The Couple Relationship and Depression
Exploring the couple relationship as causal factor and dynamic resource
NOW CLOSED
Saturday 19 November 2022
A Live Webinar with Velia Carruthers, Ann Hardy, Dr David Hewison, Melanie Shepherd and Kate Thompson
CPD Credits: 4 hours
- This event will not be recorded
- Bookings close at 9.00am GMT Wednesday 16 November 2022
Produced in partnership with Tavistock Relationships
There is a pervasive lack of awareness of the connection between relationship issues and depression. However, research shows that people in unsatisfactory couple relationships are three times more likely to have a mood disorder than those in partnerships that function well enough.
READ MORE...Furthermore, evidence reveals that up to 30% of severe depressive episodes could be prevented if the couple relationship was improved. In our presentations, we will consider how a relationship can cause depression, but can also be the source of recovery. Skills in Couple Therapy for Depression (CTfD) will be explained to demonstrate the effectives of this time-limited approach.
Our presenters will describe how the CTfD therapist formulates a dynamic picture of a couple’s interaction, hypothesising the couple’s unconscious, defensive ‘fit’ that is manifest in the depressive symptoms of one or both partners. The aim is to construct a psychodynamic understandstanding and systemic picture of the couples’s world and history to help them form a new understanding of their relationship. In doing so, the therapist must plot a path – unique to each couple – between facilitating and exploring proactive couple exercises, then stepping back to maintain an overview of the internal worlds of the couple. We will examine the therapeutic expertise and interventions employed in this highly effective approach.
Couple Therapy for Depression, is an evidence based, integrated, time limited couple therapy. Tavistock Relationships trains in CTfD on behalf of Health Education England and has done so since 2010 after being commissioned to create the training programme in 2009. CTfD is available on the NHS but its provision remains patchy and its availability is largely unknown amongst the general public.
Tavistock Relationships also offers a short course in CTfD to private practitioners keen to incorporate its competencies into their current skillset.
FULL PROGRAMME
14.00 GMT
Introductions
14.05
Dr David Hewison
From NICE Guidance to real-life therapy: the development of Couple Therapy for Depression.
This presentation will answer the question: how do you get from a NICE research-based recommendation to a practical, real-life, couple therapy that treats depression effectively? It will explore the original research evidence and the complications that unfolded from the fact that they were based on a discredited model of therapy. The competency frameworks will be explored and the mix of head-scratching, compromise and inventiveness that were necessary to develop a new framework for Couple Therapy for Depression. Finally, the framework’s innate contradictions and how they were turned into a ‘state of the art’ therapy that could be taught to therapists and delivered to couples, will be discussed.
14.35
Q&A
14.45
Kate Thompson
Couple Therapy for Depression: case histories and clinical challenges
In Mourning and Melancholia, Freud described
‘Mental features of melancholia are a profoundly painful dejection, cessation of interest in the outside world, loss of the capacity to love, inhibition of all activity, and a lowering of self-regarding feelings to a degree that finds utterance in self-reproaches and culminates in a delusional expectation of punishment’. (1917, p. 243)
Describing a case history in detail, taking the audience inside a couple’s experience of depression and therapy, we will consider the function that mental ill-health serves within the couple dynamic, and how it restricts development, intimacy and growth. The complex task for the therapist in delivering this integrated model, that necessitates moving between more active behavioural techniques and stepping back to allow psychodynamic understanding and a more systemic picture of the couple’s world and history to develop, will be described and illustrated with clinical examples.
15.15
Q&A
15.30
Melanie Shepherd
Relational Aspects of Depression
The relational aspects of depression are core to Couple Therapy for Depression. This presentation suggests some practical ways, guided by questions, to address these with couples. The questions enable the therapist to structure initial sessions, maintain their focus on the depression and relationship distress, if any, and make a therapy plan. The therapist’s questions support the couple to explore what triggered and maintains the depression; to see patterns they get stuck in, make links with their histories, draw on their strengths and commitment, and agree goals. The presentation will focus mainly on the questions which specifically address the relational aspects of depression.
16.00
Break
16.30
Panel
Discussion around a filmed clip with depressed couple with input from participants
17.00
Velia Carruthers
Couple Therapy for Depression efficacy data and filmed interview of couple who have undergone CTfD in NHS
This session seeks to apply the concepts presented by previous speakers around the bi-directional pull between depression and the couple dynamic. A film of a couple presenting with depression and relationship distress is discussed identifying the unconscious couple ‘fit’, the role of depression, their mutual defensive trap and polarisation. Evidence of CTfD’s efficacy is also presenting in analaysis from Tavistock Relationship’s research department. By tracking the data from PHQ9 (measuring depression), GAD7 (measuring anxiety) and linking this to data from each couple’s Couple Satisfaction Index, TR has linked increase in Couple Satisfaction post treatment to recovery from depression and anxiety which some consider the ‘holy grail’ and justification in working with couples and the relational aspect of depression, rather than focussing treatment solely on the individual patient diagnosed with depression.
17.30
Ann Hardy
Moving from Open Ended Therapy to Working Within a Time Limited Model
For practitioners who are used to delivering open-ended therapy, there are challenges and rewards in adopting a time-limited and focused model. This presentation considers subjects such as taking a more active and interventionist stance; the use of tools, exercises and homework; keeping a focus only on those aspects of the couple functioning that contribute to the maintenance of depression; and how to bring the work to a close, when a couple would prefer to continue. These are discussed from the perspective of a Tavistock Relationship therapist who has been delivering this model, while still working psychodynamically with her existing client base.
18.00
General Discussion
18.30
End