Illness As A Relational Process: Qualitative Analysis of Couple Therapy with Liver Patients

<p>The medical model traditionally emphasizes individual biological disease and is often unable to attend to the many ways illness impacts families and couples. Due to the focus on the biological process of disease, couples often struggle with the relational experience of illness. Quantitative research has provided ample evidence that couples coping with chronic illness from a relational orientation experience more positive outcomes than couples that cope individually. In this study, 25 therapy videos were analyzed with particular attention to how couples with liver disease work in therapy to shift to a relational illness orientation. Analyzed through a feminist lens, the results identify barriers to reciprocal caregiving: (a) autonomy discourse, (b) illness-related power, and (c) gendered power. Specific interventions that therapists employed to counterbalance the barriers were also identified: (a) emphasizing shared and relational processes, (b) counterbalancing the illness-related power, and (c) intervening in the taken-for-granted gendered power processes through therapist leadership. These main counterbalancing practices are further deconstructed into a number of in-the-moment actions that therapist utilize. For example, under the first category of emphasizing shared and relational processes, therapist introduce relational engagement as an alternative possibility, set relational goals, and emphasize the shared process of liver disease. Implications suggest that training, supervision, and practice need to address the importance of employing techniques that recognize and counterbalance (a) the influence of Western cultural values of autonomy, (b) illness-related power that organizes the couple system, and (c) the impact of gendered power on couples processes. Keywords: Couple therapy, relational coping, gendered power, chronic illness, clinical process research, Medical family therapy</p>

Name thesis:degree_name

Doctor of Philosophy (PhD)

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Counseling and Family Sciences

Year

2014

Author dc:creator

• Patrick, Elizabeth Ashley

Contributors dc:contributor

• Knudson-Martin, Carmen
• Hernandez, Barbara Couden
• Huenergardt, Douglas
• Williams-Reade, Jackie

• Counseling
• Social and Behavioral Sciences
• Couples Therapy; Interpersonal Relations - Psychology; Liver Diseases - Psychology; Disease Management - Psychology; Cross-Sectional Studies; Caregivers - Psychology; Stress - Psychological
• Relational Experience; Reciprocal Caregiving; Autonomy Discourse; Illness-related Power; Gendered Power

Statement dc:rights

• This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Language dc:language

English

Repository record dc:identifier

https://scholarsrepository.llu.edu/etd/221

OAI identifier oai:identifier

oai:scholarsrepository.llu.edu:etd-1223