Lee, Bonnie

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    Family therapy and civilization and its discontents
    (2023) Lee, Bonnie
    Myth or history, the origin of civilization was ascribed in the Hebrew scriptures to the first couple, Adam and Eve, and to the intergenerational saga of their descendants. Civilization has been a concern of psychoanalysts since the time of Freud and Jung, the fathers of depth psychology. In their mature years, they applied their theories and observations of human nature to the tumultuous events of the First and Second World Wars. Taking their cues, the author utilizes key concepts and insights from family therapy on couple conflict as a lens for analyzing international relations, with the goal for finding their parallels on the dynamics of strife and turmoil in our time and with the premise that the world could be seen as the human family writ large. The article explores how principles for couple analysis — respecting differences, boundaries, history, recognizing stress and transitions and congruent communication — can be transposed to international relations.
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    Characteristics of seekers for couple therapy for alcohol use or gambling disorder
    (Wolters Kluwer Health, 2023) Lee, Bonnie ; Shi, Yanjun; Ofori-dei, Samuel M.; Miftari, Naser
    Objective: This study examined characteristics of individuals with alcohol use disorder (AUD) or gambling disorder (GD) who were seeking couple therapy based on screening data from a randomized controlled trial on Congruence Couple Therapy at 2 out-patient addiction service sites in Alberta. Method: Screening data of couple therapy seekers (N= 171) were analyzed. Results: Seekers cited various motivations for seeking couple therapy including addiction-related relationship breaches and issues, the desire to recover from addiction together, concerns for the well-being of their children, and the lack of available couple therapy in addiction services until this trial. Significantly more females than males were first to indicate interest, and 77% of the sample had attended other treatment and mutual help programs in the past 12 months. The majority of the treatment seekers met DSM-5 diagnostic criteria for AUD and/or GD scoring in the moderate-severe range with nearly half of the seekers reporting a mental health diagnosis at least once in their lifetime. In addition, 30% of treatment-seekers reported past-year suicidal thoughts, citing their own addiction and their partners’ addiction as reasons and 57% of those individuals reported having a method/plan to carry out their suicide. Suicidal attempts in the past year was 8% based on the entire sample. Finally, 19% of treatment seekers reported experiencing intimate partner violence within the past 12 months. Conclusion: Addiction and couple relationship problems are closely connected. Despite the serious multiple concurrent concerns of seekers identified in this study, there is a general lack of couple therapy availability in addiction services. This study highlights the importance for addiction and mental health professionals to note the complex interaction of couple distress and addiction, understand couple therapy as a treatment modality, and make timely referrals for this vulnerable group.
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    Characteristics of seekers of couple therapy for alcohol use or gambling disorder
    (Wolters Kluwer Health, 2023) Lee, Bonnie K.; Shi, Yanjun; Ofori-dei, Samuel M.; Miftari, Naser
    Objective: This study examined characteristics of individuals with alcohol use disorder (AUD) or gambling disorder (GD) who were seeking couple therapy based on screening data from a randomized controlled trial on Congruence Couple Therapy at 2 out-patient addiction service sites in Alberta. Method: Screening data of couple therapy seekers (N= 171) were analyzed. Results: Seekers cited various motivations for seeking couple therapy including addiction-related relationship breaches and issues, the desire to recover from addiction together, concerns for the well-being of their children, and the lack of available couple therapy in addiction services until this trial. Significantly more females than males were first to indicate interest, and 77% of the sample had attended other treatment and mutual help programs in the past 12 months. The majority of the treatment seekers met DSM-5 diagnostic criteria for AUD and/or GD scoring in the moderate-severe range with nearly half of the seekers reporting a mental health diagnosis at least once in their lifetime. In addition, 30% of treatment-seekers reported past-year suicidal thoughts, citing their own addiction and their partners’ addiction as reasons and 57% of those individuals reported having a method/plan to carry out their suicide. Suicidal attempts in the past year was 8% based on the entire sample. Finally, 19% of treatment seekers reported experiencing intimate partner violence within the past 12 months. Conclusion: Addiction and couple relationship problems are closely connected. Despite the serious multiple concurrent concerns of seekers identified in this study, there is a general lack of couple therapy availability in addiction services. This study highlights the importance for addiction and mental health professionals to note the complex interaction of couple distress and addiction, understand couple therapy as a treatment modality, and make timely referrals for this vulnerable group.
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    Changes in work status, couple adjustment, and recovery capital: secondary analysis of data from a Congruence Couple Therapy randomized controlled trial
    (Sage, 2022) Lee, Bonnie K.; Ofori Dei, Samuel M.
    Purpose: Employment and family/social relationships are 2 of the highest priorities among those in substance use recovery. This study examined the relationship of work status with couple adjustment and other recovery capital treatment outcomes among symptomatic alcohol, substance use, and gambling participants (N = 38) using data collected in a randomized trial comparing a systemic Congruence Couple Therapy (CCT) and individual-based Treatment-as-Usual (TAU). Method: Change scores and associations between work status and couple adjustment together with 8 other recovery outcome variables at post-treatment (5 months from baseline) and follow-up (8 months from baseline) in TAU (n = 17) and CCT (n = 21) were analyzed. Results: Number of those working increased with both CCT and TAU but without reaching significance in either CCT (Cochran’s Q = 5.429, P = .066) or TAU (Cochran’s Q = 2.800, P = .247). Relative to those not working in the combined sample, those working showed significantly improved scores in post-treatment and follow-up in addictive symptoms, couple adjustment, psychiatric symptoms, depression, and life stress. Separating the CCT and TAU groups, similar trend was found in the CCT group but was inconsistent in the TAU group. Conclusion: Significantly greater improvement in addictive symptoms and recovery capital of couple adjustment, mental health, and life stress was found in the working vs not-working group. Compared to individual-based TAU, exploratory findings indicate that the systemic treatment of CCT showed a clearer and more consistent difference in improved working days, addictive symptoms and recovery capital. Replication with larger samples is needed to generalize these results.
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    Employment stress and couple adjustment among clients with disorders of gambling and alcohol use: themes of transfers in Congruence Couple Therapy
    (Sage, 2022) Lee, Bonnie K.; Merali, Noor-Khanu
    Background: Individuals with problematic gambling, alcohol and substance use commonly report lower employment rates and more employment-related problems such as job loss, work conflicts and poor performance. Method: A thematic qualitative analysis was conducted to extract employment-related themes from 21 sets of addiction counselors’ case notes of couple therapy sessions (average 10 sessions per case) from a randomized controlled trial of Congruence Couple Therapy (CCT). Case notes were examined for the types of employment issues to answer the research question: What are the interconnections of employment, couple adjustment and addictive behaviors as revealed in the CCT counselors’ case notes? Results: Five key areas of employment-related stress were identified: (1) unemployment, (2) financial concerns, (3) history of crime, (4) overworking and workaholism, and (5) workplace conflict. These themes interacted negatively with couple adjustment and addictive behaviors. Using CCT as an intervention, clients gained skills in 4 areas transferred to employment: (1) awareness of self, other and family of origin, (2) congruent communication, (3) work-family balance, and (4) enlisting spousal support. These themes intersected with enhanced work functioning and reduced stress, alcohol use and gambling. Conclusion: Employment problems negatively impacted addictive behaviors, couple adjustment and well-being of partners and addicted clients. Skills and awareness gained in CCT promoted changes in addicted clients’ employment functioning and coping with employment stress. The domains of work and couple adjustment are mutually influential in increasing or reducing stress with implications for addiction recovery. CCT as a viable intervention for enhancing employment function should be further studied.
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