HopeHope-focused Marriage Counseling (Updated)

Everett L. Worthington, Jr. Virginia Commonwealth University

A 3-hour pre-conference workshop presented at CAPS, Valley Forge, April 22, 3pre2007. As a minor part of the workshop, I present a study. CoCo-authors of the Study: Jack W. Berry, David E. Canter, Connie Sharp, Mark Yarhouse (Regent University), Michael Scherer. The study was supported by grant #239 from the John Templeton Foundation and a grant to the General Clinical Research Center at VCU M01 RR000065. And further by the John Fetzer Institute.

Workshop Objectives
By the end of this workshop, the participant will be able to  Describe hope-focused marriage counseling hope Conceptualize forgiveness within psychological and theological frameworks and be able to promote it in couples  Understand reconciliation and how to promote it in couples  Understand self-forgiveness and how to selfpromote it in couples

Forgiveness in Couples

My approach to Marital Therapy



Worthington, E. L., Jr. (1989). Marriage counseling: A Christian approach to counseling couples. Downers Grove, IL: InterVarsity Press. Worthington, E. L., Jr. (1999). Hope-focused Hopemarriage counseling. Downers Grove, IL: counseling. InterVarsity Press. Worthington, E. L., Jr. (2005). Hope-focused Hopemarriage counseling, rev. ed. Downers Grove, IL: ed. InterVarsity Press.

HopeHope-focused Marriage Enrichment has been designated as 1 of 4 ESTs (Empirically Supported Treatments) for marriage enrichment


Jakubowski, S. F., Milne, E. P., Brunner, H., & Miller, R. B. (2004). A review of empirically supported marital enrichment programs. Family Relations, 53, 528-536. 53, 528It lists Hope-focused enrichment as one of four ESTs Hopein marital enrichment: PREP, Relationship Enhancement, Couple Communication Program, and Strategic Hope-focused Enrichment. Hope-

Questions and Answers uestions

State of the Clinical Science in 1997

  

 

Gottman ratio: 5 to 1 positive to negative Therapists try to increase the ratio The action is in helping couples ACT differently with each othere.g., integrative other behavioral, solution-focused approaches solutionStress makes things worse Focus is dyad patterns of communication and conflict negotiation

A lot has happened between 199819982005: Implications of the Review of the Literature
     

Its not so much skills, communication, conflict resolution per se. Its ability to control and limit the negative emotional climate (and restore the positive emotional climate). Valuing, safety, security Hope Cutting short negative reciprocity Letting go of negative moods; not ruminating; healing ruptures in negative bonds by forgiving

Clinical Research in Couple Therapy Suggests Implications Similar to Couple Dynamics

Advances in Couple Therapy  1. CBT, IBT, EFT, Insight-oriented couple Insighttherapy: These all emphasize the emotional bond rather than skills.  2. Many continue to be popular without research base: Solution-focused Therapy, some family Solutionsystems adaptations to couples.  3. Note: the modifications have been away from skills, and toward managing negative emotional climate

HopeHope-focused Marriage Enrichment

 Journal

of Counseling Psychology, Psychology, Worthington et al. (1997) showed that 5 hours of intervention produced effect sizes greater than 1 for some DVs
What causes the power of the intervention?

FYI: Previous Component Research on Hope-focused Marital HopeEnrichment



Hammond & Worthington (1985), American Journal of Family Therapy, found leaders strongly guide couples attention to issues Therapy, in groups Worthington, Buston, & Hammonds (1989), Journal for Counseling and Development, found support of group members > 3 hours of Development, information about communication, conflict resolution, and information in psychoeducational groups Worthington et al. (1995), Journal of Counseling Psychology, found Psychology, that assessment and feedback to individual couples account for about of the ES in marital enrichment

FYI: Summaries of Hope-Focused HopeMarriage Therapy

     

   

Worthington, E. L., Jr., Ripley, J. S., Hook, J. N., & Miller, A. J. (2007). Hope-focused approach: Repairing and Hopemaintaining the emotional bond. In T. Clinton & G. Ohlschlager (Eds.), Caring for people in marriage and family life (pp. ). Worthington, E. L., Jr., Ripley, J. S., Hook, J. N., & Miller, A. J. (2007). Hope-focused couple therapy and enrichment. HopeJournal of Psychology and Christianity, in press. Hope-focused Marriage Counseling, rev ed. (2005, IVP) (includes research update since 1998) Hopeed. Worthington, E.L., Jr., Lerner, A., & Sharp, C. (2005). Repairing the emotional bond versus skills training for marital intervention. Journal of Psychology and Christianity,24, 259-262. Christianity,24, 259Worthington, E.L., Jr. (2003). Hope-focused marriage. Recommendations for researchers and church Hopeworkers. Journal of Psychology and Theology, 31, 231-239. 31, 231Worthington, E.L., Jr. (2002). Aconselhando Relacionamentos [Relationship counseling]. Aconselhamento: O Jornal do Aconselhamento Crisao Evangelico no Brasil [Brazilian Journal of Counseling], 1, 39-48. [original article, 1, 39translated into Portugese by Robson Gomes] Worthington, E.L., Jr., & Ripley, J.S. (2002). Christian marriage and marital counseling: Promoting hope in lifelong commitments. In T. Clinton & G. Ohlschlager (Eds.), Competent Christian counseling: Practicing and pursuing compassionate soul care, Vol. 1 (pp. 455-474). Denver: Waterbook Press. 455Worthington (1999). Hope-focused Marriage Counseling (IVP) HopeWorthington, E. L., Jr. (1994). Marriage counseling: A Christian approach. Journal of Psychology and Christianity, 13, 166-173. 13, 166Worthington, E. L., Jr. (1991). Marriage counseling with Christian couples. In G. R. Collins (Ed.), Case studies in Christian counseling (pp. 72-97). Dallas: Word. 72Worthington, E. L., Jr. (1990). Marriage counseling: A Christian approach to counseling couples. Counseling and Values, 35, 3-15.

Questions and Answers

HopeHope-Focused Marital Enrichment: Description of the intervention and techniques for promoting change
Hope = Willpower + Waypower + Waitpower


Theology of the Hope-Focused HopeCouple Approaches (HFCA)



 

rejoice in [marital] sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope (Romans 5:3-4, NIV). hope 5:3HFMA is founded on the belief that hope is at the depth of the Christian experience. Christ in us is indeed the hope experience. of glory (Col 1:27). Hope is one of the three most emphasized aspects of Christian character (1 Corinthians 13:13). In HFMA, the strategy taught to partners for promoting change (see Worthington & McMurry, 1994) is faith working through love (Gal 5:6). HFMA was founded upon a theology that values marriage and promotes mutual submission in love of husband and wife (see Eph 5: 25-33). 25-

HopeHope-Focused Marital Enrichment

Strategy:

Promoting Love, Work, Faith

HopeHope-Focused Marital Enrichment

 Areas:  Central Vision, Core Values, Confession & Forgiveness, Communication, Conflict Resolution, Cognition, Closeness, Commitment

Objective 1


We have now achieved Objective 1: Describe hopehope-focused marriage counseling

We will examine some of its interventions more closely

Questions and Answers

HopeHope-Focused Marital Enrichment

Interventions

HopeHope-Focused Marital Enrichment



PrePre-counseling (Phone, Preparation pamphlet, assess stage of change)

Exercise


Discuss in twos, how do you get the husband, who doesnt want to come to see a shrink, to come? Share some ways with the group

HopeHope-Focused Marital Enrichment

 Preliminary

assessment &  Report

Worthington et al. (1995), Journal of Counseling Psychology, found that Psychology, assessment and feedback to individual couples account for about of the ES in marital enrichment; probably this is the most powerful single technique you could use in marital therapy.

Assessment Battery
Marital Inventories  Dyadic Adjustment Scale  Commitment Inventory  Intimacy thermometers  Discussion of an issue they disagree about (communication, problem solving, conflict styles) Forgiveness  Decisional Forgiveness Scale and Emotional Forgiveness Scale and single items  Transgression-related Interpersonal Motivations Inventory Transgression(TRIM) Religion  Religious Commitment Inventory-10 Inventory-

Questions and Answers

HopeHope-Focused Marital Enrichment

Communication  STEPS (Situation, Thoughts, Emotions, Plans, Statement of Value)  TANGO (TAN: T = Tell what happened clearly and briefly, A = describe how the situation Affected you, N = give a Nurturing statement. Then the listener responds with the GO: G = did I Get it? Reflect back what they heard, and O = Observe the effects of the conversation and comment on them.  Listening  Requests (Making, Refusing)

Exercise

STEPS (Situation, Thoughts, Emotions, Plans, Statement of Value)

See Sherod Miller, who has a whole program that teaches this systematically, and has lots of empirical support.

HopeHope-Focused Marital Enrichment


   

Conflict Resolution
L=Listen and repeat O=Observe your effects V=Value your partner E=Evaluate both partners interests

HopeHope-Focused Marital Enrichment


     

Closeness: CLEAVE
C=Change actions to positive L=Loving romance E=Employ a calendar A=Adjust intimacy elsewhere V=Value Your Partner E=Enjoy yourselves sexually

Discuss in Groups of Four



How do you promote intimacy between couples who want to be intimate but arent succeeding? Share some strategies with the whole group.

HopeHope-Focused Marital Enrichment

Closeness

Use of Space

Demonstration and Exercise



Role playing couple with groups of observers and a counselor (size of group depends on number present)

HopeHope-Focused Marital Enrichment

 Commitment
  

Joshua Memorial Final Assessment Report

Questions and Answers

Modifications to HFCA to Account for Increased Understanding of the Importance of the Emotional Bond

Modification in Theory


Attachment Theory


Working models of
Self  Other  God


  

Schnarch (1991) and the crucible Wuthnow (2000) and religious dwelling and seeking seekingtabernacles and tents Shults and Sandage (2006) spiritual transformations in the desert

Modifications in Assessment


Full battery, emphasis on intimacy, forgiveness, and the ways that poor communication and conflict resolution damage the emotional closeness between the partners.

Modifications in Interventions
 

Emotional softening Calling attention to times of empathy of one partner for another Calling attention of times of self-sacrifice of one selfpartner for another.

Objective 1


We have thoroughly achieved Objective 1

Lets move to Objective 2: Conceptualize forgiveness within psychological and theological frameworks and be able to promote it in couples

Questions and Answers

FREE: Forgiveness and Reconciliation through Experiencing Empathy

REACH Bridge

to Reconciliation

Discuss in 3-somes Divine 3Forgiveness, and Forgiveness between partners

 

What are they? What if a person says, I forgive him but is obviously still really hurt and angry. Whats going on?

Does a husband (or wife) have to repent before the spouse is obligated to offer forgiveness?

FREE

Theory
     

Transgressions Injustice Gap Forbearance MotivationalMotivational-Decisional Forgiveness (Emotional) Unforgiveness Emotional Forgiveness

What are your questions about Forgiveness?



At least 30 minutes to discuss the topic

Questions and Answers

Objective 2


We have now achieved Objective 2a: Conceptualize forgiveness within psychological and theological frameworks [and be able to promote it in couples].

2003 Christian book

New (2006) secular book

Forgiveness (Theoretical Enrichment)



 

Forgiveness and reconciliation are primarily about repairing the damage to the emotional bond caused by a history of transgressions at the hands of each other. Trauma = damage that threatens physical existence leading to helplessness. When an attachment figure is not helpful (or is perceived as malevolent) during a time when a person is needy, an injury to the attachment system occurs. Marital problems, conflicts, and transgressions can traumatize, and if God isnt there or the partner isnt there, attachment bonds are strained or ruptured. Forgiveness is one powerful way of healing the wounds and scars of the trauma of experiencing the partner (and God) as not there during need.

Injustice Gap
Size of injustice gap is proportional to difficulty forgiving. Thus,
  

Reduce injustice Apologize Offer Restitution

Decisional Forgiveness
Make a decision  It is beneficial to forgive: physical, mental, relational, or spiritual health.  Decisional forgiveness: On the basis of Scripture or sacred writings or appeal to virtue, do you want to forgive?  Can you give decisional forgiveness now?

Emotional Forgiveness


Replacement of negative unforgiving emotions with positive other-oriented emotions, such as otherempathy, sympathy, compassion, and love. This is facilitated by other non-self-focused emotions, non-selflike hope, humility, and gratitude for having been forgiven.

Questions and Answers

Five Steps to REACH Emotional Forgiveness

FREE

REACH God


We forgive because God first forgave us REACH God before, during, and after you REACH forgiveness

FREE
Make a decision  Decisional forgiveness: On the basis of Scripture, do you want to forgive?  Can you give decisional forgiveness now?  If you cannot, are you willing to be made willing?  Have you discerned Gods heart?

Five Steps to REACH Emotional Forgiveness of the Partner

FREE

REACH
 

R = Recall the hurt Technique: not victimization, not blame; instead objective

FREE

REACH
E = Empathize with the one who hurt you  Techniques:  Letter from others point of view  Talk about others experiences
  

Empty chair Symbolizing the experience: Yellow and dark heart Multiple repetitions with sympathy, compassion, altruistic (agape) love, romantic love

Exercise


Get into groups of three or four (at least one man and woman in each group). They will role play as a couple. The other person is counselor. Counselor works with either husband or wife on an early hurt (pre-marital), involving the partner (prein empathizing. Use empty chair for the one working.

FREE

REACH
A = Altruistic gift of forgiveness

FREE

REACH
 

C = Commit to forgive Techniques: certificate, letter, washing the hands of the transgression, Richard Marks' "Firststone," nail the transgression to the cross

Exercise


HandHand-washing

FREE

REACH


H = Hold onto forgiveness during doubts Technique: hurt does not equal unforgiveness, white bears

Exercise
 

Pair up Take turns explaining to each other why a person might forgive and yet still get angry about the incident later (after forgiveness has occurred). Share creative ways of explaining this with the big group.

Objective 2


We have now achieved Objective 2b: [Conceptualize forgiveness within psychological and theological frameworks] and be able to promote it in couples.

Objective 3 deals with reconciliation

Questions and Answers

FREE

Bridge to Reconciliation
 Plank

1: Decide whether, when, and how to reconcile

Role Play


Couple exhibits very poor communication for making a reproach, for responding with an account or accounts

FREE
Bridge to Reconciliation
Plank 2: Soft talk about forgiveness (Talking about Transgressions) Reproaches Accounts  Denials  Justifications  Excuses  Confessions


FREE
Bridge to Reconciliation
        

Confessions (CONFESS) C: Confess without excuse O: Offer apology (convey sincere regret and contrition) N: Note his or her pain (empathically show that you understand the pain or anger you caused) F: Forever Value (say that you value the person) E: Equalize (Offer to make some restitution: Is there anything I can do to make it up to you?) S: Swear never again (Express intent not to harm similarly again) S: Seek forgiveness (Give reasons to promote empathy)

Exercise
 

Pair up Practice a good confession

FREE
Bridge to Reconciliation
Dealing with the confession  Accept (grant forgiveness)  Reject (withhold forgiveness)  More time needed (not yet ready to grant forgiveness)  What if one feels the reproach is inaccurate (you want to deny) or your behavior was justified? Ask, Can you explain what made you think this? [Explanation] I see why you think the way you do. Im really sorry that this occurred. I feel badly that Ive hurt your feelings. I did not mean for that to happen. I wonder if I might explain the way I was looking at the incident? [Explanation]


FREE
Bridge to Reconciliation  Plank 3: Pyramid (Five steps) Model to REACH Forgiveness  Plank 4: Reverse the Negative Cascade Criticism Defensiveness Contempt Stonewalling

FREE
Bridge to Reconciliation

Plank

5: Deal with failures in trustworthiness Attitude of gratitude Attitude of latitude

FREE
Bridge to Reconciliation

6: Promote Love Techniques: Love Bank (Harley), Increase the Gottman ratio (Gottman), Love languages (Chapman)

 Plank

Exercise
 

Pair up One person is counselor and the other is a spouse Counselor works with couple on love bank, or on love languages Switch and the other person tackles the other topic.

Questions and Answers

Objective 3


We have now achieved Objective 3: Understand reconciliation and how to promote it in couples

Objective 4 deals with forgiving the self.

Objective 4: Forgiving the Self

Can I come to forgive myself and feel no emotional unforgiveness toward myself? YES
      

I am sorry for what I did (remorse; facilitating emotion) I am grateful for what Jesus did for me in his substitutionary atonement and Gods forgiveness (gratitude; facilitating emotion) I realize I dont deserve it; it is grace and mercy (humility; facilitating emotion) I feel empathy for Jesus, who suffered and died for me (replacement emotion) I feel sympathy for Jesus, who suffered and died for me (replacement emotion) I feel compassion for Jesus, who suffered and died for me (replacement emotion) I feel love for Jesus, who suffered and died for me (replacement emotion)

Forgiving the Self: A special complicated case of forgiving

1. Forgiving the self is hard because: because:  You cant get away from your own thoughts  You are both the one who forgives and the one who offends. So you have dual responsibilities.  You did not merely hurt yourself by your acts, you probably hurt others and may need to make amends.  You probably sinned against God, nature, or humanity, and you need to restore that relationship.  You pressure self to forgive self.  You not only did something to hurt another but you also damaged your self-concept. self-

How To Forgive Yourself

1.

You did something that harmed others (directly or indirectly), and you might need to confess (to someone), apologize, make restitution, and repair damage (if this can be done without re-traumatizing the reperson). Note: You might just have to carry the yoke of guilt.

2. You must make it right with God, being willing to accept divine forgiveness. 3. You must declare decisional forgiveness for yourself. 4. You must REACH emotional forgiveness for yourself through empathizing, sympathizing, feeling compassion for, and loving yourself (as you would do for an enemy who continually disappoints you). 5. You must accept yourself as a flawed and fallen person and not expect perfection. (This often takes years.)

Questions and Answers

Thank you for your attention

Copies

of these slides are available electronically by emailing me at eworth@vcu.edu

Study Does This Method Work?

HopeHope-focused Marital Enrichment Component Analysis in the Current Study

HopeHope-focused = HOPE + FREE HOPE=Handling Our Problems Effectively (communication and conflict resolution components) FREE=Forgiveness and Reconciliation through Experiencing Empathy

Method

Design of Study
Early Married Couples
  

O HOPE O O FREE O O O

O O O

Participants
 

  

156 Couples in their first 5 months of marriage 52 per group, matched by timing of the three testing times (Note: analyses showed no differences initially on any variables in the study) Ages (18 to 62) Recruited from newspaper advertisements Paid $200 for completing assessment measures; participants in intervention paid additional $100

Measures Reported Here

 

   

DAS (used Marital Satisfaction item, 0-6) 0Positive Emotions about the spouse (19 bipolar adjectives rated 1, negative emotion, to 5 positive emotion; ex: friendly to hostile) Forgiveness of most serious hurt (0-4) (0SingleSingle-item Forgiveness of index hurt (SIF; 0-4) 0TRIMTRIM-R + TRIM-A = TRIM-Total (Index hurt) TRIMTRIMConflict Tactics Scale (low scores = better conflict tactics)

Other Measures Not Yet Analyzed

  

Salivary Cortisol (baseline relaxing versus when imagining a typical relationship interaction) Videotape discussions of (a) a topic which you disagree about and (b) a pleasant topic Numerous self-report instruments at selfdispositional level (e.g., trait forgivingness), process level (ratings of communication, intimacy, etc.), and level of specific interactions (e.g., how deal with transgressions)

Procedure


 

Couple phones in response to ad and is scheduled for and attends initial assessment Couple is assigned to condition randomly Couple attends either FREE or HOPE intervention or no treatment Couple assessed roughly at post-treatment, 1 postmonth post-treatment, 6 months post-treatment, postpost12 months post-treatment post-

Change in Procedure after Study Begins



In December 1999, about 14 months after the study began, VCUs IRB was shut down, compromising the original design of the study by interrupting for 8 months all research (which played havoc with a longitudinal design) After resumption (July 2000), to keep from losing, almost our first entire round of participants, we switched to a yoking procedure (using the matching variable of time of test and using only three measurement times instead of five as planned)

Very Preliminary Results for Some Self-report Variables Self  

Treatment x time (S) ANOVAs with repeated measures No main effects for Treatment or time are significant Following are interactions (Note the pattern is similar: Control get worse; HOPE gets better and then loses some; FREE gets better continuously)

TRIMTRIM-Revenge, Index Hurt (p<.05)

5. 5. 5. 5. 5 . t e t e t e ntr FR H P

TRIMTRIM-Avoidance, Index Hurt (p>.10, ns)

SingleSingle-item Forgiveness of Index hurt (p<.05)

. . 5 . .55 .5 . 5 . . 5 . . 5 . time time time

ontrol FR P

State Anger Scale, p<.01

1 1 . 1 1 . 1 1 . 1 1 . 1 t e1 t e t e ntr l FR P

How Forgiving Are You, in General, Toward Your Spouse? (single item), p<.01
. . . . . . . . .1 time 1 time time

ontrol FR H P

Forgiveness of Your Most Serious Hurt, p<.05

. 5 . . 5 . . 5 . .55 .5 . 5 ti e ti e ti e ontro FR H P

Current Positive Affect toward Your Spouse, 19 bipolar adjectives, p<.02

.9 . . . . . . ti e 1 ti e 2 ti e Control FR P

Marital Satisfaction, Single Item, p<.05

0 . . . . . . . . . time time time ontrol FR P

Discussion
   

Forgiveness intervention (FREE) affected variables differently over time than did HOPE HOPE gave an initial boost to the marriage but some effect eroded FREE helped people not erode and perhaps improve, especially on forgiveness matters The implication is that together they should be complementary and lasting (which is what Worthington et al., 1997, showed)