Post-Traumatic Stress Disorder (PTSD) may set in after an individual experiences traumatic situations like sexual abuse, hostility, and battering, or war in the case of veterans. Some of the ways through which PTSD affects relationships and marriages include violence, aggression, sexual and emotional problems, as well as mistrust. For this reason, for couples where one or both partners have PTSD seek the help of a therapist to help reduce the impact of PTSD and its symptoms on their relationship to improve their sexual functionality and health. A model that has been researched and tested to resolve PTSD in couple’s therapy effectively is the Cognitive-Behavioral Conjoint Therapy (CBCT). The model was developed due to influence from the fact that PTSD was mostly treated through medication and psychological interventions that would help a patient cope with the symptoms. Also, there were many behavioral therapies for couples that were used to help relational functioning but none of the methods addressed PTSD symptoms.
Definition of Model
CBCT for PTSD in couple therapy is a model that involves 15 stages, each with sessions of 25 minutes each, aimed at helping the couple to recover from PTSD or reduce the part it plays in their relationship. The stages are defined by R.E.S.U.M.E. where the letters refer to a phase. The first phase is aimed at providing Rationale and Education to the couple about the entire treatment. The second phase focuses on promoting relationship Satisfaction and Undermining factors that deter reduction of PTSD symptoms (avoidance). The third phase is characterized by finding the Meaning of the traumatic experience and working towards an End to the therapy.
To effectively use CBCT for PTSD in couples’ therapy, a certain protocol and techniques have to be used. First, the therapist has to determine the applicability of the treatment to the couple. There are exclusions and inclusions to be made—couples with recent violence and aggression, those not willing to stop drug abuse, and those with no intention to attend therapy as scheduled are excluded and referrals are made. On the other hand, mental illnesses, suicidality, cognitive disorders, and substance dependence are included. Secondly, the therapist has to determine the goals of the couple and their expectations from the therapy. The goals should be realistic to avoid frustration and thoughts by the couple that they cannot be helped. The third step is to schedule therapy sessions, at least one in a week, and start the treatment.
The goals of CBCT are to restore relational functionality between a couple, help them communicate better, reduce hostility and aggression, and to improve PTSD symptoms. To achieve these goals, the therapist must give off-session assignments that will help the couple practice the cognitive-behavioral skills they learn during the session. Time-outs should also be given during the session if there is no progress being made due to aggressive behavior or breakdowns. Assessments must be taken after every session to give an overview of the progress—filling forms and individual interviews of the partners.
Therapists are humans and might at one point or another be affected emotionally by the ordeals of their clients. However, to maintain the ability to provide help, the therapist should seek assistance from experienced colleagues and avoid vivid narration of the events during session. Also, the therapist must apply the skills during their session to encourage the couple to practice them at home. Co-therapy can be applied whereby the couple has a chance to observe their decision-making skills and therapists can consult on solutions to arising matters. At the end of the CBCT for PTSD, the couple should report positive changes in their relationship for it to be considered as successful. Some patients may recover fully and uphold healthy relationships while others may only improve partly to reduce the role PTSD plays in their daily lives.