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Cost-effectiveness of marital therapy was examined beginning with a simple question: If government or health insurers paid for the screening and, where indicated, empirically supported treatment of 100,000 randomly selected married persons (i.e., 50,000 couples) from the general population, would the financial benefits outweigh costs? Two empirically supported forms of marital therapy, behavioral marital therapy and emotionally focused therapy, were considered in aggregate as possible treatments of choice. Marital therapy appears to be cost-effective when paid for by government to reduce public costs of divorce or when paid for by insurers to offset the increased health-care expenses associated with divorce. Implications and specific needs for future research to substantiate these conclusions are discussed.

alliant international universityTrans-identified (TI) couples are a marginalized, under-served population. Extant literature concerning the treatment of relational distress with this group is sparse. Information that is available is more concerned with the transition support of the TI partner, usually male, than it is with the partner experiencing the attachment injury or the couple as a separate entity. These couples experience significant relational upheaval. This paper explores the literature on the partners and couple relationships of TI persons, and proposes the use of the Emotionally Focused Therapy attachment injury resolution model for couples experiencing this upheaval. The model, which has been supported in studies of attachment injury treatment in distressed heterosexual couples, would require minimal adaptation for use with TI couples. For example, the goal of therapy using this model with married TI couples must be repairing the relationship, not necessarily repairing the marriage. A case example is used to demonstrate the potential of this approach.

Emotionally focused therapy (EFT) for couples in which one or both partners have a history of trauma and are shame prone presents unique challenges that can potentially impede the therapeutic process. Neff’s conceptualization of self-compassion and research has demonstrated the benefits of self-compassion for both oneself and interpersonally. Gilbert’s compassion-focused therapy (CFT; 2010) is an evidence-based, integrative approach that specifically works with trauma and chronic consequences of affect dysregulation and shame. This article reviews the empirical research on EFT, self-compassion, and CFT and includes a brief review of trauma and shame. This article also discusses various ways in which Neff’s conceptualization of self-compassion and Gilbert’s CFT can be integrated into EFT for the benefit of both the EFT therapist and couples taken over by trauma and shame.