Enactments in couple therapy: A process study

Greenberg's (1986, 1991) analytic method of process research was used to identify a process in couple therapy called an enactment. An enactment was defined as a therapeutic process in which the couple talks directly to each other and the therapist coaches the couple's interaction. Observational coding was used to investigate the use of enactments in couple therapy. The purpose of the study was to investigate the association between therapist interventions and positive and negative couple interaction during enactments. Gottman's (1994) RCISS was used to measure the dimensions of couple positive and negative interaction. The Therapist Interaction Scoring System (TISS) was developed by the author to measure therapist interventions.

The sample consisted of 36 videotaped enactment segments of eight therapists and 14 couples. Stepwise regression analyses revealed significant positive associations between therapist directives to husbands and husband positive speech, and between directives to couples and couple positive speech. Therapist directives to the couple were also significantly negatively related to couple negative speech, and positively related to the ratio of positive to negative couple talk. Therapist structuring to wives was significantly positively related to wife positive speech. However, negative wife speech and the ratio of positive to negative wife talk turns were not significantly related to any of the therapist intervention variables. Therapist use of affect with husbands was significantly negatively related to husband negative talk and positively related to the ratio of positive to negative husband speech.

Enactments were divided into two groups, one with positive interaction and one with negative interaction over time. MANOVA revealed significant overall differences between the positive and negative groups. Structuring, directives, and support were used more often with positive couples.

Descriptive analysis indicated that enactments were different lengths and were not regularly used by most therapists. The frequency of therapist interventions varied greatly, and therapists handled positive and negative couple exchanges differently. Therapists also rarely directly confronted negatives or encouraged positives. Couple talk during enactments was generally positive. Couples usually engaged in either positive or negative exchanges and couples did not continue with one partner being positive and the other negative for long.