WEBVTT 00:00:11.360 --> 00:00:12.420 Welcome, everyone. 00:00:12.735 --> 00:00:14.515 My name is doctor Steven Grundman. 00:00:14.975 --> 00:00:21.555 I teach the integrative courses, philosophy, theology, and psychology in our doctorate in clinical psychology program. 00:00:22.975 --> 00:00:24.435 I'll be your emcee tonight. 00:00:25.200 --> 00:00:41.885 The Newman Lecture Series, now in its twenty fourth year, sponsored by Divine Mercy University, aims at building a body of learned discussion that is Catholic both in its breadth of research and in its dialogue with contemporary Catholic Christian thought. 00:00:43.145 --> 00:00:53.165 We are pleased to offer tonight's lecture both on campus and online, and so a few words to our audiences about submitting questions for our speaker following the lecture. 00:00:53.960 --> 00:01:00.460 For those joining us online, as questions occur to you, please type them in the chat box or the question and answer box. 00:01:01.160 --> 00:01:06.060 For technical reasons, online questions will be taken until the question and answer period begins. 00:01:07.185 --> 00:01:11.025 For those joining us on campus, we have a microphone for you here in the room. 00:01:11.025 --> 00:01:13.525 We have two microphones, one on either side in the back. 00:01:14.865 --> 00:01:15.605 Thank you. 00:01:16.785 --> 00:01:22.405 And now as father Hsu has been called away suddenly on priestly duties, I've been invited to open us in prayer. 00:01:22.840 --> 00:01:24.200 Please join me. 00:01:24.200 --> 00:01:27.100 In the name of the father and of the son and of the holy spirit. 00:01:27.240 --> 00:01:27.740 Amen. 00:01:34.855 --> 00:01:41.995 Heavenly father, we thank you for calling us to be living witnesses of your love for each human person. 00:01:43.655 --> 00:01:51.390 We thank you for inspiring the mission of Divine Mercy University and supporting our studies. 00:01:53.770 --> 00:02:04.685 We thank you especially for the presence of our distinguished speaker tonight, who will be sharing with us a great deal of research to help further our work. 00:02:07.705 --> 00:02:19.380 So we ask you to bless as well all those who are present or are able to watch this presentation with us and all those they touch. 00:02:19.440 --> 00:02:21.540 We ask all this in Jesus' name. 00:02:21.760 --> 00:02:22.260 Amen. 00:02:22.600 --> 00:02:26.340 In the name of the Father and of the Son and of the Holy Spirit. 00:02:26.400 --> 00:02:26.900 Amen. 00:02:27.200 --> 00:02:35.665 And now I invite doctor Klowicki, dean of the Institute for the Psychological Sciences, to introduce tonight's distinguished speaker, doctor Klowicki. 00:02:41.040 --> 00:02:44.900 I have the wonderful pleasure of introducing one of my colleagues and friends. 00:02:45.440 --> 00:02:47.860 This is doctor Martino Rodriguez Gonzalez. 00:02:48.240 --> 00:02:53.940 He completed his bachelor's degree in psychology at the University of Santiago de Compostela in Spain. 00:02:54.365 --> 00:03:00.225 He then obtained a master's in psychology of the family from the John Paul II Institute in Madrid, Spain. 00:03:00.845 --> 00:03:07.985 He completed his last degree, which is was his PhD at the Comillas Pontifical University in Spain also. 00:03:08.530 --> 00:03:09.590 Getting a theme here? 00:03:10.930 --> 00:03:24.150 Doctor Rodriguez Gonzalez now works as an associate researcher at the Institute for Culture and Society of the University of Navarra in Pamplona, Spain, and he maintains a private practice focusing mainly on work with couples and families. 00:03:25.545 --> 00:03:43.180 Doctor Rodriguez Gonzales is the principal investigator of three research funding projects, a randomized control trial in emotionally focused couple therapy in Spanish, divine forgiveness, psychological aspects of confession in Spanish speaking Catholics, and mental health in schools. 00:03:44.040 --> 00:03:53.465 He's also the author of eight book chapters, one book, and over 25 peer reviewed publications, primarily in journals related to family and couples therapy. 00:03:54.725 --> 00:04:03.530 He, is a fellowship and has short research visits at the University of Ottawa, University of Comimbra Comimbra. 00:04:03.750 --> 00:04:04.390 There we go. 00:04:04.390 --> 00:04:04.890 Sorry. 00:04:05.590 --> 00:04:12.730 University of Porto, Brigham Young University, Boston University, and Georgetown Family Center for the study of the family. 00:04:13.590 --> 00:04:34.510 Since 2009, he has had teaching appointments both full time and as an invited professor at the Universidad de Navara, Universidad de Francisco de Victoria, Universidad de Santiago de Compostela, the John Paul II Institute, and the Universidad de de Justo in Spain, Bilbao, Spain. 00:04:34.570 --> 00:04:35.070 Right? 00:04:35.290 --> 00:04:35.610 Right. 00:04:35.610 --> 00:04:42.750 I I I am butchering all of these with my horrible Spanish pronunciation, so I apologize to anybody who did not understand me, actually. 00:04:44.365 --> 00:04:52.225 He's fully trained in emotionally focused therapy by Sue Johnson's, institute, center for EFT in in Canada. 00:04:52.685 --> 00:04:56.705 He has level one, accreditation in emotion focused therapy by Greenberg. 00:04:57.060 --> 00:05:10.360 He's fully accredited as a family and couple systems therapist by the National Federation of Family Therapy, and he's president of the Spanish Association for the Research and Development of Family Therapy from 2019 to the present. 00:05:10.755 --> 00:05:15.335 So it's with great honor that I introduce to you doctor Martino Rodriguez Gonzales. 00:05:16.515 --> 00:05:17.975 Good evening, everyone. 00:05:18.355 --> 00:05:20.695 Thank you for this opportunity. 00:05:21.395 --> 00:05:24.520 Thank you to the Divine Mercy. 00:05:24.520 --> 00:05:33.260 Thank you, doctor Klawicki, for your words and for all all the faculty and students that are here. 00:05:36.205 --> 00:06:00.110 It's for me a real pleasure to an honor to has been invited to this Newman Lecture, and I expect to be able to share some of my ideas and thoughts and reflections about this very relevant issue, strongly connected with the family and the marriage, with mental health, and with flourishing and with psychotherapy. 00:06:01.595 --> 00:06:08.735 Here you can see this the outline, with the I I will follow in the lecture today. 00:06:09.275 --> 00:06:20.910 I I will start with a brief introduction of the topic, then I'm going to talk a little bit about the main, couple therapy approaches. 00:06:22.890 --> 00:06:32.295 And after, I'm going to mention some of the research topics, the main research topics and emerging issues in the field. 00:06:34.835 --> 00:06:43.860 After that, I'm going to talk about some key people and leading research groups and challenges in the in the field. 00:06:43.920 --> 00:06:54.100 And at the end, I'm going to talk a little bit about my work in in the lab in Navara, related with couples therapy. 00:06:55.315 --> 00:07:03.735 And at the end, I I'm going to suggest some future studies, some ideas for future studies. 00:07:05.235 --> 00:07:24.385 My intention is to present a big picture of the state of the of the couples therapy field, and this could be the is is going to be the first part, and we will have another second part of this lecture in October. 00:07:24.845 --> 00:07:26.785 More information at the end. 00:07:27.325 --> 00:07:27.825 Uh-huh. 00:07:28.605 --> 00:07:42.190 So I would like to start saying that the marriage and the family are in the core of the Catholic church message and its proposal for flourishing in life. 00:07:43.130 --> 00:07:53.225 Today, my impression is there is a deep discussion in the core of the Catholic church about some specific aspects related with the marriage. 00:07:54.245 --> 00:07:58.905 Catholic church is the same church for all over the world. 00:08:00.030 --> 00:08:03.970 Thus, the discussion is not possible to affect only one country. 00:08:05.230 --> 00:08:10.850 How we can contribute to a real flourishing of the marriage and the family? 00:08:11.470 --> 00:08:26.325 Moreover, can we contribute to build a better world transforming the couple therapist training, and the view of the person that Catholic couples therapist has? 00:08:27.025 --> 00:08:28.485 I trust we can. 00:08:29.240 --> 00:08:44.460 I think the Catholic psychologists are now more than ever in a relevant position for the Catholic church, and we can contribute to build sometimes a bridge between the church and the society. 00:08:45.855 --> 00:09:01.110 This bridge is needed particularly for The US of I I think particularly for The US people, there is a temptation of say Rome is very far away. 00:09:02.290 --> 00:09:10.550 But I think the work EMU is doing with the integration of psychology and Catholic faith is a good job. 00:09:12.475 --> 00:09:17.535 And it's a big contribution, not only for The USA, but for everyone. 00:09:18.635 --> 00:09:25.055 But we need to build more bridges, and I hope this lecture can contribute to that. 00:09:27.450 --> 00:09:33.950 The romantic relationships are a universal aspect of the human existence. 00:09:35.530 --> 00:09:42.030 It's a relevant topic across cultures with significant implications from several perspectives. 00:09:43.565 --> 00:10:06.840 Ethical, biological, for the religion as a also as social construction, studying why we partner, what leads two individuals to stay together, and which are the factors contributing to the flourishing of that union is of great importance. 00:10:07.915 --> 00:10:14.175 In the past, couple therapy was a variation from individual or family therapy. 00:10:14.635 --> 00:10:21.775 But nowadays, it stand on its own and it has its own distinct methods. 00:10:22.980 --> 00:10:40.005 According with Lebow and Snyder, which are two American authors I'm going to mention a lot in this lecture, there are three key factors have rhyme the development of couple therapy as a prominent therapeutic field. 00:10:40.705 --> 00:10:42.965 First, the couple distress prevalence. 00:10:44.305 --> 00:10:50.325 In all the occidental countries, a high percentage of marriages and in in divorce. 00:10:51.550 --> 00:11:02.930 Second, the negative impact of relationship distress on the emotional and physical well-being of adult partners and their offspring. 00:11:04.945 --> 00:11:20.020 Partners in distressed relationships are significantly more likely to have a mood disorder, anxiety disorder, or substance use disorder, and to develop more physical health problems. 00:11:21.440 --> 00:11:31.780 Uncoupled conflict and distress have been related with a long list of negative effects on children including mental health problems and physical health problems. 00:11:33.025 --> 00:11:37.605 A third factor is the higher expectations for couples relationships. 00:11:38.225 --> 00:11:43.045 Today, we expect our partner to be the perfect partner. 00:11:43.985 --> 00:11:47.445 The couple relationship should be should work perfectly. 00:11:48.890 --> 00:11:52.510 Couples therapy field is highly diverse worldwide. 00:11:53.370 --> 00:12:04.445 Research in couple therapy comes predominantly from The USA and from English speaking countries. 00:12:04.665 --> 00:12:07.485 For example, Canada, Australia, or UK. 00:12:08.265 --> 00:12:30.150 But for example, in a systematic review of the couple therapy research in greater we Greater China, it is possible to read, couple of or marriage therapy is a western creation designing to address problems arising in intimate and romantic relationships. 00:12:31.925 --> 00:12:41.145 This shows research in couple therapy from China is pretty new starting mostly in the last fifteen years. 00:12:44.670 --> 00:12:49.170 It's to take care of coupled relationships, a public health priority. 00:12:51.390 --> 00:12:53.250 In my opinion, it should. 00:12:54.430 --> 00:13:02.805 Nevertheless, the investment in research about how to the coupled relationship works is truly inadequate. 00:13:04.465 --> 00:13:14.670 It doesn't not seem as a priority for the National Institute of Mental Health in The States or the European Commission Research Grants in Europe. 00:13:17.530 --> 00:13:21.870 Which are the main couple approaches we can found in the literature? 00:13:22.650 --> 00:13:26.110 There are hundreds of different couple therapy approaches. 00:13:26.435 --> 00:13:33.095 I don't know her, but in Spain, for example, you can find a very long list. 00:13:34.355 --> 00:13:41.175 In the slide, you can check one of the most relevant approaches, in my opinion. 00:13:43.350 --> 00:13:48.570 But probably if we wait two or three years, new approaches will appear. 00:13:49.270 --> 00:13:55.715 Everyone create its own approach and try to create a space. 00:13:56.175 --> 00:13:58.995 There are good news and bad news about the approaches. 00:13:59.615 --> 00:14:01.635 Let's go first with the bad news. 00:14:03.055 --> 00:14:06.420 Just pick one couple of examples from the list right now. 00:14:06.740 --> 00:14:10.280 For example, psychodynamic, psychoanalytic, couple therapy. 00:14:11.700 --> 00:14:35.675 According with a recent systematic review of the psychodynamic couple therapy field, in the last fifty years, most of research manuscripts published in this field are case studies followed by conceptual theoretical contributions and a very few number of empirical quantitative research contributions. 00:14:36.910 --> 00:14:52.745 According with the systematic review published recently, among the 130 studies published under the field psychoanalytic coupled therapy, only two used quantitative approaches. 00:14:53.605 --> 00:14:56.265 I'm sorry, but this is not good. 00:14:57.605 --> 00:15:06.300 Case studies and theoretical manuscripts are very important, but we need good quality empirical research in psychology and psychotherapy. 00:15:07.660 --> 00:15:07.820 Psychotherapy. 00:15:07.820 --> 00:15:11.680 Another example, cognitive behavioral couple therapy. 00:15:12.780 --> 00:15:22.000 In Spain, a psychologist, 95% of the schools of psychology trained in a cognitive behavioral approach. 00:15:23.875 --> 00:15:34.775 Thus, almost any psychologist from Spain, unless he or she be trained in another specific approach, could say, I am a cognitive behavioral coupled therapist. 00:15:36.080 --> 00:15:41.220 What does it mean and which are the core skills they can show in couple therapy? 00:15:42.160 --> 00:15:43.140 It's a mystery. 00:15:44.560 --> 00:15:46.020 Nobody knows really. 00:15:47.040 --> 00:15:54.785 This is also a problem because, moreover, I know this is not only a Spanish issue. 00:15:57.005 --> 00:15:59.265 Do you want to know about the good news? 00:16:05.430 --> 00:16:25.845 Good news are double therapy is an essential health intervention and different recent systematic reviews and some meta analysis conclude that we cannot be optimistic about couple therapy. 00:16:26.785 --> 00:16:37.330 Treatment developed for distressed couples are producing large size changes across multiple key domains and relationship function. 00:16:37.790 --> 00:16:46.130 Moreover, these effects were generally maintained for as much as two years after the end of the right treatment. 00:16:47.795 --> 00:16:54.455 If we look at the list I have presented previously, we can highlight two models in particular. 00:16:55.395 --> 00:17:01.575 The integrative cognitive behavioral coupled therapy and the emotionally focused coupled therapy. 00:17:02.170 --> 00:17:12.990 These two approaches have been tested through several different RCT, randomized controlled trials, from different cultural frames and research teams. 00:17:13.770 --> 00:17:17.265 But, and also using another sorry. 00:17:17.265 --> 00:17:28.245 And also using other research designs, not only the randomized control trials, as a quasi experimental and other types of research. 00:17:30.360 --> 00:17:37.740 That means that they are two promising approaches to treat coupled distress. 00:17:38.760 --> 00:17:59.545 There are also health disorders or issues beyond coupled distress for which coupled therapy has also been proven through randomized controlled trials or other research approaches such as to treat post traumatic stress disorder or substance abuse. 00:18:02.810 --> 00:18:12.270 When we talk about evidence based treatment, we are talking about how much a treatment or approach is based on research. 00:18:13.615 --> 00:18:26.355 First, it it's important to know that the number of studies in individual psychotherapy are much higher in their number than the studies for family and couples therapy. 00:18:27.720 --> 00:18:30.780 And there are different levels of evidence in psychotherapy. 00:18:31.160 --> 00:18:47.015 In particular, in the field of couple and family therapy, there is a relevant proposal made by Sexton, Lebo, and other colleagues to classify the treatments according with their level of scientific evidence. 00:18:48.995 --> 00:18:55.470 Here is the the manuscript where is the proposal, and they suggest three levels. 00:18:55.610 --> 00:19:01.710 Level one, evidence informed treatments clearly based upon psychological research. 00:19:02.090 --> 00:19:09.390 Second level, treatments which show promising preliminary risk research results. 00:19:10.265 --> 00:19:13.885 And level three level three evidence based treatments. 00:19:14.745 --> 00:19:19.805 To achieve the third level, several conditions must be met. 00:19:20.665 --> 00:19:36.170 They must be therapy models that have achieved positive results in at least two outcome studies, which we can consider to have been tested in different cultural context and with different research groups. 00:19:36.835 --> 00:19:43.255 And that the results have been assessed through measures considered reliable. 00:19:44.515 --> 00:20:13.025 For a therapeutic model to undergo these types of studies, certain conditions must exist such such as a clear treatment model with a manual, a measure of model fidelity to test the utterance or competence of the therapist, and a clear guide about how someone can be trained in the model. 00:20:14.125 --> 00:20:17.665 Not all the coupled therapy approaches fulfill these requirements. 00:20:21.250 --> 00:20:31.270 Different and diverse research methods might be needed at different phases in the evolution of a treatment program or a treatment model. 00:20:32.185 --> 00:20:36.285 Research approaches do not produce the same type of evidence. 00:20:36.985 --> 00:20:44.445 A clinical trial is the highest quality level in terms of scientific approach to test the efficacy of a treatment. 00:20:45.450 --> 00:20:57.310 But other studies with lower internal validity, less control, and more naturalistic research settings can test the treatment model effectiveness. 00:20:58.855 --> 00:21:25.150 I'm talking here about efficacy and effectiveness, which are two relevant words when we talk about evidence based treatments because efficacy is about the performance of an intervention under ideal or uncontrolled circumstances as the best example is the randomized controlled trial. 00:21:26.625 --> 00:21:32.005 While effectiveness refers to its performance and the real world conditions. 00:21:34.145 --> 00:21:47.460 Both types of studies are important in the development of research and to test that couple model to treat sorry. 00:21:47.920 --> 00:21:52.020 To to to test that, an approach in couple therapy. 00:21:54.045 --> 00:21:54.545 Okay. 00:21:54.845 --> 00:21:59.585 Let's move to the next topic, next point in the outline. 00:22:02.285 --> 00:22:10.530 What are the main research topics or and after that, some emerging issues in the field. 00:22:11.870 --> 00:22:16.450 Here, you can see a list of several topics on the field. 00:22:16.910 --> 00:22:22.770 Many of them are also relevant topics in individual psychotherapy or family therapy. 00:22:23.605 --> 00:22:39.340 I'm not trying to present a full list of all the topics couples therapy research will address, but to share some examples to help those who are not doing research in this field to know what are the topics. 00:22:40.040 --> 00:22:43.420 Efficacy and effectiveness, we already talk about that. 00:22:44.120 --> 00:22:54.685 If there are political alliance, it's a topic itself, dropout, we have a sometimes a high rate of dropout, and this is bad. 00:22:56.025 --> 00:23:00.285 Why the couples dropout or keep going in the process? 00:23:01.065 --> 00:23:03.405 The therapist training is a big issue. 00:23:04.025 --> 00:23:09.860 The supervision, we can take together these two if we want. 00:23:10.240 --> 00:23:20.820 The measure of change, LGBT and minority, groups or different kinds of couples is another topic. 00:23:21.675 --> 00:23:28.315 Cultural competencies and and other topics that you can see in the list. 00:23:28.315 --> 00:23:35.100 We can take five or twenty hours to talk about each one of the main topics. 00:23:35.720 --> 00:23:43.580 But I would like to focus briefly in the last one, couple therapy interventions to address individual issue health problems. 00:23:45.480 --> 00:23:59.325 As Lebo and Seidler are both in a recent manuscript of 2022, couple therapy has traditionally been mostly understood as a treatment to improve relationship satisfaction. 00:24:00.345 --> 00:24:10.450 Nevertheless, in the last two decades, couple therapies have been focused on problems traditionally viewed as problems of the individuals. 00:24:11.470 --> 00:24:24.885 The strong association of couple relationship distress with individual psychological and physical health problems provides a rationale for applying coupled therapy to treat those individual issues. 00:24:25.745 --> 00:24:33.445 There are two forms of adaptations of coupled therapy for treatment for treatment of individual disorders. 00:24:34.600 --> 00:24:40.140 Disorder specific coupled interventions, and partner assisted treatment. 00:24:41.240 --> 00:24:56.575 Couple treatments of individual problems are mostly cognitive behavioral in their approach, But other theoretical models of couple therapy are already working to treat individual emotional or physical health problems. 00:24:57.755 --> 00:25:13.670 In this slide, you can see some examples of mental and physical health issues where research suggests couple interventions are helpful as substance abuse or intimate partner violence or cancer. 00:25:15.970 --> 00:25:21.645 I I want to focus in three of that to talk a little bit more. 00:25:22.185 --> 00:25:34.205 For example, in substance abuse, there are strong evidence that some of these partner assistant treatments work very well to help them. 00:25:35.300 --> 00:25:42.040 I'm not alcohol could be a case, but also other substance types of substance abuse. 00:25:42.500 --> 00:26:09.700 For the post traumatic stress disorder, I have found, more than eight, ten randomized controlled trials from different models, including one, using emotionally focused therapy to try to help couples where one member of the partner has this problem and similar, with intimate partner violence. 00:26:12.375 --> 00:26:15.275 There are also some emerging issues. 00:26:16.455 --> 00:26:24.075 They are relatively new issues in couple therapy and in most of the cases, also in individual psychotherapy. 00:26:25.735 --> 00:26:28.650 In general, I'm sorry. 00:26:28.790 --> 00:26:48.975 I'm going to mention three, and most of the ideas I'm going to share or even some sentences come from a recent manuscript by Leboe Leboe and Snyder in family process, where they mentioned a list of around 10 emerging issues in the field of coupled therapy. 00:26:49.915 --> 00:26:53.835 The technology, one of the the first on the list. 00:26:53.835 --> 00:27:04.400 The pandemic potentiate a trend toward telehealth and using electronic media as an extension of therapy. 00:27:05.580 --> 00:27:11.120 During the pandemic, almost all psychotherapy shifted to video conferencing. 00:27:12.255 --> 00:27:19.155 And in some cases, it remains as a major format for couple therapy in several countries. 00:27:20.415 --> 00:27:27.315 Couple therapies mostly report that virtual therapy seems to work as well as in person therapy. 00:27:28.390 --> 00:27:35.530 Video conference solves several constraints about costs, timing, traffic, rush hours. 00:27:36.390 --> 00:27:46.905 Nevertheless, there are unsolved questions related with, for example, how to manage couple conflicts in the distance. 00:27:48.805 --> 00:28:01.190 It's not the same, the individual psychotherapy, at when you have a couple in the screen, and you can't move it to try to somehow take their attention. 00:28:02.450 --> 00:28:08.550 Is the quality of the interpersonal communication between the therapist and the couples really similar? 00:28:11.975 --> 00:28:18.155 Is similar the quality of the therapeutic alliance across in person or virtual therapy? 00:28:19.495 --> 00:28:24.875 What about the efficacy and the effectiveness of couple therapy using teleconference? 00:28:26.340 --> 00:28:43.815 We don't have a lot of research, on these issues because the teletherapy is although it's not new because it happens since a lot of years, is the research is really new. 00:28:43.875 --> 00:28:47.095 It's it's being conducted right now. 00:28:47.235 --> 00:28:47.735 Mhmm. 00:28:48.515 --> 00:28:52.295 Another emerging issue is coupled therapy and social media. 00:28:53.890 --> 00:29:04.870 With the Internet and the globalization of the resources, couple therapy is now frequently identified by live consumers using social media. 00:29:05.745 --> 00:29:12.325 Anyone can reach for help for their marriage without considering the professional profile. 00:29:14.225 --> 00:29:38.895 If I say something that doesn't work very well here in The States, considering I live in Spain and I try to I'm very connected with a lot of Latin American countries and other European countries, also with The States where the regulation about who can provide psychotherapy is probably the strongest in the world. 00:29:39.675 --> 00:29:40.175 Mhmm. 00:29:43.355 --> 00:29:48.255 In the slide one moment. 00:29:49.230 --> 00:29:49.730 Mhmm. 00:29:50.910 --> 00:29:55.090 The people can even choose the couple therapies using. 00:29:56.430 --> 00:29:56.930 Mhmm. 00:29:57.950 --> 00:30:02.290 The channels people choose to seek a couple therapies are changing. 00:30:02.905 --> 00:30:06.765 Moreover, couple therapy has become a global market. 00:30:07.465 --> 00:30:13.885 Now we have some couples in Spain and the therapists are in other country. 00:30:14.425 --> 00:30:22.420 And Spain and these other countries doesn't have any kind of rule that says the you can't do that. 00:30:23.360 --> 00:30:27.460 It's totally possible and legal. 00:30:27.855 --> 00:30:28.355 Mhmm. 00:30:28.735 --> 00:30:40.195 Do people know the difference between a clinical psychologist with a PhD and someone with a two year master program in counseling without a bachelor in psychology? 00:30:41.135 --> 00:30:42.355 People know that. 00:30:43.520 --> 00:30:45.140 Does this matter for them? 00:30:46.480 --> 00:30:47.300 It's a question. 00:30:48.480 --> 00:30:52.900 What are the criteria people is using to choose their couple therapist? 00:30:55.055 --> 00:31:01.555 And when we move to the specific field of the Catholic church, this is also a big issue. 00:31:03.055 --> 00:31:19.970 My experience in sometimes my experience is that sometimes people rely on the Catholic identity when they look to someone for a professional help without considering the professional training dimension. 00:31:21.755 --> 00:31:24.655 This is not uncommon, for example, in Spain. 00:31:25.835 --> 00:31:28.895 I'm sure this does not happen here in The States. 00:31:30.715 --> 00:31:40.570 A third topic emerging issue is the different and new demands of of health for different types of couples. 00:31:42.630 --> 00:31:47.770 Traditional formulations of relationships are not now the most frequent. 00:31:48.645 --> 00:31:55.785 Diverse types of couples with different types of requests and demands are the rule. 00:31:56.245 --> 00:32:02.665 This this open a long list of questions about the therapies. 00:32:03.250 --> 00:32:13.830 For example, do I have, as a couple therapist, an adequate knowledge for working with a couple from a different cultural frame? 00:32:15.265 --> 00:32:22.245 Couples like to choose therapies they consider they have similar values or cultural frame. 00:32:23.185 --> 00:32:43.400 In my opinion, this makes sense and it's it has positive aspects As it contributes to promote the idea, couples with a certain religion or cultural background should be able to find a therapist who understands their culture or religion. 00:32:44.555 --> 00:33:18.275 In this field, I want to highlight the work Jesse Owen from the University of Denver together with several others as Steven Sandidge or Joseph Carrier or Jesse Fox, co editor of Integratos, the journal of the CPA, are doing in the field of psychotherapy, which includes couple and family therapy also to provide research to sustain the relevance of the spiritual competencies of the psychotherapists. 00:33:19.695 --> 00:33:39.600 I think they are working in a good direction being able to impact scientific and clinical work through research results where spirituality competencies are part of the skills a therapist needs to conduct couple therapy or individual therapy or family. 00:33:41.365 --> 00:33:41.865 Okay. 00:33:42.565 --> 00:33:48.425 Let's talk about a little bit about the key people and leading research groups. 00:33:49.045 --> 00:33:50.965 I already mentioned it. 00:33:50.965 --> 00:34:01.570 Research in coupled therapy comes predominate predominate mainly from The USA and the English speaking countries. 00:34:01.870 --> 00:34:02.370 Mhmm. 00:34:02.430 --> 00:34:08.290 This is coherent when we look at the key people and the leading research group. 00:34:11.375 --> 00:34:15.315 First, I would like to mention some senior generation. 00:34:15.695 --> 00:34:24.115 I call them senior because most of them are retired as you can see in the slide. 00:34:26.580 --> 00:34:32.680 But they are very relevant people in the, field, and they are still alive. 00:34:33.140 --> 00:34:42.915 They publish something, not a lot, but are still present doing different kind of things, and they are important. 00:34:43.135 --> 00:34:46.515 Gottman, Snyder, Johnson, Christensen, and Balcon. 00:34:47.775 --> 00:34:57.530 But if we think about research groups working now in making relevant contributions to the field. 00:34:58.070 --> 00:35:02.410 I should mention probably first, Brigham Young University. 00:35:03.110 --> 00:35:28.560 Brigham Young University has a very strong group of people, a 12 researchers linked with the school of family life, working in the marital and family therapy program, who are very good researchers, publishing three sheets, eight manuscripts, papers every year in the field of family and couple therapy. 00:35:29.900 --> 00:35:41.215 And they have very strong funds from their own university to to create a long term program in research in couple therapy and tablets. 00:35:45.355 --> 00:35:48.815 I never know how to pronounce the second author. 00:35:48.875 --> 00:36:01.740 Brian, Brian from the University of Miami is another very relevant person in the field together with Wittenberg, in Michigan State. 00:36:02.120 --> 00:36:14.035 And the Northwestern University has a very important group of people in the family institute, and, Jai Levoe is from that institution. 00:36:16.335 --> 00:36:29.170 In Canada, there is a group of researchers from different universities, Quebec, Ottawa, Laval, and others, and they work a lot together. 00:36:29.710 --> 00:36:40.675 Some sometimes, some of them are PhD students that have become professors, so they have strong relationships and they work a lot in this field. 00:36:40.975 --> 00:36:46.195 In Florida State, we have also a good group leading by Franz Finchan. 00:36:47.150 --> 00:36:55.490 And in Denver, we have a group more focused on a couple education than in couple therapy. 00:36:55.710 --> 00:37:02.455 But at the end, they they publish also some research in couples therapy. 00:37:02.915 --> 00:37:04.055 Mark Mann, Stanley. 00:37:05.635 --> 00:37:13.870 If we look at Europe, the main two are Bodenmann and Barkaliza. 00:37:14.490 --> 00:37:20.510 Bodenmann is a very relevant author in the in the area of dyadic data approach. 00:37:21.850 --> 00:37:37.485 Is a person with a very strong focus on methods and steps, but their main contributions came from the area of couple and couple therapy and couple in general. 00:37:38.550 --> 00:37:43.610 And Eran Bar Khalifa is the leading of a lab in Israel. 00:37:43.750 --> 00:37:48.010 Israel has a very strong focus as a country in research. 00:37:48.390 --> 00:37:55.815 Really, in Europe, psychotherapy is one of the stronger countries in in Europe. 00:37:56.675 --> 00:37:59.415 It's in the limit of Europe, but okay. 00:37:59.955 --> 00:38:10.560 And Aram has a lab where he studied the nonverbal facial expressions with a very new approaches. 00:38:12.620 --> 00:38:18.880 There are other people in Spain, some, Carlos Perez and Jorge Baraka, and in Italy. 00:38:19.260 --> 00:38:24.475 In Italy also, Camilo Regalia, Silvia Mazzoni in Desapienza. 00:38:25.495 --> 00:38:42.380 And I want to know I I try to look at people in Africa, Africa, and Asia, And, really, I didn't find, not only for this lecture, but in my work in the field. 00:38:43.880 --> 00:38:56.675 People you can say, this person is working in this field for ten years or twenty and is may is making relevant contributions in the main journals of the field. 00:38:57.295 --> 00:38:58.035 Not really. 00:38:58.175 --> 00:38:58.675 Mhmm. 00:38:59.455 --> 00:39:05.700 And I would like to talk a little bit also about the key people with high impact in social. 00:39:06.720 --> 00:39:16.420 Some of them are also researchers and others are not researchers, but they have a strong presence in the field of couple therapy. 00:39:17.445 --> 00:39:21.785 Of course, the the best, example is John Gottman. 00:39:22.645 --> 00:39:36.720 John Gottman has a institute and and his model is like although it's very cognitive behavioral, I I can say it's the Gottman model. 00:39:36.720 --> 00:39:51.485 It's so strong with a lot of books and and and trainings, and is really present in the media media, at least in in Europe. 00:39:51.705 --> 00:39:54.285 I think here could be the same. 00:39:54.505 --> 00:40:02.150 Sue Johnson, from Canada, the creator of the emotional dyspocussive couples therapy. 00:40:03.170 --> 00:40:08.230 Esther Perel, I'm I don't know if you are familiar with this author. 00:40:08.610 --> 00:40:32.180 She is from New York or or is located usually in New York, And she has some books about couples, and I think she has some publications, regularly in the New New York Times, Solomon, John Gray and Gary Chapman for their books, very famous, also in Europe. 00:40:32.320 --> 00:40:32.820 Mhmm. 00:40:34.240 --> 00:40:38.660 And this is some of the groups and people I can identify. 00:40:40.095 --> 00:40:42.995 Challenges in contemporary couple therapies. 00:40:44.735 --> 00:40:45.235 Okay. 00:40:45.535 --> 00:40:49.475 I want to mention nine nine challenges. 00:40:50.495 --> 00:40:54.115 I try to group in three blocks. 00:40:57.930 --> 00:41:02.190 First block, more focus on research and clinical challenges. 00:41:02.890 --> 00:41:09.630 Other more impractical challenges is what I how I decide decided to call it. 00:41:10.295 --> 00:41:15.355 And another challenge is related with the Catholic understanding of the marriage. 00:41:19.575 --> 00:41:36.130 So, in the research field, the the question of how one when the therapy ends, what happened after, and and if that improvements can maintain over time. 00:41:37.255 --> 00:41:47.195 Although there is some research focus on that, on on what happened after the end of the couple therapy, this is a weakness in the research bill. 00:41:47.655 --> 00:42:01.030 We need to understand better how to the therapy improves the relationships in the long term, which type of interventions or combination of interventions work better. 00:42:02.945 --> 00:42:10.645 Another challenge is the measure of change, how to monitoring the process of change of the couples. 00:42:11.665 --> 00:42:16.245 In a recent book, John Gottman presents a central idea. 00:42:17.130 --> 00:42:21.870 The time of self reports in research in psychotherapy is over. 00:42:23.450 --> 00:42:26.590 I will say also in psychology. 00:42:27.610 --> 00:42:29.150 We can't move forward. 00:42:29.290 --> 00:42:35.095 We can't understand really deeper sound processes using lonely self reports. 00:42:36.275 --> 00:42:42.135 We need to apply new and complementary forms to measure change in therapy. 00:42:42.595 --> 00:42:43.335 I agree. 00:42:45.000 --> 00:42:49.340 Technology is providing new and stronger ways of monitoring changes. 00:42:49.960 --> 00:43:10.955 There are some research labs as the one leaded by Eran Barkalifa in Israel where nonverbal analysis and facial expressions, psychophysiological variables, and other aspects of the couple interaction are measured in the lab through a series of couple therapy sessions. 00:43:11.650 --> 00:43:29.175 We need to understood better understand better what happens also outside the therapy session, not only to increase gut outcomes, but to detect therapeutic interventions clients do not better benefit from. 00:43:30.675 --> 00:43:32.055 The change mechanisms. 00:43:32.915 --> 00:43:44.030 Although some mechanisms of change have already been identified, There are still many questions about what creates change in couple therapy. 00:43:45.770 --> 00:43:55.895 To move forward in this question requires a complex interaction between theoretical models and strong empirical data stats. 00:43:56.915 --> 00:44:03.335 This is just another this is another area for improvement in cabo drug. 00:44:04.390 --> 00:44:12.970 If we go to the practical challenges, one first challenge is to increase the attendance to couple therapy. 00:44:14.150 --> 00:44:16.490 Couples do not seek couple therapy. 00:44:17.085 --> 00:44:30.385 Although divorce and relationship distress has, according with research, a negative impact in their lives, in their health, their relationships, their work functioning, their children if they have. 00:44:31.030 --> 00:44:35.130 People seek for treatment in depression more than in couple therapy. 00:44:35.750 --> 00:44:40.330 Why and how do couples seek couple therapy for their relationship? 00:44:41.510 --> 00:44:43.850 This is a question we need to clarify. 00:44:44.815 --> 00:44:46.915 Couples therapy is expensive. 00:44:47.695 --> 00:44:55.235 Many people can't have access to this resource either in The United States, but also in other countries. 00:44:56.095 --> 00:45:01.890 We need to find ways to provide good resources for couples with high distress rates. 00:45:02.830 --> 00:45:13.425 Health insurance does not cover couple therapy even in countries such as Spain where almost everything discovered by health insurance. 00:45:13.565 --> 00:45:25.185 Another issue in this, block of the practical challenges is the complexity of the training process of a couple therapies. 00:45:26.620 --> 00:45:32.640 According with some psychotherapists and experts, couple therapy might be the most difficult form of psychotherapy. 00:45:33.820 --> 00:45:42.085 We need to work with two clients in conflict with different demands and perspectives with high rates of uncertainty. 00:45:43.345 --> 00:45:49.685 Therapists who treat couples should be very well trained for dealing with these challenges. 00:45:50.785 --> 00:45:54.405 How to reduce the time for training a good couple therapies? 00:45:55.190 --> 00:46:04.250 How to improve efficiency, how to help how to help to learn easier, faster, and better. 00:46:06.470 --> 00:46:18.265 And the third one in this block and the last one in this block is to improve quality of couple therapies, especially in non English countries. 00:46:26.360 --> 00:46:32.620 Most therapies who offer couple therapy are not are not training in it. 00:46:33.895 --> 00:46:47.195 I mean, most psychotherapy training programs, whether in Europe or The US, do not offer a special subject or focus for training in couple therapy. 00:46:48.540 --> 00:46:56.960 And yet, these therapies will, in almost all the cases, offer couple therapy among their services. 00:46:58.540 --> 00:47:04.945 But this problem or challenge is much bigger than you could think. 00:47:07.005 --> 00:47:16.945 In the previous section about the main couple therapy approaches, I've talked about the levels of evidence according with the section proposal. 00:47:18.060 --> 00:47:24.960 And I mentioned it only two therapy approaches achieve the requirements for being considered evident based. 00:47:26.700 --> 00:47:38.905 In the third level of section classification, emotionally focused coupled therapy by Sue Johnson and integrative cognitive behavioral couple of therapy by Christensen. 00:47:40.405 --> 00:47:46.990 How many accredited couple therapies do you think you have in The States in these two models? 00:47:47.770 --> 00:47:49.390 You have several hundreds. 00:47:50.810 --> 00:47:54.990 Less than I will expect in the first economy country in the world. 00:47:56.010 --> 00:47:57.710 But let's take Spain. 00:47:58.985 --> 00:48:06.125 How many therapies accredited in emotionally focused coupled therapy do you think we have in Spain today? 00:48:07.145 --> 00:48:07.885 How many? 00:48:11.625 --> 00:48:12.125 Five. 00:48:14.100 --> 00:48:19.560 How many do you think we have in the integrative cognitive behavioral couple therapy? 00:48:21.620 --> 00:48:22.440 How many? 00:48:24.180 --> 00:48:24.680 Two. 00:48:26.155 --> 00:48:30.975 Seven for a country of almost 5,000,000 population. 00:48:32.475 --> 00:48:39.695 Thus, I think to improve the quality of coupled therapies is a challenge in the field. 00:48:45.920 --> 00:48:52.260 Let's go to the third block, the challenges related with the Catholic understanding of the marriage. 00:48:53.805 --> 00:49:04.865 Our first challenge I can identify is to have therapies with the skills to address sexual difficulties in Catholic marriages. 00:49:06.600 --> 00:49:31.915 When they when to the requirement of being trained in in couple therapy, we add training in sexology and will look for a therapist be able to conduct an intervention with a catholic couple, an intervention according with their beliefs, then the difficulties become even greater. 00:49:33.700 --> 00:49:48.245 The Francisco de Victoria University in Madrid has detected this big issue and has just launched a postgraduate course to try to help to reduce this gap. 00:49:49.025 --> 00:49:55.045 It's a first step, not complete or perfect, but a step to address this challenge. 00:49:57.105 --> 00:50:08.440 Another challenge in the field, if we think about the Catholic understanding of the marriage, is to integrate truth and love in the couple therapy process. 00:50:09.620 --> 00:50:13.080 There are a lot of couple therapies, they say they are Catholic. 00:50:15.025 --> 00:50:20.005 But they their practice is not different to any other couple therapist. 00:50:21.265 --> 00:50:27.925 And the training in the Catholic view of the human person and the Catholic faith is very weakness. 00:50:29.630 --> 00:50:31.810 Thus, the integration is not possible. 00:50:32.510 --> 00:50:35.570 But there are also a good bunch of Catholics. 00:50:36.510 --> 00:50:46.745 They say they know how to do couple therapy, but they are not really well trained even as general psychotherapists. 00:50:48.565 --> 00:50:55.545 This integration, this balance, this complexity of elements is an idea we can apply to all psychotherapy. 00:50:56.645 --> 00:51:04.250 But in my opinion, in marriage and coupled therapy, this becomes particularly an issue to address. 00:51:05.670 --> 00:51:19.655 And the third challenge, I thought about several challenges that I could write as the third one, but I did not find really one which seems to me more relevant than the others. 00:51:20.195 --> 00:51:42.055 So I want to suggest to invite you, you who are listening this lecture, either in person here or remotely, to think about what do you think is a challenge here in this third block or if you want in one of the others when we talk about couple terms. 00:51:42.595 --> 00:51:47.795 And please send to me your challenge using my email address. 00:51:47.795 --> 00:51:56.000 You can find in the slide, or if you use Google with my name and University of Navara, you will find my email. 00:51:56.780 --> 00:52:02.720 And I will consider all the challenges in the second part of the lecture in October. 00:52:05.660 --> 00:52:23.585 So my lab at the University of Navarro Since 2018 2018, I am part of the University of Navara where I work to try to transform to improve the couple therapy field in the Spanish speaking countries. 00:52:24.080 --> 00:52:31.620 This is my main research line, and we are working trying to address some challenges in the three levels I mentioned. 00:52:32.480 --> 00:52:40.525 In the clinical, the practical, and also challenges related with the marriages, Catholic marriages in therapy. 00:52:40.905 --> 00:52:48.685 We have conducted the first randomized controlled trial in couple therapy conducted ever in Spanish speaking countries. 00:52:51.960 --> 00:52:54.620 It's good news and bad news at the same time. 00:52:55.240 --> 00:53:01.340 We have tested emotionally focused therapy, approach. 00:53:01.560 --> 00:53:10.415 EFT is an attachment based model, and we think there are strong coherence with the Catholic view of the person and the marriage. 00:53:11.195 --> 00:53:19.055 We work with colleagues from Canada and The US and we are conducting other four empirical studies apart from the RCT. 00:53:19.940 --> 00:53:30.840 Our first step was to create a bridge between the best research in couple therapy, happens here in The States and Canada, and the Spanish speaking conference. 00:53:31.300 --> 00:53:41.495 The next steps we are currently starting is to develop a project to increase the quality of the training of the couple therapists in Spanish speaking countries. 00:53:43.635 --> 00:53:45.255 We have a lot of collaborators. 00:53:46.690 --> 00:53:48.870 Some of them are from here. 00:53:49.410 --> 00:53:49.910 Doctor. 00:53:50.290 --> 00:53:51.270 And doctor Holman. 00:53:51.650 --> 00:53:57.670 Doctor are also involved in some collaboration in this field. 00:53:58.210 --> 00:54:05.125 And so the model of Su Johnson, you are familiar with some of these books. 00:54:06.545 --> 00:54:16.820 We have the the randomized controlled trial we run, happen in five countries, Mexico, Costa Rica, Guatemala, Argentina, and Spain. 00:54:19.200 --> 00:54:27.105 The group of therapists and supervisors together with the researchers could be around 50 people. 00:54:30.285 --> 00:54:44.740 And we have a web page I can share with you, and it's translated also in English by by IIA, intelligence artificial intelligence. 00:54:44.880 --> 00:54:47.620 So I I don't know how good is that translation. 00:54:50.880 --> 00:55:01.015 So to finish, some of ideas to about considering the challenges, what we can do. 00:55:01.555 --> 00:55:02.375 Some ideas. 00:55:02.515 --> 00:55:10.695 We I I will I will be able to talk about future studies two hours or three, but only two minutes. 00:55:11.770 --> 00:55:19.390 DMU can lead a network to improve this field in the world with research and public engagement initiatives. 00:55:20.410 --> 00:55:22.430 DMU is in The US. 00:55:22.970 --> 00:55:32.445 The US has a strong idea of if nobody, is going to do it, I'm going to do it, more than in other countries. 00:55:33.305 --> 00:55:40.770 DMU is an ANAQUAC network with several countries, all I think no. 00:55:40.770 --> 00:55:41.910 Two are in Italy. 00:55:42.690 --> 00:55:49.430 But most of them, 80% of the ANAQUAC network is in Spanish speaking countries, mostly in Mexico. 00:55:50.770 --> 00:56:09.335 And you have very good collaborators and friends as Navara, the Catholic University of America, the John Paul II Institute, which is here in in in Washington, DC, inside the the Catholic campus that is a different institution. 00:56:10.490 --> 00:56:17.230 Also, I saw that the the Juan Pablo de Seco in Mexico is inside the Anahuac network. 00:56:19.610 --> 00:56:22.990 So I it's just an idea. 00:56:24.565 --> 00:56:26.805 You you can work in this line. 00:56:26.805 --> 00:57:03.835 Working with the model for human flourishing, what you know as CCMMP, to analyze and integrate this model with the main approaches in couple therapy, EFT and the integrative cognitive behavioral therapy, to develop an empirical study where couple therapies are trained in the metamodel, and to explore with a mixed method study the chi the changes in the therapies after get that course, that that training. 00:57:04.135 --> 00:57:04.635 Mhmm. 00:57:06.990 --> 00:57:16.290 And if we think about the challenges related with this Catholic understanding of the marriage, what are the challenges here in The States? 00:57:16.430 --> 00:57:19.570 I don't know what are the challenges here. 00:57:20.535 --> 00:57:22.555 But you you are growing. 00:57:22.935 --> 00:57:39.110 You can create an alumni network with clinicians, from EMU who are who have interest in this field of the marriage and the couple therapy and work, leading by a team of researchers. 00:57:39.330 --> 00:57:51.190 Some of them from here, for example, disconnects with the first idea to be able to develop empirical research to address these challenges you have here in The States. 00:57:52.955 --> 00:58:05.675 Thank you for your attention, and I would love to hear your comments, questions, thoughts after a break, I think. 00:58:05.675 --> 00:58:11.090 But We will break for three minutes, and then we will begin our question and answer period. 00:58:18.110 --> 00:58:21.410 Dralia, I'm one of the team leaders of the counseling team. 00:58:21.635 --> 00:58:29.415 What is your opinion to proceed with couples therapy when the couples have an intervention family order due to abusive relationships? 00:58:30.035 --> 00:58:36.695 Some of the magistrates courts in our country put in place court orders to attend couples therapy even knowing the high risk for the victim survivors. 00:58:39.130 --> 00:58:39.290 Mhmm. 00:58:39.290 --> 00:58:44.190 I I don't know the specific situation this question came from. 00:58:45.930 --> 00:58:52.565 I think for in the couple's therapy, the goals could be different. 00:58:53.105 --> 00:59:03.925 Not always the the goals can are create a safer space because sometimes the problem in the couple is they can't communicate each other. 00:59:04.690 --> 00:59:12.390 If I will find myself in this situation, first, I think about I want to be in this situation. 00:59:13.090 --> 00:59:14.230 I have an alternative. 00:59:14.530 --> 00:59:24.765 If I don't agree with this type of situation or I don't feel comfortable as psychotherapist, it's difficult for me to do a do a good job. 00:59:26.105 --> 00:59:29.485 So but maybe for other people, it's fine. 00:59:29.945 --> 00:59:37.040 They they feel okay for some reason, and I'm not saying it's okay or it's not okay. 00:59:37.260 --> 00:59:38.080 I don't know. 00:59:39.180 --> 00:59:45.280 We we have very few information about what the situation this person is talking about. 00:59:47.275 --> 00:59:53.135 So first first idea, think about I want to keep here. 00:59:53.915 --> 01:00:01.375 I'm I'm able to do a good job considering who I am in this type of setting. 01:00:02.150 --> 01:00:05.210 And if not, try to move to another job. 01:00:05.750 --> 01:00:11.930 And the second idea is caboz therapy can have different levels, different goals. 01:00:12.630 --> 01:00:20.065 For example, to apply emotionally focused caboz therapy in this context, I repeat that. 01:00:20.065 --> 01:00:40.800 We have limited information about the context, but with this information seems to me it's not a good model for this context because emotionally focused therapy try to create a safe space to increase vulnerability and this could not is not a good idea for this context. 01:00:40.940 --> 01:00:48.885 But if we need the couple talk and if it's mandatory, the couple should go there. 01:00:50.465 --> 01:00:56.565 As psychotherapist, I have a lot of freedom to decide what I'm going to do with this couple. 01:00:58.140 --> 01:01:10.240 I in my therapy room, I decide who is where for how long, if we are going to talk the three together or in individual spaces, etcetera, etcetera, etcetera. 01:01:10.380 --> 01:01:14.905 So try to look at that way to help. 01:01:16.565 --> 01:01:25.465 And and if you feel it's a very complex situation, try to look for supervision. 01:01:28.990 --> 01:01:33.410 How long does it take for one to get a certification in the area of couples therapy? 01:01:34.990 --> 01:01:35.730 How long? 01:01:36.830 --> 01:01:38.130 Depends on the person. 01:01:38.830 --> 01:02:03.420 But, at least some years, we I consider to get a certification in the area of couples therapy requires a strong training in cycle in psychology, bachelor in psychology or I know please read my words considering I am from Spain. 01:02:04.440 --> 01:02:11.515 In Spain, a social worker never is never a psychotherapist, But these these are the rules in Spain. 01:02:11.515 --> 01:02:17.375 I'm not telling here a, social worker can be a psychotherapist. 01:02:17.755 --> 01:02:46.815 But if we talk about couples therapy, after the master program to be trained in one of the two models I'm talking about, the models for the models with evidence based, mhmm, the third level, I will say between two and four years because you need to apply the model to receive supervision to be very focused on the process. 01:02:47.115 --> 01:02:47.615 Mhmm. 01:02:49.340 --> 01:02:51.520 How do you rate transactional analysis? 01:02:51.980 --> 01:02:58.080 This is an approach among others which has been used for many years by the Catholic Marriage Advisory Council in Hong Kong. 01:02:58.380 --> 01:02:58.880 Mhmm. 01:03:01.675 --> 01:03:03.135 Transactional analysis. 01:03:03.595 --> 01:03:13.215 First, I'm not an expert in transactional analysis, so what I'm going to say should be just a first idea. 01:03:14.170 --> 01:03:20.270 But as far as I know, transactional analysis, I'm sure is not an evident based couples therapy approach. 01:03:21.450 --> 01:03:36.165 So, if you look for the best thing you can give to the couple who comes, I will say transactional analysis doesn't seems to be the best thing. 01:03:37.025 --> 01:03:47.310 But at the same time, for helping the couples, we need several different levels of help, different settings. 01:03:47.370 --> 01:04:01.085 Sometimes the couples can receive an an advice and and counseling help, and another types of helps, and maybe could work. 01:04:02.265 --> 01:04:16.060 I will say if this center is a very is a center where you feel everyone there thinks transactional analysis is great. 01:04:17.400 --> 01:04:25.260 Try to talk with someone in another place, in another country that thinks transactional analysis is not very good. 01:04:26.365 --> 01:04:33.905 And talk a lot with this person and make, a new way of thinking about transactional analysis. 01:04:34.765 --> 01:04:42.460 And sometimes, there are all the people are trained in transactional analysis, and there are not an alternative. 01:04:42.680 --> 01:04:51.420 So we they can try to improve their training with another, approach or mhmm. 01:04:54.615 --> 01:05:05.630 We have recently had a debate among Catholic therapists about how to approach both a homosexual slash agnostic couple, etcetera, searching psychotherapist, from a Catholic perspective. 01:05:05.850 --> 01:05:11.630 Which are the limitations related to the issue of conscientious objection discussed a lot within EFPA? 01:05:13.370 --> 01:05:13.870 Mhmm. 01:05:14.810 --> 01:05:16.750 I don't know what is EFPA. 01:05:17.770 --> 01:05:19.790 Someone can help me with that. 01:05:20.455 --> 01:05:20.955 EFPA. 01:05:21.815 --> 01:05:25.355 Could be a a rule, a regulation. 01:05:26.135 --> 01:05:26.955 I don't know. 01:05:36.600 --> 01:05:39.100 Maybe emotion focused physician assistance? 01:05:39.400 --> 01:05:40.380 Em emotion? 01:05:40.440 --> 01:05:40.680 Mhmm. 01:05:40.680 --> 01:05:41.500 I don't know. 01:05:41.560 --> 01:05:42.620 Emotion focused. 01:05:42.680 --> 01:05:43.000 No. 01:05:43.000 --> 01:05:43.880 Position assistance. 01:05:43.880 --> 01:05:44.040 No. 01:05:44.040 --> 01:05:44.940 Position assistance. 01:05:45.080 --> 01:05:45.580 No. 01:05:46.520 --> 01:05:47.020 No. 01:05:49.245 --> 01:05:55.425 I I I will answer in Spanish, and Ferrara will translate me. 01:05:55.645 --> 01:05:56.145 Okay? 01:05:56.845 --> 01:05:57.745 Are you ready? 01:05:59.805 --> 01:06:00.305 Okay. 01:06:06.040 --> 01:06:07.420 This is a complex question. 01:06:07.480 --> 01:06:07.800 Okay. 01:06:07.800 --> 01:06:08.300 Yeah. 01:06:10.520 --> 01:06:15.900 I will say, welcome and and a loud track question. 01:06:35.860 --> 01:06:39.460 Similar to the prior situation, this is a very personal matter. 01:06:39.460 --> 01:06:44.280 So it requires it requires knowing someone who knows more about the issue. 01:06:44.805 --> 01:06:45.305 Yeah. 01:06:45.445 --> 01:06:59.945 To give an answer to this question, I think, is you need to share all the situation with someone that can know, much more details about what happened in this situation. 01:07:01.100 --> 01:07:02.000 Who are you? 01:07:02.060 --> 01:07:05.360 What how do you manage this situation? 01:07:06.780 --> 01:07:18.475 And someone with more experience, someone you trust in in in his or her criteria to try to make a. 01:07:18.475 --> 01:07:19.375 A joint discernment. 01:07:19.435 --> 01:07:20.335 A joint discernment. 01:07:22.595 --> 01:07:32.330 So if if we think about what's my opinion with this information, I don't have really an opinion. 01:07:32.470 --> 01:07:54.345 I think the the psychotherapy should be conducted in a in a in a space where both all the people involved feel comfortable as much as possible, because it it is about to create a deep relationship. 01:07:55.860 --> 01:08:08.885 So if if there are something for me as a therapist that, creates conflicts, this is everyday life in psychotherapy. 01:08:09.665 --> 01:08:16.885 But if if it's a very strong conflict, I will need supervision and maybe something more in this case. 01:08:17.745 --> 01:08:18.245 Okay. 01:08:18.865 --> 01:08:31.680 We have further questions here, but we are going to move to the the questions in here. 01:08:31.680 --> 01:08:37.380 And maybe if we have more time, I will be I will go back to the online questions. 01:08:39.415 --> 01:08:40.395 Please go ahead. 01:08:41.095 --> 01:08:44.235 I have a question, about the mechanic standpoint. 01:08:44.375 --> 01:08:48.155 How do you work in total therapy with the doses of a couple? 01:08:48.295 --> 01:08:50.635 So let me know what the approaches would be. 01:08:53.060 --> 01:08:54.520 Can you repeat the question? 01:08:54.900 --> 01:08:58.520 If the question is about myself or in general? 01:08:58.580 --> 01:08:59.640 I think in general. 01:08:59.700 --> 01:09:00.280 In general. 01:09:00.740 --> 01:09:01.240 Yeah. 01:09:04.665 --> 01:09:08.525 Honestly, I don't have an answer for that. 01:09:09.465 --> 01:09:09.965 Honestly. 01:09:10.505 --> 01:09:15.405 Because I I I only work with the heterosexual couples. 01:09:16.025 --> 01:09:17.245 It's not a choice. 01:09:17.305 --> 01:09:25.660 It's could be a choice, but all the couples that came to my, private practice are heterosexual. 01:09:28.120 --> 01:09:41.635 I think, there are a lot in the literature and in the training that is it can be applied to same sex couples or heterosexual couples. 01:09:42.655 --> 01:10:02.560 So, but, again, we came back to the question of, I think it's important the therapist feel okay and feel safe, comfortable in the in the therapy room as well as the couple. 01:10:02.780 --> 01:10:09.255 So, sorry because I don't have more ideas to share. 01:10:11.155 --> 01:10:12.055 Next question. 01:10:13.795 --> 01:10:24.280 Can we do something to reduce the the if I can do something, I can But I try to don't move my cell phone. 01:10:24.980 --> 01:10:25.880 Stay quiet. 01:10:27.140 --> 01:10:37.925 So I was wondering about, I know that in particular, like, within the gap that you can meet, there needs to be a lot of stigma around self therapy or marriage counseling. 01:10:38.225 --> 01:10:43.125 And so I was wondering, like, how would you propose lowering the stigma? 01:10:43.265 --> 01:10:47.285 And also, why does it exist? 01:10:47.660 --> 01:10:54.487 I feel like in more secular communities, it's more accepted to, like, the homeless counseling, but for some reason, within the Catholic Mhmm. 01:10:54.593 --> 01:10:59.440 I think it's the I've experienced very, like, very, very cute type of thing. 01:10:59.660 --> 01:11:00.160 Mhmm. 01:11:01.325 --> 01:11:10.065 When you say stigma, do you mean the the marriages and the couples don't go to couple therapy or the stigma? 01:11:10.205 --> 01:11:11.965 Is is that what you mean? 01:11:11.965 --> 01:11:12.445 Yeah. 01:11:12.445 --> 01:11:12.945 Okay. 01:11:13.005 --> 01:11:13.505 Yeah. 01:11:17.200 --> 01:11:22.660 I think this is, this was passed bad in the past. 01:11:22.800 --> 01:11:25.300 It's getting better, at least in Spain. 01:11:25.840 --> 01:11:32.945 I I have the impression people are more able to say, I need couples therapy. 01:11:33.885 --> 01:11:43.265 I'm going to I think we need to talk about the benefits. 01:11:45.850 --> 01:11:55.950 We need to talk about, sometimes you need, to reach for help. 01:11:56.675 --> 01:12:05.015 And as you reach for help in other issues, it it makes sense to reach for couple therapy if you need it. 01:12:07.475 --> 01:12:22.310 Maybe some training in the in the preparation courses for the for the marriage where someone can explain what is it about couple therapy because people doesn't know. 01:12:22.310 --> 01:12:35.425 Sometimes the people when in the first interview, I use some minutes to explain what's the therapy about and and what they can expect. 01:12:37.325 --> 01:12:47.560 I think if we move that information to the Catholic general population will be some something to help. 01:12:49.140 --> 01:12:52.200 And I will think about other ideas. 01:12:53.940 --> 01:12:54.600 Thank you. 01:12:56.825 --> 01:12:58.205 Thank you for your presentation. 01:12:58.665 --> 01:12:59.485 Thank you, Marcelino. 01:13:00.185 --> 01:13:01.325 I really like it. 01:13:01.785 --> 01:13:02.665 Thank you. 01:13:02.665 --> 01:13:04.285 I have two short questions. 01:13:04.345 --> 01:13:13.060 One is, have you ever thought about prevention in terms of even preparing couples to get married? 01:13:13.280 --> 01:13:13.680 Mhmm. 01:13:13.680 --> 01:13:20.340 And if so, could you share some of your thoughts in that? 01:13:20.880 --> 01:13:27.195 The other one is I'm very impressed that you are working with so many countries and so many different cultures. 01:13:27.495 --> 01:13:27.975 Mhmm. 01:13:27.975 --> 01:13:39.410 To what extent the difference in culture, how much does it weigh in being able to apply therapies to everyone if you will. 01:13:39.870 --> 01:13:40.370 Mhmm. 01:13:41.070 --> 01:13:42.210 How how much? 01:13:42.270 --> 01:13:44.850 I I don't understand very well the second. 01:13:44.990 --> 01:13:56.075 The cultural differences, how much they are relevant for, Do you mean if we can apply the same things to every culture? 01:13:56.295 --> 01:13:56.795 Okay. 01:13:57.815 --> 01:14:21.925 So going to the first question, of course, I think the lot in prevention, I also teach or give some trainings to couples, which are not in therapy or just general information or training workshops to trying to prevent the problems. 01:14:24.305 --> 01:14:31.685 I I think this is very different in the Spanish speaking world and in the English speaking world. 01:14:32.760 --> 01:14:45.660 In I found in The States and the English the English word things in the marriage as in, it it has an a negative and a positive side. 01:14:46.355 --> 01:14:52.455 But this issue of in the English speaking countries where everything is about a business. 01:14:53.555 --> 01:15:02.570 So I'm I'm I'm married, so I need to invest in my relationships to try to this keep going well. 01:15:03.430 --> 01:15:18.185 And this is sounds negative for me, but it takes a big side, which is then I'm going to try to reduce the problems in advance to take care of the relationship. 01:15:18.965 --> 01:15:23.145 This is stronger in the English speaking countries. 01:15:23.925 --> 01:15:36.880 It's more the number of couples I saw in February in the workshop in Bethesda, the workshop leading by doctor Klawicki was impressive for me. 01:15:37.260 --> 01:15:40.080 It it there are a lot of couples. 01:15:40.700 --> 01:15:54.475 In Spain, it will be difficult to solve something about, please go to this course to try to improve your relationship. 01:15:54.615 --> 01:15:56.850 But my relationship is fine. 01:15:56.850 --> 01:15:57.570 It's okay. 01:15:57.570 --> 01:15:58.630 I don't need it. 01:15:59.890 --> 01:16:01.590 So they they don't go. 01:16:03.970 --> 01:16:25.635 But we are losing, we already lose, I think, in the last forty years in Spain and probably in other countries an opportunity in the Catholic church because, now in Spain, people don't get married and only very few. 01:16:26.570 --> 01:16:35.550 But twenty years ago or thirty years ago, most people get married and they should go through a course. 01:16:36.650 --> 01:16:42.595 The church offers and is mandatory to go. 01:16:45.055 --> 01:16:54.195 And if if we be able to offer a very good course in that setting, that will be a great way of helping the marriages. 01:16:54.850 --> 01:16:59.110 But that that training usually is terrible. 01:17:00.930 --> 01:17:03.990 It's not worse. 01:17:04.690 --> 01:17:05.190 Usually. 01:17:05.410 --> 01:17:06.550 Sometimes not. 01:17:07.365 --> 01:17:11.125 So I think prevention is a big issue. 01:17:11.125 --> 01:17:16.825 I don't talk about prevention in this lecture because it's focused on couples therapy. 01:17:18.245 --> 01:17:30.620 But we can prepare another lecture only about a couple education and and the all the programs that are and and talking about the challenges. 01:17:32.440 --> 01:17:33.350 And yes. 01:17:34.315 --> 01:17:36.255 I have questions for you, doctor. 01:17:37.035 --> 01:17:38.255 And the second sorry. 01:17:38.715 --> 01:17:40.815 So the second question, I forgot. 01:17:41.435 --> 01:17:44.095 The cultural the cultural question. 01:17:44.235 --> 01:17:44.735 Mhmm. 01:17:50.990 --> 01:17:58.370 I think the for a therapist to know the culture is a plus. 01:17:58.830 --> 01:18:00.050 It helps a lot. 01:18:01.550 --> 01:18:05.115 And but it's the same this is my opinion. 01:18:05.115 --> 01:18:07.855 It's not it's not evidence based. 01:18:08.075 --> 01:18:08.955 It's my opinion. 01:18:10.155 --> 01:18:32.955 When someone asked me about the teletherapy, in couples therapy, I I should say, really, we need to wait to check what research says, but, the therapy is a very complex process where there are a lot of variables. 01:18:33.735 --> 01:18:44.555 If you ask me to choose between in person and online, I am sure in person is better, but there are other variables. 01:18:48.990 --> 01:19:07.165 If you need to choose between a very good trained couple therapies in emotionally focused therapy, for example, battle nine, And another one with a very bad training in a model nobody knows, I will do the online. 01:19:08.665 --> 01:19:09.145 Yeah? 01:19:09.145 --> 01:19:13.570 There are different variables, and you need to check. 01:19:14.030 --> 01:19:16.370 And so for the culture, it's the same. 01:19:16.590 --> 01:19:24.370 I think several aspects of the of the processor of the processor are the same. 01:19:28.075 --> 01:19:32.335 And if if you know the culture, then you can do it even better. 01:19:32.715 --> 01:19:39.775 And this is a good point to to make sure the process is going as fast as possible. 01:19:41.520 --> 01:19:49.380 But several aspects of the of the different cultural differences are very, very difficult to see. 01:19:50.160 --> 01:20:06.955 The for example, if we compare emotionally focused therapy in Spain, in The States, or in Finland, there are differences in the in the distance between the clients and the therapist. 01:20:07.960 --> 01:20:11.660 There are differences in the change of the intonation. 01:20:12.840 --> 01:20:18.300 There are differences in how the couple express themselves. 01:20:19.960 --> 01:20:26.115 But here in The States, if you take 10 couples, there are differences between them. 01:20:26.895 --> 01:20:27.395 Okay? 01:20:27.535 --> 01:20:32.515 Maybe not in the distance between the therapist and the couple if it's the same therapist. 01:20:33.375 --> 01:20:33.875 Okay? 01:20:34.415 --> 01:20:52.115 So there are some differences, but in several other aspects, I I will I can look up to a video in Finland, Spain, and States and say and and I can say, it's emotionally focused therapy. 01:20:52.895 --> 01:20:56.515 So please. 01:20:58.175 --> 01:21:04.565 This question is a clarification from the question earlier about, how to work with sexual couples Okay. 01:21:04.815 --> 01:21:05.475 In neurotherapy. 01:21:06.360 --> 01:21:13.580 You presented emotionally focused therapy and the integrative cognitive behavioral couple therapy as the only two that are evidence based. 01:21:13.720 --> 01:21:13.960 Okay. 01:21:13.960 --> 01:21:17.340 Which means that they're the only two that have randomized controlled trials. 01:21:17.560 --> 01:21:18.060 Right? 01:21:18.615 --> 01:21:23.755 My understanding is that those randomized controlled trials are only with heterosexual couples. 01:21:24.135 --> 01:21:28.935 And so I'm wondering, do you know of any research in either of those modalities Mhmm. 01:21:29.015 --> 01:21:37.070 That has randomized controlled trials for homosexual couples showing the effect efficacy of the treatment modality being the same Mhmm. 01:21:37.150 --> 01:21:39.010 As it would for a heterosexual couple. 01:21:39.310 --> 01:21:39.790 Mhmm. 01:21:39.790 --> 01:21:40.030 No. 01:21:40.030 --> 01:21:41.410 I don't I don't know. 01:21:41.710 --> 01:21:42.210 Yeah. 01:21:42.270 --> 01:21:45.170 I I can't say as a researcher. 01:21:45.915 --> 01:21:49.355 I'm sure there are no, but I I don't know. 01:21:49.355 --> 01:21:54.815 But because maybe yesterday was a new manual grade. 01:21:55.435 --> 01:21:58.475 That, but I I don't know. 01:21:58.475 --> 01:21:58.975 No. 01:21:59.195 --> 01:22:02.310 I I have yet to find them, so if you find them, please let me know. 01:22:02.410 --> 01:22:04.290 It's it's you know, we do that. 01:22:04.290 --> 01:22:10.070 We say, here's everything for one population, and then we apply it to other populations. 01:22:10.130 --> 01:22:13.430 And it may not necessarily be as effective in those other populations. 01:22:13.570 --> 01:22:14.055 Yes. 01:22:14.295 --> 01:22:14.695 Will be. 01:22:14.695 --> 01:22:15.195 Right. 01:22:15.255 --> 01:22:15.655 Mhmm. 01:22:15.655 --> 01:22:17.735 And then I have a second question about that. 01:22:18.375 --> 01:22:22.715 Gottman, John Gottman presents his model as if it is evidence based. 01:22:22.935 --> 01:22:23.415 Mhmm. 01:22:23.415 --> 01:22:26.635 Is that so how would you approach that model? 01:22:26.935 --> 01:22:27.435 No. 01:22:27.780 --> 01:22:29.960 I I I'm sorry. 01:22:30.100 --> 01:22:30.600 No. 01:22:31.620 --> 01:22:40.520 John Gottman models has a lot of research, but according with this classification is not evidence based. 01:22:40.580 --> 01:22:58.175 It could be in the second level, but not and we can discuss about if if it's, better or not, but according with this classification, it's not evidence based. 01:22:58.810 --> 01:22:59.310 K? 01:22:59.370 --> 01:23:16.275 One one important thing I explained to some people is, it it's possible we have here in the other street, couple therapies that work very well. 01:23:16.735 --> 01:23:26.355 And in fact, his his therapy works and improves the couple's, distress and reduce the couple's distress. 01:23:28.710 --> 01:23:41.850 But the problem is what this therapist is doing, how can I learn what he's doing, and and and what's the name of that? 01:23:44.715 --> 01:24:01.230 If we want to increase the quality of the couples therapies, increase the the the people who goes to couples therapy, the number of therapists, We need models we can train in the in the universities. 01:24:01.690 --> 01:24:03.790 We can test through research. 01:24:04.570 --> 01:24:27.655 So evidence based means they they have going through all these process, and they are evidence based, but maybe other models or other therapies work very well and their work works, but are not evidence based because they don't have all these studies behind. 01:24:28.730 --> 01:24:29.230 Okay? 01:24:30.890 --> 01:24:39.710 I think Thank you, doctor Rodriguez Gonzales, so much. 01:24:46.265 --> 01:24:51.785 Now as we conclude our lecture, please note that the Newman series will resume in the fall. 01:24:51.785 --> 01:24:58.210 In fact, as you heard a little bit earlier, we already have a next lecture scheduled, October 8. 01:24:58.450 --> 01:25:14.095 Doctor Martino Rodriguez Gonzalez will rejoin us on current status and future directions in couples therapy part two, marriage and couple therapy, integrative faith and anthropological reflections, and international approach in Catholic context. 01:25:14.095 --> 01:25:18.835 So looking a little bit more at the application side, and the context piece as well. 01:25:19.455 --> 01:25:24.275 And so, please do plan to join us in the fall for that lecture. 01:25:24.655 --> 01:25:25.955 Thank you all for coming. 01:25:26.095 --> 01:25:26.835 Good night.