Dyadic Coping in Couple Therapy Process: An Exploratory Study

• Author: Robert E. Emery,Monica Accordini,Davide Margola,Douglas K. Snyder,Silvia Donato
• DOI: http://doi.org/10.1111/famp.12304
• Published date: 01 June 2018
• Date: 01 June 2018

Dyadic Coping in Couple Therapy Process:

An Exploratory Study

DAVIDE MARGOLA*

SILVIA DONATO*

MONICA ACCORDINI*

ROBERT E. EMERY

†

DOUGLAS K. SNYDER

‡

This study aimed at moving beyond previous research on couple therapy efficacy by

examining moment-by-moment proximal couple and therapist interactions as well as final

treatment outcomes and their reciprocal association. Seven hundred four episodes of dya-

dic coping within 56 early therapy sessions, taken from 28 married couples in treatment,

were intensively analyzed and processed using a mixed-methods software (T-LAB). Results

showed that negative dyadic coping was self-perpetuating, and therapists tended to pas-

sively observe the negative couple interaction; on the contrary, positive dyadic coping

appeared to require a therapist’s intervention to be maintained, and succe ssful interven-

tions mainly included information gathering as well as interpreting. Couples who dropped

out of treatment were not actively engaged from the outset of therapy, and they used more

negative dyadic coping, whereas couples who successfully completed treatment showed

more positive dyadic coping very early in therapy. Results highlight the role of therapist

action and control as critical to establishing rapport and credibility in couple therapy and

suggest that dyadic coping patterns early in therapy may contribute to variable treatment

response.

Keywords: Dyadic Coping; Couple Thera py; Process Research; Sequence Analysis;

Correspondence Analysis

Fam Proc 57:324–341, 2018

DYADIC COPING IN COUPLE THERAPY PROCESS: AN EXPLORATORY STUDY

Accumulating evidence indicates that several different approaches to couple therapy

produce clinically significant positive change, at least in the short term (e. g., Lebow,

Chambers, Christensen, & Johnson, 2012; Randall, Bodenmann, Molgora, & Margola,

2010; Snyder & Halford, 2012; Sprenkle, 2012). Although encouraging, empirical evidence

on couple therapy process is somewhat limited (Friedlander & Heatherington, 2009). A

comprehensive review of couple therapy (Snyder, Castellani, & Whisman, 2006) suggested

nine major directions for future research, including three that are the foci of the present

article: (1) research on change processes using an events-based approach as a complement

to outcome studies, (2) small-scale investigations in community agency and everyday

*Catholic University of Milan, Milan, Italy.

†

University of Virginia, Charlottesville, VA.

‡

Texas A&M University, College Station, TX.

Correspondence concerning this article should be addressed to Davide Margola, Faculty of Psychology,

Catholic University of Milan, Largo A. Gemelli 1, Milan, MI 20123, Italy. E-mail: davide.margola@

unicatt.it.

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Family Process, Vol. 57, No. 2, 2018 ©2017 Family Process Institute

doi: 10.1111/famp.12304

practice settings, and (3) extension of new culturally diverse data to the field. In this arti-

cle, we investigate how change in couple therapy occurs naturalistically—that is, under

conditions of actual clinical practice—among a sample of couples treated in northern Italy.

Specifically, the goal is to intensively study isolated segments of therapy in order to docu-

ment couples’ early dyadic interaction behaviors and couple–therapist triadic interaction

patterns and to link these early patterns to treatment outcome. In so doing, this study is

consistent with prior research that indicates that couple researchers should readily move

beyond studies of couple therapy efficacy to examine microlevel processes related to proxi-

mal as well as final outcomes (Heatherington, Friedlander, & Greenberg, 2005; Sprenkle,

2002, 2012).

Dyadic Coping

Although conceptualizations of core relationship themes relating to mutual interaction

between partners are not new in the field of couple therapy (e.g., “mutual affective regula-

tion,” see Erzar & Erzar, 2006; “power inequality within couple,” see Ward & Knudson-Mar-

tin, 2012), one area of research on couple dynamics gaining increased attention over the past

15 years is dyadi c coping (DC). DC has been defined as “the interplay between the stress sig-

nals of one partner and the coping reactions of the other, a genuine act of shared coping”

(Revenson, Kayser, & Bodenmann, 2005, p. 4). The construct of DC was primarily developed

to study coping behaviors within the context of marital or other stable intimate relationships

(e.g., Bodenmann, Pihet, & Kayser, 2006; Gasbarrini et al., 2015; Iafrate, Bertoni, Margola,

Cigoli, & Acitelli, 2012), and it presumes three characteristics of those relationships: the

partners’ interdependence, their common concerns, and their mutual goals (Bodenmann,

1997, 2005). In particular, DC can be conceptualized as the mutual exchange between part-

ners in which one partner’s starting stress signal is followed by the other partner’s behav-

ioral responses of stress management (see Do nato, 2014, for a review of dyadic coping models

and empirical findings). Stress communication, whether it is verbal or nonverbal, is an

important yet distinct and insufficient aspect of the DC process (Pagani et al., 2015).

Although thepartner’s stress becomes a relational entity through communication, the dyadic

coping process is not complete until the other partner no longer responds to the stress signal.

The partner’s responses can be either positive (e.g., overt empathy) or negative (e.g., overt

hostility) in nature. DC responses are in turn perceived, decoded, and evaluated by the part-

ner who first communicated his/her own stress in a circular process, thus affecting both part-

ners. In other words, when it comes to DC—unlike general dyadic communication—joint

stress management, no matter if positive or negative, and a focused behavior in the communi-

cation circular process need to be distinctly detected.

To date, several operational definitions of DC have been proposed (Hubbs, 2008; Reven-

son, Kayser, & Bodenmann, 2005). For example, Preece and DeLongis (2005) described

five forms of DC: empathic coping, support provision, compromise, confrontation, and

interpersonal withdrawal. Kayser, Watson, and Andrade (2007) distinguished two forms

of DC: mutual responsiveness and disengaged avoidance. More parsimoniously, Boden-

mann (2005) described two broad forms of DC: positive and negative. Positive DC includes

supportive, common, and delegated (helping) behaviors; negative DC includes hostile,

ambivalent, and superficial behaviors (such as sarcasm or de-emphasizing the seriousness

of the partner’s stress). Consistent with this last classification, in the present rese arch we

defined DC as positive (involving partner support, responsiveness, or compromise), nega-

tive (involving partner conflict or denigration), or absent (involving lack of response,

change of topic, or individual “diversion”).

Most studies to date have focused on coping among couples facing major external stress,

particularly cancer (e.g., Kayser et al., 2007; McLean & Jones, 2007; Regan et al., 2015;

Fam. Proc., Vol. 57, June, 2018

MARGOLA, DONATO, ACCORDINI, EMERY, & SNYDER

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