SOWO 852 SW Practice with Couples THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF SOCIAL WORK SYLLABUS COURSE NUMBER: SOWO 852.01 COURSE TITLE: PRACTICE WITH COUPLES, FALL 2009 INSTRUCTOR: Anne Jones, MSW, PhD 563 G Tate-Turner-Kuralt 962-6537 (O) 962-7557 (Fax) (Email) annejone@email.unc.edu OFFICE HOURS: Tuesday 1:00 – 1:50 pm or By appointment CLASS WEBSITE: Accessible through - https://blackboard.unc.edu/. This will contain the syllabus, assignment descriptions and grading criteria; lecture notes, cases, and external links. Please check it periodically for announcements and make sure that you are listed for the class. COURSE DESCRIPTION: This course is a clinical seminar, which analyzes the operations and character of couple therapy as a human service approach. OBJECTIVES: 1. To develop an understanding of the dynamics of the couple/marital relationship. 2. To understand the professional social work roles, values, and ethics associated with social work intervention specifically to couples and their families. 3. To become aware of your own values, feelings and attitudes about marriage/couple conflict and dissolution. 4. To develop and deepen skills for diagnosis of and implementation of social intervention strategies for marital or relationship difficulties or dysfunction. 5. To understand marital/relationship therapy from a variety of explanatory and practice theoretical perspectives and to develop practice skills consistent with these perspectives. 6. To understand the implications and importance of race, gender, ethnicity, class, and sexual orientation on practice with couples. 7. To understand the importance and relevance of the ecological environment and community setting on assessment and intervention with couples. REQUIRED TEXTBOOK: -1- SOWO 852 SW Practice with Couples Gurman, A.S. (Ed.) (2008). Clinical handbook of couple therapy (fourth ed.). New York: The Guilford Press. Gottman, J. (1999). The marriage clinic. A scientifically based marital therapy. New York: W.W. Norton & Company. These books are available at the UNC Bookstore or can be ordered on the web (e.g., www.bestbookbuys.com, or www.textbooks.com) OTHER TEXTS THAT MAY BE USEFUL: Bobes, T. & Bobes, N.S. (2005). The couple is telling you what you need to know: Couple directed therapy in a multicultural context. New York: W.W. Norton. Dattilio, F. M. & Bevilacqua, L. J. (Eds.) (2000). Comparative Treatments for Relationship Dysfunction. New York: Springer Publishing Co. Donovan, J. M. (1999). Short-term couple therapy. New York: The Guilford Press Gottman, J. (1999). The marriage clinic. A scientifically based marital therapy. New York: W.W. Norton & Company. Gurman, A.S. & Jacobson, N.S. (Eds.) (2002). Clinical handbook of couple therapy (3rd Ed.). New York: Guilford Press. Halford, W.K. & Markham, H. J. (Eds.)(1997). Clinical handbook of marriage and couples interventions. NY: John Wiley & Sons. Harway, M. (2005). Handbook of couples therapy. New Jersey. John Wiley & Sons, Inc. Karpel, M. (1994). Evaluating couples: A handbook for practitioners. New York: W. Norton. Weeks, Gerald R. & Treat Stephen R. (2001). Couples in Treatment: Techniques and Approaches for Effective Practice. New York: Brunner/Mazel Weeks R.G., Odell, M. & Methven, S. (2005). If only I had known…Avoiding common mistakes in couples therapy. New York: W.W. Norton. OTHER RECOMMENDED BOOKS: Belsky, J., & Kelly, J. (1994). The transition to parenthood: How a first child changes a marriage. Why some couples grow closer and others apart. New York: Dell. Chapman, G. (2004). The five love languages. Chicago: Northfield publishing. DeRamus, B. (2005). Forbidden fruit: Love stories from the undgerground railroad. New work: Atria Books. Masling, B. (1994). The angry marriage. New York: Hyperion. -2- SOWO 852 SW Practice with Couples Prunty, M. (2006). Recipes for a perfect marriage. New York: Hyperion. (Fiction) RECOMMENDED WEBSITES: http://www.smartmarriages.com (Coalition for marriage, family and couple education. I highly recommend subscribing to the listserv) www.healthymarriageinfo.org (Clearinghouse for resources and information on healthy marriage) Please note: There are many other links related to course material under external links on class website EXPANDED DESCRIPTION: This class will examine the theory, practice and utilization of effective therapeutic interventions with couple relationships across the developmental life cycle of dyads. A number of theoretical approaches will be presented. The course will involve lecture, discussion, role-playing and student presentations. It is expected that students will be involved in the course through discussion, role-plays and class presentations. The course builds on knowledge and skills gained in the Foundation classes (including SOWO 500, 540, 501, 520, 521) and Social Work 802 (Family Stress, Coping, and Social Support). CLASSROOM ENVIRONMENT: The development of a supportive learning environment, reflecting the values of the social work profession, is essential for the success of this class. A supportive learning environment is fostered by listening to the ideas and views of others, being able to understand and appreciate a point of view which is different from your own, articulating clearly your point of view, and linking experience to readings and assignments. I will appreciate your contributions to making this a safe and respectful class for learning and growth ASSIGNMENTS: There are two written assignments and two experiential assignments. The first written assignment involves journaling three times during the semester. The journal is 2-3 pages and involves relating course material to professional/personal experiences. Due dates are on the syllabus. The second written assignment is a final paper in which you apply one of the theoretical frameworks covered in the course to a written case that I will give you. The paper is due 9:00 AM on 12/14/09. The first experiential assignment is a role-play demonstration that is done in groups of 3 or four and which is planned out ahead of time. The other assignment is a 30 minute team presentation in which you research and present on the “best practices” for working with a particular couple’s issue or problem. A more detailed assignment description is in the handout, “Assignment Description”. BASIS FOR EVALUATION: Attendance & participation Role-Play and handout Journal Team Presentation Final Paper 10% 25% 15% 25% 25% -3- SOWO 852 SW Practice with Couples GRADING SYSTEM: H = 94 and above P = 80 to 93 F = 69 and below L = 70 to 79 POLICY ON INCOMPLETES & LATE ASSIGNMENTS I prefer not to give an incomplete grade and will give incompletes only in compliance with University policy. If an assignment is late (not handed in class on the due date), without prior approval the grade will be reduced 10 points. The grade will continue to be reduced for each day it continues to be late. ATTENDANCE AND CLASS PARTICIPATION: Attendance and participation is worth 10 points. Attendance and participation is required and the class will rely heavily on discussion. It is expected that students will read the material and apply and discuss readings and field experiences in class. Active listening, respect and tolerance for the views of others and a stance of curiosity will all contribute to a safe and stimulating learning environment. POLICY ON ACADEMIC DISHONESTY: Please refer to the APA Style Guide, The SSW Manual, and the SSW Writing Guide for information on attribution of quotes, plagiarism and appropriate use of assistance in preparing assignments. All written assignments should contain a signed pledge from you stating that, “I have not given or received unauthorized aid in preparing this written work.” In keeping with the UNC Honor Code, if reason exists to believe that academic dishonesty has occurred, a referral will be made to the Office of the Student Attorney General for investigation and further action as required. POLICY ON ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES: Students with disabilities which affect their participation in the course may notify the instructor if they wish to have special accommodations in instructional format, examination format, etc., considered. -4- SOWO 852 SW Practice with Couples CLASS SCHEDULE SOWO 852.01 PRACTICE WITH COUPLES Class 1: 8/25 Overview of Course and Course Requirements Introductions Historical perspective of marital and couple therapy The landscape of couples and families today Why focus on couples? Class 2: 9/1 Marriage Promotion and Government: The Role of Values in Policy Formation and Practice with Couples Does marriage matter? The role of class and economics in the formation of families Practitioner held values and the myth of neutrality Class 3: 9/8 Developmental Transitions, the Role of Gender Interactions and Factors Associated with Successful Relationships – What the Research Shows Couples and life cycle stages Predictors for marital success and dissolution Gender Differences in Depression: A Marital Therapy Approach - Peggy Papp, MSW How much does gender matter? Class 4: 9/15 Assessing the Couple System The transition to working systemically Contraindications for working with a couple The use of standardized assessments JOURNAL #1 DUE Class 5: 9/22 Cognitive Behavioral Couples Therapy (CBCT) Theoretical assumptions Perspective on healthy and dysfunctional relationship Therapeutic goals Cognitive Behavioral Couples Therapy - Arthur Freeman, EdD Class 6: 9/29 Cognitive Behavioral Couples Therapy (CBCT) Continued Team Role-play Common interventions Applications to relationship education/marriage preparation & enrichment programs Strengths and limitations Class 7: 10/6 Emotionally Focused Therapy Theoretical Assumptions Perspective on healthy and dysfunctional relationship Application to trauma and illness Emotionally focused therapy with Susan M. Johnson Class 8: 10/13 Emotionally Focused Therapy Continued Team Role-play Stages and associated interventions -5- SOWO 852 SW Practice with Couples Strengths and limitations Class 9: 10/20 Gottman Method Couple Therapy (The Sound Marital House) JOURNAL #2 DUE Theoretical Assumptions Perspective on healthy and dysfunctional relationship Therapeutic goals Class 10: 10/27 Gottman Method Couple Therapy (The Sound Marital House) Cont’d Team Role-play Key interventions Strengths and limitations Applications to male arousal and violence Class 11: 11/3 Separation, Divorce and Stepfamily Issues Therapeutic and ethical issues with separating/and divorcing couples Working with couples considering divorce- William Doherty Stepfamily life cycle and structural characteristics Best practice interventions with stepfamilies Class 12: 11/10 Working with LGBT couples: What therapists need to know—Guest Speaker Common stressors Unique strengths Therapeutic interventions Ethical issues Class 13: 11/17 Cultural considerations in couples work Reflections on our own culture Common issues in cross-cultural relationships Imperatives for therapists Class 14: 11/24 No Class – Happy Thanksgiving! Class 15: 12/1 Infidelity and Sexual Dysfunction Kinds and patterns of infidelity Therapeutic dilemmas Practice recommendations Common sexual disorders JOURNAL #3 DUE Class 16: 12/8 Components of ethical practice Reflections and Wrap-up Individual Feedback and Class Evaluations FINAL PAPER DUE ON MONDAY 12/14/09 9:00AM -6- SOWO 852 SW Practice with Couples SOWO 852 READING LIST READINGS FOR CLASS 2 9/1 - THE ROLE OF VALUES IN POLICY AND PRACTICE 1. Ooms, T. (2002). Marriage and government: Strange Bedfellows? Couples and Marriage Series, 1, Washington, D.C.: Center for Law and Social Policy.) 2. Nock, S. L. (2005). Marriage as a public issue. Marriage and Child Wellbeing, 15(2), 12-32. 3. Parker, M. (2004). Who are “fragile families” and what do we know about them? Couples and Marriage Series, 1, Washington, D.C.: Center for Law and Social Policy. 4. Rasberry/Reich editorials (class handout) 5. Doherty, W. (2002). Bad couples therapy: how to avoid it. Psychotherapy Networker, December. Supplemental Optional Readings: 6. Roberts, P. (2004). I can’t give you anything but love: Would poor couples with children be better off economically if they married? Couples and Marriage Series, 1, Washington, D.C.: Center for Law and Social Policy. 7. Cherlin, A. J. (2003). Should the government promote marriage? Contexts, 2(4), 22-29. 8. Huston, T, & Metz, H. (2004),The case for (promoting) marriage: The devil is in the details. Journal of Marriage and the Family, 66(4), 943-958. (Reading room, or UNC Library electronic journal, or retrieve from: READINGS FOR CLASS 3 9/8 – DEVELOPMENTAL AND GENDER ISSUES; FACTORS ASSOCIATED WITH SUCCESSFUL RELATIONSHIPS 1. Lindahl, K., Malik, N., & Bradbury, T. (1997). The developmental course of couples’ relationships. In W. K. Halford & H. J. Markham (Eds.) Clinical Handbook of Marriage and Couples Interventions (pgs. 203-223). West Sussex, U.K: John Wiley & Sons. 2. Gottman text. Chapter 2 – Repair and Core Triad of Balance (pgs. 31- top of 56) Chapter 3 – The Sound Marital House (pgs. 87 – 96 top) 3. .Shapiro, A.F., Gottman, J.M., and Carrere, S., (2000). The Baby and the Marriage: Identifying factors that buffer against decline in marital satisfaction after the first baby arrives, Journal of Family Psychology, 14(1), 59-70. -7- SOWO 852 SW Practice with Couples 4. Henry, N.J., Berg, C.A., Smith, T.A. & Florsheim, P. (2007). Positive and negative characteristics of marital interaction and their association with marital satisfaction in middle-aged and older couples, Psychology and Aging, 22, (3), 428–441 5. Gurman text. Chapter 23 – Gender Issues in the practice of couples therapy Supplemental Optional Readings: 6. Gottman, J. & Notarious, C. (2000). Decade review: Observing marital interaction, Journal of Marriage and the Family, 62(4), 927-947. 7. Gottman, J.M., Levenson, R.W., (1999), How Stable is Marital Interaction Over Time?, Family Process, 38(2), 159-165; 8. Tichenor, V.J. (1999). Status and income as gendered resources: the case of marital power. Journal of Marriage and the Family, 61(3), 638-650. 9. Sandberg, J. G. & Harper, J. M. (1999). Depression in mature marriages: Impact and implications for marital therapy. Journal of Marital and Family Therapy, 25(3), 393-406. READINGS FOR CLASS 4 9/15 – ASSESSMENT WITH COUPLES 1. Weeks, G. R. & Treat S. R. (2001). Couples in Treatment: Techniques and Approaches for Effective Practice. New York: Brunner/Mazel Chapter 1 – Assessment and Case Formulation Chapter 3 – Balanced Intervention Chapter 4 – Systemic Intervention 2. Gurman text. Chapter 16 – Couple therapy and Physical Aggression (pgs. 478-486) 3. Read case and bring in questions for assessment Supplemental Optional Readings: 4. Doss, B., Atkins, D., & Christensen, A. (2003). Who’s dragging their feet? Husbands and wives seeking marital therapy. Journal of Marital and Family Therapy, 29(2), (165-177). 5. Estrada, A. U., & Holmes, J. M. (1999). Couples perceptions of effective & ineffective ingredients of marital therapy. Journal of Sex and Marital Therapy, 25, 151-162. 6. Beograd, M. & Medeiros, F. (1999). Battering and couples therapy: Universal screening and selection of treatment modality. Journal of Marital and Family Therapy, 25 (3), 291- 312. READINGS FOR CLASS 5 9/22 – Cognitive Behavioral Couple Therapy -8- SOWO 852 SW Practice with Couples 1. Gurman text. Chapter 2, Cognitive-Behavioral Couple therapy 2. Weeks and Treat (2001). Couples in Treatment: Techniques and Approaches for Effective Practice. New York: Brunner-Routledge. Chapter 11 Communication Techniques (pgs. 136-48) Chapter 13 Cognitive Techniques (pgs. 175 -192). 3. Review case in preparation for class Supplemental Optional Readings: 4. Sher, T.G. & Baucom, D.H. (2001). Mending a broken heart: a couples approach to cardiac risk reduction. Applied and preventive, 10,125-133. 5. Holtzworth-Munroe, A., Meehan, J.C., Rehman, U. & Marshall, A. D. (2002). Intimate partner violence: An interlocution to couple therapists. In A. Gurman & N. Jacobsen (Eds.) Clinical Handbook of Couple Therapy 3rd Edition, (pgs. 441-465), New York: The Guilford Press. 6. Pasley, K. (1993). Applying the social-cognitive-behavioral model to work with stepfamilies. In P. Boss, W. Doherty, R. LaRossa, W. Schumm, S. Steinmetz (Eds.) Sourcebook of family theories and methods: A contextual approach (pp. 558-561), New York: Plenum Press. READINGS FOR CLASS 6 9/29 – COGNITIVE-BEHAVIORAL COUPLE THERAPY CONT’D 1. Weeks and Treat (2001). Couples in Treatment: Techniques and Approaches for Effective Practice. New York: Brunner-Routledge. Chapter 13 Cognitive Techniques (pgs.175 -192). 2. Halford, W.K. & Moore, E.N. (2002). Relationship education and the prevention of couple relationship problems, In A. Gurman & N. Jacobsen (Eds.) Clinical Handbook of Couple Therapy 3rd Edition, (pgs. 400-419), New York: The Guilford Press. Chose either one: 3. Gurman text. Chapter 18, Couple therapy for alcoholism and drug abuse 4. Gurman text. Chapter 19, Couple therapy and the treatment of depression Supplemental Optional Readings: 5. Stanley, S, Markham, H.J. & Jenkins, N.H. (2002). Making the case for premarital training. Family Relations, 90, 272-280 READINGS FOR CLASS 7 10/6 – EMOTIONALLY FOCUSED THERAPY -9- SOWO 852 SW Practice with Couples 1. Gurman text. Chapter 4. Emotionally Focused Couple Therapy. 2. Kowal, J. & Johnson, S. M. (2003). Chronic illness in couples: A case for emotionally focused therapy. Journal of Marital and Family Therapy, 29(3), 299-309. 3. Johnson, S. M. (1998). Creating healing relationships for couples dealing with trauma: the use of emotionally focused marital therapy. Journal of Marital and Family Therapy, 24(1), 25-40. 4. Review case in preparation for class READINGS FOR CLASS 8 10/13 – EMOTIONALLY FOCUSED THERAPY CONT’D 1. Johnson, S.M. (2003). Attachment theory: A guide for couples therapy. In S. M. Johnson& V. Whiffen (Eds.), Attachment processes in couples and families. (pp. 103-123). New York: Guilford Press. 2. Johnson, S.M., Makinen, J. & Millikin, J. (2001). Attachment injuries in couple relationships: A new perspective on impasses in couple therapy. Journal of Marital and Family Therapy, 27, 145-155. 3. Johnson, S.M. & Whiffen, V. (1999).Made to measure: adapting emotionally focused couple therapy to partners attachment style. Clinical Psychology: Science and Practice, 6, 366-381. Supplemental Optional Readings: 3. Wiffen, B. & Johnson, S.M. (1998). An attachment theory framework for the treatment of childbearing depression. Clinical Psychology: Science and Practice, 5,478-492. READINGS FOR CLASS 9 HOUSE) 10/20 – GOTTMAN’S COUPLES THERAPY (THE SOUND MARITAL 1. Gurman text: Chapter 5. Gottman Method Couple therapy 2. Gottman text. Chapter 4, The Assessment of Marriage Chapter 5, The Disasters and Masters of Marriage 3. Review case for class Supplemental Optional Readings: 4. www.gottman.com and http://www.psychpage.com/family/library/gottman.html READINGS FOR CLASS 10 10/27 – GOTTMAN’S COUPLES THERAPY (THE SOUND MARITAL HOUSE) CONTINUED -10- SOWO 852 SW Practice with Couples 1. Gottman text. Chapter 6 – Assumptions and Intervention Overview Chapter 7 – Enhancing the Marital Friendship Chapter 8 – Solving What is Solvable Chapter 10 – Life Dreams and Shared Meaning (just 3 pages!) Supplemental Optional Readings: 2. Gottman text. Chapter 9 – Marital Friendship Chapter 11 – Resistance to change READINGS FOR CLASS 11 11/3 – SEPARATION, DIVORCE AND STEPFAMILY ISSUES 1. Gurman text. Chapter 15, Separation and Divorce Issues in Couple Therapy 2. Gurman text. Chapter 17, Couple Therapy with Remarried Partners. 3. Jones, A. (2003). Reconstructing the Stepfamily: Old Myths, New Stories. Social Work, 48(2), 228-236. 4. Pasley, K., Rhoden, L., Visher, E. B., & Visher, J. S. (1996). Successful stepfamily therapy: client’s perspectives. Journal of Marital and Family Therapy, 22(3), 343-357. Supplemental Optional Readings: 5. Oz, S. (1994). Decision making in divorce therapy: Cost-cost comparisons. Journal of Marital and Family Therapy, 20(1), 77-81. 6. Wang, H. & Amato, P. (2000). Predictors of divorce adjustment stressors, resources and definitions. Journal of Marriage and (the) Family, 62(3), 655672. 7. Walsh, F., Jacob, L., & Simons, V. (1995). Facilitating Healthy Divorce Processes: Therapy and Mediation Approaches. In N. Jacobsen & A. Gurman (Eds.) Clinical Handbook of Couple Therapy 2nd Edition (340-365), New York: The Guilford Press. READINGS FOR CLASS 12 11/10 – WORKING WITH LGBT COUPLES 1. Gurman text. Chapter 24, Gay and Lesbian Couples in Therapy: Minority Stress, Relational Ambiguity, and Families of Choice. 2. Markowitz, L. (1997). The cultural context of intimacy. Family Therapy Networker, 21(5), 51-58. -11- SOWO 852 SW Practice with Couples 3. Gottman, J.M., Levenson, R.W., Gross, J., Fredrickson, B., McCoy, K., Rosenthal, L., Ruel, A., and Yoshimoto, D., (2003). Correlates of Gay and Lesbian Couples' Relationship Satisfaction and Relationship Dissolution, Journal of Homosexuality, 45(1), 23-43. 4. Josephson G. (2003). Using an attachment-based intervention with same-sex couples. In S. M. Johnson & V. Whiffen (Eds.), Attachment processes in couples and families. (pp. 300-320). New York: Guilford Press. Supplemental Optional Readings: 5. Bepko, C. & Johnson, T. (2000). Gay and lesbian couples in therapy: Perspectives for the contemporary family therapist. Journal of Marital and Family Therapy, 26(4), 409-419. 6. Connolly, C. (2005). Lesbian couples: stressors, strengths, and therapeutic implications, Family Therapy Magazine, 4(6), 12-15. 7. Patterson, D. (2005). Gay male couples: Challenges & possibilities, Family Therapy Magazine, 4(6), 16-19. READINGS FOR CLASS 13 11/17 – CONSIDERATONS OF RACE, ETHNICITY AND CLASS 1. Handy, K. & Laszloffy, T. (2002). Couple therapy using a multicultural perspective. In A. Gurman & N. Jacobsen (Eds.) Clinical Handbook of Couple Therapy 3rd Edition, (pgs. 569-593), New York: The Guilford Press. 2. Edin, K. & Reed, J (2005). Why don’t they just get married? Barriers to marriage among the disadvantaged. Marriage and Child Welfare, 15(2), 117-137. 3. Bean, R. A., Perry, B. J., & Bedell, T. M. (2001). Developing culturally competent marriage and family therapists: Guidelines for working with Hispanic families. Journal of Marital and Family Therapy, 27(1), 43-54. 4. Gurman text: Chapter 25, African-American couples in therapy Supplemental Optional Readings: 5. Falicov, C.J. (1995). Cross-Cultural Marriages. In N. Jacobsen & A.Gurman (Eds.) Clinical Handbook of Couple Therapy (2nd Ed.), (212-226), New York: The Guilford Press. 6. Bobes T. Bobes, N. S. (2005). The couple is telling you what you need to know: Couple directed therapy in a multicultural context. Chapter 11 Illness Narratives in Couples and Families (pgs. 119-130). 7. Oropesa, R.S. & Landale, N. S. (2004). The future of marriage and Hispanics. Journal of Marriage and the Family, 66, 901-920. READINGS FOR CLASS 14 11/27 – No Class -12- SOWO 852 SW Practice with Couples 1. Research an education/enrichment program (assignment will be handed out in class and posted on Blackboard) READINGS FOR CLASS 15 DYSFUNCTIONS 12/1 - THE CRISIS OF INFEDILITY AND COMMON SEXUAL 1. Gurman text. Chapter 14. Couple therapy and the Treatment of Affairs 2. Imber-Black, E. (2000). The new triangle: Couples and technology. In P. Papp (Ed). Couples on the fault line. (pp. 48- 62). NY: Guildford Press. 3. Gurman text. Chapter 21. Couple therapy and the Treatment of Sexual Dysfunction. Supplemental Optional Readings: 4. McCarthy, B. (1999). The non-sexual marriage: Assessing viability. Journal of Sex & Marital Therapy, 25, 227-236. 5. Gordon, K.C. & Baucom, D.H. (1998), Understanding Betrayals in Marriage: A Synthesized Model of Forgiveness, Family Process, 37, 425-439 READINGS FOR CLASS 16 12/8 – ETHICAL AND PROFESSIONAL CONSIDERATONS 1. Gurman text: Chapter 26 Legal and Ethical Issues in Couple Therapy. 2. Baltimore, M. (2000). Ethical considerations in the use of technology for marriage and family counselors. Family-Journal-Counseling-and-Therapy-for-Couplesand-Families, 8(4), 390-393. Supplemental Optional Readings: 3. Patten, C., Barnett, T., & Houlihan, D. (1991). Ethics in marital and family therapy: A review of the literature. Professional psychology: Research and practice, 22, -13-