Treating Difficult Couples: Helping Clients with Coexisting Mental and Relationship Disorders

This essential handbook describes effective treatments for a particularly challenging clinical population: couples struggling with both relationship distress and individual mental health difficulties. Distinguished scientist-practitioners provide detailed accounts of their respective approaches, reviewing conceptual and empirical foundations as well as clinical procedures. Included are well-established treatments for couples in which one or both partners has anxiety, mood disorders, schizophrenia, substance abuse, sexual dysfunction, or physical aggression. Also covered are emerging couple-based approaches to managing personality disorders, PTSD, difficulties related to aging and physical illness, and other problems. Following a standard format to facilitate comparison across treatments, each chapter is illustrated with detailed case material. Provided are powerful insights and tools for couple and family therapists, clinicians providing individual therapy, and students in any mental health discipline.

Part I: Empirical and Conceptual Issues in Managing Emotional, Behavioral, and Health Concerns in Couple Therapy: An Overview
Chapter 1: Comorbidity of Relationship Distress and Mental and Physical Health Problems
Mark A. Whisman and Lisa A. Uebelacker
Chapter 2: Tailoring Couple Therapy to Individual Differences: A Conceptual Approach
Douglas K. Snyder, W. Joel Schneider, and Angela M. Castellani
Part II: Couple-Based Treatments for Emotional and Behavioral Disorders
Chapter 3: Anxiety Disorders
Donald H. Baucom, Susan Stanton, and Norman B. Epstein
Chapter 4: Depression
Steven R. H. Beach and Maya Gupta
Chapter 5: Bipolar Disorder
David J. Miklowitz and Chad D. Morris
Chapter 6: Schizophrenia-Spectrum Disorders
Kim T. Mueser and Mary F. Brunette
Chapter 7: Alcohol and Other Substance Abuse
William Fals-Stewart, Gary R. Birchler, and Timothy J. O'Farrell
Chapter 8: Sexual Dysfunction
Lisa G. Regev, William O'Donohue, and Claudia Avina
Chapter 9: Physical Aggression
Amy Holtzworth-Munroe, Amy D. Marshall, Jeffrey C. Meehan, and Uzma Rehman
Part III: Adapting Couple Therapy to Individual Problems
Chapter 10: Borderline Personality Disorder
Alan E. Fruzzetti and Armida R. Fruzzetti
Chapter 11: Paranoia
Kenneth G. Terkelsen
Chapter 12: Narcissistic Disorder
Jill Savege Scharff and Carl Bagnini
Chapter 13: Posttraumatic Stress
Susan M. Johnson and Judy Makinen
Chapter 14: Childhood Sexual Trauma
Barry W. McCarthy and Mia Sypeck
Chapter 15: Physical Illness
Gail P. Osterman, Tamara G. Sher, Gwen Hales, W. Jeffrey Canar, Reema Singla, and Tracy Tilton
Chapter 16: Aging and Cognitive Impairment
Sara Honn Qualls
Chapter 17: Bereavement and Complicated Grief
Robert M. Wills
Part IV: Integration
Chapter 18: Understanding Psychopathology and Couple Dysfunction: Implications for Clinical Practice, Training, and Research
Douglas K. Snyder and Mark A. Whisman
Index

Douglas K. Snyder, PhD, LMFT, is Professor of Psychological and Brain Sciences at Texas A&M University, where he also served as Director of Clinical Training for 20 years. Dr. Snyder has engaged in clinical practice and training of couple therapists since the 1970s, and is a clinical member of the American Association for Marriage and Family Therapy (AAMFT). He is coauthor or coeditor of several books for mental health professionals and general readers. Dr. Snyder has served as editor of the \Clinician’s Research Digest and as associate editor of the Journal of Consulting and Clinical Psychology and the Journal of Family Psychology. He is a recipient of the Distinguished Contribution to Research in Family Therapy Award from AAMFT, the Distinguished Contribution to Family Psychology Award from Division 43 (Society for Couple and Family Psychology) of the American Psychological Association (APA), and the Distinguished Psychologist Award from Division 29 (Society for the Advancement of Psychotherapy) of APA.

Mark A. Whisman, PhD, is Associate Professor of Psychology at the University of Colorado at Boulder. His research, which has been supported by the National Institute of Mental Health, has focused on the reciprocal association between relationship functioning and mental health. His other areas of interest include cognitive-behavioral and interpersonal perspectives on the onset, maintenance, and treatment of depression and relationship distress. A Founding Fellow of the Academy of Cognitive and Behavioral Therapies, Dr. Whisman has served as Associate Editor for Contemporary Psychology and as an editorial board member of the Journal of Consulting and Clinical Psychology, Journal of Family Psychology, and Clinical Psychology: Science and Practice.

This is one of the most important books on couple therapy ever published. Snyder and Whisman's sophisticated yet accessible text signifies that couple therapy is no longer of value solely for explicit relationship problems. As this eye-opening volume makes clear, couple therapy is now a first-line intervention for a wide range of clinical problems traditionally thought of as 'individual.' This superb volume should be required reading not only for courses on couple therapy, but also for any course on the treatment of adult psychopathology.--Alan S. Gurman, PhD, Department of Psychiatry, University of Wisconsin Medical School

At last, a book that tackles some of the issues that make certain couples hard to help. This is a book about couples in which the individual partners have their own problems, problems that interact with the couple's relationship. Everyone from graduate students to experienced clinicians will value the overviews of research and the practical guidelines on how to assess and treat the complexities of interactive individual and couple issues. This volume is going on my shelves in an easy-to-reach spot, so I can consult it when therapy gets stuck.--Kim Halford, PhD, Department of Clinical Psychology, Griffith University, Australia

Treating Difficult Couples: Helping Clients with Coexisting Mental and Relationship Disorders is a definitive, state-of-the-art text that pulls together the latest research and clinical innovation on couple treatment for the major individual and relational problems of our time. This volume includes chapters from a veritable 'who's who' of well-known couple researchers and clinicians. The reader will discover definitively what is known, and what isn't, about couple approaches to emotional, behavioral, and other health problems. The special strengths of the volume include its integrative conceptualization of individual diagnoses and relational problems, its survey of relevant research, and useful case illustrations. This book is well suited as a text for use in clinical, counseling, and family psychology programs, as well as marriage and family therapy programs.--Susan H. McDaniel PhD, Department of Psychiatry and Wynne Center for Family Research, University of Rochester School of Medicine and Dentistry

Finally we have a book that provides an avenue to all the research on difficult couples. This is a book that should be on the shelf of every marital and family therapist. Provided are very practical, usable, and up-to-date reviews of all the major problems that are comorbid with marital distress. This book is a real winner!--John Gottman, PhD, Department of Psychology (Emeritus), University of Washington
- This book is versatile and useful for systemically trained therapists and for researchers who wish to understand the connections between individual and relational disorders....This book will be useful to clinicians with all levels of training and experience. Further, it is a must for any clinician working in settings, such as medical facilities, where one is likely to encounter Axis I and II conditions comorbid with dysfunctional relational dynamics. --Journal of Couple & Relationship Therapy, 5/24/2003