Treating Difficult Couples

Helping Clients with Coexisting Mental and Relationship Disorders

Edited by Douglas K. Snyder and Mark A. Whisman

May 22, 2003
ISBN 9781572308824
Price: $63.00 $47.25
448 Pages
Size: 6" x 9"

This essential handbook describes effective treatments for a particularly challenging clinical population: couples struggling with both relationship distress and individual mental health difficulties. Distinguished scientist-practitioners provide detailed accounts of their respective approaches, reviewing conceptual and empirical foundations as well as clinical procedures. Included are well-established treatments for couples in which one or both partners has anxiety, mood disorders, schizophrenia, substance abuse, sexual dysfunction, or physical aggression. Also covered are emerging couple-based approaches to managing personality disorders, PTSD, difficulties related to aging and physical illness, and other problems. Following a standard format to facilitate comparison across treatments, each chapter is illustrated with detailed case material. Provided are powerful insights and tools for couple and family therapists, clinicians providing individual therapy, and students in any mental health discipline.

“This book is versatile and useful for systemically trained therapists and for researchers who wish to understand the connections between individual and relational disorders....This book will be useful to clinicians with all levels of training and experience. Further, it is a must for any clinician working in settings, such as medical facilities, where one is likely to encounter Axis I and II conditions comorbid with dysfunctional relational dynamics.”

Journal of Couple & Relationship Therapy

“This is one of the most important books on couple therapy ever published. Snyder and Whisman's sophisticated yet accessible text signifies that couple therapy is no longer of value solely for explicit relationship problems. As this eye-opening volume makes clear, couple therapy is now a first-line intervention for a wide range of clinical problems traditionally thought of as 'individual.' This superb volume should be required reading not only for courses on couple therapy, but also for any course on the treatment of adult psychopathology.”

—Alan S. Gurman, PhD, Department of Psychiatry, University of Wisconsin Medical School

“At last, a book that tackles some of the issues that make certain couples hard to help. This is a book about couples in which the individual partners have their own problems, problems that interact with the couple's relationship. Everyone from graduate students to experienced clinicians will value the overviews of research and the practical guidelines on how to assess and treat the complexities of interactive individual and couple issues. This volume is going on my shelves in an easy-to-reach spot, so I can consult it when therapy gets stuck.”

—Kim Halford, PhD, Department of Clinical Psychology, Griffith University, Australia

Treating Difficult Couples: Helping Clients with Coexisting Mental and Relationship Disorders is a definitive, state-of-the-art text that pulls together the latest research and clinical innovation on couple treatment for the major individual and relational problems of our time. This volume includes chapters from a veritable 'who's who' of well-known couple researchers and clinicians. The reader will discover definitively what is known, and what isn't, about couple approaches to emotional, behavioral, and other health problems. The special strengths of the volume include its integrative conceptualization of individual diagnoses and relational problems, its survey of relevant research, and useful case illustrations. This book is well suited as a text for use in clinical, counseling, and family psychology programs, as well as marriage and family therapy programs.”

—Susan H. McDaniel PhD, Department of Psychiatry and Wynne Center for Family Research, University of Rochester School of Medicine and Dentistry

“Finally we have a book that provides an avenue to all the research on difficult couples. This is a book that should be on the shelf of every marital and family therapist. Provided are very practical, usable, and up-to-date reviews of all the major problems that are comorbid with marital distress. This book is a real winner!”

—John Gottman, PhD, Department of Psychology (Emeritus), University of Washington

Table of Contents

Part I: Empirical and Conceptual Issues in Managing Emotional, Behavioral, and Health Concerns in Couple Therapy: An Overview

Chapter 1: Comorbidity of Relationship Distress and Mental and Physical Health Problems

Mark A. Whisman and Lisa A. Uebelacker

Chapter 2: Tailoring Couple Therapy to Individual Differences: A Conceptual Approach

Douglas K. Snyder, W. Joel Schneider, and Angela M. Castellani

Part II: Couple-Based Treatments for Emotional and Behavioral Disorders

Chapter 3: Anxiety Disorders

Donald H. Baucom, Susan Stanton, and Norman B. Epstein

Chapter 4: Depression

Steven R. H. Beach and Maya Gupta

Chapter 5: Bipolar Disorder

David J. Miklowitz and Chad D. Morris

Chapter 6: Schizophrenia-Spectrum Disorders

Kim T. Mueser and Mary F. Brunette

Chapter 7: Alcohol and Other Substance Abuse

William Fals-Stewart, Gary R. Birchler, and Timothy J. O'Farrell

Chapter 8: Sexual Dysfunction

Lisa G. Regev, William O'Donohue, and Claudia Avina

Chapter 9: Physical Aggression

Amy Holtzworth-Munroe, Amy D. Marshall, Jeffrey C. Meehan, and Uzma Rehman

Part III: Adapting Couple Therapy to Individual Problems

Chapter 10: Borderline Personality Disorder

Alan E. Fruzzetti and Armida R. Fruzzetti

Chapter 11: Paranoia

Kenneth G. Terkelsen

Chapter 12: Narcissistic Disorder

Jill Savege Scharff and Carl Bagnini

Chapter 13: Posttraumatic Stress

Susan M. Johnson and Judy Makinen

Chapter 14: Childhood Sexual Trauma

Barry W. McCarthy and Mia Sypeck

Chapter 15: Physical Illness

Gail P. Osterman, Tamara G. Sher, Gwen Hales, W. Jeffrey Canar, Reema Singla, and Tracy Tilton

Chapter 16: Aging and Cognitive Impairment

Sara Honn Qualls

Chapter 17: Bereavement and Complicated Grief

Robert M. Wills

Part IV: Integration

Chapter 18: Understanding Psychopathology and Couple Dysfunction: Implications for Clinical Practice, Training, and Research

Douglas K. Snyder and Mark A. Whisman


About the Editors

Douglas K. Snyder, PhD, is Professor and Director of Clinical Psychology Training at Texas A&M University. He has been recognized internationally for his programmatic research on couple therapy and is the author of the widely used Marital Satisfaction Inventory. In 1992, the American Association for Marital and Family Therapy honored Dr. Snyder with its Outstanding Research Award for his four-year follow-up study (along with Robert Wills) comparing behavioral and insight-oriented approaches to couple therapy, funded by the National Institute of Mental Health. A Fellow of the American Psychological Association, Dr. Snyder has served as Associate Editor for the Journal of Consulting and Clinical Psychology and Journal of Family Psychology, and as an editorial board member of Clinical Psychology: Science and Practice, Journal of Clinical Psychology, Journal of Marital and Family Therapy, Journal of Marriage and the Family, and the American Journal of Family Therapy.

Mark A. Whisman, PhD, is Associate Professor of Psychology at the University of Colorado at Boulder. His research, which has been supported by the National Institute of Mental Health, has focused on the reciprocal association between relationship functioning and mental health. His other areas of interest include cognitive-behavioral and interpersonal perspectives on the onset, maintenance, and treatment of depression and relationship distress. A Founding Fellow of the Academy of Cognitive and Behavioral Therapies, Dr. Whisman has served as Associate Editor for Contemporary Psychology and as an editorial board member of the Journal of Consulting and Clinical Psychology, Journal of Family Psychology, and Clinical Psychology: Science and Practice.


Clinicians who treat couples and individuals; students in couple and family therapy, clinical and counseling psychology, psychiatry, clinical social work, and nursing.

Serves as a text in graduate-level courses on treatment of couples and families.

Course Use

Serves as a text in graduate-level courses on treatment of couples and families.