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Biomedical subjects

Donald H Baucom

Publications and source records attributed to Donald H Baucom.

12 recordsLinked to original sources

Treating couples recovering from infidelity: an integrative approach.

Infidelity is one of the most difficult problems to address in couple therapy, most likely because it involves a traumatic relationship event that alters the ways in which couples process information about each other and established behavioral patterns. We present a three-stage treatment designed to address the cognitive, behavioral, and emotional sequelae of affairs that integrates cognitive-behavioral and insight-oriented strategies with the literatures on traumatic response and forgiveness. A case study with pretreatment, posttreatment, and 6-month follow-up data is presented to illustrate the treatment methods.

Adaptation, Psychological↗

Infidelity and behavioral couple therapy: optimism in the face of betrayal.

Infidelity is a common issue with which distressed couples and their therapists grapple. However, there are no data on the efficacy of commonly used therapies to treat couples in which there has been an affair. In the present exploratory study, the authors examined the therapy outcomes of a sample of infidelity couples (n=19) who had participated in a randomized clinical trial of marital therapy (N=134). Results show that infidelity couples began treatment more distressed than noninfidelity couples; however, evidence suggests that couples who had an affair and who revealed this affair prior to or during therapy showed greater improvement in satisfaction than noninfidelity couples. Implications for therapy with infidelity couples are discussed.

Adult↗

Methodologically sound, cost-effective research on the outcome of couple therapy.

Because of its potential to answer pressing applied questions about what treatments to use with which couples as well as its potential to answer basic questions about couple functioning, outcome research on couple therapy is vital to the field. This article describes the primary methodological issues that an investigator faces in conducting outcome research during treatment development, efficacy testing, and effectiveness evaluation. Descriptions of what has been done in the past are integrated with recommendations about what should be done in the future. Mindful of the potential expense of outcome research, the authors suggest ways in which questions can be investigated cost effectively.

Behavioral Research↗

Infidelity in couples seeking marital therapy.

The revelation of an affair is often an emotionally explosive event for a couple, yet little is known about specific individual and relationship factors that accompany infidelity. The present study examined the qualities of individuals and couples that differentiate couples with (n = 19) and without (n = 115) infidelity using couples from a randomized clinical trial of marital therapy. Findings indicated that couples with infidelity showed greater marital instability, dishonesty, arguments about trust, narcissism, and time spent apart. Gender also proved to be a significant moderator of several effects. Men who had participated in affairs showed increased substance use, were older, and were more sexually dissatisfied. Results offer initial clues to concomitants of affairs for couple therapists.

Age Factors↗

Observational coding of relationship-schematic processing.

In this article, we introduce the construct Relationship-Schematic Processing (RSP), which is defined as the degree to which individuals process information in terms of their romantic relationship. We also present an observational coding system that was developed to assess the behavioral manifestations of RSP. The coding system was applied to videotaped problem-solving interactions completed by 55 maritally distressed couples. Findings indicated that wives engaged in more frequent and higher quality RSP than husbands did. Husbands reported greater relationship satisfaction when wives engaged in more frequent and higher quality RSP; wives reported greater satisfaction when husbands engaged in higher quality relationship processing. In addition, we assessed convergent validity with other measures of marital functioning.

Adult↗

An investigation of unmet intimacy needs in marital relationships.

In this investigation we examined partners' responses to unmet intimacy needs in hopes of better understanding how these responses may affect intimacy satisfaction and overall relationship satisfaction. Eighty-four married couples, plus four additional husbands and 12 additional wives, were recruited from the community and completed measures of relationship satisfaction, intimacy need satisfaction, and attributional and communication responses to unmet intimacy needs. Consistent with the proposed mediational model, less negative attributional and communication responses to unmet intimacy needs were found to be beneficial for overall intimacy satisfaction and relationship satisfaction. In addition, more positive communication responses contributed to greater intimacy satisfaction. Limitations and clinical implications of the current study and directions for future work are discussed.

Adult↗

Prenatal and postpartum smoking abstinence a partner-assisted approach.

BACKGROUND: A partner's provision of support and smoking status has been consistently associated with women's likelihood of smoking cessation during pregnancy and relapse in postpartum. DESIGN: A three-group randomized controlled intervention trial was conducted in 1996 to 2001, with 583 women and their partners randomized to usual care (UC), woman-only (WO), or partner-assisted (PA) intervention. Follow-ups occurred at 28 weeks of pregnancy, and 2-, 6-, and 12-months postpartum. SETTING: Womack Army Medical Center (WAMC) at Fort Bragg in Fayetteville, North Carolina. INTERVENTION: Women in the UC condition received provider advice to quit and a self-help guide. The WO condition received UC components plus a late-pregnancy relapse prevention kit (booklet and gift items) and six counseling calls (three in pregnancy and three postpartum) initiated by a health advisor. Women in the PA condition received the WO intervention, and their partners received telephone counseling and a support guide emphasizing skills to help the woman build and maintain her confidence to quit smoking. Partners who smoked also received cessation aids and related counseling. MAIN OUTCOME MEASURE: Seven-day self-reported abstinence from smoking at each follow-up. RESULTS: Intent-to-treat analyses showed no significant differences by condition in women's reports of abstinence at any follow-up. In late pregnancy, more partners were abstinent in the PA condition (15%) than in the UC condition (5%), p =0.02. CONCLUSIONS: Partner-assisted smoking-cessation interventions need further refinement. Influencing young couples' support patterns may require more intensive and conjoint intervention. Partners who smoke could benefit from support for their cessation efforts.

Adult↗

Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples.

A randomized clinical trial compared the effects of traditional behavioral couple therapy (TBCT) and integrative behavioral couple therapy (IBCT) on 134 seriously and chronically distressed married couples, stratified into moderately and severely distressed groups. Couples in IBCT made steady improvements in satisfaction throughout the course of treatment, whereas TBCT couples improved more quickly than IBCT couples early in treatment but then, in contrast to the IBCT group, plateaued later in treatment. Both treatments produced similar levels of clinically significant improvement by the end of treatment (71% of IBCT couples and 59% of TBCT couples were reliably improved or recovered on the Dyadic Adjustment Scale; G. B. Spanier, 1976). Measures of communication also showed improvement for both groups. Measures of individual functioning improved as marital satisfaction improved.

Adult↗

Adult attachment and patterns of extradyadic involvement.

Relationships between patterns of extradyadic involvement (EDI) and adult attachment were examined separately with undergraduates and community adults reporting prior EDI. Those with fearful or preoccupied styles reported more intimacy motivations for EDI, and undergraduates with these styles also reported more self-esteem motivations. Conversely, those with a dismissive style reported more autonomy motivations for EDI. Those with a fearful attachment style reported ambivalence about intimacy in the EDI. Fearful and preoccupied undergraduates and community males reported a more obsessive extradyadic relationship. However, dismissive individuals did not report more casual EDI. Gender effects also emerged, with females reporting more intimacy motivations than males, and undergraduate males reporting more casual EDI than undergraduate females. In the undergraduate sample, dismissive males had the most extradyadic partners over the prior 2 years relative to all other groups, and preoccupied females reported more partners than secure females. Clinical implications of these findings are discussed.

Adolescent↗

An integrative intervention for promoting recovery from extramarital affairs.

The discovery or disclosure of an extramarital affair can have a devastating impact on partners, both individually and on the relationships. Research suggests that affairs occur relatively frequently in relationships and are a common presenting problem in couple therapy. However, despite their prevalence, there is little empirical treatment research in this area, and most therapists describe this problem as one of the more difficult to treat. In this study, we used a replicated case-study design to explore the efficacy of an integrative treatment designed to help couples recover from an affair. Six couples entered and completed treatment. The majority of these couples were less emotionally or maritally distressed at the end of treatment, and the injured partners reported greater forgiveness regarding the affair. Details of the intervention, suggested adaptations of the treatment, and areas for future research are discussed.

Adaptation, Psychological↗

The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life.

This preliminary study examined the self-efficacy of family caregivers with regard to helping cancer patients manage pain at end of life. A sample of 63 family caregivers of hospice-eligible cancer patients with pain provided ratings of their self-efficacy in assisting the patient in pain management and rated their own mood and level of caregiver strain. Patients completed measures of pain and quality of life. Data analyses revealed that caregivers who rated their self-efficacy as high reported much lower levels of caregiver strain as well as decreased negative mood and increased positive mood. Caregiver self-efficacy in managing the patient's pain was related to the patient's physical well-being. In dyads where the caregiver reported high self-efficacy, the patient reported having more energy, feeling less ill, and spending less time in bed. Considered overall, the results of this study suggest that caregiver self-efficacy in pain management is important in understanding how caregivers adjust to the demands of caring for cancer patients who have pain at the end of life.

Adult↗

Altering the course of marriage: the effect of PREP communication skills acquisition on couples' risk of becoming maritally distressed.

This longitudinal study predicted marital outcome from communication skills gained from participation in the Prevention and Relationship Enhancement Program (PREP; H. J. Markman, S. L. Blumberg & S. M. Stanley, 1989; Stanley et al., 2001) by 39 women and 38 men. Results were in the expected direction for men but not for women. Men's pre- to posttest decrease in negative communication and increase in positive communication predicted decreased risk of marital distress onset in men. Women's pre- to posttest increase in positive communication, which was related to self-reported avoidance of problem solving, predicted an increased risk of male and female distress onset. Couples with men relatively high on premarital risk factors demonstrated a greater benefit from men's positive communication skills acquisition.

Adult↗