Couples d’âge mûr et sexualité : comprendre l’impact des dynamiques relationnelles

Increased life expectancy creates the prospect of prolonged marital intimacy. However, mature couples face many challenges — physiological, cultural, and familial — and they must be able to mobilize their individual and relational resources to maintain good levels of marital and sexual satisfaction. The aim of this study is to highlight various factors that contribute to the conjugal and sexual satisfaction of older couples, and to discuss the stressing of these factors in a crisis context. 534 participants aged between 18 and 74 years old answered several questionnaires measuring their degree of sexual and conjugal satisfaction as well as the areas of strength and fragility in the relational dynamics of their couple. In addition, five couples also accepted a semi-structured interview on their relationship dynamics and their vision of the ageing couple. The results highlight the major impact of several variables contributing to an increase in relational and sexual satisfaction within couples (e.g. health concerns, conflict management, fondness…). Furthermore, a comparison between the scores of the over-51s and the younger ones highlights the areas of strength of older partners. These different factors will be discussed. Finally, we will propone therapeutic advices aimed at supporting the areas of strength of mature couples in order to accompany them towards long-term relational and sexual fulfillment.     

Therapy by written communication

A case of marital and sexual therapy using behavioural techniques was concluded using written communication. It was a successful and cost-effective intervention.     

Disseminated gonococcal infection in a married couple

Summary The rare occurence of disseminated gonococcal infection in a married couple is reported. These cases support the concept that bacterial rather than host factors are more important in determining the disease manifestations in gonorrhoea.     

Vie affective,désir d’enfant et parentalité chez les personnes avec schizophrénie

While many people with schizophrenia consider intimate relationships and parenting as central parts of their lives deeply affecting well-being and recovery, others report multiple challenges in these domains (e.g. stigma, social isolation, low self-esteem, emotional dysregulation, sexual dysfunctions, separation/divorce and domestic violence, low treatment adherence, perinatal complications, parenting difficulties, alteration of the quality of early parent-infant interactions, interruptions to the parenting role and custody loss). However, these domains are often overlooked in routine clinical practice and in psychiatric rehabilitation. It is therefore crucial to discuss these topics more systematically (e.g., desire to become involved in a relationship or to become a parent, representation of self as a prospective partner, parent or future parent, sexual dysfunctions, family planning) to improve patients’ outcome, well-being, and quality of life. In addition to the existing service provision, this paper presents discussions of individual and group-based psychiatric rehabilitation interventions (e.g., informed decision-making and shared-risk taking, group cognitive behavior therapy, metacognitively oriented psychoeducation) that were developed to improve outcomes for patients, infants, and relatives.     

慢性精神分裂症患者的康复护理模式探讨

目的：探讨结对护理模式对慢性精神分裂症患者康复的影响。方法：将96例慢性精神分裂症患者按住院顺序随机分为研究组(结对康复)和对照组(一般康复),每组各48例,在常规治疗护理不变的情况下,研究组采用结对护理模式进行康复训练。分别于入院时和康复训练12周末,采用住院患者护士观察量表(NOSIE)、阴性症状评定量表(SANS)、日常生活能力量表(ADL)对每位患者进行评定。结果：研究组和对照组各量表评分优于康复训练前,差别有显著性意义(P＜0．01),研究组疗效优于对照组(P＜0．01)。结论：结对护理模式对慢性精神分裂症患者的康复有积极作用。     

From telescope to binoculars. Dyadic outcome resulting from psychological counselling for infertile couples undergoing ART

Objective: This longitudinal study aims to evaluate the effect of psychological counselling on quality of life, marital satisfaction and need for parenthood in couples undergoing fertility treatments (ART).

Background: Recent guidelines on the ART suggest that psychological counselling should target both members of the infertile couple in order to improve their conjoint management of the infertility-related stress. However, studies on the dyadic outcome of couples are scarce.

Methods: 262 patients were originally considered in the study and completed questionnaires on quality of life, need for parenthood and marital satisfaction, before treatment (T1) and at the day of intrauterine insemination/embryo transfer (T2). For the purposes of this study, 34 counselled couples were then matched to 34 non-counselled couples by propensity scores. The Common Fate Model (CFM) was used to examine dyadic changes.

Results: Couples receiving counselling had higher dyadic quality of life and lower dyadic stress due to the need for parenthood at T2 compared to non-counselled couples. No differences were found on marital satisfaction.

Conclusion: The findings provide support for the effectiveness of counselling on interpersonal outcome. The CFM allows researchers to examine how the dyad as a whole responds to counselling, highlighting the change in the couple’s relational dynamics.     

The Monster in Between: Working with Couples in Intensive Group Treatment

ABSTRACT

In this article we elaborate on an inpatient clinical group program for couples suffering from nonpsychotic psychiatric disorders, personality disorders, and/or complex partner relational problems. In general, one of the partners has a long history in mental health care. The intervention history often includes at least some sessions of couple therapy but without sufficient success. These couples are part of that group of mental health patients that can be described as, or describe themselves as, “everything was done but nothing really helped.” The clinical inpatient couple group program was initiated in 1991 and to date (February 2004) 415 couples have been treated in 91 groups. Although our Center for Relational Problems is situated in a rural area in the northern part of the Netherlands, these couples are referred from all over the country. This proves that there is a need for highly intensive couple treatment in an inpatient setting. Nevertheless, as far as we know, this type of treatment does not exist anywhere else in the world. In this article we give details of the program and the rationale behind it.     

Vers une déconstruction des situations de maltraitances intrafamiliales

This article discusses intrafamily abuse under judicial control, the category of violent and sexual offenses against children. More specifically, it deals with the acting abuse's functional signification in family. Differents levels of analysis are questioned: situations and contexts in which the actions arrive, the author positions the married couple and parental and family functioning mode. These fields are investigate in an economic dynamics and axiological's perspective. The complexity of the situations is illustrated by the presentation of three clinical cases. This article opens lines for understanding the abuse's situations by a dynamic model.     

Congruence Couple Therapy for Pathological Gambling

Couple therapy models for pathological gambling are limited. Congruence Couple Therapy is an integrative, humanistic, systems model that addresses intrapsychic, interpersonal, intergenerational, and universal–spiritual disconnections of pathological gamblers and their spouses to shift towards congruence. Specifically, CCT’s theoretical foundations, main constructs, and treatment interventions are illustrated in a progression of six clinical phases. Promise of CCT’s systemic conceptualization and interventions for pathological gambling and future directions in its continuing evolution are discussed.