Motivating Couples for Therapy

婚姻不满是一个严重的问题，对精神、身体和家庭健康都有影响，并与离婚和配偶虐待等结果有关。一般人群中大约有20%的夫妇在某一特定时间经历过临床水平的婚姻不满意。对夫妻不满有有效的治疗方法；然而，许多可能从治疗中受益的夫妇并没有得到治疗。我建议开发和测试一种简短的干预（婚姻动机访谈；MMI），旨在增加夫妻对社区夫妻资源的动机和实际使用（即婚姻治疗）。MMI将针对那些目前没有接受婚姻不满治疗的痛苦夫妇。在发展MMI的过程中，我将整合现有的关于婚姻不和谐的文献与动机访谈干预中使用的策略。在奖学金的前6个月，我将开发和手动干预。在剩下的18个月里，我将进行一项随机临床试验，将接受MMI的一组与等候名单对照组进行比较。干预三个月后，我预计MMI组将表现出a)改变他们关系的动机增加；B)增加了关系效能（即相信自己和自己的伴侣可以解决未来的关系问题）和c)增加了夫妻治疗的使用。

Marital dissatisfaction is a significant problem, with repercussions for mental, physical, and family health, and associations with outcomes such as divorce and spousal abuse. Approximately 20% of couples in the general population experience clinical levels of marital dissatisfaction at a given time. There are effective treatments for couple dissatisfaction; however, many couples who might benefit from treatment do not receive it. I propose to develop and test a brief intervention (marital motivational interviewing; MMI) designed to increase couples' motivation for, and actual use of, couples resources in the community (i.e., marital therapy). MMI will be targeted at distressed couples who are not currently receiving treatment for marital dissatisfaction. In developing MMI, I will integrate existing literature on marital discord with strategies used in motivational interviewing interventions. In the first 6 months of the fellowship, I will develop and manualize the intervention. In the remaining 18 months of the fellowship, I will conduct a pilot randomized clinical trial, comparing a group receiving MMI to a wait- list control group. Three months following the intervention, I expect that the MMI group will show a) increased motivation for making changes in their relationship; b) increased relationship efficacy (i.e., the belief that one and one's partner can solve future relationship problems) and c) increased use of couples therapy.