This study aimed to evaluate the effect of Gottman couple therapy program targeted for discordant couples struggling with the negative impact of depression of the female partner and compare between the outcome in case of usual treatment of depression and the outcome with applying Gottman program added to the usual treatment of depression in the female partner.
Major Depressive Disorder is the world's leading cause of medical disability , and is associated with costs exceeding $219 billion in the United States each year . The association between marital discord and depression is well-established, and a large body of work now supports the bi-directional nature of this relationship. That is, marital distress plays a crucial role in the etiology and maintenance of depression. Moreover, the impact of one partner's depression on couple functioning can be profound and prolonged. About two-thirds of the people seeking individual treatment for depression report significant relationship distress. This holds true for primary care, for psychotherapy practice irrespective of the treatment model, and for couple and family therapy as well . In the caseload of family therapists, depressive disorders are the second most common presenting problem after couple difficulties . Once MDD is present, supportive interpersonal relationships are highly important for recovery. For instance, relationship functioning is not always improved following individual treatments for depression, even if the disorder itself remits . Spouses of depressed individuals may be living with the disability for many years and may be unaware or misinformed about how to support the depressed person. Given that depression and relationship distress reciprocally influence each other, researchers have focused on couple-based treatment approaches to change maladaptive relationship patterns as a way to alleviate depression. Although couple therapy most often aims to reduce overall relationship distress, couple-based interventions have also been developed to treat couples in which one or both partners struggle with impairing individual emotional or behavioral disorders . Couple therapy, by focusing on the interpersonal context of depression, might be more effective as a treatment for depression than individual psychotherapy or drug therapy. It has the twofold aim of modifying negative interaction patterns and increasing mutually supportive aspects of intimate relationships, changing the interpersonal context of depression. Specific models of couple therapy for depression have been developed, including behavioral therapies, later integrated with cognitive approaches, systemic models and emotion-focused therapy, based on attachment theory. In recent years, a trend toward integration has become evident, as in other fields of psychotherapy . It has been suggested that, despite different theoretical orientations, effective models of couple therapy share a set of common principles: (a) altering the couple's view of the presenting problem to be contextualized and dyadic; (b) decreasing emotion-driven, dysfunctional behavior; (c) eliciting emotion-based, avoided, private behavior; (d) increasing constructive communication patterns; and (e) emphasizing strengths and reinforcing gains . This study aimed to evaluate the effect of Gottman couple therapy program targeted for discordant couples struggling with the negative impact of depression of the female partner and compare between the outcome in case of usual treatment of depression and the outcome with applying Gottman program added to the usual treatment of depression in the female partner.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Gottman Method for Couple Therapy is based on "sound relationship house" theory that proposes seven relational processes: 1. Build love maps. A love map is a road map of one's partner's inner world, built by asking open-ended questions. 2. Build the fondness and admiration system by expressing affection and respect in small, everyday moments. 3. Turn toward instead of away or against by noticing and responding to a partner's bids for emotional connection. 4. Allow positive sentiment override, which results in not taking negative partner actions personally, or give the partner the benefit of the doubt. 5. Take a two-pronged approach toward managing conflict by (a) using a gentle approach in presenting complaints, accepting influence, physiological soothing, and compromise, and (b) establishing a dialogue with perpetual problems that examines and honors the existential dreams of both partners within the conflict. 6. Honor one another's individual, and perhaps unshared, life dreams.
Group 2: undergo treatment as usual for depression
Tanta University
Tanta, Egypt
severity of depression by Hamilton Depression Rating Scale
Hamilton Depression Rating Scale (HDRS): The questionnaire is designed for adults and is used to rate severity of depression by probing mood, feeling of guilt, suicidal ideation, insomnia, agitation or retardation, anxiety, weight loss and somatic symptoms. Eight items are scored on a 5-point scale, ranging from 0 = not present to 4 = severe. Nine items are scored from 0-2. The total score was calculated by summation of the first seventeen items. The severity of depression was divided into 4 categories as follows: 0- 7are considered as normal patients, 8-16 suggesting mild depression, 17-23 suggesting moderate depression and scores over 24 indicating severe depression.
Time frame: 12 months
Satisfaction score by ENRICH marital satisfaction scale
The questionnaire, which measures satisfaction with marriage and quality of adjustment to it, is composed of 15 items, each on a Likert scale of 1 to 5. Strongly disagrees with (1), somewhat disagrees with (2), neither agrees with (3), moderately agrees with (4), and strongly agrees with (5). The total scores for responding to the questions ranged from 15 to 75, and they were divided into three categories: high satisfaction (scores between 57 and 75; over 75%), partial satisfaction (scores between 37 and 56; between 50 and 75%), and low satisfaction (scores below 37; less than 50%)
Time frame: 12 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.