Journal of marital & family therapy.

L., Greenberg ; S., Warwar ; W., Malcolm 等

Emotional injuries, or incidents that significantly wound the emotional bond between a couple, and which are inflicted by one partner to another, can lead many couples to harbor lasting feelings of anger, betrayal, and resentment toward their partners, not uncommonly for years on end. While research has highlighted the great benefits of forgiveness in marital satisfaction, the process by which partners arrive to a place of forgiveness for the other can be confusing, complicated, and challenging. This study examined the effectiveness of Emotion-Focused Therapy for Couples in facilitating forgiveness.

Emotion-Focused Therapy for Couples (EFT-C) is a psychotherapy modality that is distinguished by its emphasis on a couple's attunement to, experience and expression of biologically adaptive primary emotions, such as grief over a loss or anger over an injustice, which promotes securer attachments, healthy identity development, and the maintenance of healthy interpersonal boundaries. Furthermore, as a core tenet of EFT-C, the expression of these primary emotions invites "responsive affective attunement by a partner to the other's hurt" and is believed to facilitate the mending and healing of the emotional injuries (p. 31). Because of these distinct therapeutic qualities, EFT-C was believed to be well suited for helping couples overcome long-lasting emotional injuries, and thus was evaluated for its effectiveness in accomplishing this task.

Participants for the study were recruited through advertisements in local newspapers. Participants were screened to meet inclusion and exclusion criteria, the most essential of which was for the couple to have "experienced an emotional injury by their partner at least 2 years prior and were still experiencing unresolved feelings of hurt or anger toward their partner in relation to the injury" (p. 35). The sample (N = 40) consisted of 20 couples ranging in ages between 25 and 75 years (M = 45.15, SD = 10.75). The couples, who were predominantly Caucasian (n = 34), had been living together for 4 to 53 years (M = 16.53, SD = 9.99) and had on average 2 children. The emotional injuries reported by the couples included affairs (9; 37.5%), abandonment (7; 29.2%), invalidation (4; 16.7%), deception (2; 8.3%), and alliance/triangulation (2; 8.3%). 11 qualified EFT-C therapists were utilized for the EFT-C treatment condition. A battery of ten self-report measures was administered to the couples before, during, and after treatment to assess specific domains. The measures included The Enright Forgiveness Inventory, Forgiveness Measure, Trust Scale, Unfinished Business Empathy and Acceptance Scale (EFB EA), Unfinished Business Feelings and Needs Scale (EFB FN), Dyadic Adjustment Scale, Target Complaints Discomfort and Change Scale, Global Symptom Index (GSI) of the Symptom Checklist 90 Revised (SCL-90-R), The Couples Therapy Alliance Scale, and the Structured Clinical Interview for DSM-III Axis II (SCID-II) Personality Questionnaire. Couples engaged in a 10-12 week waitlist period prior to treatment, and then were randomly assigned to therapists for 10-12 one-hour weekly couple therapy sessions.

Analysis of the therapeutic alliance based on ratings by the therapists, supervisors, and clients indicated a good adherence to the EFT model and with satisfactory therapeutic alliances across all therapists. While numerous measures were calculated, of note is the 2 3 repeated measure ANOVA on partner (injured and injurer) and occasion (prewaitlist, pretreatment, and posttreatment) that was used to assess the efficacy of treatment. This analysis revealed a significant treatment effect in domains of forgiveness F(2, 76) = 3.34, p = .05; trust F(2, 76) = 4.29, p = .025; distressing symptoms F(2, 76) = 3 98, p = .023; and unfinished business related to feelings and needs F(2,76) = 5.17, p = .017). In these domains both injured and injuring partners changed positively over time between pre-treatment measures and post-treatment measures. Additionally, 2 2 ANOVA was performed to measure a 3-month follow up in domains of marital satisfaction, forgiveness, trust, distressing symptoms, and discomfort and change related to significant marital complaints. Results of the ANOVA revealed no significant changes between the post-treatment assessment and the 3-month follow-up in the aforementioned domains, with the exception of trust, for which significant effects of deterioration were found (t = 3.48, p > .05). The overall results of the study provides support for the effectiveness of EFT-C in treating marital distress related to long-term emotional injuries when both partners exhibit the desire to stay together and enter treatment. The study also revealed that changes in forgiveness "correlate significantly with improved marital satisfaction and trust" (p. 39). Furthermore, despite results showing a decline in trust at the 3-month follow-up, the researchers noted that some of the variance may be accounted for by some significant life changes in some of the couples after therapy, but the researchers expressed that "booster sessions might facilitate more enduring relapse prevention" (p. 39). One limitation of note in the study is that it was conducted on moderately distressed couples and may not be generalizable to more severely distressed couples. JOURNAL OF ADULT DEVELOPMENT Halkitis, P., Mattis, J., Sahadath, J., Massie, D., Ladyzhenskaya, L., Pitrelli, K., Bonacci, M., and Cowie, S. (2009). The Meanings and Manifestations of Religion and Spirituality among Lesbian, Gay, Bisexual, and Transgender Adults Vol. 16, 250-262 The importance of religion in the lives of adults in the U.S. has been highlighted by much research. However, because of religious doctrines and religious institutions that are typically opposed to LGBT lifestyles, religious communities and LGBT communities infrequently tread the same soil, resulting in very little being known about the religious and spiritual beliefs and practices among LGBT adults. Halkitis et al. (2009) sought to fill the gap in research on this subject and highlight the importance of religion and spirituality in the lives of a substantial number of LGBT individuals. The researchers conducted a cross-sectional survey of religiosity and spirituality by recruiting participants from a gay pride festival in a large northeastern city in the United States. The sample (N = 498) was slightly over half male (n = 259) and slightly

under half female (n = 234), and also contained five participants identifying as transgendered. Their age ranged between 18 and 73 (M = 37, SD = 11.22), but the women in the sample were significantly younger than the men (F (2,481) = 14.17, p ----- .001), the average age for the men being 39-yearsold, and the average age for the women being 34-years-old. Heterosexual participants were excluded from the survey in accordance with the exclusion criteria, resulting in approximately 80% of the sample (n = 400) identifying as gay or lesbian, with the remaining (n = 98) identifying as bisexual. About half the sample (n = 264) was White, about a quarter (n = 121) Latino, nearly 10% Black (n = 43), with the remaining being Other (n = 32) or missing ethnicity data (n = 38). The researchers sought to answer three specific questions related to religion and spirituality among LGBT individuals: "First, in what public and private acts of devotion do LGBT adults engage? Second, to what extent do LGBT adults distinguish between religiosity and spirituality," and "third, what are the meanings that LGBT adults ascribe to the terms spirituality and religiosity?" (p. 252). To do so, participants were administered multiple measures to gain data for the quantitative analysis. These measures included measures of Sociodemographics, including level of education; Religious Affiliation; Religiosity and Spirituality; Religiosity and Subjective Spirituality; Religious Salience and Spiritual Salience; Religious Participation, with sub-measures of Non-organizational and Organizational Religious Involvement. Additionally, for the purposes of qualitative analysis, participants furnished written responses "to two open-ended questions: "What does spirituality mean to you?' and 'What does religiosity mean to you?" (p. 253). Descriptive statistics were utilized to analyze the data from the quantitative measures. Regarding

The overall results of the study provides support for the effectiveness of EFT-C in treating marital distress related to long-term emotional injuries when both partners exhibit the desire to stay together and enter treatment. The study also revealed that changes in forgiveness "correlate significantly with improved marital satisfaction and trust" (p. 39). Furthermore, despite results showing a decline in trust at the 3-month follow-up, the researchers noted that some of the variance may be accounted for by some significant life changes in some of the couples after therapy, but the researchers expressed that "booster sessions might facilitate more enduring relapse prevention" (p. 39). One limitation of note in the study is that it was conducted on moderately distressed couples and may not be generalizable to more severely distressed couples.

Greenberg, L.; Warwar, S.; and Malcolm, W. (2010).

Emotion-Focused Therapy and the Facilitation of Forgiveness Vol. 36, 28-42