Academic journal article The Qualitative Report

Couples' Conceptualizations of Problems in Couple Therapy

Academic journal article The Qualitative Report

Couples' Conceptualizations of Problems in Couple Therapy

Article excerpt

The relationship among client, therapist, and problems is complex. Research predating solution and strengths-based approaches in psychotherapy demonstrates that clients expect the therapist to be problem centered (Tinsley & Harris, 1976; Tinsley, Workman, & Kass, 1980) and for the therapist to require clients to discuss problems (Bordin, 1979; Gladstein, 1969; Glass, Arnkoff, & Shapiro, 2001; Joyce & Piper, 1998). Tambling and Johnson's (2010) qualitative study, which examined couple expectations for therapy, confirmed many of the same findings for couples that researchers discovered for individuals. Couples expected to discuss problems, the events that led up to their problems' development, and the ways in which those problems impacted individual and couple functioning (Tambling & Johnson, 2010). Decades of research send a clear message: Clients want to talk about problems (Tinsley & Harris, 1976; Joyce & Piper, 1998; Biesen & Doss, 2013).

The way in which problems are studied, operationalized, and treated reflects the theoretical orientation of the researcher and clinician. Multiple definitions of problems allow for a variety of ways in which problems are conceptualized in therapy. From a postmodern perspective, problems are socially constructed concerns that reflect the social and political context in which individuals exist (Madigan, 2011; Reynolds, 2010; White, 1994, 1995).

Problems discussed in therapy often reflect an aspect of the couple relationship that diverges from societal standards of normalcy and health (Bird, 2004; White, 2007; White & Epston, 1990). Postmodern theorists argue that the therapist need not know much about the problem and that the problem and solution may not be connected (deShazer, 1991). This challenged the connection between problems and solutions, which questioned the existence and importance of cause and effect relationships between symptoms and problems. Narrative therapy locates the problem outside of the individual. Instead of the problem existing within a person's body, the problem is situated within the broader sociopolitical and relational context in which the person exists (White, 1994, 2007; White & Epston, 1990). These ideas challenge the view that "health," "disorder," and "normalcy" are indisputable, fixed entities.

Theoretical and empirical study has focused on addressing individuals' approaches to problems in a wide array of life contexts (Berg, Strough, Calderone, Sansone, & Weir, 1998; Denney, 1992; Wagner & Sternberg, 1986; Willis & Schaie, 1993). Despite extensive study on how individuals approach problems in their lives, there remains no universal definition for the concept of problem solving. Researchers do agree, though, that problem solving is a complex and multifaceted process (Berg & Klaczynski, 1996; Denney, 1992; Willis & Schaie, 1993).

In the early 1990s, there was a call for researchers to integrate qualitative methods into the family therapy literature (Newfield, Kuehl, Joanning, & Quinn, 1991; Sprenkle, 1990; Wark, 1990). Since that time, researchers have demonstrated the utility of discourse analysis for therapists (e.g., Gale, 1996, 2000). Particularly, research demonstrates the effectiveness of using discourse analysis to analyze various dimensions of the therapy process (Couture & Strong, 2004; Hare-Mustin, 1994; Gale, Odell, & Nagireddy, 1995; Moore & Seu, 2011). There is an increasing interest in utilizing qualitative research approaches to study couples therapy, with researchers studying client dropout (Helmeke, Bischof, & Fordsori, 2002), therapists' actions (Ward & Knudson-Martin, 2012), pivotal moments (Helmeke & Sprenkle, 2000), and the process of therapy (Bowman & Fine, 2000). Regardless of the researcher's interest, discourse analysis is a useful approach to analyzing individuals' momentary constructions of meaning, particularly in systemic therapy practice (Gale, 2010). …

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