Mediation - the Way Forward

Ludwig.F. Lowenstein Ph.D

Southern England Psychological Services

1999

Introduction and Abstract

We bear a great deal to-day about confrontation and most especially the number of divorces and separations between initially, apparently well-adjusted and harmonious couples. having dealt with several hundred of such unfortunate people, I have come to certain conclusions, that many marital problems, divorces and separations and also acrimonious relationships that remain together, could be spared such ordeals, if timely intervention occurred through mediation procedures. It is unfortunate however that most of the problems to come to psychologists, psychiatrists and counsellors deal with situations where the acrimony, hatred and the apparent dissolution of relationships have gone too far or can only be mended with great difficulty.

V/'hat follows in this paper has been divided into a research of the most recent literature between 1996 and 1997 followed by the diagnosis and treatment of ?4 marriage partners or partners without marriage over a period of five years. The review of the literature encompasses comparing different therapeutic approaches by therapists and considering the general value of mediation to-day. ïhere should be a section dealing with the causes and associated features of marital problems including gender links, infidelity, power struggle, violence in the family and other problems. This is followed by diagnosing the problems of marital and relationship dysharmony and finally dealing with treatment approaches including the following - role playing, developing of empathy, eclectic psycho-dynamic treatment, cognitive behaviour treatment, solution focusing, creating physical and emotional closeness, education and other approaches.

Recent Research Literature

Family therapy researchers were criticised by Clark & Serovich (199?) for failing to address themselves to the extent to which marriage and family therapy does not recognise the importance of gay, lesbian and bisexual issues.

The literature by Kelly and Halford (1997) attempted to redress the balance in psychological study of couple relationships by focusing on what is known about emotion in relationships. Emotional processes in couple relationships were significant in understanding the quality of the relationship, and the effect of the relationship on the partner's psychological and physical health. Most research on emotion within couple relationships had been cross-sectional in nature, comparing distressed and non-distressed couples, and these findings were reviewed in the first half of the article by these researchers, While such research described differences in emotional processes between distressed and non-distressed couples, it gave no information on how these emotional processes developed over time. In the second section of the article, the authors discussed the implications of these lines of inquiry for therapy and research. Questions regarding the availability, use and application of emotion data in clinical settings were addressed. Current knowledge about how traditional behavioural marital therapy impacted on emotional distress in couples was reviewed, and several possibilities for improving traditional behavioural marital therapy were considered.

Another research study by Bennun (1997) discussed the literature on systemic marital relationship interventions with one partner only. Increasingly, marital therapists and agencies offered services to distressed couples were seen just one marital partner and needed to consider methods of treating relationships distress within this mode. Some of the empirically established methods were described as are general clinical issues.

1. General Values of Mediation

Whether there is any value on the mediation process is difficult to establish as there are rarely studies which contain a control group wherein no mediation occurs and hence comparisons can be made. Welter (1995) contended that each marriage gad its beginnings and its ending and a primary meaning of marriage that was often overlooked by marriage counsellors was the story of the marriage. The counsellor needed to obtain a family history or the antecedents of the marriage story, from each of the spouses, then the story of their marriage. Each partner was to provide information in connection with these questions and then comparisons were to be made between the two versions.

In the case of divorce mediation and the resolution of child custody disputes, Dillon & Emery (1996) examined the long term effects of using mediation to resolve such problems. 25 parents who chose mediation and 28 parents who chose litigation to resolve child custody disputes were followed up 9 years after dispute was first brought to court. Parents were asked whether the child involved in the dispute had experienced difficulties in adjustment, and whether psychological treatment was given. Frequencies of both direct and indirect contract between the child and the non-resident parent were assessed, and parents rated inter—parental cooperation and conflict. Non-custodial parents assigned to mediation reported more frequent current contact with their children and greater involvement in current decisions about them. Parents in the mediation group also reported more frequent communication about their children during the period since dispute resolution.

Following a decade of divorce mediation research which had focused on outcome such as settlement rates, cost efficiency, client satisfaction, effect on levels of conflict and cooperation, psychological adjustment and compliance, Kelly (1996) still felt that research on the mediation process and mediation behaviour had received very limited attention. The main determinants of divorce settlement negotiations between divorcing spouses and their lawyers, according to Hochberg & Kressel (1996) was a favourable settlement outcome which led to cooperative negotiating between the parties. It therefore followed that psychological adjustment was for all concerned.

The role of children in mediation was studied by Lansky et al (1996). They examined the actual practice of 324 practitioner members of the Academy of Family Mediators focusing on the inclusion or exclusion of children during the mediation process. 31(lf of respondents were attorneys, 46% had graduate-level mental health backgrounds, and an additional 7% had both legal and mental health backgrounds. The survey instrument revealed that 77% of the respondents included children, either following settlement to discuss the parenting plan or during mediation as a source of additional Information. Respondents1 reasons for including (i.e. requests by the parents or children to avoid impasse, due to divergent opinions among parents) or excluding (i.e. to avoid pressure or loyalty conflicts) children were outlined.

The training of therapists was considered by Latz (1996). She studied the administration and outcome of an experiential exercise for training beginning marital and family therapists in language skills, which aimed to sensitise individuals to the possibility of their own and clients' idiosyncratic application of words. The exercise consisted of two parts: Part 1 required individuals to interpret what they had heard from the audio of a film clip. All those participating had heard the same sounds and conversation, but each made a unique interpretation. They expressed frustration and discomfort at having to interpret only the audio portion. In the second part, the same individuals were shown the visual clip along with the audio and asked to share their descriptions. The multiplicity of meanings and flexibility of actions that was noticed in the first part of the exercise, disappeared in the second part.

Different kinds of mediation processes were compared by Vansteenwegen (1997). Differences in the verbal behaviour of two experienced couple therapists were studied in a videotaped intake session with the same couple (2 professional actors, trained on a real case). One therapist worked from an experiential viewpoint (cliënt—centred, Rogerian) and the other worked from a communicative approach (directive, problem-oriented). The therapists were both male, 40 years of age, and had over 12 years of experience as psychotherapists. For all verbal interventions the instrument utilised was the Pinsof Family Therapist Coding System. The results suggested that the communication therapist was more direct and his interventions were more directed towards the couple rather than towards the individual partners. At the same time many similarities were found between the two models.

A number of therapists have found that divorce mediation was a difficult prospect especially when arguments arose within the meetings. Greatbatch & Dingwall (1997) analysed the management of arguments between disputants in 121 divorce mediation sessions recorded in 10 agencies in England. It was found that the disputants did not always rely on mediators to initiate exits from their arguments. Instead they initiated exits on their own, often closing their argumentative exchanges without the mediators' assistance. The practices used to exit arguments in the sessions were prevalent in ordinary conversation, but their use here exhibited an orientation to conventions associated with mediation. This limited both the duration of arguments and the intensity of verbal conflict. These findings raised important questions about the interactional organisation of mediation sessions.

Finally Worthington et al (1997) founded an approach termed Strategic-hope focused relationship enrichment. They used a brief eclectic research based programme to enhance couples' relationships. 51 couples,(16 married 24 cohabiting, 11 engaged) completed 5 sessions of enrichment counselling. Couples who received enrichment counselling had higher relationship satisfaction and quality-of-couple skills at post-test and at the 3 week follow-up than did written assessment only (control) couples. Conditions did not differ in terms of quality of overall attraction or 2 measures of commitment. It was concluded that relationship enrichment using this programme was effective, powerful and cost-effective.

Prevention

There were relatively few studies in the recent literature dealing uiith the prevention of relationship problems. Meyerstein (1996) found the joining of families through re-marriage was a complex process, particularly when children were involved. A host of ambivalent feelings, role changes, marital adjustments, and new challenges had to be faced. The format of brief systemic pre-remarital counselling offered family members an opportunity to address the feelings and multiple issues of transition. Within the counselling framework, therapeutic ritual had been found to be a useful adjunctive technique.

The prevention of marital breakdown was studied by Clulow (1996). He discussed 3 preventative paradigms commonly used for preventing divorce. These were policing, medical and educational. A 4th paradigm was suggested, a consultative approach, which implied a cyclical rather than a linear view of life experience. The consultative paradigm had the potential to integrate -not only the preventative paradigms but also the concepts of prevention and cure that so often were pursued as if they existed in separate compartments.

Finally, Fraenkel et al (1997) studied the rationale for a preventive approach to helping couples in marriage. Uhile divorce rates were high and many other couples remained together, but miserable, this was surely not what couples desired from the outset. The conflict and breakdown of these crucial relationships contributed to mental and medical health problems for adults and children, behavioural disturbances in children, problems in worker productivity, and serious economic difficulties for families and societies, Too many couples sought help only after significant, often irreversible, damage had occurred. It did not have to be that way. A variety of approaches were available that were capable of being used to teach couples the skills, behaviour0! and attitudes of good relationships before they encountered damage to their union. Here, one particular cognitive behavioural approach was used, along with a review of the research on the effectiveness of such approaches and a description of some of the strategies of this model. A list of common roadblocks to the work of prevention was discussed, along with a couple of brief case examples. It was felt that there was reason to believe that couples could benefit a great deal from prevention.

Causes and Associated Features

In this section we will discuss the causes and associated features with marital disharmony and the need for mediation. These included gender links, infidelity, power struggles, lack of fertility in one or both partners, work addiction, violence between partners, physical handicaps with one or both partners, alcohol mis-use and lack of communication between the partners.

1. Gender Links

Several studies allude to gender links as important aspects in mediation processes. O'Donohue & Crouch (1996) discussed whether communication training programmes in marital therapy had been sufficiently sensitive to gender—linked factors in communication, through a research review. Communication was often a treatment target in marital therapy. Although existing data indicated that individuals tended to hold stereotypes of gender differences in language, many of these differences had not been supported in empirical investigations. Gender influences variables such as amount of conversation elicited, length of utterance, use of qualifying phrases, swearing and compliment style. Effective communication therapy had to be facilitated by evaluating each partner's gender-based expectations of his/her own communication behaviour and those regarding communication of the other partner. It was feit that a number of personality and situational variables moderated some of these effects, and need to be considered in therapy.

Gregory & Leslie (1996) examined the effect of the race and gender of 63 clients and therapists, aged 20 - 40+ years, on their male (aged 21-52 years) and female (aged 21.57 years) partners' assessments of an initial and subsequent family/marital therapy session. The individuals, belonging to Black & White families, evaluated the first and fourth therapy sessions using the Session Evaluation Questionnaire, which evaluated therapy smoothness. A strong effect for race was found, with Black females rating the first sessions with a White therapist more negatively than White females. Black males had a more positive response than Whites to the first session, regardless of the therapist's race. The therapist's sex had no significant effect on the client’s session assessment. The effect of the therapist's race decreased over time. Only the Black females with White therapists experienced an increase in smoothness over time.

A comparison was carried out between levels of sexism and feminism in the clinical decisions made by marriage and family therapists who had no training in gender issues with those who had such training, either through a separate course or by integrating gender issues throughout the curriculum. (Les l ie &•. Clossick, 1996). 150 entry-level marriage and family therapy students or therapists, aged 21-64 years) were assessed for the type of gender training received and whether the gender course was taught from a feminist perspective. Levels of feminism and sexism in clinical assumptions and interventions of the individuals were evaluated using clinical vignettes. Of the 102 individuals with some gender issue training, 64%- had received it from a feminist perspective. Though gender training alone did not influence levels of sexism and feminism in clinical decision making, levels of sexism were significantly lower for individuals who had received gender coursework from a feminist perspective.

Finally, .Stabb et al (1997) found differential treatment by gender had been an on-going area of concern and uncertainty both in society at large and in clinical research. In this investigation, the attributions of a 50 year old white male marriage and family therapist were coded and analysed over the course of therapy for three different married couples to determine if cause for positive and negative events was assigned differentially to females and males,

Additionally, the stability and globality dimensions of the therapist's attributions about the couples were examined for stereotypical gender-related patterns. The results indicated no gender differences in locus of causal attribution but some gender-related patterns in stability and globality dimensions.

2. Infidelity as a factor

Despite the commonness of infidelity in marital problems only two studies in recent years existed. Atwood & Seifer (1997) discussed the sociocultural definitions of extramarital sex that influenced the reasons couples constructed for involving themselves in extramarital sex. Information was presented on their typical psychological reactions, taking into account current research. The article presented a review of what was known and the research on extramarital sex and then concentrated on marital meaning systems -their development and maintenance - focusing on social constructionist themes and therapy which served to shift the focus of a problem-oriented approach towards a search for the strengths of the extramarital sex couple. A 4-stage constructionist therapeutic model was proposed. The stages included (1) joining the family meaning systems, (2) inviting the couple to explore their present meaning systems, (3) inviting the couple to expand their meaning systems, and (4) stabilising the new meaning systems. This approach allowed the couple to construct new meanings around the extramarital sex issue so that they were able to find a workable solution.

Using cross-cultural perspectives to understand infidelity in couples, Penn et al (1997) found that all marital therapists encountered a couple who had been or who were affected by infidelity. The literature on infidelity lacked an understanding of its impact on cultural perspectives. This article discussed the ways in which infidelity was viewed within the context of three ethnic minorities in the United States: African Americans, Hispanic Americans, and Asian Americans. The authors provided an overview of infidelity according to religious traditions.

3. Mediation of power struggles

Only one study referred to power struggles, this being of Gray-Little et al (1996). It examined the association of marital power type to (1) marital adjustment, and (2) response to behavioural marital therapy. A behavioural measure was used to classify 53 distressed couples into egalitarian, husband-dominant, wife dominant or anarchic power patterns. Marital adjustment was assessed by measures of marital satisfaction, desired relationship change and two communication indexes. At pre-treatment, egalitarian couples showed the best overall marital adjustment and anarchic couples showed the worst; at post-treatment, egalitarian and wife-led couples reported the highest marital satisfaction, and anarchic couples reported the lowest. Wife dominant couples improved the most, reporting increased marital satisfaction and demonstrating improved communication. The discussion considered the special treatment needs of anarchic couples for whom improved communication occurred in a context of continued marital dissatisfaction.

4. Fertility Problems

Only one study, that of Jones and Hunter (1996) concerned itself specifically with infertility experiences. they studied three couples1 experiences of fertility problems in the early stages of investigation; men and women were interviewed together and separately and their accounts of infertility were analysed using a discourse analytic approach. The method involved examining the narrative text for theses relevant to the question, identifying accounts used by participants to explain their experiences and hypothesising about the functions of this accounting practices. The participants reported that non-conception was not always a problem to them, but that this varied depending on time, biology, life plans, relationships within which it was being discussed. The subjectivity of people with fertility problems appeared to be less consistent and more contextually contradictory than expected.

5. Work Addiction

With the increased tendency towards the work ethic, work was considered an important aspect of marital problems by Robinson (1996). He studied the relationship between work addiction and family functioning. A theoretical model was presented which suggested that a relationship existed between work addiction, family of origin, and family functioning in adulthood. A review of the pertinent literature was presented followed by a case example and clinical implications for the practice of marriage and family therapy.

6. Violence within the relationship

Although a conmon issue, violence within the relationship only received one piece of research over the past years. Ehrensaft & Vivian (1996) used questionnaires and clinical interviews to reveal that over 6Cf?> of couples seeking marital therapy experienced physical violence in their relationship. However, fewer than 10°£ of these couples spontaneously reported or identified the violence as a presenting problem. Spouses' explanations for not spontaneously reporting couple violence were examined in 1J6 clinic couples. The top three reasons were as follows: (1) it was not a problem, (b) it v/as unstable or infrequent, and (c) it was secondary to or caused by other problems. There were no gender differences in this regard. Further, there were no differences regarding explanations offered for failure to report partner violence versus own violence. However, differences were found between mildly and severely aggressive spouses and between husband to wife and wife to husband violence.

7. Physical Handicap and marital problems

Speziale (1997) examined the changes in couples living with multiple sclerosis, particularly when sexual, cognitive and affective functioning had been affected. Two case studies of couples in whom the female partners had M.S. were presented and clinical intervention, divorce and extramarital relation-ships among couples living with MS were discussed. The author recommended a pre-requisite clinical assessment of how the intrusion of MS disrupted the roles, rules, and boundaries of the marital and sexual relationship, and the larger social systems in which partners participated (including personal and familial histories of physical and psychosocial losses, life crises, stigmatised social identities, and socioeconomic hardship, It also included unresolved grief, depression, shame, and family secrets. The author suggested that the partners benefited from knowledge about MS, prescribed drugs and symptom management techniques,

8. Alcohol Mis-use and relationship problems

Again only one study in recent years discussed the importance of alcohol mis-use leading to marital disorders (Hotunda & O'Parrell, 1997). Clients with alcohol and other substance use disorders were routinely encountered by practitioners in various treatment settings. This article traced the rationale for using marital and family therapy with alcoholics and described an ongoing behavioural marital therapy programme that exemplified an integration of clinical practice and research in this area. Specific treatment suggestions were offered and practical considerations for therapists working with families struggling with alcoholism were discussed including the role of self-help groups in family treatment, the danger of having preconceived notions about "alcoholic families", and the necessity for clinics and clinicians to possess the capacity to assess and treat comorbid psychological disorders as well as addictive behaviours.

9. Lack of communication within marital relationships

Deterioration in communication patterns had been empirically linked to eventual separation and divorce in married couples, (Hoss and Estrada, 1997). This article drew on this research in describing a clinical intervention for use with couples in conjoint therapy. The intervention involved the use of a brief videotaped interaction task, which was completed by the couple at the outset and repeated periodically through the course of marital therapy. The potential utility of this intervention as both a clinical assessment and treatment tool with a wide range of couples was discussed and a brief case example of the intervention was provided.

The question of what makes relationships last or not last was considered by McCarthy (1997). Rather than an indication of lifetime commitment, the predominant form of marriage in western societies had become "companionate". It was held together by personal and emotional consideration rather than by traditional influences. The pursuit of personal satisfaction was an essential factor in marital relationships and, as a result, marriage had become less secure. One result of this was the growth of counselling services which aimed to assist couples through the process of negotiating relationships or in coming to terms with the emotional distress of failing to do so. This research attempted to address some of the concerns about the supposed lack of research on the impact of counselling. It focused on evaluation of marriage counselling provided by an agency operating in the field of relationship counselling. The evidence suggested counselling was able to help couples re-negotiate their relationships and help them through the personal anxieties connected with relationship problems. It clearly had a role to play in helping people through the complexities of companionate marriage, although it did not work for everyone and many couples who started counselling did not complete the process.

The Diagnosis of Marital Mediation Processes

The importance of not merely assessing situations or problems relating to marital relationship difficulties, there should be the assessing of individuals especially in a relationship conflict, (Lowenstein, 1994) Marital mediation or therapy must involve the individuals and Lowenstein discussed the position of the big "T" and little "t" i.e. those who seek thrills and likely to be very extroverted personalities and those who do not seek such excitement and may be more introverted. Little "t" individuals are more eager for harmony and are conservative in their personality traits. While opposites attract in a relationship, the more the individuals have in common, the more likely the marital relationship will work except in one area, that of seeking control or dominance. Areas where there are likely to be difficulties between big "T" and little "t" individuals are in the rate of infidelity where big "T" may predominate, also in sexual dissatisfaction and problems, attitudes to love, marital abuse and spouse abuse. Sometimes there are additional difficulties between extroverts and introverts or big "T" and little "t"'s in relation to caring for children, dealing with household chores, division of labour, recreation interests, religious differences and the handling of money. It is vital when carrying out mediation processes to make each partner aware of their strengths and weaknesses and to discuss these individual differences in the diagnostic sessions.

Attributions and behaviour in functional and dysfunctional marriages v/ere studied by Bradbury et al (1996). The study examined whether spouses' attributions for partner behaviour were related to their own behaviour by assessing their attributions and observing the problem-solving discussions of couples in which (a) neither spouse was depressed or maritally distressed, (b) the wife was depressed and both spouses were maritally distressed, and (c) the wife was not depressed and both spouses were maritally distressed. To the extent they made maladaptive attributions, wives displayed less positive behaviour and more negative behaviour. Husbands' attribution and behaviour were unrelated, and associations between attributions and behaviour v/ere not moderated by marital distress and depression. These results highlighted the need to clarify how partner behaviour contributed to the attributions spouses made and to is-examine interventions designed to modify attributions in marital therapy.

Wilson & Wilson (1996) considered that there were multiple selves operating within relationships. They asserted that the issues presented by couples in relationship therapy were to be regarded as an example of negative (dysfunctional) multiple selves. The author clarified the role of multiple dysfunctional selves and their influence on each partner within a relationship. It was proposed that this provided the therapist with specific Information regarding the client’s diagnosis and intervention strategies. This consisted of 10 selves (e.g. telic, paratelic, arousal-avoiding, excitement—seeking, the conformist, negativistic types. Finally Bagarozzi (1997) suggested a Marital Intimacy Needs Questionnaire. He discussed the construction of the Marital Intimacy Needs Questionnaire which contained information on satisfaction with the intimacy in marriage which was thought to be an important aspect of a successful marriage. For marry clinicians and family researchers, intimacy had been narrowly conceptualised as a unidimensional construct and unidirectiorial process. The author, however, conceptualised intimacy as a multi-faceted construct, and identified 9 dimensions of intimacy, each having 4 inter-related components. Clinical assessments of these dimensions and components were accomplished by the use of the Marital Needs Intimacy Questionnaire.

Treatment Approaches in Mediation

The recent research suggested at least 11 approaches for the treatment of marital or relationship dysharmony. They included the following: (1) role planning, (2) developing empathy; (5) Pro-social development; (4) Eclectic Psychodynamic approaches; (5) Cognitive behaviour therapy; (6) Solution focus tests; (7) Physical Emotional Closeness Development; (8) Family of Origin Approach; (9) Involving Clergy; (10) Emotionally Focused Therapy; (11) Education-type Therapy.

1. Role Planning

Cohen et al (1996) assisted parents by mediation, in the transition from being a nuclear family to a bi-nuclear family. During the process, the needs of the children v/ere taken into consideration and the particular difficulties of the parents, who no longer functioned as a couple rather as two independent individuals jointly responsible for rearing their children. A way was proposed to create a common basis for discussion between the two spouses, who were in a conflictual situation, in order to jointly plan their parenthood in terms of times, roles and content.

As a result in the dramatic increase in women's participation in the work force, more relationship therapists were seeing couples who were dissatisfied with how domestic labour was divided in their homes (Rasmussen et al, 1996). This paper was an effort to delineate some of the complex therapeutic issues such as engaging men in therapy, exploring emotional issues connected with house-work, and the mechanism of gatekeeping or the tendency of many wives to resist or manage their husbands' efforts to increase participation in the home. Also included was a therapeutic framework for addressing client concerns about domestic responsibilities.

Another study by Worthington (1996) considered health and productivity as important values in the 20th century American society. As business companies had had become more major players in delivery of mental health services via managed mental health care, the value placed on productivity had become even more important than in the past. Here the impact of managed mental health care on marital and family interventions was discussed. Implications for helping marriages and families were grouped as follows:

1. improvement of effectiveness and efficiency of marital and family therapies;
2. documentation of effectiveness and efficiency of marital and family therapies,
3. shift to more focus on health and prevention,
4. identity of providers of services that helped marriages and families, and
5. training of providers of services to marriages and families.

2. Developing Empathy

The inverse relationship between depression and intimacy was conceptualised as a function of the couple's affective experience, with empathising as the specific mediating factor. Depression, as a disorder of excessive self-focusing was amenable to treatment approaches that helped to shift the focus of concern from self to others, as found by Odegaard (1996). This shift occurred in couple treatment when the underlying negative affect of the caretaking partner was accessed and used to pull the depressed one out of self-absorption and into an empathy, other-focused experience. Prolonged caretaking and chronic depression led to a breakdown in a couple's empathising capacity, as the caretaker's experience of fear, helplessness, or frustration activated old coping patterns of withdrawal or over—functioning such as use of control, while the depressed one slipped into further self-absorption. Unmasking the caretaker's despair activated the other's empathy, facilitating movement out of the self-absorption. Depression was in fact, in part, a consequence of under-utilised empathy.

3. Pro-social development

Rudd (1996) considered the communication effects on divorce mediation: how participants' argumentativess, verbal aggression and compliance-gaining strategies were used in mediation. She investigated the relationship among participants' argumentativeness, verbal aggression and the use of compliance— gaining strategies and their level of satisfaction with the divorce mediation process. 87 couples who participated in court-related divorce mediation, specifically to settle child custody and visitation issues, were interviewed. The results of a stepwise regression analysis indicated that the more participants used prosocial compliance-gaining strategies the more satisfied they were with the mediation. Similarly Lowenstein (1998) studied Parental Alienation Syndrome and saw a 2-step approach towards a solution. The first considered motivation towards participation in the mediation process, having hovering over them, the possibility of legal or judicial sanctions if this could not be achieved through mediation. The second step was to use the court procedure for the purpose of settling those who were unable to benefit from the mediation process, and most especially that party which failed to cooperate in that process. In a later study, Lowenstein 1998b in an unpublished study, the author presented the value of the Expert Witness in dealing with couples in a conflict situation, often concerning their children and who should have custody of them. He suggested several approaches including (1) sectarian approach; (2) the Expert Witness as an Independent Arbitrator, and presented the results of mediation as compared with the use merely of the legal system and the courts. It was found that as many others had found that of those who participated in arbitration and mediation, they achieved greater satisfaction than those brought into the legal system and the adversarial system most particularly using only solicitors within the conflict situation.

4. Eclectic Psycho-dynamic Therapeutic Approaches in Mediation

Schoenewolf (1996) in an article with the intriguing title, "The Couple who fell in hate", studied couples in which the husband was passive and the wife aggressive u/ho were a common sight in to—day's therapy clinics. Such couples u/ere difficult to work with because they had become addicted to their ritual of hate, which offered each a secondary gratification. To work with them, therapists often needed to be creative and utilise eclectic approaches. In the case described, the therapist used a paradoxical behavioural approach combined with psychoanalysis.

5. Using Cognitive Behaviour Therapeutic Approaches in Mediation

Cognitive behaviour therapeutic approaches in marital conflict were used by Cheung (1996). He used the problematic concept of attribution, which had received increasing attention in cognitive behavioural marital therapy. Research had found that the attribution dimensions of source, globality, stability, intent, and voluntariness were related to the marital distress and conflict behaviours. It was proposed that there were three levels of events for which a spouse had to make attributions: the episode level, the behaviour level, and the global relationship level. Different reattribution techniques needed to be employed to target attributional change at appropriate levels of conflict attributions.

Individual behavioural cognitive therapy in marital problems related to depression were used by Emanuels-Zuurveen & Emmelkamp (1996). 37 depressed individuals, aged 18-65 years, experiencing marital distrsss were randomly assigned to either individual behavioural cognitive therapy or marital therapy. The individual treatment condition focused on depressed mood, behavioural activity and dysfunctional cognitions, whereas in the marital condition the partner was involved in the treatment and the focus was on the communication process in the marital relationship. Multiple analysis of variance revealed that treatment led to statistically significant improvements in depressed mood, behavioural activity and dysfunctional cognitions, an increase in relationship satisfaction and improvement of communication in patients and spouses. A significant interaction effect was found, showing that marital therapy had more impact on relationship variables than the individual treatment.

6. Solution focused mediation therapy

Solution—focused therapy mediation was used by Franklin (1996). Processes of change were illustrated in a marital case study in which solution-focused therapy was being applied. This approach focused on stabilising semantics and politics at level one and on changing semantics and politics at level two. The individuals made progress in therapy as indicated by verbal reports and scores on standardised tests,

7. Developing physical emotional closeness in mediation therapy

Durana (1996) used quantitative and qualitative research methods to evaluate the impact of bonding i.e. physical closeness and emotional open-ness) and catharsis in the Bonding and Emotional Re-education. 73 adults were assessed by means of measures of marital adjustment, self-esteem, depression, anxiety, control and support. The results suggested that Bonding and Emotional Re-education in marital adjustment led to greater affection, satisfaction and self-esteem. The study explored differences in changes for males and females. Exploratory findings indicated that the Practical Application of Intimate Relationship Skills approach was useful for distressed couples and suggested that there was a gender difference associated with changes in marital satisfaction.

8. Family of Origin Approach in Mediation Therapy

An example of this was by Kane (1996) who used an experiential approach to family of origin work with marital and family therapy students. The incorporation of a day workshop into an introductory course on marriage and family therapy for graduate counselling students was described. In this workshop, participants moved through a series of experiential exercises that invited affective involvement with family-of-origin dynamics. However, because educators had to evaluated the work of trainees, they had to avoid engaging students in affective work for fear of entering into dual roles. By including a therapist whose only function in the programme was to facilitate the trainees' family of origin work, training programmes were to incorporate this component without blurring the roles of instructor and therapist,

A similar approach was used by Framo (1996). He presented a generally technique for using the family of origin as a therapeutic resource for adults in marital and family therapy. Marital and family difficulties were viewed as elaborations of relationship problems of the spouses in their original families, so sessions with the family of origin were considered a possible basis for reconstructive changes in the present family setting.

9. Mediation therapy involving the clergy

Weaver et al (1997) examined the need for greater collaboration between clergy and marriage and family therapists. Several reasons for collaboration were outlined including that clergy are frequently asked to address marital and family problems and religion played an important role in family and marital coping and support strategies. This was not accepted by everyone concerned. In addition, marriage and family therapists acknowledged the highest rates of religious involvement of any mental health profession, placing them in a unique position to be involved in the continuing education of clergy. The authors stressed the need for therapists and clergy to use each other's resources for training purposes, clinical evaluative and referral skills, and information on domestic violence and child abuse, as well as other family issues.

10. Emotionally Focused Couple Therapy

Hannah et al (1997) examined the extent to which a brief, structured couples therapy programme based on Imago Relationship Therapy was associated with improvements on the COMPASS scales of individual psychological functioning as well as on a measure of relationship satisfaction, the Marital Satisfaction Inventory (MSl). Individuals were 9 heterosexual couples, all aged 26-58 years, referred for therapy. An examination of pre to post treatment differences revealed statistically significant differences on three of the four COMPASS scales and all 3 MSI scales. The rate of improvement in individual distress per couples therapy session was approximately equal to the improvement, found in previous studies, yielded by individual therapy. The results supported previous findings that couples therapy was likely to be effective for the treatment of intra-personal difficulties and suggested that both relationship and individual distress indices should be utilised in the evaluation of the efficacy of marital therapies.

Predictors of success in emotionally focused marital therapy were examined by Dohnson & Talitman (1997). They examined client variables expected to predict success in emotionally focused marital therapy. The relationship of attachment quality, level of emotional self-disclosure, level of interpersonal trust, and traditionality to the therapy outcome variables, marital adjustment, intimacy and therapist ratings of improvement were examined, 34 couples, mean age 22—60 years participated. The couples were given 12 sessions of emotionally focused marital therapy. At the end of the treatment and at a 3 month follow-up, the couples' marital adjustment and intimacy level were assessed using various rating scales. Overall, therapeutic alliance predicted a successful outcome; the task dimension of the alliance in particular predicted couples1 satisfaction. Couples who made the most gains at follow—up also indicated lower initial marital satisfaction and included males who indicated lower levels of use of attachment figure on the attachment measure at intake. The couples most likely to be satisfied after the 12 sessions of emotionally focused marital therapy and at follow-up were couples who made a positive alliance with the therapist and, more specifically, who saw the task of this approach as relevant to their problems.

11. Education approach using mediation therapy

Arbuthnot et al (1997) studied the patterns of relitigation following divorce education. Two groups of parents were tracked for two years following their divorce: a group of 89 who attended a mandatory divorce education class and a comparison group of 23 who did not. The two groups did not differ in any assessed demographic or family characteristics. At the follow—up assessment, the parents who attended the class had relitigated over all issues, less than half as often than those who had not attended the class. Moreover, rate of relitigation was related to mastery of skills learned in the class. The results were discussed in terms of the needs for outcome evaluation and design of education programmes for divorcing parents.

Finally, Dohnson (1997) commented on marital therapy and suggested that the new "gold standard" for outcome in marital therapy was a 50% success rate. The author contended that the 50^ success rate in marital therapy, whether success was defined as improvement or recovery, was in no way accepted by the leading proponents in the field as an acceptable or sufficient standard of success in this modality.

Summary of the Research of Mediation

Virtually all research into the process of mediation and most especially the process of mediation regarding warring partners and their relationship indicated positive or more positive outcome than that through legal channels. It would appear that the mediation process provides not merely the opportunity of individuals in conflict to solve their problems through this procedure but even when the relationship has ended, mediation can play an important part in developing harmony between the partners. This must be seen as essential especially in relation to off-springs which both partners share. Numerous mediators report that frequently individuals in a relationship come too late to the mediation process. This led to acrimony between the partners with difficulties which were almost impossible to solve through mediation procedures. Even here however there is the possibility of achieving something or much more than through the legal process of the courts or through solicitors.

The assessment of the research is of fairly recent years and points to and compares to various therapeutic approaches used by therapists and mediators with warring partners. Some of the causes or associated features noted were gender links, infidelity, power struggles, violence in the family and numerous other problems. The paper their considers ways of diagnosing the problem of marital and relationship dysharmony and finally with the therapeutic or treatment approaches such as role playing, developing empathy, eclectic psycho-dynamic treatment, cognitive behaviour therapy, solution focusing, creating physical and emotional closeness, education and other approaches.

If nothing else, the mediation process, if used alongside the legal process in marital dysharmony can prove to be effective in stabilising situations that exist between once close partners, and their children. The research, of course as always indicates the importance of preventing parental or relationship splits by establishing or re-establishing communication links after a diagnostic approach to the marital relationship problem has been completed.

The Mediation Process viz a viz - 100 consecutive referrals to a thorapeutic centre

Problem

Couples often fail to realise they have relationship difficulties until it is toe late or until there is no way back to the re-establishing of a relationship. Often partners have sought others outside marriage or have been so disillusioned with the relationship that they deem it impossible to seek a reconciliation. There are however instances when some glimmer of hope still exists wherein both partners, one often more than the other, seek for the benefit of themselves and even more for their children, to seek a rescue of their relationship. V/ha t follows will bc? the delineation of the causes of marital difficulty and how they were diagnosed and ultimately treated within one centre.

Representative Causes Among marital Couples

The representative causes of marital dysharmony and eventual abandonment of one partner or the other to the relationship are discussed in Table.5. under frequency of diagnosed cause (problems of dysfunction). It will be noted that the causes are rarely singular but rather multitudinous. The most common is a general feeling of malaise or feeling that the relationship is over and that one or both partners no longer feel loved or love towards the other partner. This rather general view needs to be explored carefully in order to ascertain what are usually other specific causes related to the marital difficulty. Also important are frequent heeded arguments and sulking within the relationship, poor or negative communication, sexual problems and infidelity.

Therapeutic Approaches Adopted

The most common therapeutic approach adopted was a combination of cognitive and behavioural approaches. Rarely were cognitive methods on their own or behavioural methods used or psychodynamic procedures. Couples tended to need the feeling that there was a problem which could only be sorted out with the help of an expert. Often they relied too heavily on the expert to provide a solution to their problems and it was made clear to them that without them having control ultimately over the situation and participating effectively with the guidance of the therapist, little could be achieved.

Most couples referred themselves for help usually by one partner encouraging this. Others were referred by General Practitioners or friends but generally the motivation towards having help was there, although it varied in intensity. Once it was made clear to the couples that there was no "magic wand" that could be waved which would resolve all difficulties, but it had to be worked at conscientiously, intensively and with the guidance of the therapist better results were possible, although in some cases, no positive result was obtained. A number of couples however benefited from the sessions, even though their marriage could not be saved. They were able to resolve their conflicts and parted as amicable as possible. This naturally was beneficial to themselves as veil as to any children who were present.

Results

The results are delineated in Tables 1-8.

Table 1 indicates that most couples referred themselves for help.

Table 2 shows that most marital problems occurred in the early years between 18 and 45. 3Ocio-economic backgrounds tended to favour upper and middle class groups with working class couples being somewhat less likely to refer themselves of be referred for marital therapy, (Table.3).

Table 4 indicates the motivation to participate in the mediation process was important although some couples considered that the mediation process occurred too late or uncertain of its outcome. After the first session however there was almost immediate change of view and more positive or optimistic notions were expressed as to how the process of mediation could work favourably.

The frequency of diagnosed causes or problems in the dysfunctional relationship showed that the initial number was much higher than the ultimate number when some success had been achieved.

On the whole, there were relatively few treatment sessions for most clients. It was unfortunate that 15 of the clients dropped out before the completion of the sessions for them which might have improved the results indicated in Table 8, "Immediate Outcomes". 10$ of the couples had a relationship which was dissolved with still remaining conflict while a good number also had a relationship dissolved with little outcome conflict remaining. About half of the individuals were able to rescue their relationship.

Table 1 - Source of Referral

Table 2 - Ages of Clients

Table 3 - Socio-economic background

Table 4 - Motivation to Participate in Mediation Process

Table 5 - Frequency of Diagnosed Cause (problem) of Relationship Dysfunctions*

*Most couples and individuals gave a number of reasons

Table 6 - Method of Treatment Employed

Table 7 - Number of Treatment Sessions Required

Table 8 - Frequency of Diagnosed Cause (problem) of Relationship Dysfunctions*

Conclusions

1. The mediation process has a valuable role to play in the dynamics of resolving marital problems or relationship difficulties between couples.

2. Even when marriages or relationships are over, mediation processes can do a great deal to make a reduction of conflict possible between the individuals in the former relationship.

Bibliography

1. Arbuthnot, J.; Kramer, K.N.; Cordon, D.ft.; (1997) Patterns of relitigation following divorce education. Family & Conciliation Courts Review. Jul. Vol 35(3), 269-279.
2. Atwood, J.D.; Seifer, M.; (1997) Extramarital affairs and constructed meanings: A social constructionist therapeutic approach. Am. Journal of Family Therapy, 1997, Spr. Mol 25(1) 55-75.
3. Bagarozzi, D.A.; (1997) Marital Intimacy Needs Questionnaire: Preliminary report. American Journal of Family Therapy, 1997 Fal. Vol 25(3), 285-290.
4. Bennun, ].; (1997) Systemic marital therapy with one partner: A reconsideration of theory, research and practice. Sexual and Marital Therapy, 1997, Feb, Vol 12(1 ), 61-75.
5. Bradbury. T.N.; Beach. S.R.; Fincham. F.D.; Nelson, G.M.; (1996) Attributions and behaviour in functional and dysfunctional marriages. Journal of Consulting & Clinical Psychology; 1996 3un. Vol 64(3), 569-576.
6. Cheung, S,; (1996) Cognitive behaviour therapy for marital conflict: Refining the concept of attribution. Journal of Family Therapy, 1996, May, Vol 18(2) 183-203.
7. Clark, W.M.; Serovich, J.M.; (1997) Twenty years and still in the dark? Content analysis of articles pertaining to gay, lesbian and bisexual issues in marriage and family therapy journals. Journal of Marital & Family Therapy, 1997, Jul, Vol 23(3), 239-253.
8. Clulow, C.; (1996) Preventing marriage breakdown: Towards a new paradigm. Sexual and Marital Therapy, 1996 Nov. Vol 11(4) 343-351.
9. Cohen, P.; Dattner, N.; Luxenburq A.; (1996) Planning parenthood in the divorce transition - through-mediation. American Journal of Family Therapy, 1996, Sum, Vol 24(2), 181-188.
10. Dillon, P.A.; Emery, R.E.; (1996) Divorce mediation and resolution of child custody disputes: Long term effects. American Journal of Orthopsychiatry, 1996 Jan, Vol 66(1) 131-140.
11. Durana, C.; (1996) Bonding and emotional re-education of couples in the Pairs training: Part II. American Journal of Family Therapy; 1996 Win. Vol 24(4) 315-328.
12. Ehrensaft, N.K.; Vivian, D.; (1996) Spouses1 reasons for not reporting existing marital aggression as a marital problem. Journal of Family Psychology, 1996 Dec. Vol 10(4) 443-453.
13. Emanuels-Zuurveen, L.; Emmelkamp. P.M.G.; (1996) Individual behavioural-cognitive therapy v marital therapy for depression in martially distressed couples. Br. Journal of Psychiatry, 1996, Aug, Vol, 169(2),181-188.
14. Fraenkel, P.; Markman, H.; Stanley, S.; (1997) The prevention approach to relationship problems. Sexual and Marital Therapy. 1997 Aug. Vol 12(3), 249-258.
15. Framo, J.L.; (1996) Family of origin as a therapeutic resource for adults in marital and family therapy: "You can and should go home again". Therapie Familiale, 1996 Vol 17(3), 367-390.
16. Franklin, C.; (1996) Solution-focused therapy: A marital case study using recursive dialectic analysis. Journal of Family Psychotherapy. 1996 Vol 7(1), 31-51.
17. Gray-Little. B.; Baucom. D.H.; Hamby. S.L.; (1996) Marital power, marital adjustment, and therapy outcome. Journal of Family Psychology, 1996, Sep. Vol 10(3), 292-303.
18. Greatbatch, D.; Dinguall, R,; (1997) Argumentative talk in divorce mediation sessions. American Sociological Review, 1997 Feb. Vol 62(1 ), 151-170
19. Greqory, N,A»; Leslie, L.A.; (1996) Different lenses: Variations in clients' perception of family therapy by race and gender. Journal of Marital and Family Therapy, 1996 Apr. Vol 22(2) 239-251.
20. Hannah. N.T.; Luguet. W.; McCormick, J.; (1997) COMPASS as a measure of the efficacy of couples therapy, American Journal of Family Therapy. 1997 Spr. Wol 25(1), 76-90.
21. Hochberg, A.M.; Kressel, K.; (1996) Determinants of successful and unsuccessful divorce negotiations. Journal of Divorce and Remarriage, 1996, Vol 25 (1-2), 1-21.
22. Johnson, S.M.; Talitman, E.; (1997) Predictors of success in emotionally focused marital therapy. Journal of Marital and Family Therapy. 1997, Apr. Vol 23(2), 135-152.
23. Johnson, S.: (1997) A critical review of marital therapy outcome. Canadian Dournal of Psychiatry, 1997 Apr. Vol 42(3) 323.
24. Jones, S.C.; Hunter, M.; (1996) The influence of context and discourse on infertility experience. Journal of Reproductive and Infant Psychology. 1996. May, Vol 14(2) 93-111.
25. Kane, C.M.; (1996) An experiential approach to family of origin work with marital and family therapy trainees. Journal of Marital and Family Therapy, 1996, Oct, Wol 22(4), 481-487.
26. Kelly, J.B.; (1996) A decade of divorce medication research: Some answers and questions. Family and Conciliation Courts Review. 1996, Jul. Vol 34(3), 373-385.
27. Kelly, A.B.; Halford, U.K.; (1997) Couples in therapy: Assessing the heart of the matter. Sexual and Marital Therapy, 1997, Feb, Vol 12(1), 5-21.
28. Lansky. D.T.; Swift, L.H.; Manley, E.E.; Elmore. A.; et al, (1996) The role of children in mediation. Medication Quarterly, 1996, Win. Wol 14(2), 147-154.
29. Latz, M.; (1996) On an exercise for training beginning marital and family therapists in language skills. Journal of Marital and Family Therapy, 1996, Jan, Vol 22(1) 121-126.
30. Leslie, L.A.; Clossick, M.l .; (1996) Sexism in family therapy: Does training in gender make a difference? Journal of Marital and Family Therany; 1996 Apr. Vol 22(2) 253-269.
31. Lowenstein, L.F.; (1994) Marital Therapy: The importance of the assessment of the individuals on personality tests. Counselling Psychology Quarterly, Vol.7. No.2. 1994, 99-104.
32. Lowenstein, L.F.; (l998a) Mediation in Parental Alienation Syndrome.
33. Chapter in Book, Paedophiles, The Sexual Abuse of Children – lts Occurrence and Treatment. Published by Able Publications, England, 1998.
34. Lowenstein, L.F.; (l998b) Parent Alienation Syndrome - A Two step approach towards a solution. Chapter in Book, Paedophiles, The sexual Abuse of Children - its occurrence and Treatment. Published by Able Publications, 1998.
35. McCarthy, P.; (1997) Mediating modern marriage: A role for marriage counselling? Sexual and Marital Therapy, 1997 Augf Vol 12(3), 275-287.
36. Meyerstein, I.; (1996) Pre-marital counselling and the problem box ritual. Journal of Family Psychotherapy, 1996, Vol. 7(4) 63-70.
37. Oldegaard, P.; (1996) Empathy induction in the couple treatment of depression: Shifting the focus from self to other. Families, Systems & Health, 1996 Sum. Vol 14(2), 167-181.
38. O'Donohue, W.; Crouch, J.L.; (1996) Marital therapy and gender-linked factors in communication. Journal of Marital and Family Therapy, 1996 Jan, Vol 22(1) 87-101.
39. Penn, C.D.; Hernandez, S.L.; Bermuda?, 3.M.? (1997) Using a cross-cultural perspective to understand infidelity in couples-therapy. American Journal of Family Therapy, 1997 Sum. Vol 25(2) 169-185.
40. Rasmussen. K,S.; Hamkins, A.J.; Schwab, K.P.: (1996) Increasing husbands' involvement in domestic labour: Issues for therapists. Contemporary Family Therapy - An Int. Journal, 1996, 3un. Vol 18(2), 209-223.
41. Robinson, R.F.; (1996) Relationship between work addiction and Family functioning: Clinical implications for marriage and family therapists. Journal of Family Psychotherapy; 1996, Vol 7(3), 13-29.
42. Ross, S.A.; Estrada, A.; (1997) An empirically driven marital therapy intervention. Journal of Family Psychotherapy, 1997 Vol 8(4) 39-45.
43. Rotunda, R.J,; O'Farrell. T.J.; (1997) Marital and family therapy of alcohol use disorders: Bridging the gap between research and practice. Professional Psychology: Research and Practice, 1997, Dun, Vol 28(3), 246-252.
44. Rudd, J.E.; (1996) Communication effects on divorce mediation: How participants' argumentativeness, verbal aggression, and compliance-gaining strategy choice mediate outcome satisfaction. Mediation Quarterly, 1996 Fal. Vol 14(1), 65-78.
45. Schoenewolf, G.; (1996) The couple who fell in hate: Eclectic psychodynamic therapy with an angry couple. Journal of Contemporary Psychotherapy, 1996 Spr. Vol 26(1) 65-71.
46. Speziale, B.A.; (1997) Couples, sexual intimacy, and multiple sclerosis. Journal of Family Psychotherapy, 1997, Vol 8(1), 13-32.
47. Stabb, S.D.; Cox, D.L.; Harber. J.L.; (1997) Gender-related therapist attributions in couples therapy: A preliminary multiple case study investigation. Journal of Marital and Family Therapy; 1997, Jul. Vol 23(3), 335-346.
48. Storm, C.L.; York, C.D.; Keller, J.G.; (1997) A genderist philosophy transforms an MFT proqramme. American Journal of Family Therapy, 1997 Sum. Vol 25(2) 151-168.
49. Vansteenweqen, A.: (1997) Do marital therapists do what they say they do? A comparison between experiential and communication couples therapy. Sexual and Marital Therapy, 1997 Feb, Vol 12(1), 35- 3.
50. Weaver, A.J.; Koenig, H.G.; Larson, D.B.; (1997) Marriape and family therapists and the clergy: A need for clinical collaboration, training and research. Journal of Marital and Family Therapy, 1997 Jan, Vol 23(1), 13-25.
51. Welter, P.R.; (1995) Meaninq as a resource in marriage counselling. Int. Forum for Logotherany. 1995, Fal. Vol 18(2), 109-113.
52. Wilson, R.; Wilson, L.: (1996) Multiple selves operating within relationships. Journal of Family Psychotherapy, 1996, Vol 7(2) 41-51. Worthington, E.L.; (1996) Speculations about new directions in helping marriages and families that arise from pressures of managed mental health care. Journal of Psychology and Christianity. 1996. Fal. Vol 15(3), 197-212.
53. Worthington, E.L.; Hight, T.L.; Ripley, 3.5.; Perrone, K.M.; Kurusu, T.A, & .Jones, D.R.; (1997) Strategic hope-focused relationship enrichment counselling with individual couples. Journal of Counselling Psychology, 1997, Oct, Vol 44(4) 381-389.