COMMON FACTORS IN COUPLE THERAPY FOR PARTNER AGGRESSION: A THERAPY ...

206 Pages·2014·1.89 MB·English

ABSTRACT

Title of Document: COMMON FACTORS IN COUPLE
THERAPY FOR PARTNER AGGRESSION:
A THERAPY PROCESS AND OUTCOME
STUDY
Woochul Park, Doctor of Philosophy, 2014
Dissertation Directed By: Professor Norman B. Epstein, Ph.D.
Department of Family Science

The present study investigated roles of common factors related to outcome indices that exist
across therapy models in couple therapy for partner aggression. As client common factors,
individuals’ pre-therapy levels of trust in their partners and degrees to which they vent anger
were tested as predictors of change in relationship satisfaction and psychological aggression. As
therapist factors degree of empathy expressed toward clients, use of systemic intervention
techniques, and degree to which the therapist imposed structure on sessions were examined in
relation to therapy outcomes. Based on social learning theory, not only main effects but also
interaction effects of client factors and therapist factors on therapy outcomes were examined.
Structural equation modeling was used to test an Actor-Partner Interdependence Model in which
partners scores on measures of relationship qualities are assumed to influence each other. Female
partners benefited more from the therapy than did male partners, particularly in increases in
relationship satisfaction. However, females and males had equal reductions in psychological
aggression. Unexpectedly, lower level of trust predicted more positive change in psychological
aggression, but not in relationship satisfaction. As expected, higher venting of anger was
negatively associated with improvement in relationship satisfaction and psychological
aggression. Higher therapist use of systemic techniques predicted more positive change in
relationship satisfaction only for female partners. Interaction effects suggesting a buffering role
of empathy against the negative effect of a lower level of trust were detected. Overall, it was
client factors and not therapist factors that made differences in therapy outcome indices. Also,
predominantly actor effects rather than partner effects occurred. That is, clients’ changes on
outcome indices were related more to their own characteristics than to their partners’
characteristics. Strikingly, regarding partner effects, only male-to-female partner effects were
found, meaning that female partners’ therapeutic changes over the course of therapy were
predicted by their male partners’ characteristics. Overall, the present study demonstrated that
common factors do operate in couple therapy for partner aggression across therapy models,
although those common factors are mostly client characteristics rather than therapist behaviors
and involve male partners’ characteristics.
COMMON FACTORS IN COUPLE THERAPY FOR PARTNER AGGRESSION:
A THERAPY PROCESS AND OUTCOME STUDY

BY

Woochul Park

Dissertation submitted to the Faculty of the Graduate School of the
University of Maryland, College Park in partial fulfillment
of the requirements for the degree of
Doctor of Philosophy
2014

Dissertation Committee:
Dr. Norman B. Epstein, chair
Dr. Elaine A. Anderson
Dr. Mia Smith Bynum
Dr. Dennis Kivlighan
Dr. Carol Werlinich
I dedicate this dissertation to my parents, Jongman Park and Jeunghyun Kim.

Throughout my life, you have taught me the true love.

ii
Acknowledgements

I thank all of my dissertation committee members (Norm, Carol, Elaine, Dennis, and
Mia) for their excellent contributions. Particularly, I want to thank my advisor, Dr. Norman
Epstein. Norm, I am greatly impressed by your warm and sincere support. Thanks to your
guidance, I could enjoying this challenging academic journey. I am honored to have worked with
you. I came to have a new dream of becoming a good mentor like you. I will be missing you in
Korea.
I also want to thank my wife, Jihye Kim. Without your love, support, and encouragement,
I could not have finished this work. Definitely, this dissertation is built on your sacrifice. I am
thankful to get to walk with you through this life. You and your love towards me have always
been very touching and I really respect you.
Lastly, thank you, God. This dissertation is my response to your love towards the
suffering world. Thank you for your calling me into this beautiful field.

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Table of Contents
Dedication ii
Acknowledgements iii
Table of Contents iv
List of Tables vii
List of Figures viii
Chapter 1: Introduction 1
Chapter 2: Literature Review 12
Partner Aggression 12
A Common Factors Approach to Therapy 16
Client Common Factors in Couple Therapy Research 20
Client Characteristics Predicting Outcomes in Prior Couple Therapy Studies 21
Trust as a Common Factor Influencing Couple Relationships with Partner
Aggression 32
Anger as a Common Factor in Distressed Couple Relationships 47
Anger and Intimate Partner Aggression 59
Therapist Factors in Psychotherapy 66
Therapist Factors Influencing Psychotherapy Working Alliance and Outcome 66
Therapist Empathy 76
Systemic Techniques 79
Session Structure 81
Theoretical Model for the Study 83
Research Questions and Hypotheses 89
Chapter 3: Method 91
Sample 91
Procedures 94
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Measures 96
Independent Variables: Couple Characteristics 96
Moderator Variables: Therapist in-session behaviors 98
Criterion Variables: Couple Therapy Outcomes 99
Data Analysis Plan 105
Chapter 4: Results 107
Data Cleaning 107
Descriptive Statistics 109
Bivariate Correlations 112
Hypotheses Tests 114
Chapter 5: Discussion 130
Descriptive Statistics and Overall Change in Outcome 130
Bivariate Associations among Variables 132
Findings from the Hypotheses Tests 137
General Discussion 154
Clinical Implications 158
Limitations of the Study 161
Conclusion 164
Appendices 167
Appendix A 167
Appendix B 168
Appendix C 169
Appendix D 172
Appendix E 173
Appendix F 174
v
References 175

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List of Tables
Table 1: Individual Characteristics of the Sample 93
Table 2: Missing Data 109
Table 3: Descriptive Statistics of Client Variables and Results of T-tests Assessing Gender
Differences 110
Table 4: Descriptive Statistics for Client Variables and Results of T-tests Assessing Differences
between Pretreatment and Posttreatment Scores by Gender 111
Table 5: Descriptive Statistics for Therapist In-session Behavior 111
Table 6: Bivariate Correlations among Variables 116
Table 7: Summary of Hypotheses Tests 129

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List of Figures
Figure 1: Conceptual Model of the Study 11
Figure 2: Example APIM Model for Hypotheses Tests 106
Figure 3: SEM-APIM Model 1 for Testing Hypotheses 1, 3, and 6 117
Figure 4: SEM-APIM Model 2 for Testing Hypotheses 1, 3, and 6 117
Figure 5: SEM-APIM Model 3 for Testing Hypotheses 1, 4, and 7 118
Figure 6: SEM-APIM Model 4 for Testing Hypotheses 1, 4, and 7 118
Figure 7: SEM-APIM Model 5 for Testing Hypotheses 2, 3, and 8 119
Figure 8: SEM-APIM Model 6 for Testing Hypotheses 2, 3, and 8 119
Figure 9: SEM-APIM Model 7 for Testing Hypotheses 2, 5, and 9 120
Figure 10: SEM-APIM Model 8 for Testing Hypotheses 2, 5, and 9 120
Figure 11: Interaction Effect of Husband Trust and Therapist Empathy on Wife Psychological
Aggression 124
Figure 12: Interaction Effect of Wife Trust and Systemic Technique on Wife Relationship
Satisfaction 126
Figure 13: Interaction Effect of Husband Trust and Systemic Technique on Husband
Psychological Aggression 126
Figure 14: Interaction Effect of Husband Anger-out and Empathy on Wife Psychological
Aggression 128

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