Add To Cart

Section 23
Using Group Therapy for the Hurt and Unfaithful Partner

Question 23 | Test | Table of Contents

The current study compares two types of marital enrichment interventions that are offered in psychoeducational groups: hope-focused marital enrichment and forgiveness-based marital enrichment. (The term marriage enrichment is used throughout this article is descriptive of interventions focused only on marriages, while couples or relationship enrichment is the term to apply to all types of romantic relationships.) The hope-focused program is similar to most popular couples enrichment programs. It focuses on communication skills and conflict resolution. In the forgiveness-based marital enrichment program, the focus is on forgiveness as an essential skill for couples to learn in their marriage (McCullough, Rachal, Sandage, Worthington, & Hight, 1998). This approach begins with the assumption that relationship repair (through forgiveness) will enrich relationships and prevent problems from developing that stem from unforgiveness. Attention to communication in the forgiveness psychoeducational group is limited to supporting couples as they learn to forgive.

The goal of the present study was to investigate two adaptations of interventions that have begun to accumulate research support. Using a community sample of couples, we compared two marital psychoeducational groups--hope-focused relationship enrichment (Worthington et al., 1997) and empathy-centered forgiveness-based marital enrichment (drawn from suggestions by McCullough, 1997; Worthington, 1998a)--with a repeatedly retested wait-list control condition. To achieve this goal, the present study chose several ways to alter and extend previous investigations of both the hope-focused relationship enrichment and the empathy-based model of forgiveness.

We hypothesized that participants in both interventions would experience increased dyadic satisfaction relative to the wait-list control. We further hypothesized that hope-focused marital enrichment would have higher scores on communication than would either the forgiveness intervention or the waitlist, because in the hope-focused intervention explicit training was done in communication and conflict negotiation. We anticipated that the forgiveness intervention would promote more forgiveness of a preidentified hurt than would either the hope-focused marital enrichment or the waitlist, because in the forgiveness-based intervention, the issue of forgiveness was the focus.

Hope-focused marriage enrichment. A hope-focused marital enrichment psychoeducational group was adapted from Worthington et al. (1997). The premise of the workshop was to intervene strategically in communication, conflict resolution, and intimacy to promote a more satisfying relationship. The workshop is hope-focused in that it relies on (a) motivation for couples to take initiative in their relationship and (b) an action-oriented method for achieving goals, which Snyder (1994) called agency and pathways, respectively. In the present research, the hope-focused enrichment used five of six of Worthington et al.'s (1997) components (the forgiveness component was excluded to prevent overlap between the interventions) as follows:

Group leaders discussed Gottman's (1994) model of marital dissolution including the desirable 5 to 1 or higher ratio of positive to negative behaviors and encouraged the group to brainstorm about ways to increase their ratios.
Couples were taught a communication-of-experience technique titled Communication Tango in which one member of the couple discussed his or her thoughts and feelings and that included a valuing statement during communication (this technique is similar to Miller, Wackman, Nunnally, & Miller's, 1988, awareness wheel, which had been used in the previous research).

Couples were taught a way of resolving differences, prompted by a LOVE acrostic, which included listening (L) to their partner, observing (O) their effects on their partner, valuing (V) their partner, and evaluating (E) common interests.
An intimacy exercise was included. This exercise used the space in the room as a metaphor for emotional intimacy, encouraging couples to place themselves at a distance apart. Couples then noted how various communications could increase or decrease the emotional distance between them. This could be considered an alteration of the scaling technique (deShazer, 1985) in solution-focused therapy. It was used to encourage couples to practice saying valuing and loving statements to each other until they felt emotionally close enough to hug. Their emotional closeness was symbolized by physically moving closer to each other.

Couples wrote a love letter to each other as a memorial of their time in the course.

Empathy-centered forgiveness-based intervention. The pyramid model of forgiveness focuses on the intrapersonal aspect of granting forgiveness (Worthington, 1998b). The pyramid model hypothesizes that there are five parts to forgiveness: recall of hurt, empathy, humility, commitment, and maintenance. The model encourages individuals to empathize with their offender to promote forgiveness. Humility is fostered by having individuals recall incidents when they had inflicted harm on their partner and other people and received forgiveness. Thus, the victim might shift his or her perception from unmitigated blame to humble willingness to forgive. During commitment, the hurt or offended person commits aloud to forgiveness of the other. Finally, maintenance is the follow-up portion of forgiveness, which includes a discussion of how the offender may prove him- or herself trustworthy again and how future hurts can be handled (i.e., the interpersonal portion of asking for, granting, and receiving forgiveness). An initial version of this model was applied to couples. During the intervention, each of the concepts was applied by participants to hurtful situations involving a hypothetical couple. Couples role-played the concepts within each step of the pyramid so that they could learn the skills of forgiving. Couples participated regardless of whether they had a hurtful event for which to forgive each other at the time they were participating in the group. Application of empathy-centered forgiveness to a psychoeducational group of couples drew heavily from McCullough (1997).

Discussion: The results of this study indicate that both the hope-focused marital enrichment and the empathy-centered forgiveness-based interventions helped members communicate more positively relative to those in a wait-list control group. The hope-focused marital enrichment psychoeducational group was particularly effective at enhancing couple interactions. However, on self-report measures of marital quality, communication, and forgiveness on an index issue, couples who participated in an intervention did not differ from those in the wait-list control group. These findings raise several important questions: (a) Did either intervention produce clinically meaningful improvements? (b) Why were changes in self-reports of marital quality not as positive as in previous research on hope-focused marital enrichment? (c) Why did the forgiveness intervention not result in increased forgiveness in partners? and (d) What are the implications for future research on marital enrichment using communication-based and forgiveness-based interventions?

Why Did Forgiveness Interventions With Married Couples Not Result in Forgiveness?
The TRIM measure, which measures unforgiveness, has been validated and found useful in previous studies with individuals, but it has not been specifically validated for use with married couples, especially within marriage-enrichment settings. The TRIM had a ceiling effect in the present study. In fact, of the 86 participants who completed the TRIM at baseline, 39 scored a 12 on the TRIM, the lowest possible score on the scale. This study may not have adequately measured whether forgiveness actually occurred between partners due to measurement limitations. In addition, the empathy-centered forgiveness-based intervention differed from previous research on the promotion of forgiveness in several ways. This was the first forgiveness intervention in which both partners were counseled simultaneously. In couples, the presence of the offender in the group considerably complicated the treatment of forgiveness. Most of the attention of the group was focused on helping partners grant forgiveness. Little attention was given to interpersonal transactions involving seeking, granting, and accepting forgiveness (see Baumeister et al., 1998; Worthington & Wade, 1999). Thus important concepts like asking for and giving accounts (Gonzales, Haugen, & Manning, 1994; Gonzales, Manning, & Haugen, 1992; Hodgins, Liebeskind, & Schwartz, 1996; Mongeau, Hale, & Alles, 1994) and apologies (see McCullough et al., 1997; McCullough et al., 1998) and how to talk about hurtful events were not covered, even though partners at times thought them relevant. It is no trivial matter that no significant difference in forgiveness was found across groups because a few participants in the control group reported dramatically lower forgiveness at posttest.

Conclusion: Using brief psychoeducational interventions seems philosophically congruent for counselors as a modality to provide marital enrichment. Previous research has suggested that hope-focused relationship enrichment might be a powerful intervention when delivered to individual couples by a consultant (Worthington et al., 1997). Despite the disappointing performance of hope-focused marital enrichment groups at producing changes in self-reports of marital quality, clinically meaningful observational changes were evident in couple functioning (Gottman, 1994). Similarly, psychoeducational interventions to promote forgiveness have been shown to be effective (see Worthington, Sandage, et al., 2000). In the present study, the forgiveness intervention with couples was not effective (relative to a control group) at producing forgiveness when both partners were present in the same groups. Nonetheless, this study provided helpful suggestions for future efforts to promote forgiveness in couples. However, one must conclude from the present data that in the future, the burden of proof must be strict in efforts to show that forgiveness interventions with couples are effective.
- Ripley, Jennifer S.; Worthington Jr., Everett L.; Hope-Focused and Forgiveness-Based Group Interventions to Promote Marital Enrichment;  Journal of Counseling & Development, Fall2002, Vol. 80 Issue 4.

Personal Reflection Exercise #9
The preceding section contained information about whether using group therapy for the hurt and unfaithful partner.  Write three case study examples regarding how you might use the content of this section in your practice.

Update
Group Therapy

- Malhotra, A., & Baker, J. (2022). Group Therapy. In StatPearls. StatPearls Publishing.

Peer-Reviewed Journal Article References:
Bendixen, M., Kennair, L. E. O., & Grøntvedt, T. V. (2018). Forgiving the unforgivable: Couples’ forgiveness and expected forgiveness of emotional and sexual infidelity from an error management theory perspective. Evolutionary Behavioral Sciences, 12(4), 322–335.

Cornish, M. A., Hanks, M. A., & Gubash Black, S. M. (2020). Self-forgiving processes in therapy for romantic relationship infidelity: An evidence-based case study. Psychotherapy. Advance online publication. 

Leone, R. M., Jarnecke, A. M., Back, S. E., Brady, K. T., & Flanagan, J. C. (2020). The moderating role of infidelity on the relation between oxytocin and conflict behaviors among substance misusing couples. Experimental and Clinical Psychopharmacology, 28(3), 251–257.

QUESTION 23
In Ripley’s study, which intervention group was the most effective at enhancing couple interactions? To select and enter your answer go to Test.

Test
Section 24
Table of Contents
Top