A constructivist couple therapy model for anxiety disorders

¶ … Relationships That Influence Relationship Functioning

Factors and Influences in Functioning Related to Couple Therapy

Model

This work will fully cover the material in a model to be utilized in relationship therapy for couples. Furthermore this work will through research and study of models in viable literature construct a model that are inclusive of the factors of intrapersonal, interpersonal, situational with some indication of directionality of influence of these factors. The model will be based on anxiety disorders using a constructivist approach.

Constructivist View:

The viewpoint or position of that of "personal construct" is both expert and collaborative in nature holding as truth that "each individual is a scientist." Further, the collaboration that is articulated between the therapist and client is focused toward construct systems and their accompanying prediction. There are seven (7) questions that Kelly states should be asked by the therapist at the initial consultation or interview. Those seven questions are:

1. What is the problem?

2. When did the problem originally become noticed?

3. Under what conditions was the problem noticed?

4. What corrective actions were taken?

5. What was the effect of the corrective measures?

6. Under what conditions does the problem become most noticeable?

7. Under which condition was the problem least noticeable?

Three main techniques are used as well from the constructivist views which are listed as:

1. Triadic questioning: The main identification technique used by constructivists.

2. Laddering questioning: Discovery of heirchial constructs organization as well as core construct organization in defining value and pole of individual personality.

3. Circular questioning: Used to assess family construct systems.

The role of the therapist in counseling is one that is a "fixed" role in the Personal Construct Theory.

Anxiety Disorder Therapy

Therapies for anxiety disorder from the constructivist viewpoint will be addressed through conceptualization of a systemic mode and therapy will be through a systemic approach. There are single factor models in this arena which are those based on:

1. Genetic vulnerabilities

2. Biological processes

3. Early socialization experiences

4. Belief Systems

5. Patterns of social interaction

Integrative models are comprehensive in the framework of therapy for couples because the integrative model can account for interactional behavior patterns, pessimistic or threat-oriented belief systems as well as genetic or developmental vulnerabilities. Depression and anxiety may come from negative experiences of the individual or due to a dysfunction within the belief system as well as other factors in their environment.

The Model: Couple Therapy Model: Constructivist/Anxiety Disorder

The model labeled Figure One is a construct of what might be used in couple therapy from the Constructivist view. As can be seen the problem being experienced by the couple above is one in which the Female Partner is anxious and depressed which could be caused by genetics or could be biological such as in post-partum delivery depression or could as well be based on some factor of interaction in the couple's relationship. The Male Partner as is shown has strong family values and attempts to do all that he can to ease the burden of the Female Partner who in turn feels more worthless and subsequently more depressed. As time goes on the Male Partner is more worried and frustrated feeling that he will never again have back the happy girl he married. These feelings of anger send the female partner spiraling into deeper depression while the Male Partner suffers guilt are remorse and all of this is complicated by the Male Partner having involved his mother in the vicious cycle. Unknown to the Male Partner, the more adept he becomes at taking care of the children and household matters the more depressed and useless the Female Partner feels.

The Remedy from the Constructivist View:

The treatment for remedy of the problem in which one of the individuals is depressed or anxious should: "aim to disrupt problematic behavior patterns and transform the belief systems that underpin those." In the case of depression there are several stated interventions that may be used in assisting in ridding the couple of destructive practices in the relationship. One of the techniques utilized is "Role-Reversal." This technique is one that couples trapped in the cycles of "caregiver" and "receiver of care" are given an invitation to swap roles with one another in order to understand the depressions' impact upon the other partner. Other techniques are those listed as:

Opening space for recovery and taking it slow

Compliments and statements of affection

Other Intervention: Psychoeducation

Psychoeducational intervention is a combination of anxiety explanation with framing of therapy as a "fresh start experience and rationale for treatment." (Ibid p. 433) The idea in treatment is stated to be that: "input should be presented as a single spoken and written statement and then incorporated into discussions that occur over the course of treatment. This is considered to be an "adaptive form of treatment." Anxiety is experienced on three levels or parts which are:

Thoughts about being afraid.

Physical feelings of being afraid.

Behavioral patterns that enable the avoidance of the person, place or thing of which they are afraid.

There are four listed techniques used for coping and exposure in the treatment of anxiety which are:

1. Hierarchy Construction

2. Highlighting Habitation

3. Coping Skills Training

4. Exposure Home work Assignments

Summary and Conclusion:

This work provides a model which illustrates the cycle or process of anxiety/depression as well as the directionality along with the constructivist viewpoint as to treatment through couple therapy of this condition. Therapy is best when the process is voluntarily entered by each individual in the couple relationship. The therapist plays a vital role in this type of therapy assisting the couples in learning that "internal signs of arousal are not "harbingers of doom."