his team who could take over Joe's care on an out-patient basis. He reminded us that the most important factors to watch were Joe's weight and his mood. If either started to deteriorate alarm bells should start ringing. We needed to be constant about his weight level and if it dropped by more than a kg he would have to be readmitted.

What happens after

Despite a large number of well-documented positive after-effects, some negative after-effects have also emerged. Among these there is the frustration of not being able to communicate the significance of the experience to others. As has been argued earlier, people who have experienced an NDE may be sure about the authenticity of their experiences. By contrast, especially for those who do not have similar experiences, these are mere hallucinations induced by a dying brain, or by the effect of a certain drug, of no more interest than an especially vivid dream. The fear of being ridiculed or seen as insane by others, has led some people to keep the event private or to share it only with a few family members or friends, even if the experience was very positive (Orne 1995). It has also been observed that how well they were able to integrate the experience into their everyday life can depend on the quality of these relationships (French 2005). Another negative after-effect is the despair at...

Application

After a period of some marital discord, Paul Gauguin left his wife and five children and, with absolute sincerity and clarity of purpose, began to realize his potential as an artist. He fell in with the likes of van Gogh, Degas, and Pissarro, who mentored him in impressionism. In 1891, he decided to flee civilization in search of a new way of life, one that more matched his painting style primitive, bold, and sincere. He sailed to Tahiti and the islands of the South Pacific, where, except for a brief visit back to France, he remained until his death in 1903 (Gauguin, 1985). In Tahiti, his paintings of indigenous people grew more powerful and distinctive, and on a large scale he achieved his potential as one of the modern world's greatest artists.

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