The purpose of this systematic review is to evaluate the effectiveness of couple therapy from different therapeutic approaches on the variables of depression, anxiety, stress, and relational factors in couples with infertility. It also aims to identify whether couple therapy increases the likelihood of pregnancy. A search protocol was entered into specific databases (PsycINFO, EMBASE, PubMed, and CINAHL) and a total of 12 interventional studies are included in this review. The results show that couple therapy of six or more sessions is effective in reducing depression, anxiety, stress, and relational complaints in couples who present with a lengthier infertility history. Couple therapy also increases the likelihood of pregnancy but only in couples with idiopathic infertility rather than medical and structural infertility. An explorative comparison of the effectiveness of different therapeutic approaches shows superior results with emotionally focused couple therapy, cognitive behavioural couple therapy, and behavioural couple therapy. This review adds to the evidence base for couple therapy and reinforces the need for this modality because of the interpersonal nature of infertility.

This paper proposes a culturally safe integrative systemic model for supporting First Nations people with borderline personality disorder (BPD). Firstly, this paper examines BPD from a systemic perspective by observing its impact on family and therapeutic systems. An overview of the empirical evidence for integrative systemic therapy demonstrates its suitability for working with BPD, particularly when combining systemic, psychodynamic, and cognitive-behavioural paradigms. A case example illustrating a client's journey using the proposed model is presented to explain how elements of Bowen family systems therapy, narrative therapy, and dialectical behaviour therapy are blended with cultural components to form a culturally safe integrative systemic approach. An initial evaluation demonstrated positive preliminary therapeutic outcomes, with the main strengths being the cultural additions and the mitigation of power struggles in the treatment and family systems that are reported in the literature as detrimental to BPD interventions. Limitations concerning the practicality of replication in mainstream settings are noted, particularly where full cultural safety may be more difficult to achieve. The paper suggests that integrative systemic approaches combined with cultural elements may be effective when supporting First Nations families living with BPD. Finally, this is currently the only integrative culturally safe therapeutic approach proposed for this cohort, making it unique given the overall paucity of empirical evidence in the field.