Moving Up the Continuum of Hope: Developing a Theory of Hope and Understanding Its Influence in Couples Therapy

By Ward, David B.; Wampler, Karen S. | Journal of Marital and Family Therapy, April 2010 | Go to article overview

Moving Up the Continuum of Hope: Developing a Theory of Hope and Understanding Its Influence in Couples Therapy


Ward, David B., Wampler, Karen S., Journal of Marital and Family Therapy


For years therapists have suggested that hope is an important catalyst in the process of change. This study takes a grounded theory approach to address the need for a clearer conceptualization of hope, and to place interventions that increase hope within a therapeutic context so that therapists know how and when to use those interventions. Fifteen active and experienced marriage and family therapists from across the United States participated in hour-long phone interviews about hope in couples therapy. Moving Up the Continuum of Hope emerged as the core category from the grounded theory analysis of the data. This category represents a process, with general and specific conditions and consequences that increase a couple's level of hope. This study serves as a foundation for future process research on couples therapy, as well as research on hope in other contexts (e.g., individual and family therapy) and with other perspectives (e.g., clients).

Hope has been described as a life force: "To live a life devoid of hope is simply not to live a human life; it is not to function - or tragically, it is to cease to function - as a human being" (McGeer, 2004, p. 101). Not surprisingly, research has shown that hope positively influences both physical and psychological health (Cheavens, Michael, & Snyder, 2005), and many therapists have lauded the importance of hope in the therapeutic process. For example, Frank (1973) states, "Unless the patient hopes that the therapist can help him [or her], he [or she] will not come to therapy in the first place or, if he [or she] does, will not stay long" (p. 137). More recently, Cooper, Darmody, and Dolan (2003) assert that treatment outcome becomes more positive if the therapist can uncover hope, instill hope, or enable clients to express hope, and Hanna (2002) identifies hope as a precursor for change and possibility. "It inspires both action and courage, and it paves the way for the realization of dreams, whether simple or sublime" (p. 93).

The recent discussions around common factors of treatment have once again brought the idea of hope to the forefront (e.g., Davis & Piercy, 2007; Sprenkle & Blow, 2004). The common factors approach (Asay & Lambert, 1999; Lambert, 1992) points to four broad areas that are responsible for client change in therapy. Extratherapeutic factors are thought to explain 40% of improvement in psychotherapy and include variables related to factors clients bring with them to the therapy process, such as problem severity, client motivation, and client ego strength. The therapeutic relationship is thought to explain 30% of client improvement in psychotherapy. This variable includes the therapists' ability to show empathy, positive regard, and genuineness. Placebo, hope, and expectancy effects are thought to explain 15% of client change, and the remaining 15% is attributed to model and technique factors. Thus, even though hope is not theoretically the most important contributor, it remains an essential component in the change process.

However, within the field there have also been concerns raised about the usefulness of the common factors approach (Sexton, Ridley, & Kleiner, 2004). One specific challenge by these authors was to raise the issue that common factors, including hope, "are not conceptually clear, operationally defined, or contextualized within a clinical process enough to make them researchable or understandable" (Sexton et al., 2004, p. 137). In other words, there is need to go beyond recognition of the importance of hope in the change process by clearly defining the concept of hope and identifying processes that "make hope happen" within the therapy room. This was the purpose of the current study.

CURRENT UNDERSTANDINGS OF HOPE

A common conceptualization of hope in the psychotherapy literature (Snyder, Michael, & Cheavens, 1999) defines it as a cognitive construct with two essential components: pathway thinking and agency thinking. …

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