Healthcare Training Institute - Quality Education since 1979
CE for Psychologist, Social Worker, Counselor, & MFT!!
Going to "Prep" School
Rod Grimm Lewis and his wife Victoria paid $400 to attend a two-day PREP seminar in Los Angeles in a final attempt to save their 28-year-old marriage. "I think this will help," says Victoria, the more eager of the two. "I think of it as chemotherapy." Rod figures he's being a good sport. "I came because she asked me to," he says. "I'm about 5% of the problem, and she's 95%." Marc Sadoff, the workshop leader, says, "It's good to hear that you can acknowledge you're 5%. So many people can't see any role in the problem."
Positive communication, like Sadoff's comment, is the backbone of PREP, developed in the 1980s by psychologists Howard Markman and Scott Stanley, co-directors of the Center for Marital and Family Studies at the University of Denver. In developing it, Markham spent years taping couples having arguments and devising ways to break bad habits. The method, which relies partly on videos of other couples using the technique, is continually tweaked in light of new research, says Stanley. "The idea was to build a program for couples that was based on sound research," he says, "rather than armchair clinical speculation."
Sadoff, a clinical social worker trained in PREP, explains the method to the Lewises and a younger couple sharing the session. They are to agree to set aside a time each week to talk over their problems. These discussions must follow certain rules, which can be posted on the refrigerator door. "The word I is allowed," Sadoff says. "You is not." The partners take turns talking, without interruption. The speaker makes brief statements, which the listener must paraphrase to show he understands what was said. There are also time-outs, which allow one partner to leave the room for an emotional break. That's a scary notion for Victoria, who says that since childhood she has never felt she could leave a heated discussion without repercussions. "Where would I go?"
Rod and Victoria give it a try. While Victoria is speaking, Rod interjects to ask a question. That's not allowed, he's told. Later he doesn't correctly paraphrase what she said. Rod tries again. When he gets it right, Victoria smiles and says, "Yes! That's good." For a moment they have connected. But Rod is struggling to remember his role, and Victoria still feels unnatural: "Does anyone really talk like this?'' Sadoff assures her she will get better with practice. He explains that, although artificial, the technique provides a safe way for couples to talk about thorny issues. "We're after progress, not perfection," he says.
Six months after the first session--and despite follow-up therapy with Sadoff--problems linger. "We tried, but the techniques just don't take care of the deeper issues," says Rod, who is thinking of ending the marriage. "The future of our relationship doesn't look good."
But many evaluators award PREP high marks. While two studies did not find it more effective than other methods, two others, involving a total of 210 couples, found that those who take PREP, either before marriage or after, have lower rates of breakup and divorce than couples who took a different training class or did nothing. Also, seven studies involving about 500 couples concluded that PREP participants had less negative communication for up to five years after the course. Men are particularly partial to the method.
Such results have made PREP popular around the world and in a wide range of settings, including U.S. military bases and churches. Oklahoma has embraced it as part of a $10 million government initiative to reduce divorce. That's how Shelitha and John Coleman Jr. came to PREP in November, in a Christianized version offered free at their church, G.A.P. [God's Apostolic Prophetic] Restoration Tabernacle in Oklahoma City. The Colemans' marriage of nearly two years was doing fine, but John's parents didn't seem to think so and were interfering. "They wanted me to have the same kind of marriage they had, where I'm the man and I run the whole show," explains John, 28. He and Shelitha, 29, needed a way to declare their independence without sounding rebellious.
PREP techniques helped them do that while improving their own communication. John's parents, says Shelitha, "were having trouble letting go. Our talk revealed some things about how they feel about seeing their children grow up and live on their own. Now all four of us are using PREP methods." The religious aspect of the program was important to the couple. "We make the word of God part of the foundation of our marriage," says John. "In terms of communicating, it shows up in principles about being honest with your partner about everything. When a difficult problem comes up, you shouldn't hide."
• Lessons from the Love Lab
Gottman, a clinical psychologist, has essentially distilled the art of love and war--a.k.a. marriage--into a kind of science. After 30 years of such studies inside his physiology lab, nicknamed the Love Lab, Gottman's group has developed a model that he claims can assess whether a couple are on a path to dysfunction. Now when Gottman wires up therapy clients and videotapes them, "in the first three minutes of the conflict discussion," he says, "we can predict if a couple is going to divorce." He and research partner Robert Levenson of the University of California, Berkeley, found that during arguments, couples in stable relationships have five times as many positive factors present as negative ones. "In relationships that were working, even during conflict, there was a rich climate of positive things, such as love, affection, interest in one another, humor and support. Couples in unstable unions had slightly more negative factors than positive."
The Gottman technique usually involves a two-day workshop, followed by nine private therapy sessions, which Gottman recommends as a supplement. These attempt to conquer the four most common, corrosive negative factors in unstable unions: criticism (You never ... You always ... ), defensiveness (Who me? I'm not defensive), contempt (You're too stupid to realize how defensive you are) and stonewalling (I'll just let it blow over). Gottman says 85% of stonewallers are men.
Gottman fiercely protects the privacy of his patients and does not provide names of couples to be interviewed. He says his five-year follow-up study shows that after one year, about 75% of the treated couples are happier, "[though] we haven't been able to help the other 25% calm down. They stay irritable, cranky and contemptuous."
Reflection Exercise #5