Couple-responsible therapy process: Positive proximal outcomes

Therapist-couple struggle us. cooperation is linked to clinical outcome. Th is research conceptualizes and investigates treatment process as it relates to the occurrence of struggle versus cooperation. Models of couple-respons ible and therapist-responsible process in couple therapy were developed. Co uple-responsible process consists of enactments, accommodation, and inducti ve process. Therapist-responsible process consists of primary therapist cou ple interaction, therapist interpretation, and direct instruction. In count erbalanced order 25 couples were exposed to couple-responsible and therapis t-responsible episodes during one therapy session. Couples reviewed videota pes of the episodes and completed measures of responsibility, struggle, and cooperation. Perceived responsibility was higher and struggle was lower du ring couple-responsible episodes. No difference in cooperation was found. P resence or absence of a contrast condition, where couples reported on one t herapist process after already experiencing its opposite, led to main effec ts for responsibility and struggle, and mediated effects of struggle and co operation. Generally speaking, responsibility was even higher during couple -responsible episodes and even Lower during therapist-responsible episodes when contrast was present. Similarly, struggle was even lower during couple -responsible episodes and even higher during therapist-responsible episodes when contrast was present. For both couple-responsible and therapist-respo nsible episodes, cooperation was negatively affected by a shift from the pr ior, opposite therapist process. Significant proportions of the variance in responsibility, struggle, and cooperation, however, were not accounted for by therapist process alone.