APPRECIATIVE CHRISTIAN THERAPY:
A THEOLOGICAL PARADIGM TO FACILIATE POSITIVE CHANGE IN COUPLES
by
Eric M. Dishongh
A dissertation submitted to the faculty of
Amridge University
in partial fulfillment of the requirements for the degree of
Doctor of Philosophy
In
Marriage and Family Therapy
Dr. Dale E. Bertram, Chair
Dr. John Mark Trent
Dr. James Crabtree
January 2009
Montgomery, AL
Key Words: Appreciative Inquiry, Positive Change, Christian Therapy
“Copyright 2009 by Eric M. Dishongh”
Chapter One: Introduction
Appreciative Christian Therapy: A Theological Paradigm to Facilitate Positive
Change in Couples is a newly conceived therapy model that incorporates the underlying
notions of Christian marriage, appreciative inquiry, and positive change. These concepts
are a reflection of my personal journey as a Christian minister and Christian therapist and
are an attempt to define who I am and what I do as a professional. The following
dissertation addresses the philosophical and pragmatic issues in advancing Appreciative
Christian Therapy from a perceived conception to a constructed reality.
Statement of Problems and Sub-Problems
Church-Based Therapy
The following problems and sub-problems have informed the Appreciative
Christian Therapy paradigm. First, church leaders are often fearful of therapy, even if the
word Christian is attached to it. This fear is based upon ministers and church members
conducting therapy without adequate training resulting in reproach and embarrassment to
the church. More harm than good is typical, and churches subsequently abandon efforts
to reach out to the emotional and relational needs of the community. Due to this ignoring
of pain, Christians resort to secular therapists who conduct therapy from non-Christian
worldviews. This creates additional problems for the church because people who receive
secular therapy typically make decisions contrary to Christian principles.
Christian Therapists in Secular Settings
In church-based therapy settings, Christian therapists have freedom to discuss and
include “pastoral” topics such as God, Jesus, sin, prayer, and Bible reading. However,
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these liberties have significant limitations in secular therapy settings, especially when
clients do not bring faith to the therapy discussion. The American Association of
Marriage and Family Therapists’ Code of Ethics (2001) contains the following items:
Marriage and family therapists provide professional assistance to persons without
discrimination on the basis of race, age, ethnicity, socioeconomic status,
disability, gender, health status, religion, national origin, or sexual orientation.
(1.1)
Marriage and family therapists respect the rights of clients to make decisions and
help them to understand the consequences of these decisions. Therapists clearly
advise the clients that they have the responsibility to make decisions regarding
relationships such as cohabitation, marriage, divorce, separation, reconciliation,
custody, and visitation. (1.8)
Marriage and family therapists assist persons in obtaining other therapeutic
services if the therapist is unable or unwilling, for appropriate reasons, to provide
professional help. (1.10)
Thus, in an effort not to impose personal, religious values, some Christian therapists
conduct therapy from a completely non-theological perspective. As a result, these
therapists typically question their own faith and potentially experience guilt from being a
“non-Christian” Christian therapist.
Integration Models of Christianity and Therapy
Third, some Christian leaders completely reject the idea of integrating Christian
and secular theories. Jay Adams (1976), the pioneer of nouthetic counseling, suggests
that all of clients’ problems are the direct result of sin and must be verbally confronted
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utilizing Scripture. Thus, Adams maintains that the Bible is the only guide needed in
helping with emotional and relational distress. However, the predominant view amongst
Christian therapists is more balanced. Collins (1988) writes:
In medicine, teaching and other ‘people-centered’ helping fields, we have been
permitted to learn about God’s creation through science and academic study.
Why, then, should psychology be singled out as the one field that has nothing to
contribute to the work of the counselor? (p. 22)
McMinn (1996) describes the progress of the integration movement noting the pioneer
efforts of Everett Worthington, Jr. and Gary Collins. Organizations such as the American
Association of Christian Counselors (AACC) and the Christian Association of
Psychological Studies (CAPS) continue the efforts of integrating Christian and secular
concepts into the therapy realm.
An acceptance of the integration premise, however, does not solve the integration
problem. Ripley and Worthington (1996) have categorized methods of integration into
the following: incorporating Christian ideas into every aspect of theory; utilizing
Christian assumptions in therapy but employing secular concepts when Christian
concepts are not relevant; and dissociating theology from counseling (e.g., the presence
of a Christian client automatically creates Christian therapy). Integrating Christian and
secular concepts is extremely difficult, as previously evidenced by the lack of consensus
amongst Christian therapists in this regard.
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Importance of Study
Collaboration of Christian Therapists and Churches
First, pertaining to the importance of this study, churches have an outreach
opportunity to provide professional, competent therapy to communities from a Christian
perspective. Thus, Christian therapists have an opportunity to collaborate with churches
in this endeavor. Churches who decide to collaborate with therapists will be interested in
the doctrinal beliefs of the therapist. Since each church is unique, the practices of the
Christian therapist must be congruent with the doctrinal beliefs of the particular
congregation. Church leaders do not want conflicting messages from the pulpit and the
therapy office. For example, the minister may preach a sermon on the sin of adultery. If
the therapist advises a bored spouse to experiment with other partners, this clearly is a
contradicting message from the church.
Although there must be congruency between the doctrines presented from the
pulpit and the therapy office, there must also be an understanding that professional
therapy (even from a Christian perspective) is not synonymous with preaching. Preaching
is a direct method of spreading the good news of Jesus Christ, and Christian therapy is an
indirect method. Ultimately, both avenues have the same goal; however, the emphasis in
therapy is listening, understanding, and treating the emotional and relational needs of
clients utilizing theory and techniques consistent with biblical principles.
Integration of Christian Worldview
Secondly, there is a need for integration of sound theological and secular
principles to be utilized in church-based and secular therapy settings. In this regard,
Christian therapists can utilize the Appreciative Christian Therapy model to remain
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philosophically connected to their Christian worldview while working with non-Christian
couples. This will eliminate the predicament of abandoning personal faith while
conducting therapy, which typically results in the therapist experiencing guilt.
Faith and the Field of Marriage and Family Therapy
Third, spirituality and religion were avoided in marriage and family therapy
throughout the 20th century; however, the field is welcoming and embracing the healing
role of faith within the therapeutic process. Nicholls and Schwartz (2001) write:
Some of a family’s most powerful organizing beliefs pertain to how they find
meaning in their lives and their ideas about a supreme being, yet most therapists
never ask about such matters. For a long time, an important part of family life has
been a taboo subject in therapists’ offices. But is it possible to explore a family’s
spiritual world without proselytizing or losing sight of the problem-solving
mission of therapy? (p. 328)
Appreciative Christian Therapy will positively contribute to the MFT field’s ongoing
discussion of faith and therapy.
Appreciative Inquiry and the Field of Marriage and Family Therapy
Finally, Chenail (2005) identifies appreciative inquiry as a “Future Directions”
qualitative approach in MFT research. Appreciative inquiry (Cooperrider & Whitney,
2005) has flourished in the field of organizational change and larger systems. However,
there is a gap in the literature pertaining to appreciative inquiry and family systems. With
this in mind, Appreciative Christian Therapy is a pioneer effort in connecting
appreciative inquiry to the field of MFT.
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Delimitations
Although implications for future research will be discussed in the final chapter of
this dissertation, the current research will only address married couples, not individuals or
families. Related to this, the current research will not address dating or engaged couples.
Finally, in congruency with Christian principles to be later discussed in the literature
review, the current research will not address the Lesbian, Gay, Bisexual, Transsexual,
and Queer (LGBTQ) community.
Methodology
Research Questions
Based upon the aforementioned problems and sub-problems, I have generated the
following research questions for this dissertation. First, how can I construct a therapy
model that could be effectively utilized within church-based therapy settings? Secondly,
how can I construct a therapy model that allows Christian therapists to effectively reach
out to clients who do not bring faith/religion to the therapeutic discussion without
compromising their faith or the AAMFT Code of Ethics? Finally, how can I construct a
therapy model that effectively integrates Christian and secular principles? The
Appreciative Christian Therapy model is designed to respond to each of these research
questions.
Sampling Procedures
In regards to sampling procedures, I will gather a sample of twelve couples to
participate in the research. Participants will be recruited via letters, emails, and word of
mouth. Because I would like to have Christian and non-Christian participants, fellow
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church members will be encouraged to participate and encouraged to view this research
as an outreach opportunity for their friends and family members in need of marriage
therapy. As an incentive to potential participants, I will advertise that each couple will be
eligible to receive either a $50 restaurant gift card or two New Orleans Saints tickets to a
2008 regular season game.
Once interest is expressed, I will send each couple a formal invitation letter
followed by a phone-call to schedule the initial session. At the beginning of the first
session, each couple will complete an informed consent form, a release of confidentiality
form, a demographic intake form, Hudson’s (1992) Index of Marital Satisfaction, the
Locke-Wallace Marital Adjustment Test (Locke-Wallace, 1959), and Olson’s (1996)
ENRICH Marital Satisfaction Scale. Next, each couple will attend four therapy sessions
(no more than once a week) in which I utilize the Appreciative Christian Therapy model.
At the conclusion of the final session, each couple will complete an exit interview
pertaining to the strengths and weaknesses of the Appreciative Christian Therapy model.
Also, each couple will complete again Hudson’s Index of Marital Satisfaction, the LockeWallace Marital Adjustment Test, and Olson’s ENRICH Marital Satisfaction Scale.
Analyzing the Data
Each therapy session will be tape recorded and transcribed. Next, utilizing
qualitative techniques directly related to appreciative inquiry, I will examine the data to
identify recurring patterns and themes (Aronson, 1994) in the couples pertaining to the
Appreciative Christian Therapy model. These insights will help me determine what
significant changes are needed to improve the Appreciative Christian Therapy model. As
a methodological triangulation technique (Denzin, 1978), I will utilize the repeated-
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measures t test (Gravetter & Wallnau, 2004) to compare the post-scores of the marital
scales to the pre-scores to determine if the couples experience statistically significant
improvement in their marriages after receiving Appreciative Christian Therapy.
Definitions of Terms
Terms that will be utilized throughout this research are defined as follows. First,
Christian marriage refers to a heterosexual relationship between husband and wife as
defined by biblical precedents. Secondly, appreciative inquiry refers to the cooperatively
constructed search for the best in couples and their relationships around them. Third,
positive change refers to any change based upon a couple’s positive core that is linked
with a specific plan to improve the quality of the marital relationship (Cooperrider &
Whitney, 2005).
Organization
Following this introductory chapter, the literature will be reviewed in Chapter
Two pertaining to a theological construct of marriage, appreciative inquiry, and positive
change. In Chapter Three, the Appreciative Christian Therapy paradigm will be
introduced. Also, the methodology will be discussed, including a description of the
research design, sources and nature of data, criteria for admissibility of data,
identification of appropriate procedures for analyzing data, method of collecting data, and
the link between the data and research methodology. Chapter Four will include the results
of the study. Chapter Five will be the discussion, including an assessment of Appreciative
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Christian Therapy, implications of the study, limitations of the study, and
recommendations for future research.
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Chapter Two: Review of Literature
As previously mentioned in Chapter One, Appreciative Christian Therapy
incorporates pertinent concepts of Christian marriage, appreciative inquiry, and positive
change. Thus, the literature review will consider each of these ideas in relation to the
formulation of this new therapy model. Pertaining to Christian marriage, a theological
construct of marriage will be developed based upon pertinent biblical passages. Secondly,
the literature review will demonstrate that appreciative inquiry is predominantly utilized
in larger systems (e.g., organizations); however, there is a gap in the literature pertaining
to appreciative inquiry and family systems. Finally, pertaining to positive change from a
mental health perspective, the concepts of positive psychology and solution-focused brief
therapy will be explored.
Theological Construct of Marriage
Background
Marriage was the basic unit of society in all biblical cultures, including Jewish,
Greek, and Roman (Ferguson, 1993; Collins, 1992); thus, there is an emphasis throughout
the Bible on marital relationships. Reasons to marry included procreation,
companionship, and promotion of family fortunes (Perkin, 1987). Through the continued
influence of Catholicism and the Reformation, marriage has developed into both a
religious and legal concept (Albrecht, 2002). However, legal definitions and parameters
do not always mesh with theological foundations.
Although marriage is not considered a sacrament inextricably connected to
salvation, as advocated by Catholic and some Protestant theologians (Cahill, 2003;
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Lincoln, 1995; Knutson, 1999; Lawler, 1993; de Goytisolo, 1993; Kasper, 1980; Hauser,
2005; Rubio, 2003; Thomas, 2007; Gaillardetz, 2002), it is a biblical concept in which
couples are expected to follow. This is easier said than done. Nydam’s (2005) title, “The
Messiness of Marriage and the Knottiness of Divorce,” illuminates the difficult situations
Christian leaders face when working with troublesome couples in today’s society. Thus,
Christian therapists must have a theological foundation to their therapeutic approach.
With this in mind, a theological construct of marriage is formulated based upon
pertinent biblical passages. Hermeneutics is the process of interpreting Scripture. The
hermeneutical assumptions for this research include the following: the Bible is the
inspired Word of God (II Timothy 3:16-17); the Bible contains absolute truth pertaining
to such matters as God, morality, and marriage (John 8:31-32); the Old Testament
prepared the way for Christianity, but the New Testament is the final authority today
(Colossians 2:14; Hebrews 8:6-13); and commands, examples, and inferences (John
14:15; Warren, 1994; Woods, 1992; North, n.d.) are utilized to formulate theological
conclusions. Biblical passages pertaining to marriage will be cited and followed by
interpretive comments.
Survey of Pertinent Biblical Passages
Genesis 1:26-28. The first chapter of the Bible discusses the topic of marriage.
The Bible says:
Then God said, “Let Us make man in Our image, according to Our likeness; let
them have dominion over the fish of the sea, over the birds of the air, and over the
cattle, over all the earth and over every creeping thing that creeps on the earth.”
So God created man in His own image; in the image of God He created him; male
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and female He created them. Then God blessed them, and God said to them, “Be
fruitful and multiply; fill the earth and subdue it; have dominion over the fish of
the sea, over the birds of the air, and over every living thing that moves on the
earth.”
In the same way God created the world, man, and woman, He also created marriage. The
union between men and women is most intimate within marriage as it depicts the
intimacy between God, Jesus Christ, and the Holy Spirit (Granberg & Root, 2001). In
fact, the similarities between men and women reflect the similarities between the trinity
(Rosenau, 1994). Since God created marriage and this relationship resembles divine
attributes, these truths are an integral aspect of the theological construct of marriage.
Genesis 2:18, 23-24. In addition to the creation of marriage, the Bible teaches
secondly that marriage is an intimate relationship. The Bible says:
And the Lord God said, “It is not good that man should be alone; I will make him
a helper comparable to him.”… And Adam said: “This is now bone of my bones
and flesh of my flesh; she shall be called woman, because she was taken out of
man.” Therefore a man shall leave his father and mother and be joined to his wife,
and they shall become one flesh.
Marriage is a God-given opportunity for men and women to be together in a special way.
The “bone of my bones and flesh of my flesh” idea allows husbands and wives to
communicate thoughts and feelings in a way not possible with animals (Balswick &
Balswick, 1999). Furthermore, marital difficulties are the result of a failure to truly leave
parents, a failure to cleave to the spouse, and a failure to develop a unified relationship
(Palau, 2003). In summary from Genesis, Franks (2008) plainly concludes:
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There was the first man and first woman. They were created and brought together
by God. He made one man and one woman. Each was made for the other. The
first couple (male and female) formed the first “home.” Their “marriage” was a
God-approved mental, spiritual and physical union. The two truly became one
flesh. (p. 2)
Matthew 19:6-9. These insights into marriage from the Old Testament formulate
key principles to consider in connection with New Testament teachings. First, during His
earthly ministry, Jesus Christ expounds:
So then, they are no longer two but one flesh. Therefore what God has joined
together, let not man separate. They said to Jesus, “Why then did Moses
command to give a certificate of divorce, and to put her away?” Jesus said to
them, “Moses, because of the hardness of your hearts, permitted you to divorce
your wives, but from the beginning it was not so. And I say to you, whoever
divorces his wife, except for sexual immorality, and marries another, commits
adultery; and whoever marries her who is divorced commits adultery.”
The teachings of Jesus in this passage maintain the original sacred union of marriage
from Genesis. Divorce is not pleasing to God (Malachi 2:14; Matthew 5:31-32), despite
its common occurrence in today’s society. Christian therapists have the responsibility to
recognize the sacredness of the marital relationship. However, although divorce is not
God’s way, it is sometimes permissible. Adultery is the exception that God allows a
marriage to terminate in an acceptable manner.
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I Corinthians 7:3-5. Secondly, in addition to the mentioning of adultery in
Matthew 19:6-9, this passage discusses the sexual responsibilities of husbands and wives.
The Apostle Paul writes:
Let the husband render to his wife the affection due her, and likewise also the
wife to her husband. The wife does not have authority over her own body, but the
husband does. And likewise the husband does not have authority over his own
body, but the wife does. Do not deprive one another except with consent for a
time, that you may give yourselves to fasting and prayer; and come together again
so that Satan does not tempt you because of your lack of self-control.
According to this passage, husbands and wives are responsible to provide sexual intimacy
to each other. Wheat and Perkins (1980) discuss three principles derived from this
passage. First, spouses must understand the sexual need of each other, and the Bible
commands, not suggests, that these needs be met. Secondly, authority requires each
spouse to relinquish control to the other, thus husbands and wives do not have the right to
withhold physical affection from each other. And third, habit maintains that spouses
should engage in sex regularly and should only mutually refrain for a brief time to spend
in prayer.
Although these principles pertaining to need, authority, and habit are from God
and are not debatable, spouses should not utilize this passage as a weapon or a threat to
one another. For example, a husband should not say to his wife, “If you don’t have sex
with me, you are sinning.” Rosenau (1994) suggests that the husband is possibly sinning
because he has avoided lovingkindness and energy to appeal to his wife. In other words,
problems associated with sexual frequency are not simply limited to low sexual desire.
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Despite the fact that husbands and wives should not decline each other, they have the
responsibility to consider each other’s feelings and health in the pursuit of sexual
encounters (Boring & Warren, 1978).
Ephesians 5:22-28. Third, the New Testament describes that husbands and wives
are to love and to respect each other. The Apostle Paul writes:
Wives, submit to your own husbands, as to the Lord. For the husband is head of
the wife, as also Christ is head of the church; and He is the Savior of the body.
Therefore, just as the church is subject to Christ, so let the wives be to their own
husbands in everything. Husbands, love your wives, just as Christ also loved the
church and gave Himself for her, that He might sanctify and cleanse her with the
washing of water by the word, that He might present her to Himself a glorious
church, not having spot or wrinkle or any such thing, but that she should be holy
and without blemish. So husbands ought to love their own wives as their own
bodies; he who loves his wife loves himself.
In this passage, marriage is compared to the greatest love story ever told: Christ and the
church (Wheat & Wheat, 2005). Unconditional love and submission characterize this
relationship between Christ and the church. If the marital relationship is void of these
God-given qualities, then there cannot be any comparison with the Lord’s relationship to
the church. However, as love and submission manifest themselves in areas such as joy,
trust, commitment, unselfish nurturing, and companionship, the spiritual and emotional
union seen in Christ and the church can also be evident in the marital relationship
(Rosenau, 1994). Marriages are profound mysteries when the one flesh union
incorporates physical, emotional, and spiritual dimensions.
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Hebrews 13:4. Finally, the New Testament teaches that inappropriate
relationships are not acceptable to God. The Bible says:
Marriage is honorable among all, and the bed undefiled; but fornicators and
adulterers God will judge.
Within the marital relationship, sexuality is an “honorable” expression of love and
commitment between husbands and wives. However, by implication, inappropriate
relationships are not honorable to God. These include adultery, incest, homosexuality,
rape, fornication, prostitution, and bestiality (Flatt, 1991).
Summary
An examination of these biblical passages reveals that God has established
standards for marriage. Although polygamous relationships were recognized and not
condemned in the Old Testament, there is only divine approval of monogamous
relationships in the New Testament (Myers, 1987). Therefore, the Lord only approves of
marriage between man and woman in a covenant relationship. Any other intimate
relationship shortchanges the permanent, giving commitment that God has ordained to
occur only in the confines of marriage (Wheat & Wheat, 2005).
Appreciative Inquiry
Having a well-defined theology of marriage, however, is not enough. Christian
leaders have minimal difficulty declaring biblical notions of marriage; however,
difficulty increases when posed the question “how can we help” (Nydam, 2005)? Telling
couples to stay married and not divorced is completely different then helping couples to
stay married and not divorced. Thus, Appreciative Christian Therapy also incorporates
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fundamental tenets of appreciative inquiry, which is a model of change designed to
answer the question “how can we help?”
Background
Appreciative inquiry was developed by David Cooperrider as an attempt to create
a new model of organizational change (1986). By definition, appreciative inquiry is the
“cooperative, coevolutionary search for the best in people, their organizations, and the
world around them” (Cooperrider & Whitney, 2005, p. 8). This definition represents a
significant shift from the traditional problem-oriented models of change. According to
appreciative inquiry, organizations are not problems to be solved; instead, they are
created as solutions to meet challenges or satisfy needs of society (Cooperrider &
Whitney, 2005).
Compared to Action Research
In the development of appreciative inquiry, Cooperrider was particularly
interested in reconfiguring action research’s problem-oriented approach to change by
enhancing human development and embracing the potential for social-organizational
transformation (Cooperrider & Srivastva, 1987). There are, however, similarities between
appreciative inquiry and action research. According to Egan and Lancaster (2005), these
similarities include the following: engagement of real social systems, real time
conduction, improvements based upon change oriented processes, interactive
involvement by stakeholders, cyclical processes, variety of data collection approaches,
action-oriented, values-oriented, founded by theory building individuals, and applicable
to a variety of human systems. However, Egan and Lancaster (2005) also point out two
primary differences. First, action research focuses on problems, but appreciative inquiry
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focuses on solutions. Secondly, action research utilizes rational empiricist assumptions,
while appreciative inquiry focuses on socially constructed assumptions.
Core Principles
Constructionist Principle. Appreciative inquiry is based upon specific, core
principles. First, the constructionist principle states that knowledge and organizational
destiny are inextricably related and is a continual process of understanding and making
sense of the people and world (Cooperrider & Whitney, 2005). This social constructionist
principle is based upon the seminal works of Ken Gergen (1982, 1994), which replaces
the individual with the relationship as the primary locus of change. According to social
constructionism, meanings of experiences are constructed based upon the dynamic
relationships of people (Stavros & Torres, 2005; Peavy, 2004; Smedslund, 2004;
Anderson, 1997). Pertinent questions include: “How can I understand what has been said
or done?” and “How can I make sense of it?” Due to its intrinsic connection to social
constructionism, appreciative inquiry has the ability to manifest in numerous cultures and
contexts (van der Haar & Hosking, 2004).
Simultaneity Principle. Secondly, appreciative inquiry includes the simultaneity
principle, which maintains that inquiry and change occur simultaneously, not separately
(Cooperrider & Whitney, 2005). This recursiveness suggests that change begins the
moment the inquiry begins (Stavros & Torres, 2005). Pertinent questions include “How
did I immediately perceive what is occurring?” and “What state of body or mind
contributed to this response and my immediate reaction in how to act?”
Poetic Principle. Third, appreciative inquiry contains the poetic principle, which
implies that an organization’s story is continually coauthored with endless interpretive
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possibilities (Cooperrider & Whitney, 2005). In a metaphorical sense, relationships are
like poems, in which life stories are constantly rewritten, reread, and reinterpreted
(Stavros & Torres, 2005). Pertinent questions include “What am I focusing on?” and
“How else might this story read?”
Anticipatory Principle. Fourth, appreciative inquiry is based upon the anticipatory
principle, which states that positive images of the future result in positive actions in the
present (Cooperrider & Whitney, 2005). Humans live in anticipation of the future, which
impacts their present relationships (Stavros & Torres, 2005). Pertinent questions include
“What kind of relationship do we want to create together?” and “What actions on my part
will move us toward this kind of relationship?”
Positive Principle. Finally, appreciative inquiry includes the positive principle,
which suggests that positive affect and social bonding require hope, excitement,
inspiration, caring, camaraderie, purpose, and joy (Cooperrider & Whitney, 2005). People
with positive attitudes and images naturally move towards those images (Stavros &
Torres, 2005). Questions include “What questions can I ask that will move our
relationship forward in a positive way?” and “What appreciative actions can I take?”
4-D Cycle
Although a specific formula is not utilized in appreciative inquiry, the following
4-D cycle is typically implemented in congruence with the aforementioned definitions
and core principles. An affirmative topic choice is the most strategic aspect of the 4-D
cycle, as the agenda for learning, sharing, and action is created (Cooperrider & Whitney,
2005). The affirmative topic choice encourages the participants to focus on the area of
desired change. Once this occurs, the 4-D cycle can begin.
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Discovery. Discovery is the first step in appreciative inquiry’s 4-D Cycle. In this
stage, the whole system is mobilized to articulate strengths and best practices by
considering what is already right with the organization (Cooperrider & Whitney, 2005).
This includes exploring what is appreciated in the organization by discovering personal
strengths along with discovering the strengths of others.
Dream. Following the discovery phase, dreaming is the next stage of the 4-D
Cycle. Dreaming creates vision in relation to the group’s potential and purpose
(Cooperrider & Whitney, 2005). Stakeholders are encouraged to imagine a preferred
future, which includes life dreams, daily dreams, and situational dreams. Envisioning
impact requires the participants to go beyond what has already been discovered.
Design. In addition to discovery and dream, design is the third step in the 4-D
Cycle. Designing creates possibilities of the ideal organization (Cooperrider & Whitney,
2005). This is accomplished through the social construction of using other people’s
stories; looking for structure; utilizing strengths; and identifying personal roles in the
plan.
Delivery. Building upon discovery, dream, and design, delivery is the final aspect
of appreciative inquiry’s 4-D cycle. Delivery strengthens the capability of the entire
system, which builds hope and sustains momentum (Cooperrider & Whitney, 2005). This
concept of deliverance implies that the original affirmative topic choice has resulted in
the desired change of the stakeholders.
Applied to Relationships
Utilizing the fundamental principles of appreciative inquiry, Kelm (2005)
developed an appreciating-imagining-acting process to be utilized in daily relationships.
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First, appreciating the present involves asking questions such as “Do I feel appreciative
or good about this situation or person?” Appreciating exercises include keeping a
gratitude journal, finding the good in yourself or someone else, reframing, and changing
focus. Second, imaging the ideal involves asking questions such as “Am I clear about
what I want and is this where I’m giving my attention?” Imagining exercises include
gaining clarity, envisioning the ideal, and surfacing assumptions. Third, acting in
alignment involves asking questions such as “Do my current actions and thinking align
with what I want?” Acting exercises include enacting, acknowledging the good, and
developing conversational awareness. Stavros & Torres (2005) discuss ways that
appreciative inquiry principles enhance marital relationships. Sample questions for the
“aware spouse” include the following:
1. How can we do this differently so that we both feel good about it?
2. What are the things that you love about him or her?
3. What are his/her strengths and abilities and how do they support our
relationship?
4. How can we best communicate together?
5. When are we our best as a couple?
6. How do we bring out the best in each other?
7. How might we do this even under stress? (pp. 150-151)
Although Kelm, Stavros, and Torres’ applications of appreciative inquiry to daily
relationships were not developed within the context of marriage therapy, the questions
are adaptable for inclusion in the Appreciative Christian Therapy model.
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Positive Change
In addition to the theological construct of marriage and appreciative inquiry,
Appreciative Christian Therapy also considers positive change. According to Cooperrider
& Whitney (2005), positive change is defined as follows:
Any form of organization change, redesign, or planning that begins with a
comprehensive inquiry, analysis, and dialogue of an organization’s positive core
that involves multiple stakeholders, and then links this knowledge to the
organization’s strategic change agenda and priorities. (p. 12)
The traditional appreciative inquiry definition of positive change, however, is rooted
within larger organizations, not family systems. With this in mind, there is a need to
expand beyond positive change in relation to appreciative inquiry and explore the
development of positive change within the mental health disciplines. Thus, positive
change will be considered within the realms of positive psychology and solution-focused
brief therapy.
Positive Psychology
Martin Seligman is the pioneer in the field of positive psychology, which is an
application of positive change to the field of psychology. Beginning with his seminal
work, Learned Optimsism (1990), Seligman proposed an outlook on life centered around
optimism, not pessimism, which defied traditional mental health paradigms relying upon
deterministic ideologies. Continuing these groundbreaking advances, Seligman published
Authentic Happiness: Using the New Psychology to Realize Your Potential for Lasting
Fulfillment (2002), which has developed as the premier resource in the field of positive
psychology. Also, the Positive Psychology Center, directed by Seligman at the University
23
of Pennsylvania, is the hub of current research and trends in the field of positive
psychology. In addition to Seligman’s primary works, other researchers and practitioners
are advancing the notions of positive psychology (Ong & Van Dulman, 2007; Keyes &
Haidt, 2003; Pearsall, 2003; Peterson, 2006; Snyder & Lopez, 2007; Foster & Lloyd,
2007).
Seligman’s (2002) positive psychology approach emphasizes the past, future, and
present. First, “satisfaction about the past” rejects deterministic notions of Darwin, Marx,
and Freud and advocates the pursuit of serenity, contentment, and satisfaction. Gratitude
and forgiveness are the positive emotions associated with the past. Second, “optimism
about the future” involves a distinction between universal and specific explanations of
bad life events. Seligman (2002) writes:
People who make universal explanations for their failures give up on everything
when a failure strikes in one area. People who make specific explanations may
become helpless in that one part of their lives, yet march stalwartly on in the
others. For example, a universal (pessimistic) statement would be “You never tell
me anything.” In contrast, a specific (optimistic) statement would be “You didn’t
tell me that Suzy called yesterday.” (p. 91)
Hope is the primary positive emotion associated with optimism about the future. Third,
“happiness in the present” includes pleasures and gratifications (Seligman, 2002).
Pleasures have strong emotional components such as thrills, exuberance, and delight.
Gratifications, such as reading a book or attending a sports event, are enjoyable but do
not have the same level of emotional appeal as the pleasures. Seligman identifies twenty-
24
four strengths categorized into the follow six virtues: wisdom and knowledge, courage,
humanity and love, justice, temperance, and transcendence.
The emphasis of positive emotions dealing with the past, present, and future in
Seligman’s positive psychology approach have piqued the interest of others. The positive
psychology literature identifies a plethora of positive, human virtues such as hope, selfcontrol, forgiveness, gratitude, wisdom, humility, spirituality, belief, communication,
love, joy, contentment, perseverance, futuristic, and positivity (Snyder & McCullough,
2000; Fredrickson, 2001; Buckingham & Clifton, 2001). In fact, the VIA Inventory of
Strengths (Peterson, 2006) and the Clifton Strengths Finder (Buckingham & Clifton,
2001) have been developed to assess for positive emotions and strengths.
In the therapeutic process, the assessment and development of strengths is also
accomplished through a change in the type of questions utilized. Similar to the
appreciative inquiry approach, changing the questions results in changing of relationships
(Adams, 2004). The questions are a shift from a deficiency model to a strengths model
(Snyder & McCullough, 2000). The question “What weaknesses are sustaining this
problem?” is replaced with “What strengths do you have to solve this problem?”
Furthermore, according to the broaden-and-build theory developed by Fredrickson
(2001), positive emotions broaden thought-action repertoires; undo lingering negative
emotions; fuel resiliency; and trigger improved emotional well-being. In other words,
positive emotions not only signal human flourishing but they also produce it.
Thus, the discovery of strengths must continue with the honing of these traits with
skills and knowledge (Buckingham & Clifton, 2001). Pertaining to positive emotions and
couples therapy, Clifton and Nelson (1992) work from the premise that strengths
25
naturally develop in relationships and recommend the following principles applicable to
marital relationships: think of others in terms of their strengths; quality relationships
develop one on one; “doing for” never makes up for “doing with;” the more people know
about each other, the more likely they are to like each other; and use relationship
strengths.
These insights from the realm of positive psychology significantly contribute to
the development of the Appreciative Christian Therapy paradigm. However, there are
limitations to the positive psychology approach. First, positive psychology is a strictly
secular modality. Although Seligman (2002) recognizes research that suggests religious
people are happier than nonreligious people, positive psychology was designed void of
the Christian worldview. Secondly, as noted by Seligman (2002), the individualistic
emphasis is a major drawback of the positive psychology paradigm. Thus, a need arises
for a systemic, interpersonal paradigm for positive emotions from a Christian perspective.
Solution-Focused Brief Therapy
In addition to positive psychology, solution-focused brief therapy (de Shazer,
1988) is another therapeutic model based upon the idea of positive change. In contrast to
the individually-oriented nature of positive psychology, however, solution-focused brief
therapy is a systemic, interpersonal paradigm. Steve de Shazer (1985, 1988) is considered
the founder of solution-focused brief therapy. Following the development of the Mental
Research Institute (MRI), strategic, and systemic models (Satir, 1964; Watzlawick,
Beavin, & Jackson, 1967; Haley, 1963, 1973, 1976, 1980; Madanes, 1981, 1990),
solution-focused brief therapy became the “treatment for our times” (Nicholls &
Schwartz, 2001, 371). Solution-focused brief therapy arose to prominence in the 1980s
26
following a “tremendous demand for a brief, formulaic, commonsensical approach”
(Nicholls & Schwartz, 2001, 317). In contrast to traditional psychotherapeutic models
which encouraged months of therapy, solution-focused brief therapy significantly
reduced the number of sessions involved in the process of positive change.
de Shazer (1985) surmised the following rules of thumb for a positive start in
therapy: if it works, don’t fix it; if everything you are doing is not working, do something
different; keep it simple; if you want to do therapy briefly, approach each session as if it
were the last and only time you will see that client; and there is no failure, only feedback.
Insoo Kim Berg continued the works of de Shazer through her research (Berg & Miller,
1992; Berg & de Shazer, 1993; Berg & DeJong, 1996), her clinical practice at the Brief
Family Therapy Center in Milwaukee, and through her involvement with the SolutionFocused Brief Therapy Association (http://www.sfbta.org). Furthermore, solutionfocused brief therapy has been applied to couples (O’Hanlon & Weiner-Davis, 1989;
Weiner-Davis, 1992).
Assumptions. Solution-focused brief therapy is based upon the following
assumptions (de Shazer, 1988), which are similar to the assumptions of appreciative
inquiry and positive psychology. First, a positive focus is maintained by emphasizing
solution-oriented talk rather than problem-oriented talk. Second, exceptions suggest
solutions. Third, change is occurring all the time. Fourth, small change is generative.
Fifth, cooperation is inevitable. Sixth, people are resourceful. Seventh, meaning and
experience are socially constructed. Eighth, therapy is a recursive process. Ninth,
meaning is in the response. Tenth, the clients are the experts, not the therapist.
27
Goals. Based upon these assumptions, the construction of solutions is the primary
goal of solution-focused brief therapy (de Shazer, 1988). There are four pathways to
constructing solutions. First, the clients surmise a goal statement and then identify
exceptions to when the goal had been accomplished in the past. Second, if no exceptions
are identified, the goal statement is followed by a hypothetical situation. Third, if there a
goal statement is not yet determined, the problem statement is explored through
exceptions. Fourth, the hypothetical situation is explored when there are no exceptions to
the problem statement.
Techniques. To accomplish the goal of constructing solutions, the techniques
utilized include the exception question, the miracle question, and the scaling question (de
Shazer, 1988; Berg & de Shazer, 1993). First, the exception question challenges the client
to discuss times in which the problem did not exist or when the desired solution was
accomplished. Examples of scaling questions include: “How is this happening some
now?” and “When isn’t the problem happening?”
In addition to the exception question, the miracle question poses a hypothetical
scenario to clients who have difficulty identifying exceptions. The miracle question
challenges the clients to focus away from the negative and towards the positive by
articulating exactly what is desired. An example of the miracle question is as follows:
“Suppose you went to sleep tonight and in the middle of the night, a miracle occurred and
everything is exactly the way you would like it. When you wake up tomorrow, how
would know that the miracle occurred? What would be different?”
Third, the scaling question is a technique utilized in solution-focused therapy to
identify changes in the lives of the clients. Scaling questions allow the therapist and
28
clients to identify small changes in the process of the overall goals. An example of the
scaling question is as follows: “On a scale of zero to ten with zero being the worst and ten
being the best, how do you feel right now?” Following the number response by the client,
the therapist would say, “What would it take to get to move up one point on the scale?”
Integration Issues
As already discussed, Appreciative Christian Therapy integrates notions from the
theological construct of marriage, appreciative inquiry, and positive change. Secular
models of marriage therapy abound in the field, including brief strategic, cognitivebehavioral, object-relations, structural-strategic, transgenerational, integrativebehavioral, narrative, and solution-focused couple therapy (Gurman & Jacobson, 2002).
Christian models of marriage therapy also abound, including frameworks developed by
Dennis B. Guernsey, Willard F. Harley, Jr., Gary J. Oliver, Everett L. Worthington, Jr.,
and H. Norman Wright (Worthington, 1996). However, none of these models are capable
of functioning in their purest forms in both secular and Christian therapy settings.
In the development of an integrated model for secular and Christian therapy
settings, the Christian worldview cannot be compromised. Collins (1988) writes, “It is of
crucial importance that the guides be committed to the inspiration and authority of the
Bible, both as the standard against which all psychology must be tested and as the written
Word of God with which all valid counseling must agree” (p. 23). At the same time,
however, the integrated model must also be able to stand alone from a secular
perspective. Thus, the key is to identify ideas and concepts that are supported by
Christian and secular researchers. The Appreciative Christian Therapy paradigm will
29
satisfy the demands of Christian and secular constraints. To accomplish this task, certain
fundamental philosophies must be considered.
Social constructionist vs. Christian worldview
Cooperrider and Whitney (2005) maintain that “constructionisn replaces
absolutist claims or the final word with the never-ending collaborative quest to
understand and construct options for better living” (p. 50). However, the Christian
worldview maintains that absolute truth exists (John 8:24). Is it possible, then, for social
constructionism to make a Christian turn? The answer is yes but with clarification.
There is absolute truth which must be maintained pertaining to moral and marital
parameters defined by God; however, there are strands of relative truth pertaining to the
functioning of husbands and wives within marital relationships, which are not an issue of
right and wrong. Couples have numerous options for constructing strong, positive
relationships; however, these options for better living cannot contradict absolute, biblical
truths. With this understanding, the notions of social constructionism (and appreciative
inquiry) can be successfully integrated within a Christian worldview without a complete
abandonment of their philosophical tenets. For example, suppose a couple describes their
sexual relationship as “boring.” The Christian therapist would not encourage either
partner to have an extramarital affair; however, he or she would assist the couple in
constructing solutions that do not contradict biblical mandates to overcome the boredom
(e.g., increased communication pertaining to desires).
Examples of Integration
Positive change and appreciative inquiry have been integrated into Christian
ministries. Mundey (1997) identifies keys to positive change in churches, which casting a
30
vision, creating opportunities to learn, grow, and change; and being alert to the reality of
transitions. Strommen (1997) model of positive change in churches includes steps such as
uniting around needs, engaging in action, and sustaining long-term innovation. Branson
(2004) demonstrates the effectiveness of incorporating appreciative inquiry with
congregational assessment. Paddock (2003) discusses an integration of appreciative
inquiry and the ministries of the Catholic Church. Although not developed into a therapy
model, Paddock surmises the following positive questions for potential use with couples
planning to marry:
1. What attracted you to one another? What is it about the other that caused you
to say, she or he is the one?
2. Tell me about a time when you were able to resolve a difficult difference of
opinion, so that the outcome pleased you both.
3. Without being humble, what are the strengths you believe that you personally
bring to the marriage?
4. What are the qualities you see in your partner that will strengthen the
marriage?
5. What, to you, is the essence of your relationship, the part of who you are that
makes the relationship what it is?
6. Imagine it is 30 years from now, and you have a stable and happy marriage, a
model of cooperation, mutual respect and love. Describe the three things that
made it possible. (p. 51)
Paddock’s “pre-marital” questions are easily adaptable and will inform the construction
of questions for the Appreciative Christian Therapy model.
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Conclusion
Based upon this literature review, there are two significant gaps in the literature.
First, the literature pertaining to the integration of appreciative inquiry and positive
change with marriage therapy is scarce. Secondly, the gap widens considerably when
approached from a Christian worldview. Therefore, the Appreciative Christian Therapy
paradigm, which will be formulated in the next chapter, will attempt to successfully
integrate the concepts related to Christian marriage, appreciative inquiry, and positive
change.
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Chapter Three: Methodology
In the first chapter of this dissertation, problems and sub-problems were explored
suggesting the need for an integrative, therapeutic paradigm from a Christian perspective.
In the second chapter, the literature was reviewed in the fields of biblical Scripture,
appreciative inquiry, positive psychology, and solution-focused brief therapy. This
methodological chapter will provide a description of the research design, including the
introduction of the Appreciative Christian Therapy paradigm, and also the processes
involved with participants, collection of data, and data analysis.
Description of the Research Design
Research Questions
Based upon the aforementioned concerns, I have generated the following research
questions for this dissertation. First, how can I construct a therapy model that could be
effectively utilized within church-based therapy settings? Secondly, how can I construct a
therapy model that allows Christian therapists to effectively reach out to clients who do
not bring faith/religion to the therapeutic discussion without compromising their faith or
the AAMFT Code of Ethics? Finally, how can I construct a therapy model that
effectively integrates Christian and secular principles? The Appreciative Christian
Therapy model is designed to respond to each of these research questions.
Relationship of Qualitative Research Methodology to Research Questions
Specifically, appreciative inquiry has been selected as the qualitative research
methodology because of its inherent similarities to the Christian worldview. As will be
discussed in further detail, appreciative inquiry strives to capitalize on people’s strengths,
33
not weaknesses. Also, as previously mentioned, appreciative inquiry is an uncharted
qualitative research methodology in the field of marriage and family therapy.
Assumptions
Appreciative Christian Therapy is based upon the following underlying
assumptions. First, biblical hermeneutics is the process of interpreting Scripture. For the
purposes of Appreciative Christian Therapy, the hermeneutical assumptions include the
following: the Bible is the inspired Word of God (II Timothy 3:16-17); the Bible contains
absolute truth pertaining to such matters as God, morality, and marriage (John 8:31-32);
the Old Testament prepared the way for Christianity, but the New Testament is the final
authority today (Colossians 2:14; Hebrews 8:6-13); and commands, examples, and
inferences (John 14:15; Warren, 1994; Woods, 1992; North, n.d.) are utilized to
formulate theological conclusions. Secondly, absolute truth must be maintained
pertaining to moral and marital parameters defined by God; however, there are strands of
relative truth pertaining to the functioning of husbands and wives within marital
relationships, which are not an issue of right and wrong. This assumption was explored
in-depth in the literature review pertaining to the integration of Christianity and social
constructionism. Finally, the researcher assumes that the reader has a fundamental
knowledge of concepts and methods related to marriage and family therapy such as
systems theory, family of origin, family life cycle, empathy, rapport, and attentive
listening (Nicholls & Schwartz, 2001).
Introducing Appreciative Christian Therapy
The Appreciative Christian Therapy paradigm was created by me and is based
upon the Bible, Cooperrider’s appreciative inquiry, Seligman’s positive psychology, and
34
deShazer’s solution-focused brief therapy (see Figure 1 and Figure 2). The pursuit of
positive change in couples is at the heart of Appreciative Christian Therapy. In this
paradigm, positive change is guided by the theological foundations of Christian marriage
(Genesis 1:26-28; Genesis 2:18, 23-24; Matthew 19:6-9; I Corinthians 7:3-5; and
Ephesians 5:22-28), including the aforementioned assumptions. Absolute truth is
contained in the foundation of positive change; however, the manifestations of positive
change will be socially constructed and unique to each couple. In other words, the
Appreciative Christian Therapy paradigm recognizes the absolute truth in the Bible while
at the same time appreciates the notion that each couple must construct their own
pathway to change without the breeching of godly standards.
Session Outlines
Session One. Discovery characterizes the first session of the Appreciative
Christian Therapy model. The question “What has given the couple satisfaction in the
past?” guides the entire session. For the good times mentioned, thankfulness (I
Thessalonians 5:18) is the positive emotion emphasized. For the bad times mentioned,
forgiveness (Ephesians 4:32) is the positive emotion emphasized. The following
questions are utilized to facilitate the discovery process:
1. Think back to the time when you were dating. What attracted you to each other?
What were the things that you loved most about your husband/wife?
35
Figure 1. Venn Diagram
Appreciative Christian Therapy
36
Appreciative Christian Therapy:
A Theological Paradigm to Facilitate Positive Change in Couples
Figure 2. The Appreciative Christian Therapy paradigm was created by Eric Dishongh and is based upon the Bible, Cooperrider’s
appreciative inquiry, Seligman’s positive psychology, and deShazer’s brief, solution-focused therapy. The model can also be utilized
without direct reference to the biblical passages, if necessary.
2. As you think over the years of your marriage, you will likely recall many good
times and bad times. For the moment, tell me about a memorable high point in
which you felt most satisfied and pleased with your marriage relationship.
3. Suppose that I have a conversation with someone who knows each of you well.
What would this person say are your greatest strengths that you bring to the
marriage?
4. Imagine that it is now 2020 and that you have a happy and stable marital
relationship. Describe three things that made it possible.
5. Homework: In order for positive change to occur in marriage, a couple must
experience satisfaction about the past. Pertaining to the good times, identify three
things that you are appreciative/thankful for about your spouse. Pertaining to the
bad times, identify three things that you need to forgive your spouse for.
Session Two. Dreaming characterizes the second session of the Appreciative
Christian Therapy paradigm. The question “What is optimistic about the future for the
couple?” guides the entire session. Hope (Romans 5:5) is the positive emotion
emphasized. The following questions are utilized to facilitate the dreaming process:
1. Review and discussion of homework assignment.
2. Miracle Question: Suppose that while you are asleep tonight a miracle occurs, and
you wake up tomorrow morning and your marriage is exactly the way you would
want it in the future. What would be different?
3. Exceptions Question: Tell me about a time in which this has happened already in
the past.
38
4. Scaling Question: On a scale of one to ten, how would you describe the
relationship now with one being the worst and ten being the best? What would
have to occur for you to move up one or two points on the scale?
5. Homework: In order for positive change to occur in marriage, a couple must also
experience optimism about the future. Identify at least five positive items that you
remain hopeful will occur in your marriage in the future.
Session Three. Designing characterizes the third session of the Appreciative
Christian Therapy model. The question “How can the couple experience happiness in the
present?” guides the entire session. Joy (Philippians 4:4) is the positive emotion
emphasized. The following questions are utilized to facilitate the designing process:
1. Review and discussion of the homework assignment.
2. Speaking directly to your spouse, what is going to be your role in making your
future dreams reality?
3. Speaking directly to your spouse, what can you do to bring out the very best in
your spouse?
4. What role will others play in creating a joyful relationship in the present
(extended family, friends, church family, etc.)?
5. Homework: In order for positive change to occur in marriage, a couple must also
experience happiness during the present. Identify at least ten enjoyable items
(interests, hobbies, etc.) that you can do together as a couple.
Session Four. Delivering characterizes the fourth session of the Appreciative
Christian Therapy model. The question “How can the couple continue to sustain
momentum?” guides the entire session. Perseverance (Galatians 6:9) is the positive
39
emotion emphasized. The following questions are utilized to facilitate the delivering
process:
1. Review and discussion of the homework assignment.
2. Reflecting upon this entire process, what are the most important things that will
keep your marriage headed in the right direction?
3. What barriers do you anticipate will keep you from sustaining positive
momentum and maintaining perseverance?
4. What are you going to do about these barriers?
5. Closure: Review of previous sessions and discussion of termination of therapy.
Since the concepts in the Appreciative Christian Therapy paradigm are supported
by biblical and secular literatures, this model is ideal for both Christian and non-Christian
therapeutic settings. If necessary, the model can legitimately be utilized without direct
reference to the biblical passages and without compromising the Christian worldview.
For example, therapy may be conducted in a secular setting where direct references to
Christianity are prohibited. Also, if the clients do not bring faith to the therapeutic
discussion in a secular setting, ethical guidelines must be considered pertaining to the
“imposing” of personal beliefs.
Trustworthiness and Rigor
Reliability and validity in qualitative research is drastically different than
reliability and validity in quantitative research because of the underlying presuppositions
of each methodology (Golafshani, 2003). Qualitatively, reliability and validity pertain to
the trustworthiness and rigorous quality of the research. To accomplish trustworthiness
40
and rigor of the Appreciative Christian Therapy paradigm, the following actions will be
taken. I will give an account of all research procedures, including focus of study, role of
researcher, and context of data collection (Hoyt & Bhati, 2007). I will explain all aspects
of the study verbally and in writing to the participants and encourage the participants to
express any concerns to the dissertation chair, Institutional Review Board, or myself. The
audio tapes and transcripts of sessions will be secured in a safe location and destroyed
two years after completion.
In addition to the previously mentioned ethical concerns, a methodological
triangulation (Denzin, 1978) will be implored, which entails more than one research
method to derive data. The primary research component will be qualitative; however, the
quantitative repeated-measures t test (Gravatter & Wallnau, 2004) will provide additional
insights pertaining to the trustworthiness and rigor of Appreciative Christian Therapy
(Reliability and validity for the quantitative instruments are provided in a subsequent
section entitled “Repeated-Measures t Test.”). Finally, I will be mindful of my personal
biases as I repeatedly listen to the audio tapes and review the transcripts.
Participants
Recruiting Participants
In regards to sampling procedures, I will gather a sample of twelve couples to
participate in the research. Participants will be recruited via letters, emails, and word of
mouth (see Appendix A). Because I would like to have Christian and non-Christian
participants, fellow church members will be encouraged to participate and encouraged to
view this research as an outreach opportunity for their friends and family members in
41
need of marriage therapy. As an incentive to potential participants, I will advertise that
each couple will be eligible to receive either a $50 restaurant gift card or two New
Orleans Saints tickets to one 2008 regular season game.
Sampling Procedures
Once couples express interest in participating, I will send each couple a formal
invitation letter (see Appendix B) followed by a phone-call to schedule the initial session.
At the beginning of the first session, each couple will complete an informed consent form
(see Appendix C), a declaration of procedures and practices form (see Appendix D), a
demographic information form (see Appendix E), Hudson’s (1992) Index of Marital
Satisfaction, the Locke-Wallace Marital Adjustment Test (Locke-Wallace, 1959), and
Olson’s (1996) ENRICH Marital Satisfaction Scale. Next, each couple will attend four
therapy sessions (no more than once a week) in which I utilize the Appreciative Christian
Therapy model. At the conclusion of the final session, each couple will complete an exit
interview pertaining to the strengths and weaknesses of the Appreciative Christian
Therapy model. Also, each couple will complete again Hudson’s Index of Marital
Satisfaction, the Locke-Wallace Marital Adjustment Test, and Olson’s ENRICH Marital
Satisfaction Scale.
Data Collection
Pertaining to data collection, I will take notes throughout each session. Each
therapy session will be tape recorded and transcribed. The exit interview will also be tape
recorded and transcribed. The demographic information and scores from the instruments
42
will be inputted to SPSS. In order for the data to be included in the study, the couple must
complete the three instruments, four sessions of therapy, and the exit interview.
Data Analysis
Thematic Analysis
Once the data is collected, I will utilize qualitative techniques directly related to
appreciative inquiry to analyze the data. I will examine the data from the sessions to
identify recurring patterns and themes (Aronson, 1994) in the couples. These insights will
help me determine what significant changes need to be made to the Appreciative
Christian Therapy model.
Repeated-Measures t Test
As a methodological triangulation technique (Denzin, 1978), I will utilize a
repeated-measures t test (Gravetter & Wallnau, 2004) to compare the post-scores of the
marital instruments to the pre-scores to determine if the couples experience statistically
significant improvement in their marriages after receiving Appreciative Christian
Therapy. The selected scales are appropriate for this research project because each
measures overall couple satisfaction. A brief description of the selected instruments is
now provided.
First, Hudson’s (1992) Index of Marital Satisfaction (IMS) will be utilized in this
research design. The purpose of this scale is to measure the degree of satisfaction in
couples. The IMS has high levels of alpha reliability (.96) and test-retest reliability (.96),
and the instrument has an excellent concurrent validity, discriminant validity, and
construct validity; participants in the development of this scale included single and
43
married individuals who were primarily Caucasian (Hudson, 1997). The scale has 25
items focusing on magnitude of problems in the marriage relationship. The IMS is hand
scored by summarizing the items (13 of the items are reverse scored); subtracting the
number of completed items; multiplying the number by 100; and dividing the number of
items completed multiplied by six. The resulting number will be 0-100, in which scores
30 and above suggest significant clinical problems and scores 70 and above suggest
severe stress with possibility of violence in the relationship.
The Locke-Wallace Marital Adjustment Test (Locke & Wallace, 1959) is the
second inventory utilized in this research project. The purpose of this scale is to measure
marital adjustment, which is defined as the accommodation of a couple to each other. The
Locke-Wallace Marital Adjustment Test has a high level of alpha reliability (.90) and
significant levels of discrimanant validity and concurrent validity; normative data is
based upon 118 married couples, in which 48 of the couples were considered maladjusted
prior to the research (Locke & Wallace, 1959). The instrument contains fifteen items,
each weighted differently. The items are hand scored and range from 2-158, in which
scores of 100 or less indicate maladjustment in the marriage relationship.
Third, Olson’s (1996) ENRICH Marital Satisfaction Scale provides a global
measure of satisfaction in couples. This scale is a part of the abbreviated ENRICH Couple
Scales, which also includes marital communication, conflict resolution, and idealistic
distortion. The Martial Satisfaction Scale has an Alpha reliability of .86 and test-retest
reliability of .86, and the assessment of discriminant validity and cross-validity reveals
that the ENRICH inventory significantly distinguishes between distressed and nondistressed couples; these norms are based upon a national sample of 21,501 married
44
couples. (Fowers & Olson, 1989). The abbreviated ENRICH Couple Scale utilized in this
research project has 35 items, ten of which pertain directly to the Martial Satisfaction
Scale. The scale is hand scored by summarizing the ten items to obtain a score of 10-50.
The five categories of marital satisfaction are very high (41-50), high (36-40), moderate
(29-35), low (23-28), and very low (10-22).
Conclusion
The methodological framework has been provided for this dissertation, including
the research design, selection of participants, data collection, and data analysis. The
Appreciative Christian Therapy paradigm was also introduced. The next chapter will
present the results of the research conducted for this project.
45
Chapter Four: Results
In the previous chapter, the methodology was discussed. This results chapter will
provide a thematic analysis of the research, including the demographics, therapeutic
experience, and levels of marital satisfaction for each of the couples. A summary of the
recurring themes will be discussed, and the repeated-measures t test will determine if
there is statistically significant improvement in the couples’ level of marital satisfaction
after receiving Appreciative Christian Therapy. Finally, the positive and negative
feedback of the model generated from the couples will be included.
Thematic Analysis
Couple One
Demographics. Mike and Sally are a Caucasian couple in their late-fifties and
have been married for thirty-seven years. They have two adult children who currently live
a few states away. Mike is an offshore consultant, and Sandy owns an independent travel
company. The couple is financially stable. They are both active members of the Church
of Christ, in which they consider their faith very important.
Therapeutic Experience. In session one, Mike and Sally enjoyed talking about
their positive experiences in the past. Mike described himself as the traditional jock who
was interested in a beautiful, young lady. At first, Sally was not interested in him;
however, after several attempts, she finally decided to go on a first date. Once the couple
realized they were compatible with each other, Sally made it abundantly clear to Mike
that she would not marry him unless he became a Christian. So, Mike started attending
church with Sally and soon thereafter became a Christian. After they were married, the
46
couple would often fish and camp with other Christian friends. As the couple reflected
upon their marriage, both agreed that they were currently experiencing the highest point
of their marriage. This was due to Mike’s upcoming retirement and their upcoming move
to Florida. Pertaining to relational strengths, Sally said, “People have told us they want
what we have: a friendship, strong in our faith, and always being involved with church.”
Mike continued, “I wouldn’t be the man or the person that I am today if it weren’t for her.
Like I said earlier, I was rough around the edges. I have an extremely bad temper. But I
don’t lose it as much anymore.” In response to the 2020 question, the couple mentioned
remaining faithful in the church, going fishing and camping with each other and their
family, and remaining financially stable. The session concluded with an introduction of
the first homework assignment.
Session two began with a review of the homework. On the appreciative side,
Mike mentioned fishing, spending time together, and being best friends. Sally mentioned
growing spiritually together and “sticking it out over 37 years of being together.” On the
forgiveness side, neither Mike nor Sally wrote anything. This could be attributed to the
couple not having enough trust to share with the therapist and/or the couple attempting to
“show off” that they don’t have any problems. Pertaining to the miracle question, Sally
mentioned that they would have completed their move to Florida. Mike added that he
would be fully retired. In regards to relational issues, the couple discussed improved
relationships with their aging mothers. Sally explained:
What you do for one you have to do for another. Mother’s hot, and then the
other’s cold. Then you’re favoring one and not the other. My mother tends to give
in to give peace but his will keep bothering you about it.
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The exceptions question was not successful in helping the couple because they were not
willing to expound upon this problem in their relationship. For the scaling question, the
couple each answered, “Nine.” They would not seriously answer the follow up question
pertaining to moving up on the scale. At this point, I became slightly frustrated because
of the couple’s flowery answers and the ineffective utilization of the therapy model. The
session concluded by introducing the second homework assignment.
Session three was much more successful than the prior two sessions. It began with
a review of the five items that Mike and Sally remain hopeful will occur in the future.
The list included the following: “continue to stay strong in the church and in the faith;
live and demonstrate family values; don’t assume- communicate, communicate; make
time for each other; socialize with Christians; and open home to friends.” In reflection of
how each would contribute to accomplish these future dreams, the couple discussed their
upcoming move to Florida. Mike said, “We’ll move and get right back involved with the
church. We’ve kind of stood back here because we knew the move was coming.” Sally
explained that they have become distracted with the upcoming move because they are not
able to have friends over and have not been involved with the church. The question
pertaining to the role others will play in creating joy in the present was a turning point in
the therapeutic process. This question helped the couple realize the upcoming challenge
they will face in Florida once they live close to both of their mothers. Mike’s mother and
Sally’s mother both vie for time from the couple, which creates continual stress and
conflict. Mike said, “It’s like putting a cat and dog together in the same room.” Following
a brief discussion of the family life cycle, Mike and Sally discussed ways in which
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boundaries can be established to balance the potential marital discord from their mothers.
The session concluded with an introduction of the third homework assignment.
At the beginning of session four, the couple explained that they completed the
homework assignment but could not locate it. From memory, they recalled the following
enjoyable items: “fishing, camping, having friends over, and spending time with their
grandchildren.” In reflection of the entire therapeutic process, the couple mentioned faith,
family values, and communication as the most important items to keep the marriage
headed in the right direction. Mike and Sally identified their mothers as potential barriers
in their marital relationship, especially once they move to Florida. The discussion focused
on repeated ideas from session three of how to handle potential conflict with their
mothers. Session four concluded with the feedback questions and the completion of the
three marital inventories.
Level of Satisfaction. Qualitatively, prior to attending therapy, Mike and Sally
both described their level of marriage satisfaction as good. Following therapy, the couple
considers their level of satisfaction as even better. Sally expounded upon one of the
therapeutic benefits when she said, “Hearing ourselves agree that we have the same goals
was beneficial because we don’t always talk about them. Speaking them out loud and
telling someone else has been extremely helpful.”
Pertaining to the quantitative pre-inventory scores, Mike’s scores were IMS =
4.60, Locke-Wallace = 127, and ENRICH = 45. Sally’s scores were IMS = 6.67, LockeWallace = 134, and ENRICH = 41. These pre-scores demonstrated high levels of
marriage satisfaction. Pertaining to post-therapy, Mike’s scores were IMS = 4, LockeWallace = 131, and ENRICH = 48. Sally’s scores were IMS = 4.67, Locke-Wallace =
49
137, and ENRICH= 45. The post-scores demonstrate increased levels of marriage
satisfaction from both the husband and wife’s perspective.
Couple Two
Demographics. Keith and Jacque are an African American couple. Keith is 45years old, and Jacque is 38-years old. They have been married for nine years and have
four children together who are currently living with them. Keith works as an operating
room technician, and Jacque is a school administrative assistant. The couple is financially
dependent upon Jacque’s father, who is currently allowing them to live with him. They
both express that faith is very important to them, despite not being members of a local
congregation. Rather, they regularly visit a local Church of Christ.
Therapeutic Experience. In session one, the couple reflected upon their dating
relationship and early years of marriage. Keith and Jacque were introduced to each other
by a mutual friend. Keith was impressed with Jacque’s physical appearance, and Jacque
was impressed with Keith’s sense of humor. The couple lived together for fifteen years
and had two children together prior to getting married. They have been married for nine
years. In reflection upon the high point of the relationship, Jacque discussed Keith’s
presence during her pregnancies. She says, “He was always there, even during the doctor
appointments and everything.” For Keith, the high point has been the opportunity to serve
as a leader in the family, “especially once we decided to get married.” Pertaining to
greatest strengths, Keith mentioned dependability and reliability, especially related to
providing for the family. Jacque mentioned, “Laughter and the ability to have a good
time.” Pertaining to the 2020 question, the couple discussed a continued commitment to
each other, moving into their own house, and an increased level of faith, including
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placing membership with a local congregation. The session concluded with an
introduction of the first homework assignment.
Session two began with a review of the homework. On the appreciative side,
Keith wrote, “Good mother for our children, lots of fun, and good cooking.” Jacque was
thankful for Keith’s willingness to work, sense of humor, and when they attend functions
together for the children. On the forgiveness side, Keith wrote, “Not letting me be the
head of the house.” Jacque wrote, “When he doesn’t listen to me.” Following the
homework review, the couple discussed the miracle question. Keith emphasized that he
would “have the final word” in the family, and Jacque said, “We wouldn’t be living with
my dad.” Pertaining to the exceptions question, the couple reminisced when they rented
an apartment when they first got married; however, they have never owned a home
together because of financial and credit problems. Discussion followed about financial
strategies to buying a home, including saving money, making a budget, and “not running
up credit card debt.” For the scaling question, Jacque described the relationship as a
“five” and Keith described it as a “four.” To move up one point on the scale, Jacque
asked Keith to be home an extra hour each evening. Keith responded, “I would be happy
to do that if she would do things with me like watch television together.” The session
ended with an introduction of the second homework assignment. The couple also agreed
to follow up on spending an hour together for at least two nights during the next week.
Session two began with a review of the homework. The couple mentioned the
following items as future goals: “buying a house, more respect for each other, better
communication, and financial stability.” Pertaining to roles in accomplishing these future
goals, the couple predominantly discussed improving their communication. Keith said:
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I guess I would say talk slower and clearer. I will give definitions of the words
I’m speaking. I’ll make a statement, and she’ll take that statement to mean
something I didn’t even mean it to mean. I guess I need to just make my
statements more understandable.
Jacque attributed some of the communication problems to the environments in which
they were reared. She said:
He’s from the west coast; I’m from down south. I can’t change the way I speak no
more than how he says things. I’ll ask him a question and get another answer.
Repeating what I ask works sometimes. Maybe I can try that.
After listening to the couple dialogue about communication, I implemented an active
listening activity in which the couple was very receptive. As the conversation transitioned
into the role of others, Keith mentioned that all of his friends and family live out of state
but all of Jacque’s friends and family live close to them. The couple brainstormed ways
in which some of Jacque’s friends could become friends with Keith as well. Also, the
couple discussed the supportive impact of Jacque’s dad as they are saving money to buy
their own home. The session ended with an introduction of the third homework
assignment.
At the beginning of session four, the couple was excited to share their list of
enjoyable items, which included the following: “movies; church; watch television; out to
eat; read the Bible; sex; sleep; talk; being with the family; and backrubs.” The couple
shared that after they compiled the list, they decided to go see Tyler Perry’s latest movie.
I emphasized the importance of continuing to date and have fun together, especially as a
couple works towards achieving difficult goals. In reflection of the most important items
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to keep the marriage headed in the right direction, Keith and Jacque both mentioned
continuing to attend worship together and keeping open lines of communication. Jacque
mentioned that they are doing much better in both areas. Pertaining to barriers, Keith
said, “As long as we keep improving our communication, we will be fine.” Jacque
reminded Keith of an incident during the past week in which they failed to communicate.
Discussion followed pertaining to how the couple could each do better when that
particular situation arose again in the future. Session four concluded with the feedback
questions and the completion of the marital inventories.
Level of Satisfaction. Qualitatively, prior to attending therapy, Keith and Jacque
described their level of marriage satisfaction as “It could be better.” Following therapy,
the couple expressed increased levels of marriage satisfaction. Keith said, “Before
coming here, I didn’t feel like I was being heard. We still have a long way to go, but at
least I think she listens a little better to me.” Similarly, Jacque said, “Finding out how he
felt about certain things makes me feel a lot better and then having the opportunity to tell
him how I feel has really improved our communication with each other.”
Pertaining to the quantitative pre-inventory scores, Keith’s scores demonstrated
low levels of marriage satisfaction (IMS = 45.14, Locke-Wallace = 87, and ENRICH =
30), whereas Jacque’s scores demonstrated slightly higher levels (IMS = 17.33, LockeWallace = 103, and ENRICH = 31). Pertaining to post-therapy, the inventories indicate
improved levels of marriage satisfaction. Keith scores were IMS = 33.33, Locke-Wallace
= 99, and ENRICH = 38, and Jacque’s scores were IMS = 12.67, Locke-Wallace = 111,
and ENRICH = 40.
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Couple Three
Demographics. Steve and JoAnn are a Caucasian couple in their mid-thirties and
have been married for six years. They have two children adolescent daughters living with
them and one daughter from Steve’s first marriage. Steve is a fabrication designer, and
JoAnn is a part-time secretary in a doctor’s office. The couple has a combined income of
approximately $60,000. They are both active members of the Church of Christ, in which
they consider their faith very important.
Therapeutic Experience. Session one began with the couple reminiscing back to
their dating relationship. Steve described his initial attraction to JoAnn as follows: “I
would have to say what first attracted me to her was a combination between her smile and
real good personality. And she’s got some beautiful eyes.” JoAnn also discussed her
attraction to Steve by mentioning his “good looks” and willingness to share his thoughts
and feelings with her. The couple identified the time period following Steve’s conversion
to Christianity as the high point of their relationship. Steve said, “I just noticed a big
change, a growth with us. It really brought us together more as a couple.” JoAnn added:
At first, it was rocky. It was a different relationship. We were living in the world.
We had a lot of things that were bad that we didn’t’ realize at the time but cause
problems in a relationship- jealousy and fighting. We don’t have that anymore.
As the couple reflected upon their greatest strengths, Steve identified his willingness to
be involved as much as possible with his family. JoAnn mentioned her efforts of looking
out for Steve’s best interests. Pertaining to the 2020 question, the couple mentioned
growing in their faith and knowledge of the Bible, keeping affection in the relationship,
54
and doing activities together. The session concluded with an introduction of the first
homework assignment.
The second session began with a discussion pertaining to the homework
assignment. On the appreciative side, Steve was thankful for JoAnn’s willingness to not
hold grudges against past mistakes; her willingness to encourage him after a bad day; and
her willingness to be not only a wife but also a friend. JoAnn was thankful for Steve’s
love and support of her and their three daughters; his willingness to grow as a Christian;
and his support in keeping the house and yard clean. Pertaining to the forgiveness side,
Steve and JoAnn mentioned that they have completely forgiven each other of all past
mistakes. JoAnn explained, “I was very jealous in the beginning of our relationship, but
our whole lifestyles were different. We had a lot of things to be jealous for. I guess I
forgave him when Jesus forgave him. And it’s been great ever since.” Pertaining to the
miracle question, Steve mentioned he would notice a difference in their ability to manage
finances. JoAnn concurred and discussed frustrating attempts in the past of managing
finances, including a budget and having individual and joint banking accounts. The
couple identified brief time spans in the past in which they were able to remain within
their budget. Conversation followed in leading the couple in repeating past, successful
attempts pertaining to finances. In addition to the slated homework assignment, the
couple was also asked to draft a tentative budget. Following this forty minute discussion
of constructing solutions to the financial situation, the couple answered the scaling
question by both saying “Ten.” I immediately realized the incongruence of the scaling
response to the prior conversation, so I asked the couple to identify small types of
positive change that would enable them to move up from a “ten to an eleven” on the
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scale. They responded with the implementation of the previous financial solutions,
including a new budget. The session concluded with an introduction of the second
homework assignment. In between sessions one and two, the couple’s oldest daughter
was suspended from school for fighting with another student, which also ignited an
intense argument at home between the couple and their daughter. I was expecting this
topic to arise during the second session, but the couple did not discuss it. This can be
attributed to them being embarrassed about the situation and/or the couple being fearful
that they wouldn’t be a “happy” couple.
Session three began similarly to how session two ended with the couple still using
flowery language to describe their relationship. This is partly evident by the couple’s
responses to the second homework assignment, in which they wrote the following:
We hope to remain in love with each other; we hope that we don’t grow apart
from each other; we hope to grow closer than what we are right now; we want to
grow old together; and we want to die at the same time like in the movie The
Notebook.
Before proceeding to each spouse’s role in making the dreams a reality, I asked the
couple to expound upon these dreams to be more concrete. They expounded upon the
first item pertaining to remaining in love with each other. Steve mentioned that he would
focus on each day in the present and “try to do the little things that make her happy such
as asking her how her day went, doing a load of clothes without her asking me, and just
complimenting her.” JoAnn also mentioned “doing the little things” such as keeping the
house clean, cooking dinner, and maintaining a positive attitude. The next question
pertaining to the role of others enabled the couple to answer more authentically than any
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other prior question of the therapeutic process. The couple shared for the first time the
incident with their oldest daughter and its impact on the family. Steve and JoAnn
mentioned that the incident has caused them to reassess their parenting style. Also, the
couple genuinely shared their frustrations with JoAnn’s ex-husband, who constantly
creates stress within the family. Discussion followed with constructed solutions of how to
deal with the ex-husband. As the therapist, I felt some sense of progress because the
discussion seemed real, in contrast to the flowery responses at the beginning of the
session. The session concluded with an introduction of the third homework. Prior to
leaving my office, the couple expressed genuine gratitude to me for listening to them talk
about the situation with their daughter.
The fourth session began with a review of the homework. Steve and JoAnn
included on their list of enjoyable items the following: “fishing; going on dinner dates;
walking; bike riding; talking on the swing; shopping; gardening; cooking; entertaining
family and friends; and going on long weekend trips.” In reflecting upon the most
important items to keep the marriage in the right direction, Steve said, “We always need
to be open-minded to always want to please each other. It still falls back to basic faith,
fundamental aspect of being Christians.” JoAnn mentioned the importance of Steve
realizing and fulfilling her needs. Pertaining to potential barriers, the couple did not
anticipate any specific events; however, they did mention the importance of remaining
unified in raising their children. The session concluded with the feedback questions and
the completion of the marital inventories.
Level of Satisfaction. Qualitatively, prior to attending therapy, Steve and JoAnn
described their level of marriage satisfaction as “pretty good.” Following therapy, the
57
couple expressed increased levels of marriage satisfaction. Steve said, “For me, anytime
people sit down for whatever reason. I think it’s always helpful. It’s helpful for me to go
over questions, and I think it’s helpful to sit down and talk.” In agreement, JoAnn
continued, “That’s true. This has been good to talk about these things because we usually
don’t talk about them. We just kind of live it.”
Pertaining to the quantitative pre-inventory scores, Steve’s scores demonstrated
high levels of marriage satisfaction (IMS = 12.67, Locke-Wallace = 122, and ENRICH =
34), and JoAnn’s scores were high as well (IMS = 12.00, Locke-Wallace = 119, and
ENRICH = 34). Pertaining to post-therapy, the inventories indicate an overall improved
level of marriage satisfaction. Steve’s scores were IMS = 9.33, Locke-Wallace = 129,
and ENRICH = 41, and JoAnnn’s scores were IMS = 20.00, Locke-Wallace = 136, and
ENRICH = 35. As shown by JoAnn’s scores, her pre-IMS score demonstrated a higher
level of satisfaction than her post-IMS score. However, the other pre-scores and postscores showed slight improvement, which matched her qualitative description of marital
satisfaction.
Couple Four
Demographics. Barry and Veronica have been married for six years. Barry is a
31-year-old Caucasian, and Veronica is a 24-year-old Hispanic. The couple has been
married for six years and has two young children living with them. Barry works as a plant
mechanic, in which he earns approximately $65,000 annually. Veronica is a stay at home
mother. They are both active members of the Church of Christ, in which they consider
their faith very important.
58
Therapeutic Experience. At the beginning of session one, Barry and Veronica
enjoyed discussing how they met and their dating relationship. Veronica was in the
United States to attend school, and she met Barry while attending worship on a Sunday.
In addition to the physical attraction, the couple was fascinated with the “excitement
about something new” as they learned each other’s languages and cultures. After one year
of dating and to prevent Veronica from having to return home, the couple decided to get
married. In reflection of the marriage’s highest point of satisfaction, Barry and Veronica
described the present as the best. Although the couple realized they have much to
improve upon in their marriage following a three month separation from each other, they
have been working better as a team since being reconciled. Pertaining to individual
strengths, Barry mentioned spiritual, emotional, and financial stability, and Veronica
mentioned love for the family. In reference to the 2020 question, the coupled listed
increasing their faith, love, and communication with each other. The session concluded
with an introduction of the first homework assignment.
At the beginning of the second session, the couple explained that they did not
complete the homework, but they had verbally discussed it with each other. The point
they emphasized was the need to “forgive and forget” the recent three month period in
which they were separated. When asked about the miracle question, Barry said, “We
would have less financial stress and would have more money to do things.” In searching
for exceptions, Veronica mentioned that she had started a small business at home two
years ago, which generated two-hundred additional dollars a month. Discussion followed
about strategies to start that business again. For the scaling question, the couple both
mentioned “Eight.” To create small change, the couple each agreed to spend less money
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on trivial items such as music downloads and text messages. The session concluded with
an introduction of the second homework assignment and an encouragement to the couple
to complete the assignment.
The third session began with a review of the homework, in which the couple had
constructed three goals for the future. These goals were “less financial stress,
geographical change, and more recreational time together.” Pertaining to individual roles
and bringing out the best in each other, Barry and Veronica emphasized ways in which
they could move farther away from Barry’s parents. Barry admitted that he had ignored
Veronica’s prior requests to move, and Veronica admitted to “pestering” Barry about the
situation. When the “role of others” question was asked, Veronica started crying. Barry
explained that this was an extremely sensitive issue because his parents have not forgiven
Veronica for leaving home for three months. After seeing Veronica’s reaction, Barry
assured her that they would start looking for homes that would be farther away from his
parents. The session concluded with an introduction of the third homework assignment.
When the fourth session began, the couple expressed appreciation to me for
having them complete the third homework assignment, which related directly to one of
their previously mentioned future goals. The couple listed the following enjoyable items:
“having more sex; traveling; going out to eat; going to the movies; relaxing at home;
going to sporting events; and going to concerts.” In reflection of the most important items
to keep the marriage headed in the right direction, the couple mentioned increased levels
of faith and support for each other. Barry’s parents were identified as the primary barrier,
in which additional conversation followed about moving to a nearby town. This would
allow Barry to continue working at his current job and would generate more “freedom”
60
from his parents. The session concluded with the feedback questions and completion of
the marital inventories.
Level of Satisfaction. Qualitatively, prior to attending therapy, Barry described
the marriage relationship as “much better than it was a year ago this time.” In connection
to Barry’s comment, Veronica says, “Yes, but we still have a lot of problems to deal
with.” Following therapy, Barry and Veronica both agree that the relationship had
improved. Veronica explained,
Sometimes when I try to talk to my husband, he either doesn’t listen to me or he
just gets mad at what I am trying to say. But I found he listened much better when
we would meet together with you.”
Barry mentioned, “I openly admit that during the past few weeks I feel like I’ve tried
better to listen to Veronica. I also feel like we are more on the same page with our goals
as a couple.”
Pertaining to the quantitative pre-inventory scores, Barry and Veronica’s scores
were very similar and indicated high levels of marriage satisfaction. Barry’s scores were
IMS = 12.67, Locke-Wallace = 120, and ENRICH = 43, and Veronica’s scores were IMS
= 12.67, Locke-Wallace = 124, and ENRICH = 39. Pertaining to post-therapy, the
inventories indicate slightly improved levels of marriage satisfaction. Barry’s scores were
IMS = 10.00, Locke-Wallace = 126, and ENRICH = 46, and Veronica’s scores were IMS
= 11.33, Locke-Wallace = 129, and ENRICH = 42.
Couple Five
Demographics. Brian and Lacie are a Caucasian couple in their mid-thirties and
have been married for eleven years. The couple has one nine-year-old adopted daughter.
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Brian is a full-time refinery mechanic, in which he earns approximately $60,000
annually. Lacie is a stay at home mother and also owns a part-time business. The couple
are members of the Church of Christ, and their faith is very important to both of them.
Therapeutic Experience. At the beginning of session one, Brian and Lacie
discussed their dating relationship, in which they “lived in sin for seven years because
they were living together.” Brian was attracted to Lacie’s loyalty and transparency, while
Lacie was attracted to Brian’s looks and “wonderful personality.” The couple mentioned
a brief three-month period prior to the adoption of their daughter as the high point of the
marriage because they were making decisions together and were excited about becoming
parents. Pertaining to individual strengths, Lacie mentioned her faith and desire to learn
more about their daughter’s emotional and behavioral disorders. Brian mentioned his
willingness to provide for the family and his desire to “always follow through with
whatever needs to be done.” In reference to the 2020 question, Lacie immediately said,
“Our daughter Mary would be grown and out of the house.” She continued her
frustrations by saying,
We’re not united on how to raise this child. And I don’t think we’ve ever been. In
the beginning, we had an idea of the definition of parents, and then everything
changed. The screaming never stops, and I don’t think people in my circle
understand what I’ve got going on being up all night.
In addition to the parenting issue, the couple also mentioned growing in their faith and
becoming more financially stable. The session concluded with an introduction of the first
homework assignment.
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The second session began with a discussion of the homework assignment. On the
appreciative side, Brian was thankful for Lacie’s commitment to the family, her
submissiveness, and her resourcefulness. Lacie was thankful for Brian’s commitment to
her and Mary, his stability, and his protection. On the forgiveness side, Brian mentioned
the recurring problems pertaining to Lacie’s health and lack of memory, which
significantly hinder the couple from doing enjoyable activities and having meaningful
conversations. Lacie mentioned, “His expectations of me and Mary are too high
sometimes. We can’t possibly be what he would like me to be or us to be, and this falls
under the health and memory category.” In addition to expectations, Lacie also discussed
Brian’s temper and worrying about meaningless items such as a scratch on their wood
floor. Pertaining to the miracle question, Brian said,
An ideal day would be that I would leave to go to work. She would wake up and
work in her garden picking vegetables. I would come home, and dinner would be
on the table. She would have more energy, and there wouldn’t be any family
fighting.
In response to Brian’s “Little House on the Prairie” day, Lacie did not express any
problems with his requests; however, she included in her response the desire for Brian to
be more thankful for “the duties of a housewife” and to show interest in Mary’s life such
as her schooling assignments and also more respect. In searching for exceptions to when
any of these items have occurred in the past, Brian pointed out that Lacie functions much
better when he compliments her, and Lacie discussed the need to “allow Brian to figure
things out himself without nagging him.” Conversation followed to implement these
exceptions again during the next week. Pertaining to the scaling question, Brian said,
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“Seven,” and Lacie said, “Six.” To create small change, Brian agreed to spend thirty
minutes helping Mary with her homework during two days of the next week. Lacie
agreed to have a cooked meal two days during the next week. The session concluded with
an introduction of the second homework assignment.
The third session began with a review of the homework assignment, in which the
couple listed the following as future goals: “financially security, increased faith,
appreciative child, family volunteering, and joy as an entire family.” Pertaining to
individual roles and bringing out the very best in each other, Brian mentioned, “I think
for me it all revolves around my patience. If I would just control my temper more, that
would make an enormous difference.” Lacie expressed appreciation for Brian’s attempt
to become more patient. She explained that she would start taking better care of herself
physically and be more sexually responsive to Brian because she knows that he values
health and intimacy. In reference to the roles others will play in the marriage, Brian and
Lacie discussed the estranged relationships with both sets of parents due to their
conversions to Christianity several years ago. Thus, the couple has relied heavily on their
church family as a positive influence on family life. The session concluded with an
introduction of the third homework assignment.
The fourth session began with a review of the homework assignment, in which
Brian and Lacie mentioned the following enjoyable items: “gardening; raising livestock;
riding four wheelers; going out to eat; having sex; volunteering; being more involved at
church; having friends over to their home; and travelling.” Reflecting upon the most
important items to keep the marriage headed in the right direction, Lacie said, “Open
communication and growth as a couple and as parents.” Brian added, “I agree, and we
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also need to get involved with the church by our new house.” Pertaining to potential
barriers, the couple discussed the possibility of becoming “mentally lazy,” in which
efforts would cease to improve the marital relationship. To prevent this from occurring,
the couple discussed ideas such as saying “I love you” to each other everyday and having
devotionals in their home at least twice a week.
Level of Satisfaction. Qualitatively, in reflection upon the level of marriage
satisfaction before and after therapy, Brian said,
I don’t think anything is different. I enjoyed the sessions, but I just don’t know if I
got anything out of them. This was no different than any other counseling we’ve
been to in the past.
In response to Brian’s comments, Lacie disagreed about the notion that nothing has
changed in their marriage. She explained to Brian the following:
Things have changed because it has given me a chance to talk to you. In other
counseling situations, I haven’t been able to really explain myself well. I could do
it kindly and gently and briefly here. I’ve been feeling a change in you even if you
can’t see it. I’ve been asking you questions that we haven’t talked about in a long
time. Last night when we talked, it was about something that I haven’t been
confident enough to talk to you about in years. I wouldn’t have been able to do
that had we not gone through this.
Brian was receptive to Lacie’s comments, but he did not change his initial thoughts that
the marriage was currently the same as it was prior to therapy.
Pertaining to the quantitative pre-inventory scores, Brian’s scores demonstrated
low levels of marriage satisfaction (IMS = 42.67, Locke-Wallace = 91, and ENRICH =
65
26), and Lacie’s scores were similarly low (IMS = 28.67, Locke-Wallace = 68, and
ENRICH = 30). Pertaining to post-therapy, the inventories indicate improved levels of
marriage satisfaction. Brian’s scores were IMS = 33.33, Locke-Wallace = 108, and
ENRICH = 32, and Lacie’s scores were IMS = 23.33, Locke-Wallace = 83, and ENRICH
= 36. Despite Brian’s qualitative description of his level of marital satisfaction remaining
the same throughout therapy, the quantitative scores indicated a higher level of
satisfaction at the conclusion of therapy.
Couple Six
Demographics. Clint and Jessica are a Caucasian couple who have been married
for thirteen years. Clint is 45-years-old, and Jessica is 38-years-old. The couple has two
pre-adolescent children. Clint is a refinery mechanic, and Jessica is an independent sales
consultant. The combined annual income is approximately $85,000. The couple both
express that faith is very important. Clint is an inactive Catholic, and Jessica is an active
member of the Church of Christ.
Therapeutic Experience. During the first session, Clint and Jessica reminisced on
their early dating relationship. Several months following Clint’s divorce from his first
wife, the couple started dating. Their first date was at Applebee’s, in which they
discovered numerous common interests. Before Clint and Jessica got married, they
agreed on some “non-negotiable” items. Jessica agreed to always allow Clint to be a shift
worker and a hunter, and Clint agreed to always allow Jessica and their children to attend
the Church of Christ. These non-negotiable items have contributed to the couple’s current
level of marital distress. Pertaining to a memorable high point, Clint discussed their first
year of marriage in which they had a smaller home and were able “to do more things
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without having to worry about money.” Jessica also recalled the first year of marriage in
which Clint agreed to allow her start a home business, which eventually resulted in
financial success. In reference to individual strengths, Clint identified dedication to
family through cherishing and working hard. Jessica pointed out her efforts to bring
“peace and harmony” to the family. Pertaining to the 2020 question, the couple
mentioned financial stability, spiritual growth as a family, and development of more
common interests. The session concluded with an introduction of the first homework
assignment.
The second session began with a review of the homework assignment. On the
appreciative side, Jessica was thankful for Clint’s trustworthiness, hard work, and when
he “attends worship services with the rest of the family.” Clint was thankful for Jessica’s
leadership with the kids pertaining to church, her support, and her honesty. On the
forgiveness side, Jessica mentioned the need to forgive Clint for his harsh language and
other temper outbursts. Clint mentioned Jessica’s bad financial skills and inability to keep
the house clean. Pertaining to the miracle question, Clint very plainly said, “I would wake
up and the house would be clean.” Jessica answered, “The kids and I would have a
greater sense of peace and belonging into this family.” When the couple was asked to
identify instances in the past when these items occurred, Clint discussed a two-month
period last year in which their two children completed chores; however, he said, “That
didn’t last for long because we didn’t have any discipline.” Discussion followed of how
Clint and Jessica could be involved with the reimplementation of chores and discipline to
create a cleaner house. Jessica mentioned, “You know when the house is clean I do notice
that Clint is a lot nicer to me and the kids, so I think this will be a big step in the right
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direction.” Pertaining to the scaling question, Clint and Jessica both said, “Seven.” In
order to create small change, Jessica asked Clint to stop cursing in front of the children,
and Clint asked Jessica to “catch up on all of our bills for this month.” The couple each
agreed to follow-up on these requests. The session concluded with an introduction of the
second homework assignment.
There was a two-week gap between the second and third sessions, which
significantly hindered the therapeutic process. The third session began with the couple
explaining that the homework assignment was not complete. Clint and Jessica smiled at
each other throughout the session, which was a complete contrast to the first two
sessions; however, the couple had difficulty focusing on the conversation. The role of
others question enabled the conversation to be more focused again. Clint and Jessica
discussed their families of origin, in which they both explained their personal
expectations of marriage are largely influenced on how they viewed their parents’ marital
relationships. The session concluded with an introduction of the third homework
assignment.
There was another two-week gap between the third and fourth sessions, which
further hindered the therapeutic process. The couple had not completed the third
homework assignment; however, they found the second homework assignment, in which
they listed goals to accomplish for the future. Saving more money was the first goal, and
the couple agreed to allow Clint to start paying the bills. Growing spiritually and
implementing more discipline were the other two goals listed. Discussion followed about
generating pragmatic solutions to accomplish these goals; however, it seemed that the
couple was simply trying to “get through” the last session. A lack of trust was identified
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as a potential barrier, but the couple did not identify any solutions to overcome this issue.
The session concluded with the feedback questions and completion of the marital
inventories.
Level of Satisfaction. Qualitatively, prior to attending therapy, Jessica described
their level of marriage satisfaction as “very low.” In contrast to Jessica’s initial
description, Clint explained that he thought therapy would not be very beneficial because
they “have a good marriage already.” Following therapy, both agreed that the process had
increased their level of satisfaction. Jessica said, “These sessions have given us an
opportunity to touch base about things that usually don’t get to talk about. I’m still not
completely happy, but things are better.” Clint continues, “I agree that things are better
for us. The main thing is that I’ve learned how much she doesn’t like it when I yell and
curse. Just changing that has made a big difference.”
Pertaining to the quantitative pre-inventory scores, Clint’s scores demonstrated
high levels of marriage satisfaction (IMS = 6.67, Locke-Wallace = 108, and ENRICH =
37), however, Jessica’s scores showed lower levels of satisfaction (IMS = 52.63, LockeWallace = 67, and ENRICH = 24). These quantitative results matched the couple’s
qualitative comments prior to session one. Pertaining to post-therapy, the inventories
indicated an improved level of marriage satisfaction for the couple. Clint’s scores were
IMS = 4.00, Locke-Wallace = 119, and ENRICH = 38, and Jessica’s scores were IMS =
33.33, Locke-Wallace = 87, and ENRICH = 31.
Couple Seven
Demographics. Chris and Stacey are a Caucasian couple in their early-twenties
and have been married for nearly two years. The couple does not have any children. At
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the beginning of therapy, Chris and Stacey were both unemployed. They are currently
living with Clint’s mother and also financially dependent upon her. The couple are active
members of the Church of Christ, in which they both consider their faith very important.
Therapeutic Experience. At the beginning of session one, Chris and Stacey
enjoyed reminiscing about their dating relationship. The couple met at a Christian
university in Texas. They were enrolled in the same history class. Stacey recalled Chris’
outgoing personality, physical appearance, and sense of humor. Chris recalled Stacey’s
willingness to travel and “to try new things.” Pertaining to the memorable high point,
Stacey remembered the first few months they were married and said, “I enjoy those times
when we get to do those things with just me and him. It was when we were living on our
own way far away from family.” Chris replied, “Yeah, our high point is definitely not
right now. We are stuck living with my mom, and she’s driving us crazy.” Pertaining to
greatest strengths, Chris mentioned loveable and funny. Stacey mentioned her patience
and kindness. In regards to the 2020 question, the couple listed maintaining their
Christian faith; having fun together; and upholding their commitment to each other. The
session concluded with an introduction of the first homework assignment.
The second session began with a review of the homework assignment. On the
appreciative side, Chris mentioned Stacey’s support, willingness to be with him, and
desire to be a Christian wife. Stacey appreciated when Chris does “the little things” such
as bringing home chocolate. She was also thankful that he finds her attractive and his
willingness to help with household responsibilities. On the forgiveness side, Stacey
emphasized the need to forgive Chris for “not stepping up to his mom,” which has
created “a giant monster” in their relationship. Stacey also mentioned Chris’ weaknesses
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of listening and being short-tempered. Chris discussed the need to forgive Stacey for not
being a companion for health and recreation and for ignoring him sexually. Pertaining to
the miracle question, Stacey responded, “We wouldn’t be in this house with his mom.”
Chris mentioned, “We would have morning sex and then get up and go to work.”
Discussion followed about the frustrations living with Chris’ mother and with the
difficulties of finding adequate employment. Both agree that these stressors have affected
the emotional and sexual intimacy of the relationship. Pertaining to exceptions, the
couple recalled the period early in their relationship when they lived two states away
from both sets of parents. The conversation continued with the construction of solutions
pertaining to job searches and financial independence from Chris’ mother. For the scaling
question, Chris described the relationship as a “Four”, and Stacey described it as a
“Five.” To move up one point on the scale, Stacey asked Chris to not side with his
mother when the next argument arose, and Chris asked Stacey to have sex with him at
least once a week. The session concluded with a review of the second homework
assignment. Also, I asked the couple to follow-up on the small scale solutions they
constructed.
In between sessions two and three, Stacey was hired as a shift supervisor at a
retail store. So, the beginning of session three focused on the excitement of the new
career, which was an accomplishment for the couple. Chris went on an interview during
the past week, and he was waiting to hear back from the company. Following this initial
discussion, the couple shared their responses to the homework assignment. They listed
the following items as future goals: “move away to establish their own home; get
involved with a local church; raise a Christian family; develop healthy lifestyles; and
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paying off loans.” Pertaining roles and bringing out the best in each other, the couple
emphasized the need to encourage each other with eating right and with exercising.
Stacey said, “We think about the goal more than actually doing anything about it. With
Chris’ dad dying with a heart attack and his mother’s father dying from a heart attack, it’s
not something we want to mess with. It’s a very serious thing.” The couple mentioned
that they will resume their morning walks together as a source of encouragement. The
couple also discussed the financial goal in detail. Chris finding a job was a main priority,
especially with the increasing difficulties living with his mother. Pertaining to the roles
others play in the marriage, the couple discussed at length the negative impact of Chris’
mother on the marital relationship. Solutions were constructed, which included a threemonth time table to have secured jobs and to find an apartment. The session concluded
with an introduction of the third homework assignment.
Session four began with the couple discussing their list of enjoyable items, which
included the following: “traveling; going to the movies; trying new things; cooking;
planning for a house; playing with the cats; and watching television together.” Reflecting
upon the therapeutic process, the couple mentioned the following as the most important
items to keep them headed in the right direction: “being faithful Christians and
establishing an unconditional love for each other.” Pertaining to potential barriers in the
relationship, the conversation shifted again to Chris’ mother. Emphasis was placed upon
Chris and Stacey both doing their parts in accomplishing the primary goal of moving
away from Chris’ mother. The session concluded with the feedback questions and the
completion of the marital inventories.
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Level of Satisfaction. Pertaining to the qualitative comparison of marital
satisfaction levels prior and after therapy, Chris and Stacey had a difference of opinion.
Chris said, “It definitely helped me to be more aware of problems and goals and values
that Stacey has; however, I wouldn’t say it improved the marriage, just more conscious.”
In response to her husband’s comments, Stacey explained, “I think it helped us
communicate better in a forum when he’s not on the computer and being mad at me
because I’m complaining about his mom.” Following Stacey’s comments, Chris agreed
with her that they have been able to discuss their issues in a more constructive manner.
Pertaining to the quantitative pre-inventory scores, Chris and Stacey’s results
were approximately the same and revealed a moderate level of marriage satisfaction.
Chris’ scores were IMS = 24.67, Locke-Wallace = 89, and ENRICH = 28, and Stacey’s
scores were IMS = 23.33, Locke-Wallace = 91, and ENRICH = 22). Pertaining to posttherapy, Chris’ scores were IMS = 37.33, Locke-Wallace = 107, and ENRICH = 31, and
Stacey’s scores were IMS = 34.67, Locke-Wallace = 102, and ENRICH = 31. As evident,
the Locke-Wallace and ENRICH scales indicated higher levels of satisfaction; however,
the post-IMS scores suggested lower levels of satisfaction.
Couple Eight
Demographics. Derek and Amy are a Caucasian couple in their mid-twenties and
have been married for seven years. The couple has three young children. Derek is a
structural engineer, in which he earns approximately $40,000 annually. Amy is a stay at
home mother. The couple are active members of the Church of Christ, in which they both
consider faith very important.
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Therapeutic Experience. Session one began with the couple reminiscing on their
dating relationship and decision to get married. Derek and Amy grew up in the same
church youth group together and began dating in high school. Derek mentioned Amy’s
appearance and her willingness to laugh at his jokes. Amy discussed Derek’s physical
appearance and his intelligence. Shortly after high school graduation, the couple
unintentionally got pregnant, so they decided to get married a couple of years earlier than
originally anticipated. Pertaining to the memorable high point, the couple both agreed
that moving into their current house two years after they were married increased their
satisfaction. Amy identified her greatest strengths as remaining positive and taking care
of the three daughters while Derek works. Derek discussed his desire to be a spiritual
leader and provider for the family. Pertaining to the 2020 question, the Derek listed
“staying faithful to God and continuing to provide for the family,” and Amy emphasized
the “need to raise the children right.” The session concluded by introducing the first
homework assignment.
The second session began with discussing the homework assignment. On the
appreciative side, Derek expressed gratitude for Amy raising the girls; cooking; and
helping others. Amy was thankful for Derek finishing school; providing for the family;
and helping with their three daughters. Derek and Amy explained that the forgiveness
aspect of the assignment was difficult because they did not have any “looming” items
from the past, so they decided to list items that recur on a regular basis. Derek only
mentioned the house’s uncleanness, and Amy expressed her desire to forgive Derek when
he loses his temper and for leaving his belongings throughout the house. Pertaining to the
miracle question, Amy immediately mentioned that their youngest daughter “would be
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sleeping in her own crib and not in our bed.” Derek discussed how this has occurred with
all three of their daughters and has negatively impacted their time for sexual intimacy. In
searching for exceptions, the couple mentioned that the crib was setup when the baby was
born; however, after months of sleeping in their bed, Derek packed the crib to create
more space. The couple agreed to make room for the crib and attempt allowing the baby
to sleep in it again. On the scaling question, Derek and Amy both mentioned, “Eight.” So,
when I asked them what each could do to progress one point on the scale, Derek
promised to set the crib up again. Amy agreed to clean out the area where the crib
belongs. The session ended with an introduction of the second homework assignment, in
which I explained to the couple the difference between individual, couple, and family
goals and asked them to focus on marital goals.
In the third session, Derek and Amy derived the following goals: “travel to San
Antonio for a second honeymoon; have a fourth child; continue to teach their children
about Christianity; obtain more education; and buy a bigger house.” Pertaining to
individual roles and bringing out the very best in each other, the couple emphasized the
goal of purchasing a bigger house, which would require earning and saving more money.
The recent hurricane distracted the couple from their typical spending patterns, so the
discussion focused on a renewed effort by each spouse to follow the family budget.
Derek and Amy both expressed the incredible support that each of their families and
church family play in creating joy in the marital relationship. The session concluded with
an introduction of the third homework assignment.
Session four began with a review of the homework assignment, in which the
couple listed the following enjoyable items: “watching sports; going to Saints and LSU
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games; playing cards; going out to eat once a month; attending events with their children;
bowling; traveling; shopping; and planning church events together.” When I asked the
couple to identify the most important items to keep them headed in the right direction,
Derek mentioned the importance of “having the common goal of being Christians.” Amy
also mentioned the role of faith and the need to remain committed to each other.
Pertaining to potential barriers, the couple did not identify any specific items; however,
Derek mentioned, “The lack of communication could be a problem.” Amy also reminded
Derek the importance of “following through with things we say we are going to do.” The
session concluded with the feedback questions and completion of the inventories.
Level of Satisfaction. Derek and Amy described their level of marriage
satisfaction prior to therapy as “good.” Following the fourth session, they both agree that
the marriage improved even more. Derek facetiously remarked, “I think we improved
from a 10 to 11. I think it reinforced most of the things we were already doing well.”
Amy continued by mentioning that the four sessions helped them “better appreciate each
other.”
Pertaining to the quantitative pre-inventory scores, Derek and Amy’s demonstrate
high levels of marriage satisfaction. Derek’s scores were IMS = 3.33, Locke-Wallace =
149, and ENRICH = 41, and Amy’s scores were IMS = 10.00, Locke-Wallace = 111, and
ENRICH = 37. The couple’s post-therapy scores suggest a slight improvement in marital
satisfaction. Derek’s scores were IMS = 0.67, Locke-Wallace = 151, and ENRICH = 49,
and Amy’s scores were IMS=6.67, Locke-Wallace, 151, and ENRICH=40.
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Couple Nine
Demographics. Lee and Susan are a Caucasian couple in their late-twenties and
have been married for three years. The couple has a two-year-old daughter. Lee is a
service technician, in which he earns approximately $35,000 annually. Susan is a stay at
home mother. The couple are members of the Church of Christ. Lee describes his faith as
very important, and Susan describes hers as important.
Therapeutic Experience. At the beginning of session one, Lee and Susan joyfully
reminisced on their dating relationship. The couple met on a paintball field in North
Louisiana while they were both “stinky and sweaty,” which enabled Susan to say, “Our
relationship definitely didn’t start based on physical appearance!” In addition to paintball,
the couple engaged in other outside activities such as shooting guns and flying airplanes.
Lee and Susan described the high point of the relationship during the first year prior to
conceiving their first child. The couple unintentionally got pregnant, which created “a
complete change of life” from which they were accustomed. Lee and Susan love their
two-year-old daughter Michelle; however, they are still adjusting to parenthood. Lee
described his strengths as loving and providing for his family, and Susan described her
strengths as patience and financial discipline. Pertaining to the 2020 question, the coupled
listed maintaining their faith, “creating break times away from Michelle,” and becoming
financially stable, which would entail Lee finding a better paying job. The session
concluded with an introduction of the first homework assignment.
In between sessions one and two, Lee and Susan went on a weekend trip together
as a couple, which was a constructed solution from session one. At the beginning of
session two, the couple explained the relaxing, romantic weekend, in which they went out
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to eat and saw a couple of movies while Michelle was staying with Lee’s parents. A
discussion of the homework assignment followed. On the appreciative side, Susan told
Lee that she was thankful when “you agree when I say we don’t have the money for
upgrades or hobbies such as guns, airplanes, and miscellaneous items.” She is also
thankful for Lee’s support of her and Michelle and for having a career in which she can
stay home. Lee was appreciative of Susan’s desire to stay at home, her patience, and her
discipline with Michelle. On the forgiveness side, Susan discussed her frustrations when
Lee reads a book at the dinner table; when he teases her; and when he gets angry at
Michelle for crying. Lee discussed frustrations about the unclean house, about lack of
discipline with Michelle, and about Susan remaining “quiet instead of telling me when
something is wrong.” Pertaining to the miracle question, Susan said, “The bank account
would be bigger.” Lee mentioned a cleaner house, in which Susan replied, “I would also
have help keeping the house clean.” In searching for exceptions, Susan mentioned that
Lee used to help with dishes and laundry during their first year of marriage. Discussion
followed about roles and expectations for each spouse and how the couple’s families of
origin distributed responsibilities. For the scaling question, Susan described the
relationship as a “Seven” and Lee as an “Eight”. In response to what each couple could
do differently to create small change, Lee agreed to fold one load of laundry during the
next week, and Susan agreed to vacuum the house during the next week. The session
concluded with an introduction of the second homework assignment.
At the beginning of session three, the couple joyfully discussed Lee’s recent
interview with a company in Tennessee offering to pay him $10,000 more than his
current salary. The couple has decided to accept the offer and will be moving to
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Tennessee within the next three weeks. In discussing the homework, the couple listed the
following five items that they would like to occur in the future: “buy a house; have
another child; work better as a team; get out of debt; and grow spiritually.” Pertaining to
individual roles to accomplish these goals and ideas to bring out the very best in each
other, the couple emphasized the financial and teamwork goals. Lee pointed out the need
to update the budget, especially since he will be earning more money. Susan directly
asked Lee to “help me clean and pack our stuff” in preparation for the upcoming move.
The couple agreed to follow-up on these two items during the following week. In
reference to the role others will play in creating a joyful relationship, the couple
discussed that there will be no family members living close to them in Tennessee;
however, they do have several friends near their new home, in which they plan to
reacquaint with once they move. Also, Susan explained that they will rely on their friends
and family members during the next few weeks to help them with moving to Tennessee.
The session concluded with an introduction of the third homework assignment.
The fourth session began with a review of the homework assignment, in which the
couple listed the following enjoyable items: “reading books together; playing video
games; playing paintball, shooting at the range; playing racquetball; camping; shopping;
and watching movies.” As the couple reflected upon the most important items to keep
their marriage headed in the right direction, Lee said, “We need to find a good
congregation in Tennessee, and we need to maintain a common focus with common
goals.” Susan elaborated, “I agree. This includes us staying within our budget and helping
each other around the house and with Michelle.” The stress with the upcoming move was
the only barrier identified by the couple; however, they do have a plan in place, which
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includes the assistance of family and friends. The session concluded with the feedback
questions and the completion of the marital inventories.
Level of Satisfaction. In the qualitative reflection upon the therapeutic process,
Lee and Susan maintained that therapy was beneficial; however, because of their pending
move, the overall level of satisfaction has not improved. Susan explained, “Once you
factor in the stress of the move, I feel pretty much about the same. But once you take that
out, it would be a little higher.” Lee continued, “That’s pretty accurate. We may be an
odd case because we’re going through additional stress. I do feel more satisfied because
we communicate more on some things.”
Pertaining to the quantitative pre-inventory scores, Lee and Susan’s results
revealed a moderate level of marriage satisfaction with Lee’s scores slightly better. Lee’s
scores were IMS = 12.00, Locke-Wallace = 120, and ENRICH = 45, and Susan’s scores
were IMS = 17.33, Locke-Wallace = 116, and ENRICH = 36. Pertaining to post-therapy,
Lee’s scores were IMS = 12.67, Locke-Wallace = 112, and ENRICH = 41, and Susan’s
scores were IMS = 16.67, Locke-Wallace = 97, and ENRICH = 39. As evident from the
couple’s results and corresponding with their remarks, some of the inventory scores
suggested lower levels of satisfaction. The Locke-Wallace post-scores decreased for Lee
and Susan. Lee’s post-IMS and post-ENRICH scores suggested less satisfaction.
However, Susan’s post-IMS and post-ENRICH scores suggested greater satisfaction.
Couple Ten
Demographics. Frank and Beth are a Caucasian couple who have been married
for two years. Frank is 36-years-old, and Beth is 27-years-old. The couple does not have
any children. Frank is a licensed plumber, and Beth is an office assistant. The couple has
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a combined annual income of approximately $65,000. They are active members of the
Church of Christ and consider their faith as very important.
Therapeutic Experience. At the beginning of the first session, Frank and Beth
discussed how they met on an online, Christian website for singles. Following extensive
emails and telephone calls, the couple began dating in person and eventually got married
once they determined their level of love and comfort with each other. Frank said:
There’s always a certain amount of fear about sensitive issues that you’re afraid
you’ve may have done wrong. I knew she was always going to listen and be
understanding. You’ll always have initial reaction but in the end, she’s always
going to be there for me. I felt that. And then the comfort that I saw with her
around my parents and family that was a big help. You always feel comfortable.
Pertaining to the high points in the marriage, Frank recalled the time and energy Beth
placed in celebrating his birthday for the first time as a married couple, which included a
birthday cake that consumed several hours of time. Beth simply identified instances when
Frank “goes out of his way to do little things I like and just to know that he thought of
me.” In reference to individual strengths, Frank mentioned his love, compassion, and care
for his wife, and Beth mentioned her willingness to take care of her husband and “to
make sure that he’s happy.” Pertaining to the 2020 question, the couple discussed
growing spiritually in their faith; having children; and owning a house. The session
concluded with an introduction of the first homework assignment.
The second session began with a review of the homework. On the appreciative
side, Beth was thankful for Frank’s ability to provide, to listen, and to comfort her during
good and bad times. Frank was also thankful for Beth’s ability to listen and to comfort
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him and also for her willingness to assist with his aging parents. On the forgiveness side,
the couple wrote the following items together:
We have to forgive each other when we’re not patient with each other. A lot of
the impatience has to do with when we’re tired and cranky at the end of the day.
We kind of just want our space from our jobs. We argue and snip at one another.
The second thing is to forgive ourselves when we allow each other to slip up on
our goals. A lot of it has to do with our health and changing our eating habits.
Sometimes we don’t help each other to get off of food when we’re using it as an
emotional crutch and when we’re feeling lazy.
Pertaining to the miracle question, the couple discussed having two children in their own
house in a neutral location from both sets of their parents, and they also emphasized
increased levels of physical health. In searching for exceptions, the couple focused on the
health issue, in which they have been motivated in the past to lose weight in preparation
for an event or seeing a relative. In the past, the couple have also been active members of
a fitness center, so conversation followed in which the couple made verbal commitments
to each other to start exercising at least three days a week. Pertaining to the scaling
question, the couple each mentioned, “Seven.” To create small change, Frank agreed to
look for a better paying job once during the next week, and Beth agreed to cook two
healthy meals during the next week. The session concluded with an introduction of the
second homework assignment.
At the beginning of session three, the couple discussed the homework assignment,
which included the following futuristic goals: have children; have a home in Mississippi
or Georgia; grow spiritually; lower debt; and have a “non-gluttonous” diet. Pertaining to
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individual roles and bringing out the very best in each other, Frank and Beth emphasized
the healthy lifestyles. They agreed to start attending the weekly weight-loss meetings on
Friday nights together as a couple. The conversation then shifted to the moving and
financial goals, in which Beth explained she had been saving additional money for the
last several weeks to assist in the potential move. Frank discussed the current economic
situation as a discouraging aspect of finding a better job, but he promised to Beth to
continue looking for a new job. Pertaining to the role that others play in the marriage,
Beth explained:
Others do play a role, although we don’t recognize it or admit it. My parents for
one, they kind are pulling for us to move closer to them. His parents don’t try to
hold us back, but they don’t push us either to move away from them. Most of our
friends and family know that we have a goal to move somewhere else, and I kind
of get aggravated having to answer the questions all the time because it doesn’t
seem like we’ve made much progress.
Frank continued Beth’s thoughts by expounding upon the role of his parents in reference
to the move, which at times is very supportive and other times a hindrance. Conversation
followed pertaining to the impact of in-laws on their marital relationship. The session
concluded with an introduction of the third homework assignment.
At the beginning of the fourth session, the couple discussed the homework
assignment, which they included the following enjoyable items: “traveling; going to the
movies; going out to eat; shopping; walking; relaxing; watching television; having
friends over; and having sex.” In reflection of the most important items to keep the
marriage headed in the right direction, Frank and Beth mentioned growing spiritually;
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communicating better; and eating healthier. Pertaining to potential barriers in the
relationship, Frank discussed again the “troubling economy” in connection with obtaining
a higher paying job. To help overcome this barrier, Beth assured Frank that she would
“continue being patient as long as I know you are still trying to find a better job.” The
session concluded with the feedback questions and the completion of the marital
inventories.
Level of Satisfaction. For Frank and Beth, the level of satisfaction couple
generated substantial conversation, especially compared to the other couples. In response
to the question, Beth comments:
I think the level could’ve increased a little bit, but it’s probably about the same. I
think the thing that’s helped is talking about everything, getting things on the
table. We talk about it all the time, but it kind of helps when you’re in front of
someone else. It’s an accountability thing. You know, I told Eric I was going to
do this. We got to do something. Ultimately, when asking the questions, Frank
has coming up with his own reply. That makes me feel better knowing that he’s
trying to do better. Before, a lot of times, I thought that he was trying to avoid or
procrastinate. By talking about it, there’s been a lot of thought about it. It made
me feel good that I would be thinking about something, and he would answer the
same way. It’s good that he thinks that way too. It’s good that we agree on some
things.
Frank’s response to Beth’s comments revealed shock, but it also showed a better grasp of
her current level of satisfaction in the marriage. He says:
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With Beth’s answer, I’m a little surprised. I thought we were doing much better. I
think the satisfaction to me has increased with this communication because it lays
aside some of the fears. In the first five years, there’s a lot of fears and a lot of
growth in becoming one as a married couple. Those kinds of things about one
another, you go through the process. You think about how those things relate to
the bigger things in life, you realize there’s a lot of fear. A lot of fear resided in
me if we were on the same page. I do feel like we are, and there is a greater
amount of marriage satisfaction because we are on the same page. I was hoping
she would say that too.
Beth agreed that the relationship is strengthened but emphasized her desire to continue
working towards their established goals after the final session of therapy.
Pertaining to the quantitative pre-inventory scores, the couple’s scores
demonstrated moderate to high levels of marriage satisfaction. Frank’s scores were IMS
= 8.67, Locke-Wallace = 123, and ENRICH = 37, and Beth’s scores were IMS = 12.67,
Locke-Wallace = 133, and ENRICH = 42. Pertaining to post-therapy, Frank’s scores
were IMS = 8.00, Locke-Wallace = 133, and ENRICH = 45, and Beth’s scores were IMS
= 8.67, Locke-Wallace = 126, and ENRICH = 42. As evident and consistent with his
remarks, Frank’s post-scores suggested higher levels of satisfaction. Also, consistent with
her remarks, Beth’s scores suggested the same or slightly less levels of satisfaction.
Couple Eleven
Demographics. Henry and Nancy are a Caucasian couple in their late-thirties who
have been married for fifteen years. The couple has three pre-adolescent children. Henry
is a refinery mechanic, and Nancy is a part-time public relations coordinator. The couple
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has a combined annual income of approximately $70,000. They are both active members
of the Church of Christ. Henry describes his faith as very important, and Nancy describes
hers as important.
Therapeutic Experience. At the beginning of the first session, Henry and Nancy
reminisced on their dating relationship. Henry was initially attracted to Nancy’s
forwardness, friendliness, and physical beauty, and Nancy was initially attracted to
Henry’s physique, stability, and maturity. The couple described their first two years of
marriage prior to having children as the high point in the relationship because they were
very supportive of each other and would “always have get togethers with friends.”
Pertaining to individual strengths, Henry mentioned his willingness to provide for his
family, his care, and “being level-headed.” Nancy mentioned her love of laughter, life,
and her children; however, at this point, she did not mention love for her husband. In
reference to the 2020 question, the couple listed improving communication; enjoying
each other’s company; and working together as a couple. The session concluded with an
introduction of the first homework assignment.
The second session began with a review of the homework assignment. On the
appreciative side, Henry was thankful for Nancy being morally grounded; loving to the
children; and outgoing at church. Nancy was thankful for Henry’s providing for the
family and for interacting with the children, especially when he helps the children get
ready for church on Sunday mornings. Pertaining to the miracle question, Nancy said, “I
would know something was up if he leaned over and looked at me and said good morning
instead of hit the alarm and just get out of bed.” Henry discussed the presence of more
affection and also improved communication by saying, “I wouldn’t have to guess what
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we need to do or get prepared for. I kind of feel like we’re walking on egg shells all the
time, and there’s always a bunch of surprises that I didn’t know anything about.” In
searching for exceptions, the couple discussed communication being better in the past
when there was a family calendar. So, they decided to start that process again. In
reference to the affection issue, the couple agreed to simply greet each other in the
mornings. Pertaining to the scaling question, Nancy said, “Four,” and Henry said, “Five.”
To create small change, the couple promised to implement the previously constructed
solutions in regards to communication and affection. The session concluded with an
introduction of the second homework assignment.
At the beginning of the third session, the couple discussed the homework
assignment, in which they listed the following futuristic goals: “working together; loving
and mutually respecting each other; achieving financial goals; dating regularly; and
sharing feelings without fear of consequences.” Pertaining to individual roles and
bringing the best out of each other, Henry agreed to begin acknowledging Nancy’s
presence as opposed to simply walking past her and “doing the little things for her that I
wouldn’t do for the kids.” Nancy discussed the need to develop a more submissive
attitude, instead of “doing whatever I want to do all the time.” Conversation followed to
construct specific solutions to accomplish these ideals. Pertaining to the role of others,
Henry’s sister is the only surviving family member; however, Nancy’s family is much
larger and is very supportive. The couple also mentioned the encouraging role of their
church family. The session concluded with an introduction of the third homework
assignment.
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The fourth session began with a review of the homework assignment, in which
Henry and Nancy listed the following enjoyable items: “doing home improvement
projects; going to football games; shooting at the range; going to the movies; cooking;
and entertaining at the house.” In reflection of the most important items to keep the
marriage headed in the right direction, the couple emphasized patience with each other
and the continuation of couple and family meetings on a weekly basis. There were no
specific barriers identified; however, the couple discussed ways to avoid “lapsing into the
old way of doing things.” The session concluded with the feedback questions and the
completion of the marital inventories.
Level of Satisfaction. In their qualitative reflection of the therapeutic process,
Henry and Nancy recognized they still have much to improve in their marriage but also
agreed that their level of marital satisfaction is greater following therapy compared to
before therapy. Henry said, “For sure, we have been working together and being more
affectionate and being in love and showing that love. For certain, it takes effort. I admit
you got to work together. I think we have.” Nancy continued, “I just feel more important.
I feel like you have really made an effort to make me a part of your day, everyday. I
guess our focus has improved on working together instead of your way, my way.”
Pertaining to the quantitative pre-inventory scores, Henry and Nancy’s results
revealed low levels of marriage satisfaction, especially with Nancy. Henry’s scores were
IMS = 56, Locke-Wallace = 74, and ENRICH = 18, and Nancy’s scores were IMS =
74.00, Locke-Wallace = 29, and ENRICH = 18. Pertaining to post-therapy, Henry’s
scores were IMS = 45.33, Locke-Wallace = 82, and ENRICH = 32, and Susan’s scores
were IMS = 62.00, Locke-Wallace = 34, and ENRICH = 24. Overall, the post-scores
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suggested low levels of marital satisfaction; however, the post-scores consistently suggest
higher levels of satisfaction in comparison to pre-therapy. These results correspond with
the couple’s qualitative remarks.
Couple Twelve
Demographics. Randall and Denise are a Caucasian couple in their mid-twenties
who have been married for nearly one year. The couple is expecting their first child in
about four months. Randall is a structural engineer, and Denise is an elementary school
teacher. The couple has a combined income of approximately $55,000. They are active
members of the Church of Christ and both describe their faith as very important.
Therapeutic Experience. The first session began with Randall and Denise
reminiscing on their dating relationship and decision to marry. The couple met at church.
Randall was the first Christian that Denise had ever dated, which was a major source of
attraction for her. Randall was also attracted to Denise’s level of faith and conservative
Christian beliefs. Pertaining to the high point, the couple identified the present,
“especially after getting through the very low point of the first trimester.” Pertaining to
individual strengths, Denise described her patience and commitment to her husband.
Randall discussed his optimism and his “strong will.” In reference to the 2020 question,
the couple mentioned being united as parents; growing in their faith; and having higher
levels of intimacy, including sexually and emotionally. The session concluded with an
introduction of the first homework assignment.
In between sessions one and two, the couple moved out of an apartment and into
their first house. The second session began with the homework assignment. On the
appreciative side, Denise was especially thankful for Randall’s support and care during
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her father’s current illness. Denise was also thankful for Randall’s current job, in which
will enable her to stay home after the baby is born. Randall was thankful for Denise being
“easy going, considerate, and unselfish.” On the forgiveness side, Denise elaborated on
Randall’s impatience and temper, and Randall discussed Denise’s forgetfulness and lack
of cooking. Pertaining to the miracle question, Denise said, “We wouldn’t be arguing all
the time, and we would be settled into our new house and on the same page of how to
raise this child.” Randall continued the frustrations by discussing how unorganized and
hectic their lives were because of their transitions. In an attempt to search for exceptions,
the couple discussed their extreme frustrations of “accidently becoming pregnant” and
the difficulties with buying a new house. For the scaling question, the couple both
mentioned “Eight.” To create small change, Randall promised to read ten Bible verses a
day with his wife. Denise promised to have the kitchen completely unpacked, so she
could start cooking again. The session concluded with an introduction of the second
homework assignment.
At the beginning of the third session, Denise was elated because the kitchen was
completely finished; however, Randall was embarrassed that he did not follow through
with the Bible readings. For the second homework assignment, the couple listed the
following futuristic goals: “becoming more organized; planning better financially; getting
along as a couple and as friends; growing spiritually; and raising faithful children.”
Pertaining to individual roles and bringing out the best in each other, Randall verbally
committed to Denise that he would continue providing for the family and would also
“start doing a better job with unpacking and taking care of stuff around the house.”
Denise reaffirmed her roles pertaining to cooking, laundry, and paying the bills. In
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reference to the role of others, the couple discussed that all of their family members live
in Virginia. Denise said, “By moving down here, we definitely had to rely on each other.”
Randall discussed the need to make better friendships and become more involved with
their congregation. The session concluded with an introduction of the third homework
assignment.
The fourth session began with the homework assignment, in which the couple
listed the following items to enjoy together: “going to festivals; cooking; eating out at
restaurants; gardening; watching movies; traveling; visiting family; conducting Bible
studies; and fishing.” In reflection of the most important items to keep the marriage
headed in the right direction, the couple discussed the foundational aspect of faith and the
“need to remain on the same team.” Randall and Denise identified busyness and fatigue
as potential barriers to the relationship, in which they plan to “do the little things each
day” to building a stronger relationship. The session concluded with the feedback
questions and the completion of the marital inventories.
Level of Satisfaction. As Randall and Denise reflected on their levels of
satisfaction prior to therapy and after therapy, they responded rather differently. Denise
said, “It definitely wasn’t a waste of time. It’s stuff that’s got us back onto our feet.
Things are starting to level off. Things are starting to get organized.” However, Randall
described the relationship as “the same, maybe worse.” With the couple’s recent move to
a new house and with the third trimester of pregnancy on his mind, Randall explained:
Based on the circumstances, it can’t be helped. These kinds of circumstances
weaken marriage. It’s the nature of the beast. Environmental circumstances affect
marriage. One or the other person can have nothing to do with it. For example, if I
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lost my job, that might weaken our marriage. It’s nothing that I did or you did,
that’s the way it happens. The current circumstances have affected our
satisfaction. It’s nothing she’s doing wrong; it’s nothing I’m doing wrong. It’s just
weakening my satisfaction of what I want marriage to be. We haven’t had time
for each other. There’s lots of things we haven’t had time for that I’m not satisfied
with. Since the time we’ve started with you, we’ve gotten nothing but busier. My
satisfaction has gone down. That’s nothing we can help. We have to suck it up.
It’s because of the here and now. I mean she’s always tired and that just naturally
weakens the marriage. It really does. It’s not anything that anybody does. Your
method has really helped us. But, it’s based on the environment.
Following these comments, Randall continued to emphasize that therapy was not a waste
of time and that he could “see the light at the end of the tunnel.”
Pertaining to the pre-scores from the inventories, the couple demonstrated high
levels of marriage satisfaction. Randall’s scores were IMS = 9.33, Locke-Wallace = 116,
and ENRICH = 46, and Denise’s scores were IMS = 5.33, Locke-Wallace = 117, and
ENRICH = 38. Pertaining to post-therapy, Randall’s scores were IMS = 14.67, LockeWallace = 110, and ENRICH = 42, and Denise’s scores were IMS = 8.00, Locke-Wallace
= 127, and ENRICH = 42. As evident and consistent with his remarks, Randall’s post
scores from all three inventories suggested slightly lower levels of satisfaction. Also,
consistent with her remarks, Denise’s scores suggested slightly higher levels of
satisfaction.
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Summary of Recurring Themes
As evident from the sessions, the Appreciative Christian Therapy model
generated discussions on prevalent marital issues, including the denial of problems,
relationship roles, finances, communication, sex, parenting, in-laws, careers, moving,
physical health, and leisure activities. The occurrence of these themes reflects upon the
trustworthiness and rigor of the Appreciative Christian Therapy paradigm in relation to
marital therapy. In addition to the previously mentioned items, the role of faith and social
constructionism are two of the most recurring themes, which will now be discussed in
greater detail.
Role of Faith. First, faith was the most recurring theme in all of the sessions with
the twelve couples. Pertaining to the 2020 question, all of the couples included faith as an
essential component of happy and stable marital relationships. Pertaining to the five
positive items that couples remain hopeful will occur in the future, an aspect of faith was
included in every list. As couples designed ways to have joyful relationships in the
present, faith was included in all of these discussions. Finally, when couples reflected
upon the most important items to keep their marriages headed in the right direction, an
aspect of faith was included in every response.
Social Constructionism. In addition to faith, social constructionism was the
second most prominent theme throughout the research project. As previously discussed,
the Appreciative Christian Therapy paradigm incorporates social constructionism and the
Christian worldview. The idea is not to compromise on fundamental, absolute truths
pertaining to morality, rather the goal is to facilitate couples to construct unique solutions
to their unique situations. In other words, “there’s more than one right way” to create
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higher levels of marital satisfaction. During Steve and JoAnn’s second session,
conversation focused on determining a better way to handle finances. The following
statement depicts my application of social constructionism to Steve and JoAnn’s issue
pertaining to finances:
You know there’s no right or wrong way of doing it. It’s just a matter of whatever
works. Some folks use one joint account and do everything out of that. Some have
two separate accounts and no joint account at all. But others have a joint account
but do have the little individual accounts. It could work either way. The biggest
thing is that both of you are in agreement on it.
The notion of social constructionism also became evident during Lee and Susan’s second
session when they were discussing relationship roles. The following statement reveals my
application of social constructionism to this marital issue:
There’s no right or wrong way to do this, but the key for any couple is to figure
out who is going to do what. Traditionally, guys cut the grass and take out the
trash, and the wife cooks and does the laundry. It doesn’t matter who does what,
but the bottom line is that you are both in agreement and the expectation is the
same. With this in mind, how are you going to get to that point?
These explanations provided insights to the couples pertaining to their unique marital
situations, which facilitated the construction of solutions.
Repeated-Measures t Test
As previously discussed, a repeated-measures t test was utilized as a
methodological triangulation technique to assess the trustworthiness and rigor of the
Appreciative Christian Therapy paradigm. Each couple completed the Index of Marital
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Satisfaction, the Locke-Wallace Marital Adjustment Scale, and the ENRICH Marital
Satisfaction Scale at the beginning and at the conclusion of therapy. The post-scores of
the marital instruments were compared to the pre-scores to determine if the couples
experienced statistically significant improvement in their marriages after receiving
Appreciative Christian Therapy.
The pre-scores and the post-scores from the twelve couples are found in Table 1.
In analyzing the Index of Marital Satisfaction scores, there is no statistical evidence that
Appreciative Christian Therapy will increase levels of marital satisfaction, t(23) = 1.57, p
> .05, two tailed (see Table 2). However, an analysis of the Locke-Wallace Marital
Adjustment Scale reveals statistical evidence that Appreciative Christian Therapy will
increase levels of marital satisfaction, t(23) = -3.36, p < .05, two tailed (see Table 3). In
addition, an analysis of the ENRICH Marital Satisfaction Scale reveals statistical
evidence that Appreciative Christian Therapy will also increase levels of marital
satisfaction, t(23) = -5.35, p < .05, two tailed (see Table 4). In conclusion, two of the
three marital inventories suggest improved levels of marital satisfaction after receiving
Appreciative Christian Therapy.
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Table 1: Pre-Scores & Post-Scores (IMS, Locke-Wallace, and ENRICH)
preIMS
Couple 1
Couple 2
Couple 3
Couple 4
Couple 5
Couple 6
Couple 7
Couple 8
Couple 9
Couple 10
Couple 11
Couple 12
preLocWall
preENRICH
postIMS
postLocWall
postENRICH
Mike
4.60
127
45
4.00
131
48
Sally
6.67
134
41
4.67
137
45
Keith
45.14
87
30
33.33
99
38
Jacque
17.33
103
31
12.67
111
40
Steve
12.67
122
34
9.33
129
41
JoAnn
12.00
119
34
20.00
136
35
Barry
12.67
120
43
10.00
126
46
Veronica
12.67
124
39
11.33
129
42
Brian
42.67
91
26
33.33
108
32
Lacie
28.67
68
30
23.33
83
36
Clint
6.67
108
37
4.00
119
38
Jessica
52.63
67
24
33.33
87
31
Chris
24.67
89
28
37.33
107
31
Stacey
23.33
91
22
34.67
102
31
Derek
3.33
149
41
.67
151
49
Amy
10.00
111
37
6.67
151
40
Lee
12.00
120
45
12.67
112
41
Susan
17.33
116
36
16.67
97
39
Frank
8.67
123
37
8.00
133
45
Beth
12.67
133
42
8.67
126
42
Henry
56.00
74
18
45.33
82
32
Nancy
74.00
29
18
62.00
34
24
Randall
9.33
116
46
14.67
110
42
Denise
5.33
117
38
8.00
127
42
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Table 2: Repeated-Measures t Test (IMS)
Paired Differences
95% Confidence Interval
of the Difference
Pair 1
preIMS - postIMS
Mean
2.34917
Std. Deviation
7.31413
Std. Error
Mean
1.49299
Lower
-.73932
Upper
5.43765
t
1.573
df
23
Sig. (2-tailed)
.129
Table 3: Repeated-Measures t Test (Locke-Wallace)
Paired Differences
95% Confidence Interval
of the Difference
Pair 1
preLocWall - postLocWall
Mean
-7.875
Std. Deviation
11.471
Std. Error
Mean
2.342
Lower
-12.719
Upper
-3.031
t
-3.363
df
23
Table 4: Repeated-Measures t Test (ENRICH)
Paired Differences
95% Confidence Interval
of the Difference
Pair 1
preENRICH postENRICH
Mean
Std. Deviation
Std. Error
Mean
Lower
Upper
t
df
Sig. (2-tailed)
-4.500
4.118
.841
-6.239
-2.761
-5.354
23
.000
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Sig. (2-tailed)
.003
Feedback from Couples
As previously mentioned, the twelve couples were given an opportunity to
provide positive and negative feedback from their therapeutic experience. The feedback
generates valuable insights in the effectiveness of the Appreciative Christian Therapy
model. The positive feedback will be included first, and the negative feedback will be
second. The following excerpts capture the positive feedback:
Keith: This is the way I would’ve run this program.
Steve: For us, I wouldn’t have changed anything. You’ve been flexible about
working around the four sessions. I like the timing- the hour sessions.
JoAnn: I like how you ask the question and let both people answer. It’s not onesided. It gives equal opportunity for both to talk.
Barry: Thank you for taking the time and helping us out. This has been really
helpful for me and my wife.
Veronica: I wouldn’t change anything.
Lacie: I liked how everything was quick and to the point. I liked how it didn’t
drag out over a long period of time. Starting counseling is very hard for
people. You have to dig up things, especially if you’re depressed. Small
categories to let you branch out and come back to do what you need to do
to move forward. It gave me an opportunity to speak and to have a better
communication.
Jessica: I enjoyed the model because we were able to touch base about things that
we usually don’t talk about. And, I liked it because it was from a Bible
perspective, not a worldly perspective. I also liked the inventories because
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it’s kind of like going to the doctor and figuring out what the symptoms
are.
Stacey: I liked that it came from a positive perspective. It wasn’t like ‘Let’s talk
about all the negative things, rather let’s talk about the positive.’ That was
really good because you always talk about the negative and the problems
first and not the things we enjoy and the reasons we are together. That was
nice to talk about and write down. Most problems we already knew about
but the good things we don’t talk about as much. It’s really nice to hear
these things.
Derek: I think the positive attitude and design of this model is helpful. It’s easy to
be a pessimist and always talk about the bad things. But, if you can be an
optimist and look at the good things, it might make it easier to talk about
the bad stuff. I like that everything is positive. I’ve never been to any other
counseling. I can’t tell you a lot of dislikes, but I like the positive nature
and that it’s biblically based. God made us, and he knows how to fix us. I
like how you have everything backed up with Scripture. About homework
one, I liked part one and part two. But you do the thankfulness, so you
don’t leave a session feeling horrible. Here’s all the bad stuff about us,
maybe we can get to the good stuff later on. I think that was good.
Susan: I think the time frame is great.
Nancy: I liked the homework and how they related to what we did that day. It
kept everything fresh in our minds for a week, and I like how we
discussed it and thoroughly went over it afterwards. I like how it’s broken
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down keeping your focus on one thing at a time. The positive thing is what
we’ve lacked. As a couple and as a family, focusing on the positive on all
of it was helpful. Talking about what we can do different and what’s
coming up, and talking about it right then was very helpful for me. I think
it’s going to help us more. Not that we’ve totally eliminated problems, I
know we haven’t. They’ll be things that come up that we’ll have to deal
with. Right now, I can’t say remember such and such happened two
months ago, but thinking about these positive things have prepared me for
battle in a good way. It’s shown me that there is a solution. Instead of
focusing on the problem and you not seeing my way on it, but there’s
more a focus that there is a solution, that it’s not hopeless. So, whenever
we do argue about something, there’s some positive things in there that
will make things easier.
Henry: We just didn’t deal with the negative and harp on it.
Randall: I really, really liked it. It was very good. I think it was like marriage
enrichment. It was a proactive thing. Before there’s a problem, we get it
all together. In engineering, you can see something that’s going to happen
down the road, but you can get fixed right then. That’s always the way to
go. And that’s what I feel like this program has done. You had some really
good question in each session. It touches on everything that we hold as
very important component of our marriage. But, I like how it’s setup
where couples can talk about what they feel comfortable about. It doesn’t
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force you to be dishonest. You can choose what you lay out on the table.
This was very positive.
In addition to the positive feedback, the couples also provided feedback on areas
which could be improved. The feedback is arranged in the appropriate categories as
follows:
Wording of IMS Inventory
Sally: The only thing that I saw that was confusing and could create
problems for folks that is the wording on the first day on the first
sheet.
Mike: I know what they’re doing with the rhetoric. Asking the same
questions but in different ways. Have you ever given a deposition?
Attorneys do the same exact thing. It’s so they can get to the
correct answer, but it was very confusing.
Demographic Form
Clint: Why do you need to know how much money I make? That question
is too personal and is none of your business.
Inventories in Separate Rooms
Sally: I would like to think that the couples could do them separately. If
someone was having real serious issues, they may not feel
comfortable sitting there answering it.
Mike: I don’t think either one of them needs to see the other’s sheets or
be sitting on side of each other. A dominant, intimidating spouse
could affect how one answers the questions on the inventories. It
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would be good for them to meet in the separate rooms and not see
what the other one wrote.
Family of Origin & Roles Inventory
Lee:
The one thing I brought up was roles in marriage. I was raised with
my mom and dad’s ideas of whose does what in the family and she
was raised differently. It would be a good idea to get a list and
what you see as male roles and female roles. It may be an
interesting thing to ask in your inventory.
Individual Sessions
Sally: It’s a reality check for some people, especially if they don’t know
how to communicate or they don’t know each other’s needs or
wants. I know we have friends that have gone to marriage
counseling, and they meet separate with him and then her and then
they meet together. And someone’s going to be more apt to talk
about things that are bothering them one on one than if he’s sitting
right there next to her and he’s going to rebuttal or she’s going to
rebuttal everything.
More than Four Sessions
Sally: We also realize that this was a four session model, but some
people may have to get into more depth.
JoAnn: You should have a session to discuss the inventories.
Beth: What I was going to say is that maybe for a situation, I know this is
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a test model, but I think it would take more than a four week model
for most couples. Some of the sessions may need to be more
detailed than they were. It may not get fixed in four weeks.
90 Minute Sessions
Brian: I know you’re following a model, but I wish the sessions were a
little longer. Maybe, an hour and a half?
Didn’t See Any Other Couples
Keith: (laughing) I was wondering if I just got manipulated by my wife
into this marriage thing because I didn’t see any other couples.
Advice
Steve: Personally, advice giving has always been helpful, but I don’t think
it would go over well to give advice to a couple. It’s better to do
that one on one, rather than in a couple’s session. For example, the
movie Fireproof. I thought it was awesome with what his dad did
for him. His dad gave him advice as a father and as a friend. I’ve
always been one to seek advice, but some don’t. I’m not afraid to
ask. My advice for you is that you could pick up on stuff like that.
Chris: I don’t like how you tried to get us to come up with solutions to
our own problems. That’s up to you to figure out. You should think
of some things on your own when you’re not in session with these
people of a good method of you would do if you’re in that
situation. We would just keep seeing you forever until you told us
what to do.
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Stacey: Most people are probably like us, in that we’ve exhausted all that
we can think to do. We need you to tell us what to do. I feel like
we’re at a loss. I want someone to give me a fresh perspective.
Homework #1
Chris: On homework assignment number one, I think you should have a
part about forgiving yourself.
No Different than Other Counseling Models
Brian: I don’t think it was the counseling. I don’t think anything is
different. I enjoyed the sessions, I just don’t know if I got anything
out of them. We’ve done this before, and it’s the same. It has
nothing to do with Eric.
Use More Scripture
Chris: I have two points. First, if this is for Christians, it would be cool to
involve Scriptures.
Talk More About Problems
Chris: As far as getting people to realize what they need to work on, it felt
like everything was sugar coated and repeated. The third and
fourth session was pretty much the same thing. It’s like the Joel
Osteen approach- just make everything nice and pleasant. I think to
really get to the root of people’s problems there should be more
detective work. I think most of our big faults are from deeply
rooted stuff.
Derek: I’m sure where there are parts where you have to talk about the bad
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things. Thankfully, I don’t think we have too many bad things in
our relationship, but I think they need to be addressed at some
point.
Frank: I like the model. I like the positive approach to things. You need to
try to get specific to the roots. Maybe before they even got
married, there were problems with that person individually. This is
when you’re getting into a can of worms that get bigger and
bigger. I can see where that would be a problem, especially in
today’s society. I’m just saying a couple may be going along very
well. And then something comes up and it triggers emotions that
happened before they even got together as a couple.
More Written Materials
Henry: A thin paperback book would help or even more handouts. I see
what you’re talking about, but I would like to read more and give
examples of the wrong way and right way. We could go back and
say, ‘This is what Eric was talking about it.’ I probably didn’t take
good notes.
Conclusion
This chapter provided the results of the research, including the demographics,
therapeutic experience, and levels of marital satisfaction for each of the couples.
Recurring themes, including faith and social constructionism, were discussed, and the
repeated-measures t test demonstrated that two of the three marital inventories reveal
105
statistically significant improved levels of marital satisfaction in the couples. Finally, the
positive and negative feedback generated from the couples was included. The results
from this chapter will serve as an underlying guide in the adjustments to improve the
Appreciative Christian Therapy model, which will be discussed in Chapter Five.
106
Chapter Five: Discussion
Following the introduction, literature review, and methodology chapters, the
results of the study were presented in the previous chapter. In this final chapter, the
results will be discussed. An evaluation of the Appreciative Christian Therapy model will
be provided, including a consideration of the original research questions and the
necessary adjustments to the model. The limitations of the study and recommendations
for future research will also be discussed.
Model Assessment
Research Questions
At the beginning of the study, I generated three research questions. First, I asked
the question: “How can I construct a therapy model that could be effectively utilized
within church-based therapy settings?” I strongly believe that the Appreciative Christian
Therapy paradigm meets the needs of any congregation desiring to implement therapy
into their local ministry because of the emphasis on the Christian worldview and on
biblical Scriptures. By the conclusion of this study, one couple’s level of spiritual
commitment increased as evidenced by placing membership with the local congregation.
Also, one of the wives rededicated herself to the Lord and to her local congregation.
Furthermore, all of the participants actively engaged their faith in the process of positive
change. These items clearly show the “outreach” potential of incorporating Appreciative
Christian Therapy into a local congregation.
Secondly, I asked the question: “How can I construct a therapy model that allows
Christian therapists to effectively reach out to clients who do not bring faith/religion to
107
the therapeutic discussion without compromising their faith or the AAMFT Code of
Ethics?” Although the Appreciative Christian Therapy is adaptable to non-Christian
clients and non-Christian therapy settings, this particular study did not effectively address
this question because only one of the twenty-four participants was not a Christian. This
issue will be addressed in the limitations and future research sections.
Finally, I asked the question: “How can I construct a therapy model that
effectively integrates Christian and secular principles?” I maintain that the Appreciative
Christian Therapy paradigm effectively integrates Christian and secular principles. The
Christian worldview, including biblical Scriptures, was integrated with the secular
principles of Cooperrider’s (1986, 1987) appreciative inquiry, Seligman’s (1990) positive
psychology, and deShazer’s (1985, 1988) brief, solution-focused therapy. The integration
was carefully constructed to prevent the compromising of the Christian and the secular
principles. The biggest challenge in this regard was the integration of absolute truth and
social constructionism (Gergen, 1982, 1984); however, as shown in the results chapter,
there is value in viewing these concepts in an integrated manner.
Adjustments to the Model
Use of Inventories. I received negative feedback pertaining to the wording of the
Index of Marital Satisfaction inventory. Additionally, I had to repeatedly provide
clarification on the “conventionality” and “philosophy of life” items of the LockeWallace inventory. I did not receive any negative feedback from the ENRICH inventory,
which found statistically significant improvement in the couples. Thus, as I continue to
research this model by conducting couple’s therapy, I plan to utilize the ENRICH
inventory but not the Index of Marital Satisfaction or the Locke-Wallace inventories.
108
Since the Appreciative Christian Therapy model does not focus on assessment, the
utilization of one inventory will not hinder the model, rather simply provide a glimpse of
relational issues at the beginning of the therapeutic process. Additionally, based upon
other feedback that I received, the couples will be asked to complete the inventory in
separate rooms to minimize the potential for inauthentic responses.
Additional Sessions. Secondly, I also received suggestions pertaining to the
number of sessions in the model. The impetus of the four-session design is based upon
deShazer’s (1985, 1988) brief, solution-focused model, healthcare’s impact on marriage
and therapy, and cost sensitivity to the couples. Personally, I do not believe that the
couples who suggested adding more sessions to the model would have made the
recommendation if they were paying for the therapy. However, I realize that a foursession therapy model is not ideal for all couples, especially if long-term marital discord
exists. Thus, I have adjusted the Appreciative Christian Therapy model to include the
following phases: Phase 1: Discovery, Phase 2: Dream, Phase 3: Design, and Phase 4:
Delivery. Phase 1 will include one individual session with each spouse, if necessary. The
other three phases will include more than one session and/or 90-minute sessions, if
necessary. However, despite these changes, the model will retain its brief, solutionfocused emphasis and will contain a total of six to eight sessions.
Forgiveness on Homework Assignment #1. Third, since a majority of the
participants are “faithful Christians,” there was difficulty completing the forgiveness
portion of the first homework assignment. In the original model, the first homework
assignment states:
109
In order for positive change to occur in marriage, a couple must experience
satisfaction about the past. Pertaining to the good times, identify three things that
you are appreciative/thankful for about your spouse. Pertaining to the bad times,
identify three things that you need to forgive your spouse for.
The couples had difficulty identifying specific events in the past, which had not been
forgiven. I believe this difficulty would not have existed with non-Christian participants.
However, the couples in the study discussed recurring, undesirable behaviors in their
spouses, which required forgiveness on a regular basis. In addition, one of the
participants suggested the opportunity for self-forgiveness. With these ideas in mind, I
have revamped the first homework assignment as follows:
In order for positive change to occur in marriage, a couple must experience
satisfaction about the past. Pertaining to the good times, identify three things that
you are appreciative/thankful for about your spouse. Pertaining to the bad times,
identify three things that you need to forgive your spouse for. If specific events in
the past do not exist, identify recurring behaviors that require forgiveness on a
regular basis. Also, if necessary, identify anything you need to forgive yourself
for.
There will not be any adjustments to the other homework assignments because of the
effectiveness within in therapy and the lack of negative feedback from the couples.
Problem Talk & Advice. As anticipated, I received negative feedback from some
couples who were expecting more opportunities to talk about their problems and more
advice from me. The positive, solution-focused basis of the Appreciative Christian
Therapy model is in contrast to traditional models of therapy and traditional expectations
of clients. Throughout the therapy sessions, I was being pulled by some couples away
from solution talk towards problem talk. I quickly realized that some couples enjoyed
talking more about their problems, than talking about potential solutions.
I also came to realize that some couples want the therapist to do the work for them
(e.g., advice), rather than working towards the construction of solutions. An altering of
the Appreciative Christian Therapy paradigm to accommodate problem talk and advice
giving would contradict the underlying, philosophical ideals of the model. Thus, I am not
changing the model in this regard. However, when couples complain in the future about
the lack of problem talk, I will attempt to show them that the construction of solutions
does not ignore problems, rather it solves problems. Also, I will remind the couples that I
have an awareness of the ENRICH inventory results to guide me in the therapeutic
process. When couples ask for my advice, I will respond in a way similar to how I
responded to Steve and JoAnn during their fourth session:
If I tell you what to do and then three weeks later if it turns out not to work, you
will come back and tell me that I didn’t know what I was talking about. I see my
role as helping you to think through things. I may give ideas, but I do not advice.
The whole idea is to get you to make your own solutions. If you come to “own”
whatever you decide to do, it’s going to empower you, and you won’t have to rely
on anybody else.
Hopefully, couples will not be disappointed with an approach that discards problem talk
and advice-giving, rather they will embrace the opportunity for positive change in their
relationships.
111
Limitations of the Study
The current research only involved married couples, not individuals, families, or
engaged couples. Also, despite the original intent to include non-Christian couples, the
study only included one non-Christian spouse. Finally, the study was conducted entirely
in a church-based therapy setting.
Future Research
As previously mentioned, the Appreciative Christian Therapy model was utilized
with predominantly Christian couples in a church-based therapy setting. With this in
mind, research is needed with Christian individuals and families in church-based therapy
settings. Secondly, research is needed with non-Christian participants in church-based
therapy settings. Finally, research is needed for the utilization of the model in secular
settings. This would entail using the aspect of the model which does not include the direct
references to Christianity or biblical Scriptures.
Conclusion
Appreciative Christian Therapy: A Theological Paradigm to Facilitate Positive
Change in Couples incorporates the underlying notions of Christian marriage,
appreciative inquiry, and positive change. This study enabled the Appreciative Christian
Therapy model to advance from a perceived conception to a constructed reality. The
model encapsulates my continual journey as a Christian minister and Christian therapist
to facilitate in others deeper levels of faith and stronger marital relationships. My desire
112
is for Appreciative Christian Therapy to be utilized as a mechanism of positive change in
the fields of Christian therapy and also marriage and family therapy.
113
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Appendix A: Recruitment Letter
August 2008
Greetings:
I am writing to you in hopes that you can help me out. Don’t worry- I’m not asking for
any money!!!
As most of you know, I am in the process of writing a dissertation for my PhD in
marriage and family therapy. For my research, I have designed a new Christian therapy
model for couples called “Appreciative Christian Therapy.” To complete my dissertation,
I need to utilize my new model with 14 couples. This is where you come in.
I need your help in recruiting the 14 couples. Do you know any married couples that
would be willing to attend 4 one-hour therapy sessions (once a week for 4 weeks)? If so,
please let me know. They can either be Christian or non-Christian couples. Also, the
identity of the couples will remain strictly confidential.
There is absolutely no cost at all for the couples who participate. In fact, as an incentive
for couples to participate, I will be giving away items such as Commander’s Palace gift
cards, New Orleans Saints tickets, and one night hotel accommodations in New Orleans.
If you have any questions or know of someone willing to participate in the research,
please contact me by phone (504-606-1267) or by email (ericdishongh@yahoo.com).
Sincerely,
Eric Dishongh, MAMFC
Associate Minister, Hickory Knoll Church of Christ
Doctoral Candidate, MFT Intern & Counselor Intern
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Appendix B: Invitation Letter to Participants
Date: ________
Dear Sir or Madam:
Thank you for your interest in participating in my research.
I am in the process of writing a dissertation for my PhD in marriage and family therapy.
For my research, I have designed a new Christian therapy model for couples called
“Appreciative Christian Therapy.” To complete my dissertation, I need to utilize my new
model with 14 couples. This is where you come in.
You will be asked to attend 4 one-hour therapy sessions (once a week for 4 weeks) at the
Hickory Knoll Church of Christ, which is located at 2201 Hickory Ave. in Harahan. Your
identity will remain strictly confidential. In writing my dissertation, I will use fictitious
names and will change other identifying information to protect your anonymity.
There is absolutely no cost at all for you to participate. In fact, as an incentive for you
and your spouse to participate and complete the four therapy sessions, I will be giving
away items such as Commander’s Palace gift cards, New Orleans Saints tickets, and one
night hotel accommodations in New Orleans.
In order to setup your first appointment, please contact me by phone (504-606-1267) or
by email (ericdishongh@yahoo.com). Let me know if you have any questions.
Sincerely,
Eric Dishongh, MAMFC
Associate Minister, Hickory Knoll Church of Christ
Doctoral Candidate, MFT Intern & Counselor Intern
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Appendix C: Informed Consent Form
Purpose/Description of the Research
The purpose of this research study is to design a new Christian therapy model for
married couples called “Appreciative Christian Therapy.” The results of this study will
significantly contribute to the development of this new model, which ideally will create
higher levels of marital satisfaction for the couples who participate and other couples in
the future. An invitation was given to any married couple who desired to participate in
the study. You were selected to participate in this research based upon your expressed
interest in the study. You and your spouse are one out of approximately 14 couples
participating in the study.
At the beginning of the first session, each couple will complete an informed
consent form, a demographic information form, and three marital inventories. Next, each
couple will attend four one-hour therapy sessions (no more than once a week). At the
conclusion of the final session, each couple will complete an exit interview pertaining to
the strengths and weaknesses of their therapy experience. Also, each couple will
complete the three marital inventories again. The data analyses will reveal recurring
themes and patterns from the Appreciative Christian Therapy model. Pertaining to the
inventories, data analyses will be group averages for the purpose of determining if the
couples experience increased levels of marital satisfaction after receiving Appreciative
Christian Therapy.
Assurances & Conditions of Participation
You are free to decide not to participate, or later, to withdraw your consent and
discontinue participation in the study at any time without prejudice. If you decide not to
complete the study, you will not be eligible to receive any of the incentives (see below).
To ensure confidentiality is maintained, you will choose fictitious names to be
referred to during data collection, data analysis, and publication. All identifying
information in the transcripts will be altered. Tape recordings and transcripts from the
therapy sessions will be securely stored indefinitely in a locked filing cabinet. Access to
the data is limited to me, my dissertation committee (Dr. Bertram, Dr. Trent & Dr.
Crabtree) and my clinical supervisor (Ms. Annie Forsyth). Confidentiality will be broken
only in instances of child or elderly abuse or if the participant is believed to be a threat to
self or others. In these instances, the proper authorities will be notified. If you decided to
withdraw from the study, your data will also be withdrawn from the study and destroyed.
Risks & Benefits
You should be aware that therapy poses potential risks. In the course of working
together, additional problems may surface of which you were not initially aware. If at
anytime during the study you experience any discomfort or other concerns, please feel
free to contact me or one of my dissertation committee members or the Amridge
University Institutional Review Board.
Page 1 of 2 _______ Initials
126
In addition to the compensation benefits (see below), you will experience the
benefit of receiving marriage therapy at no cost. Typically, marriage therapy costs $50$100 per session. You will be receiving four hours of marriage therapy at no cost. In
addition to the financial benefits, you can also reasonably expect to learn more about
your spouse with the potential of improving your marital relationship.
Financial Considerations
As a benefit to you to participate in the study, you will become eligible to receive
a $50 restaurant gift card or two New Orleans Saints football tickets to one 2008 regular
season game. As previously mentioned, therapy services provided to you at no cost is an
additional benefit.
Contacts
Should you have any comments, concerns, or questions regarding this research,
you can contact Eric Dishongh (504-606-1267), Dr. Dale Bertram, Dissertation Chair
(334-387-7834), or Dr. John Mark Trent, Amridge University Institutional Review Board
(1200 Taylor Road, Montgomery, AL, 36117; ph. 800-351-4040, ext. 105).
Consent Signatures
YOU ARE MAKING A DECISION WHETHER OR NOT TO PARTICIPATE.
YOUR SIGNATURE INDICATES THAT YOU HAVE DECIDED TO PARTICIPATE
HAVING READ THE INFORMATION PROVIDED ABOVE.
By signing below, I agree that the previous items have been properly explained
and that I understand what is expected of me in order to participate. Additionally, I
confirm that a copy of this informed consent form has been given to me for my own
records.
_____________________________
Signature of Participant
_____________________________
Date & Time
_____________________________
Signature of Researcher/Investigator
_____________________________
Date & Time
_____________________________
Witness
_____________________________
Date & Time
Page 2 of 2
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Appendix D:
Eric Dishongh, M.A.M.F.C.,
MFT Intern & Counselor Intern (CI 3602),
Hickory Knoll Church of Christ
P.O. Box 23067, New Orleans, LA 70123
2201 Hickory Avenue, Harahan, LA 70183
Telephone #504.737.4335
DECLARATION OF PRACTICES AND PROCEDURES
Qualifications: I earned a Master of Arts degree in Marriage & Family Counseling from the New Orleans
Baptist Theological Seminary in May 2005 and am currently pursuing a PhD in Marriage and Family
Therapy from Amridge University. I am a MFT Intern and a Counselor Intern (CI 3602) registered with the
LPC Board of Examiners (8631 Summa Avenue, Baton Rouge, LA 70809, ph. 225.765.2515). My
supervisor is Annie G. Forsyth, LPC, LMFT (1799 Stumpf Blvd., Bldg. 2, Suite 10, Gretna, LA 70054; ph.
504.831.0876).
Counseling Relationship: The central purposes of marriage, family, or individual therapy are to allow the
clients to better understand themselves and their relationships with others. Enhanced functioning as couple,
family, or individual is stressed to promote healthy interactions and greater satisfaction. Furthermore, I am
committed to a uniquely integration of psychological, systemic, and Christian principles. Thus, I am willing
to address spiritual concerns in therapy if you express such a desire. While I may not openly discuss
Christian values or beliefs with clients who do not raise this as an issue of concern, my style of therapy will
always be in harmony with my Christian faith.
Areas of Expertise: In addition to my academic studies in marriage and family counseling, I have
individual and group experience in anger management with children, adolescents, and adults. I have
experience dealing with inpatient child and adolescent clients. Also, I have experience with individuals,
couples and families dealing with divorce, parenting/family issues, alcohol/drug abuse, academic/career
concerns, and death.
Office Procedures & Fee Scales: Initial appointments can be made in the Hickory Knoll Church of
Christ’s office or by telephone. I have appointments available Monday through Friday from 8am to 4pm.
Evenings and weekend appointments made upon request. After the initial counseling session, appointments
will be scheduled with the therapist. You will be given a reminder slip with the date and time of the next
appointment. If you need to cancel or reschedule your appointment, please provide a 24-hour notice.
There are currently no fees for therapy sessions; however, occasionally there are fees for inventories (i.e.
Prepare/Enrich) utilized in conjunction with therapy. Payment (cash or check) is made directly to the
Hickory Knoll Church of Christ and is due at the time of service. Payment is not accepted from insurance
companies.
Services Offered & Clients Served: My therapeutic orientation is systemic but also depends on the type
of problem being addressed. Although my approach is systemic and eclectic in nature, I will draw from the
following therapies: solution-focused, cognitive-behavioral, and structural therapies. I serve couples,
families, and/or individuals. I work with adults and children.
Code of Conduct: I am required by law to adhere to the Louisiana Code of Conduct for Licensed
Professional Counselors and the Louisiana Code of Ethics for Licensed Marriage and Family Therapists.
Copies of these codes are available upon request.
Privileged Communication: Material revealed in counseling will remain strictly confidential except for
material shared with my supervisor and under the following circumstances in accordance with state law: 1)
The client signs a written release of information indicating informed consent of such release; 2) The client
expresses intent to harm himself/herself or others; 3) There is a reasonable suspicion of abuse/neglect
128
Appendix D (continued)
against a minor child, elderly person (65 or older), or a dependent adult, or 4) a court order (such as child
custody suits) is received directing the disclosure of information.
It is my policy to assert privileged communication on behalf of the client and the right to consult with the
client if at all possible, except during emergency, before mandated disclosure. Verbal authorization to
release information will not be sufficient except in emergency situations. I will endeavor to apprise clients
of all mandated disclosures as conceivable.
In the event of marriage or family counseling, material obtained from an adult client individually may be
shared with the client’s spouse or other family members only with the client’s written permission. Any
material obtained from a minor client may be shared with the client’s parent or guardian.
When working with a family or couple, information shared by individuals in sessions where other family
members are not present must be held in confidence (except for the mandated exceptions already noted)
unless all individuals involved sign written waivers at the outset of therapy. Clients may refuse to sign such
a waiver but should be advised that maintaining confidentiality for individual sessions during couple or
family therapy could impede or even prevent a positive outcome to therapy. If an impasse results from such
confidentiality, referral to another therapist might result.
Ms. Forsyth will monitor my work with clients. I will review my cases with Ms. Forsyth. Part of my
supervision will be group supervision where other interns will also be present. Your signature at the end of
this form includes permission for audio- and videotaping of sessions and the sharing of information from
my notes. Ms. Forsyth, the other interns, and I will maintain the confidentiality of this shared information
as described in this section.
Emergency Situations: If an emergency situation should arise, you may seek help through hospital
emergency room facilities or by calling 911.
Client Responsibilities: You, the client, are a full partner in counseling. You must make your own
decisions regarding such things as deciding to marry, separate, divorce, reconcile and how to set up custody
and visitation. That is, I will help you think through the possibilities and consequences of decisions, but my
Code of Ethics does not allow me to advise you to make a specific decision. My style of therapy, however,
will always be in harmony with my Christian faith. Your honesty and effort is essential to success. If as we
work together you have suggestions or concerns about your counseling, I expect you to share these with me
so that we can make the necessary adjustments. If it develops that you would be better served by another
mental health provider, I will help you with the referral process. If you are currently receiving services
form another mental health professional, I expect you to inform me of this and grant me permission to share
information with this professional so that we may coordinate our services to you.
Physical Health: Physical health can be an important factor in the emotional well-being of an individual. If
you have not had a physical examination in the last year, it is recommended that you do so and to list any
medications that you are now taking.
Potential Counseling Risks: The client should be aware that counseling poses potential risks. In the course
of working together additional problems may surface of which the client was not initially aware. If this
occurs, the client should feel free to share these new concerns with me.
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Appendix D (continued)
I have read and understand the above information.
Client Signature ________________________________
Date ____________
Client Signature ________________________________
Date ____________
Client Signature ________________________________
Date ____________
Client Signature ________________________________
Date ____________
______________________________________________
Eric Dishongh, MAMFC, MFT Intern & Counselor Intern
____________
Date
______________________________________________
Annie G. Forsyth, LPC, LMFT
____________
Date
Parental Authorization:
I, ____________________, give permission for Eric Dishongh to conduct counseling with my
______________________ (relationship).
Name of Minor ________________________________
Signature of Guardian ___________________________
130
Date _____________
Appendix E:
Eric Dishongh, MAMFC
Associate Minister, Hickory Knoll Church of Christ
Doctoral Candidate, MFT Intern & Counselor Intern
Demographic Information Form
* Please check one answer for each of the following.
1. Gender:
___ Male
___ Female
2. Age:
___ 18-29
___ 30-44
___ 45-59
___ 60 & Older
3. Ethnicity: ___ African American ___ Caucasian ___ Hispanic/Latino ___ Other
4. Years Married: ___ 0-10 ___ 11-20
5. Number of Children: ___ 0
___ 21-30
___ 1
___ 2
6. Education: ___ High School
___ 4-yr College
7. Employment: ___ Full-Time
___ Part-Time
8. Your Income: ___ $29,999 or Less
9. Religion: ___ Church of Christ
___ 31-40
___ 3
___ 4 or more
___ Graduate School
___ Retired
___ $30,000-$59,999
___ Catholic
___ 41 or More
___ Other
___ Unemployed
___ $60,000 or More
___ Protestant
___ Other
10. Faith Importance:___ Very Important ___ Important ___ Somewhat ___ Not Much
131