Infidelity

1. Establish Type of Treatment (1)

A. A discussion was held to identify the type of treatment that will be conducted.

B. Relationship therapy was selected as the type of treatment to be conducted, focusing on the expectation that the affair will end; the goal will be to salvage the relationship.

C. Ambivalence therapy was identified as the appropriate treatment, with the goal to clarify the future of the relationship and the affair.

D. Separation therapy was identified as the appropriate treatment, with the focus on ending the relationship and separating under the best possible terms.

2. Negotiate Noncollusion Contract (2)

A. A noncollusion contract was presented to the partners, stipulating that the therapist will not agree to secrecy with either.

B. The therapist's role was emphasized as one of working for the mutual well-being of the couple.

C. The partners were supported for their acceptance of the noncollusion contract as presented by the therapist.

3. Discourage At-Home Discussions about the Affair (3)

A. The partners were directed to avoid deep discussions at home about the affair or the future of the relationship during the first month of treatment.

B. The partners agreed to avoid deep discussions at home about the affair or the future of the relationship during the first month of treatment.

C. The partners agreed not to make threats about the safety of others.

D. The partners reported avoiding deep discussions about the affair and the future of the relationship outside of the treatment setting and were reinforced for this compliance with the therapeutic process.

E. The partners reported ongoing discussions about the affair or the future of the relationship during the first month of treatment and were redirected to discontinue this pattern.

4. Assess for Suicidality and Homicidality (4)

A. Each partner was asked independently about whether they have any thoughts, intent, or means to hurt themselves or others.

B. A partner identified concerns related to suicide, and appropriate steps were taken to assure that partner's safety.

C. A partner identified concerns related to homicidality, and appropriate steps were taken to ensure safety.

D. The partners were assessed, but no evidence of homicidality or suicidality was present.

5. Teach the “Pause, Calm, and Think” Technique (5)

A. The partners were taught about the “Pause, Calm, and Think” technique.

B. The partners were taught how to pause the conversation, including letting the other partner know that you want to pause the discussion.

C. The partners were taught the calm-down technique, focusing on diaphragmatic breathing, counting to ten, etc.

D. The partners were taught the think phase, taking responsibility for ways in which one is making the conflict worse, and planning how to respond in a mindful, nonescalating manner.

E. The partners were encouraged to examine thinking by asking how accurate their thinking is, how situationally focused their thinking is, and whether this discussion will help get them what they want.

F. The partners were reinforced for their understanding of the “Pause, Calm, and Think” technique.

G. The partners have struggled with the use of the “Pause, Calm, and Think” technique and were provided with remedial instruction in this area.

6. Practice “Pause, Calm, and Think” Technique (6)

A. Partners were asked to practice the “Pause, Calm, and Think” technique within the session.

B. The partners utilized real life experiences to practice the “Pause, Calm, and Think” technique within the session.

C. The partners were assigned at-home implementation of the “Pause, Calm, and Think” technique.

D. The partners' use of the “Pause, Calm, and Think” technique in at-home situations were reviewed.

7. Emotions Elicited By the Affair (7)

A. In individual sessions with the partners, each partner was requested to discuss emotions elicited by the affair.

B. Individual sessions for each partner were able to focus on the emotions elicited by the affair.

C. The partners had difficulty completely identifying their emotions and were offered potential emotions, such as fear, guilt, anger, shame, and ambivalence.

8. Express Volatile Emotions via a Letter (8)

A. Since emotional volatility was high, each partner was asked in an individual session to write a letter to the other conveying the emotions elicited by the affair.

B. Each partner has written a letter to the other conveying the emotions elicited by the affair and these were shared.

C. Since both partners have not written a letter to the other conveying the emotions elicited by the affair, this resistance was reviewed and the letter was reassigned.

9. Read Letter in Individual Therapy (9)

A. Within the individual session, each partner was asked to read his/her letter and discuss their emotions.

B. The partners were validated for the emotions in their letter to the other partner.

C. The partners were assisted in bringing out softer emotions (vulnerability, hurt, regret) as well as positive feelings toward the partner.

10. Counsel Participating Partner about Hurt Partner's Openness (10)

A. In an individual session, the unfaithful partner was counseled about how the hurt partner will be most open to listening to the unfaithful partner if he/she can clearly and considerately convey insight into the meaning of his/her behavior.

B. In an individual session, the unfaithful partner was counseled about how the hurt partner will be most open to listening to the unfaithful partner if he/she can clearly and considerately convey authentic contrition for the harm to the hurt partner and the relationship.

C. The unfaithful partner was reinforced for his/her insight into how the meaning of his/her behavior and the authentic contrition for the harm to the hurt partner and the relationship was important.

D. The unfaithful partner was reinforced for his/her verbalizing of insight into the meaning of his/her behavior and authentic contrition.

E. The unfaithful partner has a poor understanding about how or why he/she should considerately convey insight into the meaning of his/her behavior and his/her authentic contrition, and was redirected in this area.

11. Revise Letters (11)

A. Each partner was asked to revise his/her letter with feedback from the therapist.

B. Each partner has revised his/her letter and the letter was read in a conjoined session.

12. Provide Guidelines for Discussing Affair (12)

A. In a conjoint session, the partners were provided with guidelines for discussing the affair.

B. The necessity of being clear was emphasized, including specificity, sharing thoughts and feelings, paying attention, asking clarifying questions, and summarizing content and feeling.

C. The importance of being considerate was emphasized, including providing positive reinforcement, considerately expressing negatives, emphasizing listening despite disagreement, and reserving judgment.

D. The partners displayed a clear understanding of guidelines for discussing the affair, which was reinforced.

E. The partners have not displayed a clear understanding of the guidelines for discussing the affair and were reminded about these important parameters.

13. Rate Clarity (13)

A. The partners were asked to discuss feelings and thoughts about the affair.

B. The partners were asked to rate themselves on how clear they were about their thoughts and feelings.

C. The partners were fairly realistic about the clarity of thoughts and feelings and this was reinforced for them.

D. The partners have not been realistic about ratings of feelings and thoughts, and were provided with additional feedback in this area.

14. Rate Consideration of Communication (14)

A. The partners were asked to discuss feelings and thoughts about the affair.

B. The partners were asked to rate themselves on how well they did on being considerate.

C. The partners seem to have a realistic assessment of the considerateness of their communication, and this was reinforced.

D. The partners did not have very realistic ratings of their considerateness of communication and were redirected in this area.

15. Normalize Hurt Partner's Experience (15)

A. The partner hurt by the infidelity identified a variety of emotions related to the situation.

B. The partners were provided with handouts of common reactions to trauma (e.g., symptoms of major depressive disorder, and posttraumatic stress disorder).

C. The hurt partner's reaction to the infidelity was assessed as it relates to symptoms of reaction to trauma.

D. The hurt partner's emotional reaction to the infidelity was normalized as a common reaction to trauma.

16. Teach Anxiety Management Techniques (16)

A. The hurt partner was taught anxiety management techniques to help cope with intrusive thoughts.

B. The hurt partner was taught anxiety management techniques, such as setting aside worry times, keeping a journal, using diaphragmatic breathing, and thought-stopping techniques.

C. Anxiety management techniques were modeled to the hurt partner.

D. The hurt partner was reinforced for the reported use of anxiety management techniques.

E. The hurt partner has not used anxiety management techniques and was provided with remedial assistance in this area.

17. Identify and Share Intrusive Thoughts (17)

A. The hurt partner was asked to describe intrusive thoughts about the affair.

B. The unfaithful partner was directed to listen empathetically and supportively to the hurt partner.

C. The unfaithful partner was directed to use specific skills, such as paraphrasing the content of the hurt partner's statements, reflecting the emotional meaning of the hurt partner's statement, and taking responsibility for causing distress.

D. As the hurt partner described intrusive thoughts, empathetic support was modeled for the unfaithful partner.

E. Positive feedback was provided as the unfaithful partner listened empathetically and supportively.

F. The unfaithful partner did not listen empathetically and supportively and was given specific redirection in this area.

18. Teach About Self-Change Plan (18)

A. The partners were taught about the five components of a self-change plan: (1) describe the behaviors that would be changed; (2) examine the pros and cons of the current behaviors; (3) set a goal, describing as precisely as possible what is to happen; (4) create an action plan, pinpoint a specific plan for enacting the goal; and (5) evaluate enactment of the plan.

B. The partners were asked to practice the use of the self-change plan in-session.

C. Positive feedback was provided as the partners displayed a mastery of the self-change plan technique.

19. Rate Implementation of Self-Change Plan (19)

A. The partners were asked to make a global evaluation of how they did on implementing the self-change action plan before the next session.

B. The partners were asked to jot down short answers to questions such as “What did we actually do?”, “What positives resulted?”, “What negatives resulted?”, and “What do we need to do from here?”

C. The partners have rated themselves on the self-change action plans and the results were reviewed.

D. The partners have not rated themselves on the self-change action plan and were redirected to do so.

20. Generate Factors that Contributed to the Affair (20)

A. The partners were asked to generate a list of factors that set the context for the affair.

B. The couple was asked to identify couple factors that may have contributed to the affair.

C. The couple was asked to identify external factors that may have contributed to the affair.

D. The couple was asked to identify individual factors that may have contributed to the affair.

E. The couple has generated a variety of factors that may have contributed to the affair and these have been processed.

F. The couple struggled to generate significant factors that set the context for the affair, and were provided with specific examples in this area.

21. Review Beliefs (21)

A. Each partner was asked to describe beliefs regarding monogamy, need for excitement, escapism, romantic love, admiration, and growth.

B. As the partners described beliefs about monogamy and other issues, patterns were summarized and reviewed.

C. The partners were directed to describe how these beliefs might have made an affair more likely.

D. The partners displayed insight into how beliefs played a role in making an affair more likely and were provided with positive feedback in this area.

E. The partners struggled to identify how beliefs made an affair more likely and were provided with feedback in this area.

22. Summarize Why and How the Affair Happened (22)

A. Each partner was asked to summarize their understanding of how and why the affair happened.

B. The hurt partner described his/her understanding of how and why the affair happened.

C. The unfaithful partner summarized his/her understanding of how and why the affair happened.

D. The partners' understanding of how and why the affair happened were summarized, compared, contrasted, and synthesized.

23. Assess Relationship Strengths and Needs (23)

A. The current strengths and needs of the relationship were assessed via interviews.

B. Psychological inventories were used to assess the strengths and needs of the relationship.

C. The results of the relationship strengths and needs evaluation were shared with the couple.

24. Identify Specific Feedback Desired (24)

A. Each partner was asked to describe in detail the specific changes that are most desired from the other partner to feel more loved, respected, or committed.

B. “How Can We Meet Each Other's Needs and Desires?” from the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma) was assigned.

C. The homework assignment has been completed, and key concepts were reviewed.

D. The uncompleted homework assignment was reassigned, and the reasons for noncompletion were reviewed and problem-solved.

E. An emphasis was placed on the partners to make requests from the other partner that are brief and ask for a positive behavior to increase rather than a decrease in negative behavior.

F. Each partner identified specific positive changes that are desired to help each feel more loved, respected, and committed.

G. When requested behaviors became more complicated, vague, or focused on decreasing negative behaviors, the partner was redirected.

25. Assess Pre-Affair Functioning (25)

A. The partners' pre-affair functioning was assessed through taking a relationship history.

B. The partners were questioned about their pre-affair functioning, including how they met, why they were attracted to each other, the steps in the relationship, the postmarital adjustment, and the highs and lows during the relationship.

C. The partners' description of their pre-affair functioning was summarized and paraphrased to them.

26. Increase Caring Behaviors (26)

A. The partners were assigned to “catch your partner pleasing you,” including recording at least one positive behavior for each day by the partner and at least one by self.

B. The partners have used the “catch your partner pleasing you” exercise, and the results of this were processed.

C. An increase in caring behaviors was noted.

D. A decrease in selective negative attention was noted.

E. The partners did not regularly record at least one positive behavior by the partner and by self and were redirected to do so.

27. List Changes (27)

A. Each client was assigned to list changes for self and the other partner that would improve the relationship.

B. A structured questionnaire, Areas of Change (Weiss and Birchler), was used to help the clients list the changes that would improve the relationship.

C. “Positive and Negative Contributions in the Relationship: Mine and Yours” from the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma) was assigned.

D. The homework assignment has been completed, and key concepts were reviewed.

E. The uncompleted homework assignment was reassigned, and the reasons for noncompletion were reviewed and problem-solved.

F. The partners have developed a list of changes for self and the other partner that would improve the relationship, and these were reviewed within the session.

G. The partners have not developed a list of changes for self and other partner and were redirected to do so.

28. Prioritize Behaviors to Benefit the Relationship (28)

A. Each client was assigned to list and prioritize behaviors that would benefit the relationship, from the least to the greatest in terms of effort, trust, and the sacrifices that each behavior would require.

B. A Cost-Benefit Analysis (Birchler and Weiss) test instrument was used to prioritize behaviors helpful to the relationship.

C. The partners were directed to mutually enact the list of behaviors, starting with the least amount of trust and commitment first, following later with those of greater cost.

D. The partners were reinforced for implementing the lowest items on the priority list of behaviors that would benefit the relationship.

E. The partners have not implemented the lowest items on the priority list and were redirected to do so.

29. Treat Specific Problems (29)

A. A treatment plan was developed to address specific relationship problems.

B. As treatment for their secondary problems has been enacted, the couple's secondary problems have decreased.

30. Discuss Forgiveness (30)

A. The partners were asked to share their definitions and thoughts about forgiveness.

B. The partners were fairly realistic about their definitions and thoughts about forgiveness, and this was reinforced.

C. The partners were not very typical in regard to their definitions and thoughts about forgiveness, and were provided with feedback in this area.

31. Give Information on Forgiveness (31)

A. The partners were provided with information about forgiveness.

B. The partners were provided with a handout from Baucom, Snyder and Gordon about forgiveness.

C. It was emphasized that forgiveness is a process; a release from being dominated by negative thoughts, feelings, and behaviors; a chance to learn about and gain more understanding of your partner, your relationship, and yourself.

D. Information about forgiveness emphasized that it is not forgetting, reconciliation, an immediate event, or one-time event.

E. The partners displayed their accurate understanding of the concepts related to forgiveness, and were reinforced for this.

F. The partners did not display a clear and accurate understanding of the concepts related to forgiveness and were provided with remedial feedback in this area.

32. Discuss Fears and Apprehensions of Forgiveness (32)

A. The partners were asked to discuss their fears and apprehensions about forgiveness.

B. Support and encouragement were provided as the partners discussed their fears and apprehensions about forgiveness.

33. Discuss Outcomes of Forgiveness Choices (33)

A. The partners were directed in a discussion about the repercussions of not forgiving.

B. The partners were directed in a discussion about the potential payoffs for forgiving.

34. Challenge Maladaptive Beliefs (34)

A. The partners were assisted in challenging maladaptive beliefs about forgiveness.

B. The concept that forgiveness implies weakness was directly challenged.

C. The concept that forgiveness condones or excuses the affair was challenged.

35. Discuss Key Relationship Questions (35)

A. The partners were asked to discuss key relationship questions, such as how they chose to get together, and how they have developed and matured as individuals and as a unit over the years.

B. The partners were assisted in discussing key relationship questions related to their strengths and accomplishments as a couple and how they have survived and surmounted struggles over the years.

C. The couple was assisted in discussing how the affair fits into the tapestry of their relationship.

D. The partners were supported as they discussed key relationship questions.

36. Review Factors Contributing to Decisions (36)

A. The partners were provided with information about factors to consider when deciding on the future of their relationship.

B. The partners were provided with information from Baucom, Snyder and Gordon regarding “Factors to Consider in Reaching a Decision about Your Relationship.”

C. The partners were assisted in evaluating each other, their relationship, themselves, and their relationship with the environment/other people.

D. The partners were supported and encouraged as they discussed key factors to consider when deciding about their relationship.

37. Discuss Levels of Trust (37)

A. The partners were assisted in discussing the different levels of trust that can exist in a relationship.

B. The partners were directed to identify what they trust the other partner to do currently.

C. The partners were assisted in identifying what they are unable to trust the other partner with currently.

D. The partners were assisted in identifying areas in which they only have partial trust in their partner.

E. The partners were supported and encouraged as they discussed issues related to trust.

38. Brainstorm Closure Ritual (38)

A. Using brainstorming techniques, both partners were helped to devise an appropriate ritual to signify that the unfaithful partner takes responsibility for the affair and asks forgiveness, and that forgiveness is granted by the hurt partner.

B. Emphasis was placed on the need for the ritual to convey that the affair is forgiven but not forgotten, and that both partners now move forward.

C. The partners were provided with feedback as they developed an appropriate ritual to signify taking responsibility and giving forgiveness.

D. The partners did not develop a ritual to signify responsibility and forgiveness and were provided with redirection in this area.

39. Brainstorm Recommitment Ritual (39)

A. Brainstorming techniques were used to help the partners devise an appropriate ritual to identify their mutual recommitment to an explicitly monogamous relationship.

B. The partners were supported for their selection of an appropriate ritual to signify their mutual recommitment to an explicitly monogamous relationship.

C. The partners failed to identify an appropriate ritual to signify their mutual recommitment to an explicitly monogamous relationship and were provided with additional feedback and redirection.

40. Develop Plan to Decrease Effects of Affair (40)

A. The partners were assisted in devising a plan for reclaiming places, people, or events tarnished by the affair.

B. The partners have developed a plan for reclaiming places, people, or events tarnished by the affair, and this was reviewed.

C. The partners have used the plan for reclaiming people, places, or events tarnished by the affair, and the use of these techniques were reviewed.