Treating Difficult Couples
For individuals in the U.S. & U.S. territories
In Treating Difficult Couples, Dr. Douglas K. Snyder demonstrates his approach to working with difficult couples—those experiencing deficiencies in relational skills, a major life crisis, or longstanding and counterproductive relational patterns. Because of the complexity of this couples therapy, the approach involves multiple therapeutic modalities, requiring therapists to combine two or three approaches for any given couple. The primary goal of this approach is to help difficult couples to understand themselves and each other as partners.
In this session, Dr. Snyder works with Mary and Gary, a couple who, although they are 50 years old, have only been married several years. Mary has been diagnosed with cancer, and it has infiltrated much of her body, including her brain. Dr. Snyder helps this couple deal with the emotional impact of Mary's illness on their lives, something they have not faced because they have been too caught up in the daily tasks of medical care, family life, and work.
Dr. Snyder defines difficult couples as couples that come to therapy with one or more of the following:
- a lack of basic relationship skills, including deficits in listening, parenting, managing money, or expressing themselves
- a major life crisis such as infidelity or illness
- one or both partners exhibiting a longstanding and enduring pattern of relating that gets in the way of them using their relationship skills
Although this approach falls broadly into the category of insight-oriented psychotherapy, it requires a number of therapeutic modalities. It is hard to work with a difficult couple from a single therapeutic approach because most couples are dealing with issues that go beyond ordinary relational problems. Therapists must be prepared to work through family systems issues, childhood abuse or neglect, and coexisting mental disorders, as the core issues difficult couples deal with frequently involve these domains.
Therapists will need to be armed with specific information about various mental disorders, because one or both partners may have depression, anxiety, or be engaged in substance abuse. In addition, necessary changes in partners may involve cognition, behavior, or affect, so therapists should be prepared to explore all three domains to elicit change.
Douglas K. Snyder, PhD, is professor and director of clinical psychology training at Texas A&M University. He received the American Psychological Association's (APA's) 2005 award for Distinguished Contributions to Family Psychology for his work on empirical approaches to assessment and interventions with distressed couples.
Dr. Snyder is the author of the Marital Satisfaction Inventory (MSI) and coeditor of the book Treating Difficult Couples: Helping Clients With Coexisting Mental and Relationship Disorders. He received the American Association for Marriage and Family Therapy's 1992 Outstanding Research Award for his 4-year follow-up study comparing behavioral and insight-oriented approaches to couple therapy, funded by the National Institute of Mental Health.
Dr. Snyder is a fellow of the American Psychological Association and has served as associate editor for the Journal of Consulting and Clinical Psychology and the Journal of Family Psychology.
- Snyder, D. K. (1999). Affective reconstruction in the context of a pluralistic approach to couples therapy. Clinical Psychology: Science and Practice, 6, 348–365.
- Snyder, D. K., & Schneider, W. J. (2002). Affective reconstruction: A pluralistic, developmental approach. In A. S. Gurman & N. S. Jacobson (Eds.), Clinical handbook of couple therapy (3rd ed., pp. 151–179). New York: Guilford Press.
- Snyder, D. K., Schneider, W. J., & Castellani, A. M. (2003). Tailoring couple therapy to individual differences: A conceptual approach. In D. K. Snyder & M. A. Whisman (Eds.), Treating difficult couples: Helping clients with coexisting mental and relationship disorders (pp. 27–51). New York: Guilford Press.
- Snyder, D. K., & Whisman, M. A. (Eds.). (2003). Treating difficult couples: Helping clients with coexisting mental and relationship disorders. New York: Guilford Press.
- Snyder, D. K., & Whisman, M. A. (2003). Understanding psychopathology and couple dysfunction: Implications for clinical practice, training, and research. In D. K. Snyder & M. A. Whisman (Eds.), Treating difficult couples: Helping clients with coexisting mental and relationship disorders (pp. 419–438). New York: Guilford Press.
- Snyder, D. K., Wills, R. M., & Grady-Fletcher, A. (1991). Long-term effectiveness of behavioral versus insight-oriented marital therapy: A 4-year follow-up study. Journal of Consulting and Clinical Psychology, 59, 138–141.
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