THE EXPERIENCE OF HOPE BY COUPLES IN COUNSELING USING A REFLECTING TEAM THROUGH THE LENS OF ATTACHMENT: AN INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS by CAITLIN PHOEBE EDWARDS B. A., University of Redlands , 2011 A thesis submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of th e requirements for the Master of Arts in Degree of Counseling , School of Education and Human Development 201 8
ii This thesis for the Master of Arts in Coun seling degree by Caitlin Phoebe Edwards has been approved for the School of Education and Human Development by Robert Allan, Chair Diane Estrada Kat Austin Date: 12/15/2018
iii Edwards, Caitlin Phoebe (M. A., Counseling) The Experience of Hope by Couples in Counseling Using a Reflecting Team through the Lens of Attachment: An Interpretative Phenomenological Analysis Thesis directed by Assistant P rofessor Robert Allan ABSTRACT Historically, hope has been studied from a cognitive, not experiential, lens and rarely from an attachment perspective. The aims of this research project were to explore how couples experience hope when using a reflecting team as part of their counseling process as well as if their experience of hope differed based depending on their attachment style. To examine these questions, three couples were completed attachment and hope measur es as well as participated in interviews assessing their experience of hope in relation to the reflecting team. The research was methodologically directed by interpretative phenomenological analysis, which draws on the making of the reflecting team process. Three themes emerged from the participants experience including the both/and experience of being seen by a reflecting team, the benefits of outside perspectives, and the experience of hope differing depe nding on attachment style. The form and content of this abstract are approved I recommend its publication. Approved: Robert Allan
v ACKNOWLDGEMENT S The completion of my Master of Arts in Counseling thesis has required a number of people to assist in the process and I will mention a few of them here. First, I would like to thank the research participants who generously offered to discuss their experiences in their relatio nships despite the difficult and sometimes painful topic. Misti Klarenbeek McKenna aided the process of recruiting research participants at the Denver Family Institute. Dr. Robert Allan has been an incredible support, as he has aided me in finding a topi c, helped to deepen my understand ing of attachment, and provided well thought out comments throughout the process. I cannot thank him Degree. Although my parents have very little understanding of what I do, I also would like to ack nowledge their support of continuously pushing myself to take on more and think outside the box. F inally, I would like to thank the members of my cohort, whom, by expressing interest , aided me to keep working no matter the level of my frustration.
6 TABL E OF CONTENTS CHAPTER 1. I 2. LITERATURE REVIEW ....... ...... ..............................13 Attachment a nd ....... ...... ..............................20 ....... ....................................20 ...... ...... .................. ............22 ...... ...... ..............................2 3 ....................................26 ....................................2 9 3. ..... ...... ..............................3 1 The Research ..... ...... ..............................3 1 Resear 2 Interpret ative Phenomenological 2 ..... ....... ..............................3 4 Hermeneut 6 8 Method ...... ........................... ... 39 Desig 39 Dat a Collect 0
7 4. RESULTS 3 5. 4 Analysis of Superordina te Theme 1: Being Seen by the Reflecting Team: A Both/An 7 Does the Reflecting Team Underst and Us?............................. .............................. 58 Is the Reflecting Team Judging Us?..... ................................... .................... ..........6 4 No Model for Suc cessful 68 Being Seen as Failing . ........ ..............................7 4 Efficacy 79 Analysis of Superordinate Theme 2: Hope as a Result of Outside Perspecti v 2 Hope as a Result of Outside Perspectives Brining Insight in to the Relatio 3 Outside Perspe ctives as 89 Outside Perspectives as a Remin der of Relatio nship Stre .96 06 Anxiously Avoid ant: Halo 07 Anxious: R ebecca an 09 Avoi dant: .............................11 1 S ecure: Da 1 6. ....... .............................11 2 Discussion: RHS and ECR R .11 2
8 Relat ionship H ope Scal 2 Experiences in Close 14 Discussion: Superordinate Theme One 17 Cog nitive Di 17 Understandi ..12 0 A Lack of Relationship M .............................12 1 Being Seen: A Highlight of Feel .............................12 2 Ther .12 3 Discussion: Sup 25 Hope: A Result of Options, Evidence, Action, a 25 26 .............. ......................1 27 .............................1 29 .............................13 0 Discussion: Atta .............................1 33 Valid ity an d Reliabi 37 37 38 39 1 Impli cation . 14 1
9 45 Directions for Future R 46 0 68 Appendix A 68 Appendix B 69 3
10 LIST OF TABLES Table .. 4 4 2 . 55
11 CHAPTER 1 INTRODUCTION Attachment theory has been used to explain childhood behavior, parenting styles, work personality, and interactions within couple relationships (Bowlby, 1988; Flaherty & Sadler, 2011; Mondor et al., 2011; Richards & Schat, 2011). Insecure attachment propo ses to explain a number of negative outcomes within intimate relationships (Oka, Sandberg, Bradford, & Brown, 2014; Seedall & Lachmer, 2016 ). However, there has been much less research done on how attachment style influences the positive aspects of forming a romantic relationship. One positive aspect of creating a romantic partnership is hope (Merolla, 2014). Although many biological and mental health studies have found positive emotions, especially hope, to be an integral part of wellness, there a re fewer studies discussin g hope as an experience between human beings (Snyder, 2002). Indeed, when hope has been studied as part of couples counseling, hope is us ually studied from the aim to understand the experience of hope for individuals displaying an avoidant and anxious attachment style in couples counseling as part of the reflecting team process. The few studies that have explored hope for couples in counseling often cite a desire for new perspect ives as an integral process of creating or sustaining hope (Egeli et al., 2013, 2014). One method, which routinely provides multiple new perspectives for both couples and therapists, is the use of a reflecting team (Egeli et al., 2013). Reflecting teams are used in couple and family therapy both as a learn ing tool and as a way to suggest new ideas or ways of behaving to clients (Pender & Stinchfield, 2012). As couples in therapy can become stuck in an iterative, problematic cycle, providing new perspect ives can help to sustain hope (Egeli et al., 2013; Pender & Stinchfield, 2012). Yet, not
12 much is known about how hope is experienced by individuals with different attachme nt st yles. Therefore, the researcher hopes this paper will contribute to a deeper u nderstanding of how a ship, specifically regarding attachment style.
13 CHAPTER 2 LITERATURE REVIEW Attachment Attachment Theory Attachment is biological drive to connect to others which leads to the characteristic pattern s humans develop in relationship to others and is used to explain emotional distress and personality disturbance (Marrone, 2014). Attachment is a basic human need and is crucial for healthy human development (Bifulco & Thomas, 2013; Van Rosmalen, Van Ijzendoorn, & Bakermans Kranenburg, 2014). Children who do not form basic levels of attachment, who do not receive responsive care from their attachment figures, are at high risk for neurocognitive and physiological abnormalities ( Perry, 2007; Van Rosmalen et al., 2014). However, children who experience at tentive responses by their parents or caregivers develop go on to secure, stable, and balanced attachment styles as adults (Bowlby, 1988). John Bowlby interactions with their mothers after periods of hospitalization (Holmes & Farnfield, 2014). Bowlby theorized there are three stages of attachment: the orientation of a baby toward other onment, and a child abilit y attachment representation a child develops leaves marks on their relationships throughout adulthood (Van Rosmalen et al., 2014). Overall, the attachment style of both the parents and chi behavioral, psychological, and developmental well being (Reese, 2007).
14 Mary Ainswor th furthered attachment theory by developing the experiment protocol and attachment measurement tool called the Strange Situation Procedure (SSP), which involved a Rosmalen et al., 2014). This procedure was originally designed to see how a child used their mother as a secure base but evolved in to a method to describe attachment (Van Rosmalen et al., 2014). Measuring attachment through the SSP involves determining if the behavior of the child indicates trust in the caregiver as well as how quickly the balance between focus on the parent and expl oration of the environment is equalized (Van Rosmalen et al., 2014). Bowlby and work resulted in an attachment classification system that defines children as having a secure, insecure ambivalent , or an insecure avoidant attachment style (Van R osmalen et al., 2014). Further research added the disorganized attachment style for children who displayed characteristics of both insecure ambivalent and insecure avoidant attachment strategies (Van Rosmalen et al., 2014). Securely attached children hav e a belief that the world is reliable and predictable, which is supported by consistent, respondent caregivers ; they will show distress during the SSP and (Van Rosmalen et al., 2014). Insecure avoidant children experience s tress during the SSP but avoid showing that stress to the returning caregiver (Van Rosmalen et al., 2014). Insecure ambivalent children show obvious signs of s tress as their caregiver leaves and continue to do so upon their return (Van Rosmalen et al., 20 14). However, unlike securely attached children who can be comforted by the caregiver, insecure ambivalent children are not easily comforted and show conflicting desires of want to be with the caregiver as well as resist their attention (Van Rosmalen et a l., 2014). Children who display a disorganized
15 attachment style also display conflicting emotions: they show obvious fear of the caregiver but at the same time use him/her as the only source of safety (Van Rosmalen et al., 2014). Attachment t heory suggests the type of parenting a child receives results in long term attachment styles (Rees, 2007). Securely attached children possess the belief that the world is basically safe and predictab le, where as insecurely attached children have little or no exp erience with safety and consistency (Van Rosmalen et al., 2014). Furthermore, inconsisten t parental attention results in insecure ambivalent attachment (Reese, 2007). Insecure avoidant children typically experience disinterested, disinvested parenting (R eese, 2007). Disorganized attachment style results from mixed emotional styles and chaotic parenting (Bifulco & Thomas, 2014; Van Rosmalen et al., 2014). As part of development, a child learns how to do things alone, when to ask for help, and how consist ently help will be given , thereby developing their individual capacity for self reliance (Bifulco & Thomas, 2013 ; Reese, 2007 ). Positive parental attention, proving the world is consistent and predictable, promote s a positive internal working model of att achment in childhood and beyond (Bifulco & Thomas, 2013). A lack of consistent parental support increases the biological responses to stress but decreases the hormones that balance them, resulting in an overworked and under soothed physiological response t o personal relationships (Bifulco & Thomas, 2013). C hildren that do not receive attentive care in their early life often believe others to be unreliable and untrustworthy as well as view themselves negatively (Bifulco & Thomas). Stressors throughout devel opment , such as parental divorce or the death of an attachment figure, Thomas, 2013). Adult Attachment
16 Bowlby (1988) suggests early attachment style is a throughout li fe . The quality of early caregivers influences how adults respond to stress, regulate emotions, and manage interpersonal relationships (Hazan & Selcuk, 2015). Attachment styles influence how an adult selects an intimate partner as well as how he/she negotiates other social relationships (Marmarosh, Whipple, Schettler, Pinhas, Wolf & Sayit, 2009). As with children, adults need a secure base: distress or disorganization can occur when an adult cannot access th ose with whom they have an attachment relationship (Hazan & Selcuk, 2015). Bartholomew and Horowitz (1991) concluded there are four distinct adult attachment styles based on how the adult views themselves and others. Securely attached adults have a posit ive view of both self and others (Bartholomew & Horowitz, 1991). Preoccupied adults have a negative view of self, but a positive view of others; dismissing avoidant adults possess a positive view of self but view others negatively (Bartholomew & Horowitz, 1991). Fearful avoidant adults have a negative view of both themselves and other people; unresolved adults have no consistent strategy for interacting with others (Bartholomew & Horowitz, 1991; Bifulco & Thomas, 2013). Attachment style in adulthood rel consistency of relationships influences how they think, act, and feel (Bifulco & Thomas, 2013). Securely attached adults typically have satisfying and stable r elationships with others, where as avoidant in dividuals do not desire to share their time with o thers (Tidwell, Reis, & Shaver, 1996; Monteoliva, Garcia Martinez, & Salinas, 2014). Attachment avoidance is characterized by rejecting closeness and reduced utilization of social su pport (Marmarosh et al. , 2009). Adults with a preoccupied attachment style often experience negative emotions in their relationships as well as struggle with jealously and conflict (Monteoliva, Garcia Martinez, & Salinas, 2014).
17 Indeed, adult attachment anxiety is related to f ears of abandonment and sensitivity to rejection (Marmarosh et al., 2009). When faced with a threat, adults with an anxious attachment style will respond with proximity seeking behaviors, where as adults with an avoidant attachment style will demonstrate distance seeking behaviors (Doumans, Pear son, Elgin, & McKinley, 2008). Furthermore, s tressful events result in hyper activation of the proximity seeking response for adults with insecure attachment st yles (Bifulco & Thomas, 2013). However, when faced w ith a stressful event, adults with an avoidant attachment style shun sharing and closeness (Bifulco & Thomas, 2013). Avoidant adults tend to also have fewer close relationships, more mental health problems, and struggle with personal disclosure in therapy (Bifulco & Thomas; Marmarosh, 2009; Sable, 2007). Adult Attachment in Romantic Relationships According to Mondor, McDuff, Lussier, and Wright (2011), attachment in romantic relationships involves two dimensions: anxiety over abandonment and proximity a voidance. For partners who have an anxious attachment style, excessive worry regarding rejection can elicit proximity seeking (Seedall & Lachmer, 2016). An anxious attachment style tends to be activated quickly, which can help couples establish a secure base, but can also elicit constant demands for reassurance (Mondor et al., 2014). Anxious individuals use proximity seeking to gain security, even in high functioning relationships (Mondor et al., 2011). Although attachment anxiety can cause problems in couple relationships, attachment avoidance is more predictable of couple distress than anxiety (Mondor et al., 2011). People with avoidant attachment styles often question the persistent nature of the relationship, doubt consistency in others, and distanc e themselves physically or psychologically from their partner
18 (Domingue & Mollen, 2009; Seedall & Lachmer, 2016). Furthermore, avoidant individuals are less likely to report feeling happy when they make their partner happy, sacrifice for relationships, an d often dislike being a source of support for their partner (Far rell, Simpson, & Overall, 2016). On the other hand, a secure adult attachment style is associated with mutuality, comfort with commitment and intimacy, as well as reciprocal caregiving (Domingue & Mollen, 2009). One common reason cited by couples seeking counseling is to improve communication (Zarei & Sanaeimanesh, 2014). Communication is a method to engender intimacy and trust in romantic relationships (Domingue & Mollen, 2009). Negative communication reciprocity, responding to a partner with negative affect, is a consistent predictor of relationship dissatisfaction (Domingue & Mollen, 2009). Indeed, criticism, contempt, defensiveness, and stonewalling are the most damaging communication behaviors in couple relationships (Domingue & Mollen, 2009; Gottman, 1999) . These communication styles are most c ommonly associated with individuals who display an avoidant attachment style (Farrell, Simpson, & Overall, 2016). I ndividuals who use an avoidant attachment to cope with stress often diminish conflicts or withdraw from conflict for fear of personal self d isclosure (Domingue & Mollen, 2009). However, partners of these individuals can behave in ways that diminish the consistent distrust, fear of abandonment, and desire for independence that characterize communication with a partner who demonstrates an avoid ant attachment style (Farr ell et al., 2016). Indeed, demonstrating appreciation and acknowledging sacrifices made by a partner with an avoidant attachment style significantly improves couple communication (Farrell et al., 2016). Furthermore, if one member of the couple has a more secure attachment style, conflict is easier to manage (Domingue & Mollen, 2009).
19 Although people typically choose a partner with the same attachment style, many couples who present for counseling report opposite attachment style s (Wilson et al., 2013). Typically, in clinical couples, women report having an anxious attachment style, where as men report having an avoidant attachment style (Mondor et al., 2011 ). When there is a consistent pattern of demand and withdrawal in a relat ionship, dissatisfaction with the relationship increases (Domingue & Mollen, 2009; Mondor et al., 2011). However, negative communication patterns can be mitigated and changed throughout the course of therapy (Seedall & Lachmer, 2016; Zarei & Sanaeimanesh , 2014). Attachment and Hope Jian, Huebner, and Hills (2013) postulate hope is a result of supportive caregivers who encourage environmental exploration and model a positive orientation toward life. By meeting the initial goal of felt security, a secure base will develop, resulting in a positive future orientation and the belief that goals can be met (McDermott, Cheng, Wright, Browning, Upton & Sevig, 2015). People who measure higher in hope often indicate a strong, secure relationship with an adult dur ing childhood (Shorey, Snyder, Yang, & Lewin, 2003). A positive view of the self and others which develops from relationships to parental attachment figures leads to dispositional hope, indicating attachment provides a structure for hopeful thinking (McDe rmott et al., 2015). Securely attached individuals typically report having high hope: they have a positive orientation toward the future and find life meaningful (Shorey et al., 2003; Simmons, Gooty, Nelson, & Little, 2009). They are also able to call on a strong social support network in times of distress (Shorey et al., 2003). Hope for romantic relationships in particular develops by having romantic needs met in previous relationships (Sable, 2007; Welch, & Houser, 2010).
20 Furthermore, securely attached individuals view both themselves and others as worthy of positive, intimate relationships (Welch & Houser, 2010). Lower hope individuals often report feeling rejected by their parents (Shorey et al., 2013). Indeed, an insecure attachment style is asso ciated with lower levels of hope (Jankowski & Sandage, 2011; Ringer, Buchanan, Olesek, & Lysaker, 2014). Anxious, avoidant attachment, and disorganized attachment styles are associated with increased loneliness, higher emotional distress, overall life dis satisfaction, and lower hope for the future (Lavy & Littman Ovadia, 201; Shorey et al., 2013). Specifically, in clinical populations, anxious individuals report more hope than individuals who have a self reported avoidant attachment style (Lavy & Littman Ovadia, 2011; Ringer et al., 2014). The attachment style engendered during childhood provides a structure for the development of hope (Shorey et al., 2013). Hope Hope has traditionally been studied as a cognitive concept that examines what contributes t hope is important (Yeung, Ho, & Mak, 2015; Scioli, Ricci, Nguyen, and Scioli, 2011; Snyder, 2011). More recent definitions of hope offer a more experiential, inter subjective definition (Ratcliffe, 2011; Romdenh Romluc, 2011; Ward & Wampler, 2010). In this paper I will use the definition of hope is the most applicable to what I will be discussing, both cognitive and intersubjective theories are worth examining, particularly in relation to attachment, couples in counseling, and reflectin g groups. Cognitive Theories of Hope
21 According to Snyder, Irving, and Anderson (1991) hope is a positive motivational state which involves goal directed behavior (agency) and the ability to plan to meet goals (pathways thinking). Agency and pathways conti nually augment each other, creating additional pathways more alternative pathways, learn from experiences, and distance themselves from negative past events (Snyder, 2000). Snyd er (2000, 2002) theorizes both the positive and negative emotions relating to hope are caused by goal directed thought: when goals are successfully completed, positive emotions occur , but when goals are impeded well being is compromised. Persons with high hope will have enduring positive emotions in the face of adversity, where as those with lower hope will be overcome by the emotional lassitude of goal impediment (Snyder, 2002). It is essential to imagine multiple desirable futures in order to sustain ho pe (Lynch, 1965). Hope and well being are linked by both cognitive reappraisal of a situation and the assessment of a situation and, therefore, changing its emo tional impact (Gross & John, 2013). People deemed to have higher hope rethink their life circumstances as well as view events more positively than people with lower hope (Snyder, 2002; Yeung, et al., 2015). In addition to viewing hope as composed of agen cy and pathways thinking, Scioli, Ricci, Nguyen, and Scioli (2011) view hope as a network composed of attachment, mastery, survival, and spiritual structure and social assets (Scioli construct of hope consists of feedback loops that enable both maintenance and expansion of hope.
22 Scioli et al. (2011) believe hope consists of five different levels: biological moti ve systems, endowments and supports, hope traits, the faith system, and hope behaviors. Biological systems include physiological motivation structures, whereas endowments and supports are comprised of family, culture, and spiritual beliefs (Scioli et al., 2011). An ability to mediate power, attachment motives, and mattering compose hope traits (Scioli et al., 2011). The faith system can be made up of religion or other values, such as faith in others (Scioli et al., 2011). Hope based behaviors include a s ense of openness, trust, and acts of care (Scioli et al. 2011). numerous circumstances in which hope is a factor (Snyder 2000, 2002). This theory does explain how hope is thou ght of, as well as the behavior it engenders (Snyder, 2000, 2002). Scioli hope encompasses more than simply the cognitive mechanisms which support hope and includes both biological and social aspects. However, both theories fail to fully explain the experiential nature of hope. An Experiential View of Hope Overall, there is a paucity of information regarding the personal experience of hope. However, one subjective view of hope was put forth by Dufault and Martocchio (1985). In this view, hope has two separate but related dimensions: generalized hope and particularized hope (Dufault & Martocchio, 1985). Generalized hope refers to an overall hopeful outlook, whereas particularized hope focuses on a single incident, situation , or event (DuFault & Martocchio, 1985). These dimensions are personally significant and comprised of dynamic thoughts, Martocchio, 1985). Each aspect of hope in cludes affective, cognitive, temporal, contextual,
23 (Dufault & Martocchio, 1985; Rawdin, Evans, & Rabow, 2013). Although this definition is more intersubjective t han those previously explored, there has been very little research done using nature of hope. Meirav (2009) gives a more subjective definition of hope than o nes previously put forth: hope is an orientation toward the future. Furthermore, hope consists of a wish and the analysis of the likelihood of that wish being fulfilled (Meriav, 2009). This definition is very similar to the one put forth by Ward and Wampl er (2010). Therefore, hope is a personal ly subjective, emotional state focused on the beliefs and feelings surrounding a desired outcome (Meirav, 2009; Ward & Wampler, 2010). Indeed, hope can be an active or passive state, involve enthusiasm or dread, dep hope arises (Ratcliffe, 2011). There have been a number of different studies done on the experience of hope. Hope may involve connecting with others, finding meaning, and reaffirmi ng faith (Bally, Duggleby, Holtslander, Mpofu, Spurr, Thomas, & Wright, 2013; Holtslander & Duggleby, 2009). Hope can be built by increasing knowledge, spirituality, and familial support (Mosalanejad, Parandavar, Gholami, & Abdollahifard, 2014). Hope can also be the process of gaining inner strength and self confidence, particularly in therapy (Holtslander & Duggleby, 2009). As both beliefs and feelings are aspects of a subjective, intrapersonal experience, the cognitive conception of hope disregards it s essential experience (Ratcliffe, 2011; Romdenh Romluc, 2011). Hope is more than an agentic cognitive process, but rather an emotional, personal experience of beliefs and feelings in relation to the future (Ward & Wampler, 2010).
24 For many people the exp erience of hope involves a positive orientation toward the promise of the future, working toward meaningful alternatives, and faith in the world (Ratcliffe, 2011). High levels o f hope are correlated with lower levels of depression, higher overall life sat isfaction, and finding meaning in life in non clinical populations (Feldman, 2009; Smedema, Chan, & Phillips, 2014). Hope and Relationships Hope has been studied as a healing factor for both mental and physical illness (Waynor, Goa, Dolce, Haytas & Reilly, 2012). For clinical populations struggling with mental illness, increased hope is related to a decrease in suicidality, more active copin g, and increased empowerment (Waynor et al., 2012). Furthermore, hope is related to self acceptance, rebuilding relationships, and increased independence (Kirst, Zerger, Wise Harris, Plenert & Stergiopoulos, 2014). In clinical populations, hope has been demonstrated to predict positive psychological variables in people with spinal cord injuries (Jackson, Wernicke, & Hagga, 2003). Hope, more than optimism and self esteem, enhances the prediction of positive outcomes regarding both mental and physical illn ess (Snyder, 2002). However, while hope can improve both mental and physical illness, there is less information regarding how hope is related to personal relationships. Traditionally, hope has slow, 1981). Therapists are expected to create an environment that produces hope by building an adequately structured therapeutic process in which clients feel appreciated, accepted, understood, and are responsible for taking initiative to improve communi cation (Hof, 1993). Indeed, therapists who believe in positive outcomes for their clients influence the therapy outcome (Blow & Sprenkle, 2001).
25 More recently studies are being performed regarding the experience of hope in personal relationships. Accord the quality of their relationship. Hope also influences constructive conflict management and positive communication between couples (Merolla, 2014). Additionally, hope also infl uences the ideas about couple relationships across the lifespan (Villar & Villamizar, 2012). For younger couples, hopes center on consolidation and survival of the relationship as well as meeting normal relationship markers, such as having children (Villa r & Villamizar, 2012). Older couples, on the other hand, hoped for the ability to support a family and ward off physical illness (Villar & Villamizar, 2012). For many couples in long term relationships, common hopes include relationship maintenance and m aking positive growth changes both personally and as part of a relationship (Villar & Villamizar, 2012). Many couples enter into a relationship with ideas of how that relationship will develop and grow (Egeli, Brar, Larsen & Yohani, 2014). However, pro can erode hope and increase mistrust, confusion, and vulnerability (Egeli et al., 2014). If eroded (Simpson, 2004). The therapeut and vulnerability in order to increase communication and positive feelings as well as decrease negative interactions and defensive behavior (Egeli et al., 2014). Although hope is a personal meani ng related experience, the levels of hope and optimism 2014). This is particularly important in couple relationships, as hopeful couples are better able to c ope with changes in their health and in their relationship (Rock et al., 2014). For couples in therapy, hope can be a key factor in determining therapeutic outcomes (Egeli, Brar, Larsen, &
26 Yohani, 2013). Indeed, couples in therapy expect their hope to ma intain positive momentum over the course of treatment (Egeli et al., 2013). hope in a relationship: options, actions, evidence, and connection. For couples in counsel ing to be hopeful, they must be able to see their potential future, act on possible choices, have motivation and evidence of change, and build connection throughout this process with their partner (Ward & Wampler, 2010). Typically, this process involves a hope to the couple (Ward & Wampler, 2010). Additionally, in order for couples to create their Wampler, 2010). Part of the expectatio relationship, which may provide different and helpful insights (Egeli et al., 2013). Presenting possibilities to improve the relationship and further coping skills can enhance hope for sustaining the relationship (Egeli et al., 2013). Furthermore, the identification of both relationship and individual strengths, increasing partner suppor t, and highlighting growth serves to beget hope throughout the counseling process (Egeli et al., 2013). Reflecting teams are one method that can be used to help couples see their relationships from multiple perspectives and, therefore, create new possibil ities (Egeli et al., 2013). The following section examines reflecting teams and their relation to hope. Reflecting Teams The use of a reflecting team involves a team of therapists observing a couple or family therapy session (Faddis & Cobb, 2016). Ori ginally, in Milan, the families and therapist teams
27 were not given an opportunity to interact: the team of therapists simply observed the therapy session from behind a one way mirror (Faddis & Cobb, 2016; Mitchell, Rhodes, Wallis, & Wilson, 2014). Tom And ersen changed the model by encouraging the family and team of therapists to switch places in the middle of the session, allowing the family to observe the comments made by the reflecting tam (Faddis & Cobb, 2016). Generally, studies indicate re transparent model is more beneficial, citing connection, collaboration, and empowerment (Mitchell et al.; Smith, Sells, & Clevenger, 1994). The use of a reflecting team in therapy involves three distinc t steps (Mitchell et al, 2014). First, a couple o r family participates in a therapy session with their primary therapist while being observed by the reflecting team (Egeli, Brar, Larsen, & Yohani, 2014; Pender & Stinchfield, 2012). Then the primary therapist and clients switch rooms with the reflecting team and watch as the team discusses the session behind the same one way mirror (Pender & Stinchfield, 2012). Finally, the reflecting team observes the primary therapist discuss the experience with the clients (Egeli et al., 2014). The reflecting team, t herapist, and clients can also stay in the same room and discuss the process as a group (Pender & Stinchfield, 2012). In order to maximize the benefits of the reflecting team for clients a thorough description of the process should be provided beforehand, and the clients should always have the opportunity to withdraw (Pender & Stinchfield, 2012). West (2002) suggests it may be helpful to discuss anxieties and objectives regarding the reflecting team proces s before beginning the session. Egeli et al. (2014) state clients often experience both hope and vulnerability throughout the reflecting team process, and it is often beneficial to discuss both of these possible feelings with clients.
28 During the session, therapists can decrease client anxiety b y validating client struggles, especially vulnerability (Mitchell et al., 2014). Pender and Stinchfield (2014) assert it is necessary for reflecting teams to behave both professionally and respectfully throughout the process. Finally, reflecting teams wh o provide nonjudgmental, collaborative feedback help clients to feel more comfortable being open and disclosing personal information (Pender & Stinchfield, 2014). After the session is complete, Mitchell et al. (2014) suggest a break between the session w ith the counselor and feedback from the reflecting team can be beneficial for clients. Clients who are given to space to process working with a reflecting team often retain more information than those who did not receive a break (Mitchell et al., 2014; Pe nder & Stinchfield, 2012). Furthermore, letters providing both positive feedback and areas of growth were particularly helpful in aiding families to retain the thoughts and emotions brought up during the reflecting team process (Mitchell et al., 2014). Th e reflecting team process often generates repetitive themes for clients. One primary theme is that of different perspectives (Pender & Stinchfield, 2012). Indeed, the benefits of hearing multiple perspectives can be empowering for both couples and famili es, especially if the reflecting team is comprised of different genders (Egeli et al., 2014; Egeli et al., 2013; Mitchell et al., 2014; Pender & Stinchfield, 2014). A second theme involves being able to relate to others: although hearing multiple perspect generated by the reflecting team (Pender & Stinchfield, 2012). Therefore, keeping the clients in mind at all times is imperative (Andersen, 1987). Furthermore, nonjudgment al language and
29 dialogue are essential to helping clients to benefit from the use of a reflecting team (Andersen, 1987). The use of a reflecting team can allow for more trusti ng, nurturing, and comforting communication to occur during therapy (Pender & Stinchfield, 2014). The process is particularly helpful when therapists emphasize positive aspects of the familial relationship, offer different perspectives, and normalize probl ems (Pender & Stinchfield, 2014). Placing the couple or family in a positive light has been shown to be beneficial as part of a reflecting team process (Pender & Stinchfield, 2012). Fe elings of vulnerability are common during the reflecting team process; it can be become more self conscious, couples and families often get lost in the content of their session and display uncharacteristic patterns of behavior, such as less frequent interruptions (Egeli et al., 2014; Mitchell et al., 2014). Furthermore, families tended to provide space and truly listen to et al.). Reflectin g teams can be particularly useful with couples and families (Pender & Stinchfield, 2012). One theory suggests problems emerge for couples when they view their problems from only one perspective (Egeli et al., 2014). The couple may be stuck in a negative iterative cycle that weakens their capacity to solve the problems at hand (Egeli et al). Therefore, one purpose of a reflecting team is to break apart the negative cycle by offering new perspectives (Egeli et al.). Reflecting Teams and Hope
30 Egeli , Brar, Larsen, and Yohani (2013) concluded that participating in the reflecting team process involved three separate experiences of hope: hope as understood before the reflecting team process, hope while participating in the process, and hope during the d ebriefing process. The type of hope experienced before the reflecting team process involved anticipation, hope for positive progress, and a desire for new perspectives (Egeli et al., 2013; Pender & Stinchfield, 2014). Specifically, couples desired relatio nship clarification regarding and support for their decisions (Egeli et al., 2013). When entering into the reflecting team process, couples often express ed a generalized hope that the reflecting team process would be helpful, thereby decreasing feelings o f vulnerability by refusing to establish a particularized hope about the process (Dufault & Martocchio, 1985; Egeli et al., 2014). Hope during the reflecting team process can also be expressed by being willing to try something n ew (Egeli et al., 2014). Egelie et al. (2014) reported m any couples express a desire for new perspectives which would encourage relationshi p growth. Indeed, new perspectives provided by both the therapist and the reflecting team help families to understand both their verbal and n onverbal communication more deeply (Mitchell et al., 2014). The hope experienced throughout the reflecting team process involves the reflecting al., 2014) . Couples often feel hopeful when the reflecting team acknowledges that change can be difficult and suggest future possibilities (Egeli et al.). Furthermore, a reflecting team that comments on the positive progress of the clients can increase client hope (Egeli et al.). When a hopeful as well (Egeli et al.).
31 with their relationship as well as the therapeutic process (Egeli et al, 2013). By acknowledging a (Egeli et al., 2014). Although the debriefing process can be a wa y to strengthen the goals for a couple in counseling, it can also result in increased vulnerability if the couple fears they cannot make the desired progress (Egeli et al., 2014). For the majority of couples, the reflecting team process serves to provide new ways to encounter and address their problems, engendering hope for the future of the relationship (Egeli et al., 2013, 2014; Mitchell et al., 2014).
32 CHAPTER 3 METHODOLOGY Interpretative phenomenological analysis (IPA), as a research methodology, allows for understanding of a particular phenomenon on the participants own terms (Smith, Flowers, & Larkin, 2009). Indeed, the individual is considered to be an expert of their li fe and their experiences (Sm ith et al., 2009). IPA researchers desire an intimate understanding of a personal lived experience, as well as how the participant makes sense and meaning of the experience (Smith, 2010). While simultaneously trying to underst necessitates a hermeneutic of suspicion, indicating that one should also use external theories to illuminate common themes (Smith et al., 2009). As the author desire d b oth for their relationship as generated by reflecting teams through the lens of attachment, understanding how the couple makes sense of the experience necessitates a phenomeno logical resea rch methodology. The author aim ed for a deep comprehension of a cou counseling using a reflecting te am. Furthermore, the author desire d to know how couples make sense and meaning of the hope for their relationship, as influenced by their attachment style. Therefore, interpretat ive phenomenological ana lysis was an ideal resea rch methodology to use to gain the level of understanding the author desired. Merleau (Merleau Ponty, 2013, p. 274). All perce ptions are grounded in the person that perceives them and are colored by culture, temporality, and personal experience (Romdenh Romluc, 2011).
33 Therefore, the lived perceptions of the author of this study will impact how the research is experienced as well as how the data is analyzed and interpreted. The author of this study was first exposed to attachment theory as an undergraduate student working with Dr. Catherine Salmon to explore the impact of attachment on bir th order and sexual practices. In part in Counseling at the University of Colorado , the author also desired to explore how attachment style impacted couples who come knowledge of co uple dynamics and attachment increased due to the exposure to Emotion Focused Therapy in the Counseling Techniques course. Upon graduation, the author desire s to work with couples and families , and understanding ability to respond to a couple The author currently has an internship at Evergreen Psychotherapy Center Attachment couples and families, the author has an ever deeper understanding of both attachment and how hope impacts relationships. In Merleau l field is an every changing an e ver evolving landscape based on changing experiences (Romdenh Romluc, 2011). Research Questions 1. How do couples exp erience hope within their relationship? 2. How do reflecting teams impact the hope couple has for their relationship? 3. How do anxious and avoidant attachment styles influence the experience of hope in a relationship? Interpretative Phenomenological Analysis I nterpretative Phenomenological Analysis combines three distinct traditions: phenomenology , hermeneutics, and idiography. IPA engenders both a hermeneutical and
34 s tudies the meaning linking comprehensive units of experience (Smith et al., 2009). In terms of hermeneutics, an IPA researcher is constantly engaged in a double hermeneutic: the researcher is trying to make sense of what a participant is trying to make se nse of (Smith et al., 2009). As it is order to try to make sense of the phenomenon (Eatough & Smith, 2006). IPA also operates from a hermeneutic of empathy : the researcher aims to understand the experience and tries to recreate the experience on its own terms (Smith, 2009). Not only does (Smith, 2009). The IPA researcher both wants to stand alongside the participant but a lso IPA also draws on Idiography. The idiographic perspective emphasizes the individu ality sense of emotions, actions, feelings, and experiences (Eatough & Smith, 2006). Overall, IPA allows a researcher to explore topics with flexibility a nd detail (Ryninks, Roberts Collins, McKenzie McHarg, & Horsch, 2013). IPA is systemic, in that it acknowledges (Ryninks et al., 2013). Furthermore, the person al is acknowledged, as the researcher can explore a phenomenon from their own values, and the interpretations made by the researcher are limited by the ability of the participant to articulate their own experiences (Ryninks et al., 2013). IPA places the p articipant as the expert of their own lives, and desires to understand and interpret their individual story in order to find common themes in an experience (Smith et al., 2009). The
35 following section examines the formative traditions of Interpretative Phe nomenological Analysis. Phenomenology As a whole, phenomenology is concerned with understanding lived experience (Eatough & Smith, 2006). Edmond Husserl, the founder of phenomenology, believed that there were two types of experiences: a stream of conscio usness and the component parts (Zhang, 2016). Husserl believed that by understanding the essential features of an experience, one could transcend the experience itself and reveal the common essential features of a particular experience (Smith et al., 2009 ). Husserl acknowledged the realness of the lifeworld and, therefore, was concerned not with existence, but how things were understood (Moran, 2000). Husserl stated that one must ack to the things on thinking, seeing, and remembering (Cairns & Emb ree, 2012). In order t o do this, Husserl recommends ing ting aside the natural attitude in favor of describing and reflecting on each phenomenal component of an experience (Smith et al., 2009). This creates an intentional relationship be tween the process and experiences of consciousness, i.e. the seeing of something (Cairns & Embree, 2012). For Husserl, there are two components of experience: the noema, or what is thought, and the noesis, or the act of thinking (Moran, 2000). Husserl bel ieved the noesis, the reflection or conscious mental processes, allowed true understanding of the noema (Moran, 2011).
36 transcendental reduction. The eidetic reductio n establishes an essence, whereas the transcendental reduction forms the essential features of an experience (Smith, et al., 2009). By using transcendental reflection, Husserl suggests we are able to explore the essential features of our conscious life (S mith et al. 2009). One must always repeat the process of bracketing in order to suspend scientific and preconceived ideas of a phenomenon (Moran, 2000). a historical, so cial, and temporal context (Moran, 2000). Heidegger believed humans are existence, humans are provided with limited choices that are situated in their social and tempor al context (Gjesdal, 2011). Furthermore, Heidegger used phenomenology as a way to decipher human factual life (Moran, 2000). As being is always in relation to others and the world, then interpretation is an essential part of an intersubjective life (Mora n, 2000; Smith et al., 2009). Heidegger, although not completely abandoning bracketing, was more concerned with the question of existence itself, rather than putting aside preconceived ideas to understand experience (Moran, 2000). Indeed, Heidegger spends much of his time discussing b eing and existence (Moran, 2000). or inauthentic (Moran, 2000). I nauthenticity, or the normal condition of doing what others do, Authenticity, on the other hand, resembl es bracketing in so much that it (Moran, 2000). Like Heidegger, Jean Paul Sartre believed humans make meaning out of engaging with the world we inhabi t (Smith et al., 2009). Sartre used two terms to describe this engagement:
37 for itself (le pour soi) and in itself (en soi), indicating human consciousness and the world respectively (Moran, 2000). Sartre asserted that self consciousness always happens in relation to others and existence is always in relation to the others in the physical world (Smith et al., 2009). For Sartre, life must always be seen contextually, in terms of both life history and personal context (Moran, 2000). Sartre wrote and develo ped his ideas about phenomenology alongside Maurice Merleau Ponty, who, although in agreement with Sartre regarding the importance of context, had a very different idea of how intersubjectivity is defined (Moran, 2000). For Merleau Ponty the notion of int ersubjectivity is grounded in the body (Romdenh we can never truly understand another, as we do not inhabit their body (Moran, 2000). Experiences are always unde rstood in terms of body, context, and the relation to others (Romdenh Romluc, 2011). everyday conceptual framework that one must move beyond in order to try to under stand the Romluc, 2011, p. 22). Merleau Ponty believes the individual physical and perceptual ways of knowing about existence are more important than abstract or logical theories ; he also acknowledges both the personal and the systemic are involved in perception ( Romdenh Romluc, 2011; Smith et al., 2009). Hermeneutics Hermeneutics, or the theory of interpretation, describes the relationship between intention and interpretation (Gjesdal, 2011). Although originally created to explore biblical texts,
38 hermeneutics expanded as a way to explore al l Western art and philosophy (Smith et al., 2009). Interpretative Phenomenological Analysis always involves the double hermeneutic of the a lived experience (Smith et al., 2009 ). One of the hermeneutical component s of IPA is the hermeneutic circle (Smit h et al., 2009). T here is a dynamic relationship between the whole and the parts of an experience (Smith et al., 2009). In order to understand the whole, one must understand the parts, and in order to understand the parts, one must look at the whole (Smith et al., 2009). In order to correctly take a hermeneutical stance during IPA research, one must manage and minimize presuppositions and habits (Warnke, 2011). Friedrich Schleiermacher, one of the first philosophers to expand hermeneutics beyond biblical texts, believed interpretation is comprised of grammatical interpretation, or the exact textual meaning, and psychological interpretation, or the interpretation by an individual (Huang, ntention through the particular impression a text makes on th e reader (Smith et al., 2009). Schleiermacher emphasized language, indicating understanding begins with language (Huang, 1996). Furthermore, Schleiermacher believed the analyst can offer additi onal insight into a text, expanding beyond what the writer intended (Smith et al., 2009). Heidegger also explored hermeneutics, as he believed phenomenological understanding was most easily accomplished through poetry and art (Moran, 2000). Heidegger b elieved access to Dasein could only be achieved by interpretation (Vasterling, 2014). For Heidegger, things could have both visible and hidden meanings, and the sequence at which meanings appeared is
39 important (Smith et al., 2009). Interpretation makes b racketing cyclical and only partially For IPA in particular, important aspects of a phenomenon may not emerge until later in the research (Smith et al., 2009). Indeed, priority is given to new objects that emerge, not preconceived notions (Smith et al., 2009). Heidegger believed if we look at things without presuppositions, we are closer to the truth (Moran, 2000). Hans Gadamer, another hermeneutical scholar, suggested one who is interpreting a text is always projecting meaning on to the text itself (Smith et al., 2009). Therefore, there is a constant process of revising projections and making way for new ones as they emerge (Smith et al., 2009). Thus, a dia making of the text (Smith et al., 2009). (Moran, 2000). Language carries a cultural tradition, as well as a communal and i ntersubjective understanding (Moran, 2000). Gadamer stated a personal interpretation of a text cannot recreate the intentions of the author: although interpretations are dialogues between the past and present, the original intentions cannot be created due the historical gap between the reader and the writer (Smith et al., 2009). Interpretation, especially individual interpretation, is an important aspect of the final component of IPA. Idiography Idiography is concerned with the particular (Smith et al., commitment to the particular, the sense of detail , al., 2009, p. 29). There is a desire to understand a particular phenomenon in a particular context from a particular point of vi ew (Smith et al., 2009).
40 phenomenon of interest (Smith et al., 2009). These generalizations are most often develop ed through analytical induction or proposing hypothesis which are tested against each case in turn (Smith, Harre, & Van Langenhove, 1995). However, cases can be written up and compared side by side, using the quasi judicial approach (Smith et al., 1995). Both methods can result in well analyzed themes in IPA resear ch through understanding shared experiences from an individual point of view. Method Design Although Interpretative Phenomenological Analysis is the methodological framework for this study, the nature of the information that will be gathered necessitat es a mixed methods design . As discussed below, the author used two assessments, the Relationship Hope Scale (RHS) and the Experiences in Close Relationships Revised adult attachment questionnaire (ECR R) (Erickson, 2015; Fraley, Waller, & Brennon, 2000). The ECR R assessment aids in the determination of attachment style (F raley et al., 2000). The author used this assessment to divide my participants in to groups based on their attachment classification. The author utilized the Relationship Hope Scale to determine if the reflecting team quantitatively impacted the hope each participant had for the future of their relationship. Mixed methods research involves collection and analysis of both qualitative and quantitative data and integrates these two types of data in such a way as to advance understanding ( Watkins & Gioia, 2015 ). Mixed methods research assumes that no research
41 question can be a nswered by one method alone and the collaboration of methods furthers know ledge more than a single method (Watkins & Gioia, 2015 ). Furthermore, a mixed methods study utilizes the strengths of both types of research and offsets the disadvantages of each me tho d (Watkins & Gioia, 2015 ). This study utilize d a convergent parallel design. This type of design involves the collection of qualitative and quantitative data concurrently (Watkins & Gioia, 2015 ). Both quantitative and qualitative data is compared or restated and then interpreted ( Watkins & Gioia, 2015 ). This research design is often used when a researcher needs to collect both types of data and if both types of data are equally valuable in understanding the population ( Watkins & Gioia, 2015 ). The s trengths of convergent parallel design include the intuitive nature of the design and the efficiency of data collection ( Watkins & Gioia, 2015 ). Challenges can occur when there are differing sample sizes or when the researcher has expertise in one area ov er the other ( Watkins & Gioia, 2015 ). The author use d th is design as the author gathered data concurrently and both the ECR R and RHS aid ed in unders tanding the couples interview ed . However, although this study qualifies as a mixed methods design, the emphasis will be on the qualitative data collected. The author used a very small sample size for the study, which results in a loss of power and st atistical significance for the quan titative data ( Watkins & Gioia, 2015 ). The results o f both the ECR R and RHS are included as part of data analysis, but the majority of the analysis will focus on themes generated from interviews. Data Collection Recruitment
42 Interpretive phenomenological analysis demands purposive sampling, as one wants to research people experiencing a particular phenomenon (Smith et al., 2009). Indeed, participants , 2009, p. 49). Furthermore, a homogenous sample is best suited for IPA: a homogenous sample reveals the commonalities of the phenomenon, instead of illuminating personal differenc es (Smith et al., 2009). Smith et al. (2009) suggest that dividing the sam ple is sometimes necessary in orde r to underst and a perspective. As the author desired to understand hope t hrough the lens of attachment, the my participants are grouped based on their attachment style as indicated by the ECR R. IPA does not emphasize particular numbers of participants for a research study, but rather the experience they have in common (Smith et al., 2009). Although Smith et al., (2009) recommend three participant s for a Masters level thesis . Although the author had six participants, recommendation. This sample si ze allow ed for a detailed analysis of each case, as well as analysis of the similarities and differences between cases (Smith et al., 2009). The a uthor recruited participants with the help of both Denver Family Institute and Dr. Robert Allan, who also conducted research on reflecting teams at this institution , which routinely uses reflecting teams as part of therapeutic treatment . Denver Family Ins titute generated a list of potential participants who have participated in the reflecting team process, taken the Experiences in Close Relationships Revised Adult Attachment Questionnaire, and desired to participate in individual interviews (Fraley et al., 2000). By participating in the survey , the couples received one free session; they received an additional free session for participating in the interview.
43 c arefully about data collection and take great care to engage participants on terms that are 115). In order to phenomenologically capture the interpretations, the author used both interviews and journaling to collect data. Using multiple methods increases the credibility of a qualitative study, as well as provides a thick and rich description of an experience ( Jacobson & Christensen, 2014). Interviews Prior to conducting the interviews, the author participated in one reflecti ng team as well as observed Dr. Robert Allan interview a co uple involved in a similar research . The author then conducted interviews of two couples at the Denver Family Institute. The interviews the auth or conducted f ocused on how the reflecting team influenced how the couple experienced hope for the future of their relationship. These interviews were gu ided by the interview guide in A ppendix A. To complete the total of three in terviews, the author used thesis advisor , Dr. Allan, conducted. Questions , as listed in the interview guide, were participant to discuss their experience at length (Smith et al., 2009, p. 59). Furthe rmore, each interview began with a question that elicits a descriptive experience. Beginning in this manner helps the participant to feel comfortable talking (Smith et al., 2009). The author conducted two interviews with different couples one time each . The . Each interview was approximate ly 30 minutes long , as facilitated by the interview guide. After the interviews were complete d the author transcribe d the interviews word for word to allow for
44 further analysis. To protect participants confidentiality, the author changed all the participa nts names. The author was unsuccessful at contacting the research coordinator at the Denver Family Institute to facilitate a third interview. As such, the author was forced to use an interview conducted by Dr. Robert Allan. Dr. Robert Allan interviewed one couple one on one occasion. Prior to each interview conducted at the Denver Family Institute both the author and Dr. Robert Allan asked participants to sig n a consent form (Appendix B). Both Dr. Allan and the author used interview guides to conduct t he interviews. Although the questions were not the same, they Journaling . An integral part of data analysis in IPA is journaling by the author regarding reflections on their process (Smith et al., 2009). examination, clarification, and critique of the data and research material colle cted (Humble & Sharp, 2012). Journaling can be used to create a narrative, track emotion and cognitions, as well as to evaluate progress (Dwyer, Piquette, Buckle, & McCasliln, 2012). Indeed, journaling can be an excellent way to engage in both reduction and reflection (Finlay, 2011). Furthermore, reflexivity is crucial to qualitative research (Berger, 2015). Reflexivity is evaluation of researcher affects the research, but also about how the researcher affects the res earcher (Fluery, 2015). T o perform the necessit ated reflexivity, the author journaled after ev ery inter view and during data analysis. The author also journaled after meetings with my thesis advisor and thesis committee.
45 Bracketing . As mentioned above, bracketing is a device used to generate understanding beliefs and knowledge about the phenomenon in question (Chan, Fung, & Chien, 20 13). However , Husserl himself was somewhat unclear about how bracketing and the eidetic reduction can be achieved (Smith et al., 2009). Indeed, many pre understanding cannot be completely eliminated (Chen et al., 2013). One cannot preconceived notions (LeVasseur, 2003 ). Overall, bracketing is only partially achievable and, as Heidegger indicated, cyc lical, as one must continually bracket with every new topic that is discussed with the participant (Moran, 2000 ; Smith et al., 2009 ). Participants Previous attachment research indicates that it takes approximately two years for people to use their partne rs for attachment functions (Hazan & Zeifman, 1999). Specifically, by two years many couples use their partners for proximity seeking, as a safe haven, and finally as a secure base (Hazan & Zeifman, 1999). As such, the author each couple to have been in their current relationship for a minimum of two years. Although the length of the relationship was known, marital status was not included on the demographic questionnaire. The two couples the author interviewed composed of a self identified female mem ber and self identified male member. An integral part of qualitative research is upholding confidentiality, thereby necessitating the use of pseudonyms ; as such, the author changed each of the names of the participants (Nespoor, 2000). The first couple i nterviewed, re named Cassie and James, reported their relationship has lasted seven years . Both Cassie and James reported their age as 27. Cassie reported her income as between 30,000 to 49,999 thousand dollars per year whereas James reported his annual income as between 15,000 to 29,999 thousand dollars.
46 The second couple, pseudonyms Damien and Rebecca, reported a 13 year relationship. Damien reported his age as 40; Rebecca reported her age as 36. Damien reported his income as between 45,000 to 59,999 thousand dollars annually. Rebecca reported her annual income as 60,000 to 79,999 thousand dollars. The couple interviewed by Dr. Allan both reported their gender identity as female and being in a relationship for two years . Halona reported her age as 31 and reported making over 100,000 thousand dollars annually. Joana reported her age as 38. Although the demographic questionnaire asked gender identity, it did not ask about sexual orientation. Consequentially, it is uncl ear if the participants identify as gay, lesbian, heterosexual etc. Table One : Participants Pseudonyms Age Gender Attachment Style Pre RHS Score Post RHS Score Cassie James 27 27 Female Male Anxious Anxiously Avoidant 5.2 5.0 5.2 5.8 Rebecca Damien 36 40 Female Male Anxious Secure 4.2 6.0 6.0 6.4 Halona Joana 31 38 Female Female Anxiously Avoidant Avoidant 5.2 7.0 6.6 7.0 Instruments
47 Experiences in close relationships questionnaire. The Experiences in Close Relationships (ECR) adult attachment questionnaire was originally developed by Brennan, Clark, and Shaver (1998) in order to assess attachment anxiety and avoidance (Parker, Johnson, & Ketring, 2011). The assessment was later revi sed by Fraley, Waller, and Brennan (2000) in an effort to provide consensus in attachment measures as well as provide more precise estimates across anxious and avoidant trait ranges. Indeed, the Experiences in Close Relationships Revised (ECR R) provides more evenly distributed item discrimination values across the entire trait ranges of avoidance and anxiety (Sibley, Fischer, & Liu, 2005). The ECR R was created by manually rotating the items of attachment indicated by Brennan et al. (1998) until the cl usters of anxiety and avoidance were linked in a meaningful way (Sibley & Liu, 2004). Furthermore, Fraley et al. (2000) narrowed the items based on their discrimination value, in order to more evenly distribute items across trait ranges (Sibley & Liu, 20 04). The final version is a 36 item questionnaire with a seven point Likert type scale ranging According to Fraley et al. (2000), secure adults score low on both attachment anxiety and avoidance, whereas fearful adults are high on both dimensions. Preoccupied adults score low on attachment avoidance, but high on attachment anxiety (Fraley et al., 2000). Dismissive adults score low on attachment anxiety and high on attachment avoidance (Fraley et al., 2000). Overall, Fraley et al. (2000) asserts the ECR R assesses an comfort with closeness and dependency or a reluctance to be . 142 143) . The ECR R is both a reliable and valid measure of adult attachment (Fraley et al., 2000). Alpha estimates of reliability tend to be around .90 (Sibley & Liu, 2004). Internal consistency
48 reliability is also high, appr oximately .90 (Sibley & Liu, 2004). Compared to a wide variety of measures assessing similar constructs to attachment, the ECR R demonstrates good construct validity (Fairchild & Finney, 2006). Shared variances for the measure hover around 90 percent, an d latent factors are moderately correlated at r =.51 (Fairchild & Finney, 2006; Sibley & Liu, 2004). Sibley, Fischer, & Liu (2005) found the ECR R to have highly stable indicators of latent attachment, r s of .90 and .92, respectively. Fraley et al. (2000) reported that ECR R measures of anxiety and avoidance displayed levels of stability equivalent to r s between .94 and .95 . Additionally, h ierarchical linear modeling analyses suggest the ECR R explains between 30% to 40% of the between person variation of attachment related emotions experienced during interactions with a romantic partner , further validating the measure (Sibley et al., 2005). Overall, the Experiences with Close Relationships Questionnaire has acceptable to good estimates for internal consi stencies, factor structure, and test retest reliability (Sibley et al., 2005). As this research aims to explore hope through th e lens of attachment, the author used the ECR R to assess each interviewees level of anxiety and avoidance in re sponse to relati onship stress. As such the author divide d participants into groups based on their attachment style . The author then compare d the responses to my interview questions based on the type of attachment style assessed in the ECR R. Relationship hope scale. The Relationship Hope Scale (RHS) has recently been developed by Dr. Scott Stanley and Dr. Alan Hawkins (Erickson, 2015). It co nsists of five items that assess the hope a person feels for his or her relationship, regardless of the current quality of the relationship (Erickson, 2015). The qu estions are measured on a seven point Likert type scale
49 Confidence Scale (Trathen, 1995) and were modified in order to better assess relationship change and growth (Erickson, 2015). nd Confirmatory internal consistency reliability. Therefore, the RHS is a unidimensional measure of hope as one construct (Erickson, 2015). Erickson (2015) demonst rated that the RHS is a valid assessment of hope by using item response theory. The RHS also has good construct validity, and is correlated, but not isomorphic, with relationship happiness (Erickson, 2015). The overall mean of relationship hope is high a nd the distribution of the Relationship Hope Scale is negatively skewed (Erickson, 2015). Furthermore, the RHS does not differentiate between gender, income level, education level, race, or first or second marriages (Erickson, 2015). However, the RHS do es discriminate well amongst those who are thinking about divorce at different levels (Erickson, 2015). The scale provides the most relevant information at the lower levels of the hope construct but does not discriminate well with those who demonstrate hi gh levels of relationship hope (Erickson, 2015). Overall, this new assessment is a reliable and valid measure of hope. Fo r my purposes, the Relationship Hope Scale was administered before the couple attended the therapy session with the reflecting team in order to assess their level of hope prior to th Then, the RHS was administered af ter the couple met with the reflecting hope for their relationships. Ethical Issues
50 Ethical issues for qualitative researchers include dignity, privacy, confidentiality, and avoidance of harm (Bresler, 1995). Furthermore, informed consent, anonymity, and sensitivity are also important for qualitative researchers (Van Den Hoonaard, 2002). Smith et al. (2009) believe the avoidance of harm to be the primary ethical principle for qualitative researchers. Indeed, Smith et al. (2009) suggest it is important to be aware if the discussion of certain topics can cause the participants harm. Therefore, informed consent will be an important part of the data collection process. The author followed all the ethical guidelines as laid out by the University of Colorado Denver Instituti onal Review Board. The author stored the audio recorded interviews on passwor d protected computer. The author did everything possible to ensure confidentiality, includi ng removing identifying information from quotations . The author informed the participants that they may withdraw from the study at any time up to the time where data analysis begins, as recommend ed by Smith et al. (2009). As no participants decided to wi thdraw from the study, no data needed to be destroyed. Data Analysis This allows for a researcher to flexibly analyze the data, noting when new themes emerge throughout the analytic and interpretive process (Smith et entative, inductive, and process oriented (Smit et al., 2009). Overall understanding is derived from describing a lived experience and the meaning attached to that experience (Smith et al., 2009).
51 Analysis typically involves four strategies: line by lin e analysis of the transcripts from each interview, identification of emergent themes, the development of a dialogue between the researchers and the data, and the development of a way to describe the relationships between themes (Smith et al., 2009). Super vision, collaboration, and reflection can also be important strategies for data analysis (Smith et al., 2009). Furthermore, developing a full narrative which is developed theme by theme and supported by visual tables can aid interpretation and understandi ng (Smith et al., 2009). Smith et al. (2009) state there are four levels of analysis within IPA which allow for a hermeneutic of empathy. The first level is the primary theme (Smith et al., 2009). The second level includes metaphors or other content th at generate meaning during data analysis (Smith et al., 2009). The third level examines how meaning has evolved over time (Smith et al., 2009). Finally, the fourth level, which represents the hermeneutic of suspicion, uses outside theories to examine the Although IPA does not have a fixed set of steps to follow during analysis, there are a number of suggestions made to encourage the generation of a thick, rich description of the visualize the conversation (Smith et al., 2009). Smith et al. (2009) suggest the following steps in data analysis: 1. Reading and re reading the transcripts i n order to immerse oneself in the data. 2. Initial noting of language, content, and concepts. 3. Develop emergent themes by noting patterns, relationships, and connections 4. Search for connection across emergent themes. 5. Move to the next case and repeat the proc ess.
52 6. Look for patterns across cases. Evaluation of Research Qualitative researchers discuss the validity of their researcher differently than do quantitative researchers (Russell & Gregory, 2013). As many qualitative methodologies, including IPA, are inherently flexible, the methods by which qualitative research is evaluated also necessitate flexibility (Yardley, 2000). Instead of focusing on sample size or replication, qualitative researchers evaluate their research in terms of sensitivity to context , commitment, rigor, transparency, coherence, and the impact of the research (Russell & Gregory, 2003). Sensitivity to context. Awareness of previous literature, both empirical and philosophical, s research to the work of others (Yardley, 2000). Indeed, the awareness of the philosophy that grounds the research allows for deeper and farther reaching analysis (Yardley, 2000). Furthermore, the analysis of the findings must be sensitive to the data i tself (Yardley, 2000). For qualitative researchers, sensitivity can be shown by linking findings to empirical evidence, focusing on unexpected findings, and awareness of the researcher to the socio cultural context in which the data is collected (Horsburg h, 2003; Yardley, 2000). Description of the social structures surrounding the participants is essential in order to place the data within a wider context (Horsburgh, 2003). Successful IPA research embeds the data within the empirical and philosophical context as Additionally, the philosophical base of phenomenology, especially that of Sartre and Merleau o ne cannot be seen unless they are in relation to others and the world ( experiences by acknowledging familial, social, and cultural impacts (Smith, 2009).
53 Commitment and rigor. Yardley (2000) defines commitment as prolonged engagement with the material to be studied, competence in the skills used to conduct the research, and immersion within the relevant literature, data, and theory. Rigor, on the other hand, refers to whether or not t he sample chosen is able to provide sufficient information for a thorough, saturated analysis (Yardley, 2000). Often phenomenology demonstrates both rigor and commitment through extended reflection on and empathic exploration of the data (Yardley, 2000). Interpretative phenomenological analysis in particular connects the analyzed data to its philosophical underpinnings in phenomenology, hermeneutics, and idiography (Smith, 2009). Furthermore, the process of data analysis, including transcription, case by case analysis, and thematic analysis, lends itself to data immersion (Smith, 2009). IPA research explores the Additionally, successful IPA research presents vivid, susta ined analysis as well as exploration of almost every sub theme that emerges in cross case comparison (Smith, 2011). Chosen extracts demonstrate convergence, divergence, representativeness, and variability within the data (Smith, 2011). Transparency an d coherence. Findings in qualitative research are interactions between the participant and the researcher (Horsburgh, 2003). As such, the narrative created is often constructed or recreated by the researcher (Horsburgh, 2003). It is the quality of this reconstruction, the ability to make the researcher meaningful to the reader that demonstrates transparency and coherence (Yardley, 2000). Transparency can be further achieved by describing the data analysis, including the coding process, in detail and by providing excerpts from the interview transcriptions (Yardley, 2000).
54 Reflexivity, or the description of how the researcher impacts the research, also establishes transparency (Horsburgh, 2003). Ack nowledgement that the author has their own history that i nevitably impacts the research help to provide the reader with an honest and open account of how the researcher was conducted and analyzed (Horsburgh, 2003; Yardley, 2000). Overall, IPA research should have a clear focus (Smi th, 2011). Providing vivid, descriptive quotes from at least half the participants that illustrate the themes and sub themes of the research is indicative of well conducted research (Smith, 2011). Furthermore, Mason (2012) suggests IPA researchers demons trate transparency by showing that data analysis is researc h has been done well and is trustworthy (Rodham, Fox, & Doran, 2013). Impact and importance. Research has theoretical, practical, and socio cultural impacts (Yardley, 2000). As such, it is essential for the qualitative researcher to relate their data t o a wider theory and situate the data within the appropriate sociocultural context in order to generalize the findings (Horsburgh, 2003; Yardley, 2000). Often qualitative research has a practical component, and is closely related to clinical practice (Yar dley, 2000). IPA researchers typically link their work to the overarching phenomenological, hermeneutical, and idiographic base as well as situate their findings in a historical, temporal, and social context (Smith, 2009). For instance, Smith (2004) di scusses the impact IPA has had on which forms a vital current in contemporary health psychology research [in the United IPA inherently attempts a very personal
55 understanding of a phenomenon, this methodology also acknowledges the impact of theory, practicality, and context (Smith, 2004; 2011). CHAPTER 4 RESULTS Each participant completed the Relationship Hope Scale (RHS) before and after the reflecting team process reflecting team score was 5.0 and his post reflecting team score was 5.8. reflecting team RHS score was 5.2, whereas her post reflecting Each participant also compl eted the ECR R prior to the reflecting team process. As determined by this instrument, Cassie displays an anxious attachment style, whereas James displays an anxiously avoidant style. Damien presents with a secure attachment style and Rebecca presents wi th an anxious attachment style. Halona reported an anxiously avoidant attachment style and Joana reported an avoidant attachment style. Table 2: Results Name Pre RHS Score Post RHS Score Attachment Style Cassie James 5.2 5.0 5.2 5.8 Anxious Anxiously Avoidant Rebecca 4.2 6.0 Anxious
56 Damien 6.0 6.4 Secure Halona Joana 5.2 7.0 6.6 7.0 Anxiously Avoidant Avoidant CHAPTER 5 ANALYSIS Interpretative Phenomenological Analysis provides a structure for analysis that allows the analyst to be both flexible and creative (Smith et al., 2009). Indeed, Smith (p. 80) discusses a s their data. IPA analysis is demanding, both conceptually and reflectively, as IPA requires active engagement with each ader in my approach, it is worthwhile to describe each stage of my analysis (Smith et al., p. 79). The author followed the process of analysis recommended by Smith et al. (2009). After transc ribing interviews one and two, the author rea d and reread each transcript and made notes in a research journal regarding both the process of reading the t ranscripts as well as anything the author found p articularly significant. Once the author obtained intervi ew three, the author preformed the same process of readin g the transcripts and note taking. The initial notes and highlights of distinguishing phrases.
57 After setting up a table in Microsoft Word for each inter view that included columns for exploratory comments, emergent themes, and superord inate themes, the author began close analysis of the three transcripts to develop emergent themes. Table 1 below provides an example of this analysis of my first superordina te theme. Smith et al. (2009) suggest that this task ex perience. As with the remainder of the analysis, this stage involves the hermeneutic circle, as each part of the transcript is interpreted in relation to the whole, and the whole of the transcript is related back to each part (Smith et al., 2009). Table 3 : Sample of Data Analysis Transcript Descriptive Comments Emergent Themes Superordinate Themes Interviewer: So what was the reflecting team for the two of you? Damien: I thought it was awesome. I really enjoyed it. I really thought that sort of what I experienced. Like, having to go outside of the three of us in therapeutic setting, sort of offering feedback on what they perceived in our rel ationship. And sometimes the three of us spend so much time talking about issues and problems like the strengths and D quick to respond about experience D had a positive experience with RT Repetition of really as indicative of high level of positivity Personal growth D experienced benefit of multiple perspectives Conversations with regular therapist are problem saturated, RT reminded D of relationship strengths/care RT as a positive exper ience growth Importance of multiple perspectives RT as a reminder of relationship strengths Hope as a result of outside perspectives
58 care in our relationship. Rebecca: Yeah. The strengths. RT reminded R of strengths Short sentence, emphasize the importance of strengths RT as reminder of relationship strengths Hope as a result of outside perspectives Damien: Like when we heard them talking about the strengths yeah that was really awesome. RT discussed strengths=positive experience emphasis on how important hearing about strengths was Reminder of strengths almost seems as though it was an imperative at this point in the relationship RT as a reminder of relationship strengths for both R and D Hope as a result of outside perspectives After the author developed the emergent themes f o r each transcript separately, the author began to group them together to find overarching similarities. Each group was titled with a distinctive label, which conveyed the conceptual nature of each group. As each group was created, the author repeatedly r eturned to the original transcript to assure that the theme directly related to what each participant had stated. Smith et al. (2009) suggest each theme should both be grounded and abstract in order to give voice to the particular nature of the participan statement as well as provide the analyst and the reader with an idea of the concept behind each psychological knowledge about the contextual meaning of the partici (Smith et al., 2009). Again, the hermeneutic circle comes in to play, as the themes both reference specific aspects of the transcript as well as the transcript as a whole (Smith et al). Furthermore, Smith and colleagues sugge st that the main task for the analyst at this stage is to create overall themes that will elucidate uniting the emergent themes across all transcripts.
59 By crafting these overarching themes, it is possible for the analyst to make sense of the data across a ll three interviews (Smith et al., 2009). As part of my process to create superordinate theme on e and superordinate theme two, the author created a frequency table which allowed me ounts together, the researcher develops a gestalt which illuminates the relationship between themes (Smith et al.). The creation of the table of themes provided the author the ability to develop two superordinate themes which encompassed the predomin ant themes of each transcript as well as write up a narrative account of the relationship between e make sense of the research 2009, p. 41). The narrative holds both the par I understandings represent the I (Smith et al.). Finally, the discussion following the analysis connects to the wider range of information in the literature, a llowing the reader to situate the study both in their personal experience as well as within relevant research contexts. Analysis of Superordinate Theme 1: Being Seen by the Reflecting Team, A Both/And Experience This chapter discusses one superordinate theme: the cognitive dissonance the participants experience while being observed by the reflecting team. While the participants fear judgment and voice uncertainty that the reflecting team can truly understand them, the experience also generates a sense of efficacy within the ir relationships. There are four emergent themes within this superordinate th eme and I have created a section for each emergent theme.
60 First, the author discuss es understand their exp eriences and identities. Then the focus moves to the fear of judgement crated by being observed by outsiders. The third segment focuses on how being seen by the reflecting te The fourth chapter illustrates how the participants felt as though they were failing in th eir respective relationships. The aspect of this superordinate theme conclude s with a chapter discussing the enduring internalization from the reflecting team experience was a sense of efficacy. Sartre (1956) asserts human beings only become aware of ourselves through the gaze of another. Only once we are aware we are being w atched do we learn of our own existence (Sartre, 1956). As humans perceive themselves being perceived we learn to objectify ourselves in the same way we are being objectified (Sartre). Thus, the participants could only see their relationship with any sen se of objectivity once they realized they were being seen by the reflecting team. This objectivity is neither negative nor positive, but simply a consciousness Does the Reflecting Team Understand U s? One of the primary questions that emerged during the interviews with the couples was the question of whether or not the reflecting team understood both the individuality of each member of the couple as well as their relation ship. Joana states: I was wondering, I think while I was listening Is there any gay co That's what I wanted to know. Are they all straight women, married ... that's what I wanted to know, too. Were they saying that based on how they see women as a straight couple, just being best friends, kind of thing. That's what I wanted to know, too, because just the way they were talking it sounded like we were sisters or something like that. It kind of di dn't ... I'm not too sure how it made me feel, it was just kind of like ... That's what I wanted to know, too.
61 This passage ondering indicates the extent to which she was plagued by the uncertainty as to whether or not the reflecting team was grounded in her experience of her relationship. She questions whether there is someone among the reflecting team who has knowledge of ex istence through shared experiences. There is deep seated doubt as to whether the reflecting team could possibly understand the experience of being in a gay relationship; indeed, Joana asks if the women among the reflecting team could possibly know what it would mean to have romantic feelings for another woman or if they simply believe that Joana remains uncertain if the reflecting team could possibly understand h er romantic feelings for another woman, feelings that go beyond what the reflecting team seems to be able to comprehend. of her questioning the right of the reflecting t eam to comment on her relationship at all if they do not have either the academic or the personal understanding of the lived existence of being in a nderstanding of their relationship was to her. Without this understanding, Joana fears that the hope she experienced during the process is unfounded. indicates how i nherent her lived experience of being a gay woman is in her relationship. The I think I always have that lens of how it matches gay couples, but also people of colo r.
62 her reality as a gay woman of color. Not only does Halona wonder if the reflecting team could understand her as a gay woman, but she also adds on the layer of a woman of color. She goes on to say : thinking, do people recognize the different aspects and characteristics that we bring to ... In our Just as a lens is something one cannot see well without, Halona goes on to describe the aspects of her identity that she carries around all the time, parts of her that she is never a ble to shed . By repeating her question as to whether people recognize t hese aspects of her identity she wonders if the reflecting team can see her at all, much less see how the identities she carries affects her in her relationship with Joana. Again, there is the question as to whether the reflecting team has a right to comm part of their lived experience as gay women of color. At this moment, Halona does not even seek understanding: she only seeks that the reflecting team become aware of and acknowledge that she possesses identities that are beyond what they may be used to confronting. Halona demonstrates an awareness that society deems her different and that these differences affect her relationships as well as how even well meaning p eople view her and her partner. Indeed, she is painfully cognizant that these identities are something she cannot be without, yet often go unacknowledged by those who do not understand her lived experiences. Although Halona reports that there was nothing specific the reflecting team said or did to engender this uncertainty she goes on explain: It just brings up the question for me. But I think, I don't know, during the session, I think I was just really appreciative to hear any feedback about how we inte racted and who we
63 are from an outside perspective. And I know the outside perspective, I don't know who they are, we don't know what their experience is to give us feedback around our specific relationship, but it's still, to me, was really positive in the way that I felt like they perceived our relationship. But, it would be really interesting to see how it would be different if it was women of color This passage also illustrates one of Joana and Hal the feedback the reflecting team provides is almost overwhelmingly positive and the question of understanding lingers . Initially, the reflecting team is seen as something to be appreciated; Halona is grateful to hear any outside perspectives on her relationship. Yet, despite how po sitive the experience was for her, she would prefer the reflecting team to be composed of those who share her identities and, therefore, would better be able to understand and, therefore, comment on her experiences in her relationship. A different refle able to see Joana and Halona more clearly. Their lenses would allow them to provide more meaningful spirituality and how we support each other in that, and our culture. could not see them in ways that were fundamental to their existence, even though the reflecting team was able to see many positive aspects about their relationship . As such, they were not able to see how Halona and Joana relate to each other either romantically or spiritually, leaving a hole in their experience; a hole that could onl y be filled by those who are truly able to recognize inherent aspects of their relational identity, such as trauma, sexual orientation, and ethnicity. lesbian woman of colo role. She feared the reflecting team
64 str h that woman's just trying to be a man. reflecting team limiting her, putting her in a box because of their experience of gender as binary, sees her as playing a role, pretendin Joana struggles to balance her desired gender role, she believes the reflecting team could not see her as she was, thereby limiting their understanding of who Joana is in relation to Halona. Inde assumptions made for straight relationships, again underlining the questio n of whether the reflecting team was able to see Joana and Halona in a romantic way. If their relationship is not seen as romantic, as an attachment relationship, there is the potential that the reassuring feedback provided by the reflecting team is inval id. Joana and Halona continue to wonder if the reflecting team could objectively and truly see them. If the reflecting team could not see Halona and Joana, how could Halona and Joana objectively reflect on their relationship? This question also appears in relation to gender roles. Prior to the therapy session, participants completed questionnaires inquiring about the hope they had for the future of their know, I does Halona question the ability of the reflecting team to u nderstand her struggles as a lesbian woman of color who has experienced trauma, but she questions the inc lusivity of the materials used in the study as well. Halona wants to be seen, wants to be known at all levels of her participation in the study; not only does she want to be seen in all her various identifies, she also
65 wants to be asked about them, which affords her the ability to self identify and explain the parts of herself that are most salient. Indeed, she further explains how do you express your genders and your gender roles, and what is important to you about that in your relationship. Because I think that, then the way that we interact in our sessions is affected by that and so for them to understand that and then to take that into Halona makes the expre experience that they do not experience gender as binary. This use of genders not only illustrates how Halona walks in the world but also how she expects the reflecting team to interac t with her. She expects the reflecting team to see her and Joana not just as women, but as whole people who embody aspects of both genders and create roles for each other in their relationship from this blending. Halona further desires that the reflect ing team perceives how gender roles impact her relationship with Joana. Halona essentially states this twice: she states that gender is an important aspect of a relationship as well as explains that gender roles affect their therapy sessions, underscoring the importance of the impact of gender roles in her relationship. The and she believes she cannot truly be seen unless the reflecting team is able to conside r how her the comments made by the reflecting team. Halona and Joa na mention the effort they have made to work through their trauma and better their relationship multiple times during the interview, indicating they are aware of the
66 progress that they have made and that their relationship is enhanced because of therapy. improvements something that the reflecting team should see as they all have knowledge of the therapeutic process. Halona fears that not only does the reflecti ng team lack the ability to see how her identities impact her way of being but also the effort she is putting forth in a realm in which they supposedly have expertise. For another participant, James, his uncertainty regarding understanding does not stem from how he walks in the world, but rather how he is able to make sense of feedback. He states I remember sitting there at the end, um, after we had our session and we were all or something like that. For me, I like those specific objectives that I can, like, work on through the week. of sources, including difficulty finding t he words to express his thoughts, reluctance to express his disappointment in his experience, portraying social desirability to the interviewer, or all three. the reflecting team as affirming, he is simultaneously aware that the reflecting team could not give him what he needs to work on his relationship. This is a death of the potential of this experience; his feeling of affirmation coincides with a feeling of loss that the reflecting team could not provide him with what he truly needed methods he can use to improve his relationship.
67 While the reflecting team is able to see his interactions with Cassie as loving, they cannot see his profound desire for skil l s to better his relationship . While James acknowledges that what moment is truly a both/and: he both experiences disappointment and affirmation resulting from his experience with the reflecting team. Is the Reflecting T eam Judging U s? potentially be indicative of the reflecting team seeing her and James in a positive light, it is more likely that her statement portrays the fear and anxiety she experienced at the outset of the reflecting team process. er fear of judgement she fears she is going to be perceived as something, not necessarily be seen for her true self. The possibility of being seen as opposed to how seems to give up agency. Cassie has no control of how the reflecting team will perceive her. Rather, the reflecting team will pass judgment, making Cassie in to something he passivity of her statement: the reflecting team will perceive her , and she has no control over their perceptions. difficult because it felt like Big Brother is 1984 as
68 statement is a pri me example of cognitive dissonance: she describes the experience of the reflecting team as both positive and unsettling. Despite the positive aspects of her experience, Cassie experienced discomfort, as she was utterly and uncomfortably aware that an unkn own group of people were watching her at a time when she was expected to be vulnerable. observed but it also implies judgment: reality television is inherently judgmen tal, as viewers constantly appraise and assess the cast. Cassie not only felt the discomfort of her relationship being examined but also felt as though the reflecting team as evaluating her relationship. The evaluation was unlikely to be positive neither the characters in the novel nor in the show frequently had affirmative experiences resulting from unending observation. Cassie anticipated that the reflecting team would develop a potentially negative opinion of both herself and her relationship, as ther e exist few positive connotations with either 1984 or the reality television show. Joana and Halona also experienced the uncomfortable sensation of being watched: H alona : So , it was kinda hard because it didn't feel, when we were talking Jo ana : It ki nda led to interrupting, because they kept knocking on the window, too. H and telling us to speak up . Because then it made us hyper aware that people were watching us I t didn't feel as natural. The beginning of the reflecting team experience w as difficult for both Joana and Halona: they felt uncomfortable being observed, making it difficult for them to be present in their knocking on the window, an u nanticipated reminder that Joana and Halona were being observed
69 by people who may not understand their cultural contexts. The consistent interruptions prevented Joana and Halona from truly engaging in the therapeutic process and being vulnerable. By sta ting that the provides context for her experience: while therapy itself is a peculiar exerci se, the reflecting that the reflecting team is both artificial and contrary to what could be considered normal. Simply by being unnatural, the reflecting tea m created a sense of uneasiness for Halona and Joana. Halona experienced the awareness of potential judgment as part of how she interacts with Joana. Halona states: And then Jo ana didn't say anything , and I could tell that she was, that she felt uncomfortable with that. It made me really want to go over and support her and we talked about it in the session, but when they were reflecting on that, to me it was like "Uh oh", like we didn't really, we have different communication styles and sometimes that comes up in our relationship. ongoing differing styles of communicating created a moment in session which invited the potential for judgment, as Halona did not respond in a way that could be perceived as supportive from the outside. Halona worries that her ways of being with Joana, especially concerning how they show each other support, will not be perceived as comforti ng or reassuring by the reflecting team. She dreads their judgment that she did not do enough for Joana in session and does not put differing ways of conveying how they need support.
70 As w ith Cassie, Halona experienced cognitive dissonance regarding her experience of the reflecting team. Immediately after she describes the unnatural nature of the experience, she goes on to explain: But then, I think when we got into it though, when we act ually started talking in the session and everything, I think it went better. And then I just, I remember the things that they shared back with us were really helpful and insightful. It was really comprehensive, all the things that they said. Once Halona a nd Joana were able to create some sense of therapeutic normality, their experience of the reflecting team improved. Indeed, the reflecting team transitioned from a potentially judgmental entity to a group of people that were able to provide support and cr eate awareness of how Joana and Halona are in their relationship. The reflecting team was able to interactions with each other. The reflecting team was mutually an uncomfortably unnatural experience as well as a tool for Joana and Halona to gain insight into elements of their relationship. Halona reports that, despite her fear of judgement, the reflecting team was able to see the support she seeks and she also perceives that the reflecting team was able to see that she and Joana know and understand each other deeply. The reflecting team was able to convey that they saw the degree to which Halona and Joana are able to provide ongoing care and comfort. By knowing that the reflecting team was able to truly see the love and care in their re lationship, Halona feels comforted that despite their differences, she and Joana are able to both ask for and receive support from each other successfully.
71 No Model for Successful Relationships As part of being seen by the reflecting team, Joana and Halona as well as James voiced their struggle with the lack of a model of what a healthy, successful relationship looks like. Without knowing how to create a relationship, they could not know if what they were doing was correct. By seeing themselves thro ugh the reflecting team, both couples were able to explore how the lack of a model for a successful relationship impacted them as well as how they ex perience success, again facing cognitive dissonance. James stated: For me, I think, it validated a lot o mean, with social media and stuff you always see these projections of ideal relationships And so , to, you know , to validate to say that the struggles that we are going through are real but from their perception they could it was cool because they had like whatever, you k now. To me it felt validating for the struggles that we are going through. The image that one creates on social media is often an ideal. Routinely, there is little s pace created to convey the struggles and conflict inherent in normal relationships. As s uch, idyllic image that others choose to portray. This leaves those who are observing feeling inadequate or as though they are failures by comparison. James expres ses this deeply when he states that it relationship. In this context, James is aware that the social media portrayals are not real, but rather projections of a false identity. At the same time, he struggles not think negatively of his relationship he craves an ideal that h e knows that does not exist. Yet, James cannot help but believe that he and Cassie are not living up to that imagined ideal. He and Cassie are creating a
72 relationship in isolation: they have n o other couple to compare their relationship to and, as such, are inherently unable to see that other couples do struggle also. Therefore, the validation by the reflect ing team is profound and word validation underlines the enorm ity of this feeling. The validation by the reflecting team has created an internal shift for James, which is emphasized by his appreciation that the reflecting team could recall specific instances of the session which were meaningful. James is able to no w that their struggles are common . could not understand, that their struggles are standard and legitimate until the reflecting team was able to endorse his reality. As no one else seemed to be struggling, James felt that his problems were a fantasy something that could not possibly be true because no one else experienced it. As no one else f ought or had conflict, no one else had a reality he could share, he could not accept that his relationship could be imperfect. By validating the difficulties of his and ationships are naturally imperfect and conflictual. Unlike social media, his relationship with Cassie will never be perfect. In the process of feeling validated, James was able to accept having struggles and difficulties as a normal part of sharing a lif e with someone. James is also able to accept the duality of not having a model of a healthy relationship while at the same time be willing to explore what that would mean to have such a relationship with Cassie as a result of the observation and validatio n by the reflecting team. While James struggles with the problem of a realistic model of a healthy relationship, Joana and Halona struggle with simply having a healthy model o f a lesbian relationship. Joana
73 reported: go to school for being in a relationship, you kind of have to just ... . You're all on your own, and I guess that was, it was kind of like a grade. You're doing it right. That's the best way that I can describe it. rela tionship, and she feels this as a loss; she longs for a prescription of how to be with Halona in ways that will both meet their needs. It is as though Joana has been wandering without sight, without guidance and simply muddling through how to be in a rela tionship. Therefore, the affirmation from the reflecting that she is succeeding in being in relationship with Halona is exceedingly more meaningful. Joana consistently uses the metaphor of grading throughout the interview, which connotes both evaluatio To receive a grade is to be told by an expert that one is succeeding or failing. The reflecting team was able to provide her with the evaluation that she is succeeding, affirming her abilities to difficult to believe one has received a passin g grade. and Halona may be unsure as to whether the reflecting team understands them, the reflecting also affirms for them that they can create a wholesome rel ationship together. The reflecting team itself may not be able to model a successful lesbian relationship but is able to see Joana and The lack of a model for successful relationships is particularly relevant to Joana a nd Halona as a lesbian couple, as this following exchange demonstrates:
74 Interviewer: Okay. Because what I'm curious about is whether you're saying that as a same sex couple, you feel like we don't have any role models out there, there's no examples, or a re you saying that for any couple? Jo: I would say for any couple. Interviewer: Okay. H: I would say for any couple, but at the same time, I think it's even harder for same sex couples because even though I've seen healthy relationships, I haven't seen and haven't been in positive and happy same sex relationships. To me yes, it is for everybody, but at the same time, I think Interviewer: Yeah. H: Because you don't see that reflected in the media and I also personally haven't been around positive role models either. Interviewer: Right. H: There's a lot of things out there that reflect negatively on same sex couples, and the media, and health wise, and music, and things like that. I think it's consciously and subconscio usly it just makes it seem like it's harder to really think about and have modeled a positive relationship in that respect. While there is dearth of examples of healthy relationships, ones that both involve conflict and concurrence, there is an even large r gap for same sex couples. Rarely are same sex couples portrayed positively in the media: they are stigmatized and depicted as deviant or perverse. Halona particularly feels this lack: she herself has not experienced safe and affirming same sex relation ships. Therefore, she continuously questions her ability to create something meaningful and enduring with Joana
75 and the negative experiences in her past make coping harder and her strugg les with Joana more challenging. Moreover, the reality that building healthy same sex relationships is more difficult for Halona is exhausting. She has to contend with negative portrayals by the media, damaging experiences in health care, and a society that unapologetically rejects an inherent part of her identity. Halona absorbs the constant social criticism both consciously and unconsciously, resulting in a negative self image and fear that she will never be able to create a fulfilling, profound rela tionship with Joana. As a result of the social stigma direct ed at same sex couples, Halona seems to be unable to conceptualize how to create a healthy same sex relationship . The consciously and subconsciously absorbed shame overwhelms her capabilities to even imagine what she would want in a relationship. Without a model, she little knowledge of what a positive same sex relationship would look like and desperately desires someone to show her how to break through the social barriers placed upon her and her relationship with Joana. Indeed, she voices her frustration with the lack of relational representation for all aspects of her identity I think just always having our lens on and also now that brings up couples and people who have had trauma and things like that. What are our rule books, what are the grades, Not only does society lack an example of how t o be in an affirming same sex relationship, but there are no examples of how to create a close relationship if one has experienced trauma, which intrinsically makes being close to another person difficult. Halona is never able to separate herself from her identity; she cannot find an example of herself anywhere. As humans learn by example, she questions how she can possibly know
76 anything about engendering a successful relationship. She does not even know how to define success with her background: she cri es out against the lack of instructions and evaluation systems for people who carry her identities and lived experiences. Discouraged, she feels around in the dark for any affirmation or validation of her struggles in trying to create a thriving relations hip with Joana. Indeed, Halona states: I do want to feel validated, and as Jo ana said, you don't really have a rule book or a grading system for how you're doing and to have people tell you that you're doing well, and just to point out the positive thing s that you're doing. To me, it just made me really hopeful that even if we have problems or differences we can work them ou t ... . Like James, Halona seeks validation that her struggles with Joana are real. She longs for others, especially the reflecting t eam, to see the effort she is making to create a sustainable relationship. As Halona has no exposure to syllabi or instruction manuals for how to create deep, meaningful connections, she is unsure if she is succeeding. No one provided directions for Halo na through the process of creating a thriving intimate relationship; she is in the process of developing new skills and desires to feel affirmed in this process. Just as a young child who has learned to ride a bike desires to show off her abilities, Halon a wants the reflecting team to see and substantiate her abilities to be a good partner to Joana. Also, like James, Halona has to contend with the world of idealized relationships: she is unable to tell others that she and Joana are struggling. Without th e space to voice her struggles, Halona is unable to know who she and Joana are in their relationship. She cannot know what is confirmation and affirmat with Joana provide her with a feeling of realness and grounding. She is now able to see and feel
77 validated in both the positive and negative facets of her relationship: the reflecting te comprehensive observation of her relationship enables Halona to fully see herself as well. relationship are real. Halona knows that she and Joana are able to utilize their relationship strengths to work through struggles together, despite simultaneously knowing that there is no Halona to fully see her beliefs regarding the positive qualities of her relationship with Joana. Despite their lack of a model for successful relationships, despite the lack of a guide for how to relation Being Seen as Failing in the R elationship Prior to their involvement in the reflecting team process, Cassie, James, and Rebecca all felt as though they were not succee ding as being a couple. They believed they were not meeting the basic requirements of being married, including creating a supportive environment and treating each other well. The reflecting team enabled them to see the temporal nature of these feeling th rough the contrast between their feelings of failure and relationship strengths. Cassie describes feeling unbearable tension in her relationship : , we feel like we have significant stress and strain and that just in life in general and it was coming to the point where we were like struggling with every normal everyday marriage things and stuff on top of it. The recent changes Cassie and James experi enced within their relationship resu lted in unmanageable stress which has caused severe disruption in their ability to be together as they have in the past. Couples with one or both members in school often struggle with finding quality
78 time, being present in the relationship, and supporting each other while managing their individual requirements (Offstein, Larson, McNeill, & Mwale, 2004; Springer, Parker, & Leviten b attleground. She was fighting for both the ability to stay in medical school as well as the ability to stay married. The constant battle for both her individual career needs and her relationship needs wore her down. Indeed, Cassie is exhausted: all the fighting both intra and interpersonally caused her to believe that she was failing with simple everyday tasks of being a couple. She and James were no longer able to simply be together like they had in the past each day was a profound struggle to stay to gether. More and more problems piled on, surpassing their abilities to keep going in their relationship. Each little thing that was added on became more and more overwhelming to the point where Cassie could no longer believe her marriage was capable of l asting without outside help. James and Cassie both agreed that the difficulties facing their relationship were overpowering: J ames : Yeah , I agree. All of the stress was building up. There were a couple moments where we got in some fights and we just wan ted to find some coping mechanisms for both of us to try and side step some of the build up to those fights. C assie : Yeah , we were both experiencing panic attacks surrounding, l ike, our fights. And so , we James describes the fi ghting in their relationship akin to the inevitable eruption of an active volcano. The stress placed on their relationship by internal and external factors resulted in
79 an almost cataclysmic shakeup of their relationship. Knowing that neither he nor Cassi e had the emotional capabilities to endure the problems facing their relationship, he sought outside help. way to handle these overwhelmingly negative emotional experiences Additionally, James desires skills to prevent fighting with Cassie; he does not see the problem as resulting from an insecure connection. He desires tangible methods and step by step instructions from the reflecting team and from therapy to prevent feeling doubtful about his relationship. James is also profoundly uncomfortable with conflict. His statements indicate an intense fear surrounding the loss of his relationship and a belief that he does not possess the abilities to enable the rel ationship to continue. and the fear of dying ( American Psychiatric Ass ociation, 2013) . Cassie is not only scared of the end of the relationship, she is terrified of losing James. She is petrified that all the fighting they are experiencing will cause them to lose themselves and each other, which resulted in severe mental a nd physical symptoms. Cassie treats their fighting as a failing grade. Like grades, their fighting is something that can be corrected and improved. She sees their problems as something that can be amended with outside assistance, much like a student goi ng to a professor for tutoring. Indeed, Cassie sees therapy as the last possible hope for their relationship. To further underscore the feelings of failing in their relationship, James states: get help with counseling, was because, like, we had gotten in a couple arguments and,
80 just like this little jab that you would throw out, like an empty threat, you know? But it was, like really scary, and, so on that questionnaire, you know, we were like, do we feel to try, but there were James expresses his reluctance to discuss his reasons for coming to counseling through shame regarding hi s belief that his relationship with Cassie was failing is palpable there is not a more socially standard definition of a failed relationship than divorce. Furthermore, seeking therapy is often associated with societal shame; in a society that emphasizes i ndividualism, perseverance, and achievement, seeking relational help from others is often looked down upon possibility of divorce he is ashamed of their need to see k outside help. James also discusses the increased fighting in his relationship, which has led to their consideration of ending it. Fighting with Cassie is abnormal, worrisome, and a demand for change. Indeed, James describes his fear of the potential l overwhelmingly unsettling. p ain but more irritation and annoyance. Cassie and James became used to their fighting. Their forces himself to discuss the fighting at a distance: he does this opposed to taking ownership of his role in the breakdown of their relationship. deep rooted attachment fear of losing Cassie, which is ove rpowering. While this fear drives
81 Cassie and James to seek help to sustain their relationship, the fear causes also doubts that they have both the ability and true desire to continue to be together. While James does express a want to continue his relati onship, initially there is no hope remains an uneasiness as to whether or not the effort could or would result in the strengthening of their marriage. James fe els as though he and Cassie and both failing and remains unsure as to whether or not their effort can improve their situation. The r eflecting team provides clarity for James, enabling him to formalize and articulate how he has been experiencing his failur e in his relationship. Cassie agrees, stating: Cassie and James believe they are failing in their relationship, but Cassie acknowledges that they can be hypercritical as well. They have created a comprehensive record of all the ways in which their relationship has gone wrong, which does not allow them to see any positive aspect. Nor are they able to see the strengths that have kept them together thus far. Like many couples that come for counseling, they are lost in a sea of failure, unable to see the shore (Fishbane, 2012). Rebecca also explores her as one of those big things where we are not treating each other well. And . made clear by her experience with the refle cting team. She could not see any part of her
82 the reflecting team observes Rebecca and she explores the experience with the interviewer, she communicates her feelings of utter despair and overwhelming fear. Not only have the failed in their relationship, but they have received the worst grade imaginable. An F is only give n to those who have utterly botched an assignment. Often, effort has to be put in relationship, rather the opposite is true. As further evidence that she and Dam ien felt like failures I think there Rebecca struggled to see or h ear anything positive in her relationship. She was so caught in a negative cycle with Damien that she could only hear that he did not value her or their relationship. Part of the belief of their failure lies in the fact that they stopped believing that t heir relationship was worth the effort. Each couple experience s failure as all encompassing. T hey experience the utter fear that losing only person they are closest to can beget. As they see themselves through the reflecting team, they realize that, prior to seeking therapy, they did not feel remotely successful. They were not being in their rela tionships as they desired, but rather caught in an impenetrable negative sequence of feelings and behaviors. because before all that I felt like, I guess, I was run for successful relationships, but also that she is caught in a cycle in which she does not feel able
83 to break. S he keeps trying various ways to build something positive, but she has little idea as to whether or not she is successful. Thus, no matter how much effort Joana puts forth, she feels as though she is failing in her relationship. Efficacy At the same t ime the couples are able to articulate this failure, they also experience the previous quote: Halona: Affirmation. Jo: Yeah. Yeah. Joana, despite per previous feelings that she was not able to find ways to be successful in her relationship, received affirmation from the reflecting team that she is doing well. This is the ultimate experien ce of cognitive dissonance, a both/and experience; through the observation of the reflecting team, the couples experience the feelings associated both the potential loss of their on that they are not failures in their relationship but rather are succeeding despite the struggles they face. Rebecca o ther people recognizing that we can treat each other well and we care nterests was really powerful for me to have Rebecca describes her changing view of her relationship; she moves from feeling like her relationsh ip has failed utterly to comprehend that she has agency. She is now able to choose the path and direction of her relationship. Rebecca has the ability to not only hear the negative, but rather remember her relationship strengths. The
84 reflecting team, by reminding her of the positives in her relationship, empowers Rebecca to remember that she and Damien do care about each other. Damien and Rebecca explore how being able to see the positives in their relationship enables them to change how they interact with each other: I: So, it opened up this whole new way that you see your relationship? it just helped how awesome and special our relationship is. e in our relationship. R: Yeah. I think that also we had worked through a lot of different barriers before t hen that were also preventing us from having connection and intimacy. And so , working through like all of able to sink in. That was really powerful. Damien also frees himself from being caught in a negative cycle by trying to see the effort he makes to see how exceptionally good his relationship is not without difficulty. And yet, despite the strenuousness of this intentionality, hi s attempts result in positive change. Rebecca describes hearing from the reflecting team about the positives in relationship as a culmination of her experience in therapy: she can hear about the strengths of her relationship with Damien because of the w ork they have done prior to truly see each other. The reflecting team seeing her love for Damien assisted her to see their love also. This experience is so powerful for Rebecca that it takes her a while to truly explain how she was feeling. The
85 reflecti on of her love from both Damien and the reflecting combined to shred any barriers to prevent intimacy and create a compelling case for her ability to strive to continue her relationship. Cassie states it made us realize, or at least made me rea this Cassie recognizes the individuality of her experience: the hope for her relationship is a combinatio n of the reflecting team seeing relationship strengths and her remembrance of those strengths to engender efficacy. Cassie also uses metaphors such as strength, a nd competence. Cassie awakens to the hopeful possibility that her relationship can overcome the fear that has been threatening it through her own capable action. strong relationship as one in which a deep, solid connection exists that can help her and Joana work through current and future problems. Moreover, the reflecting team helped Halona find hope for her future by seeing that her relationship does have strengths. Seeing these relationship strengths, Halona now believes she has the capabilities to tackle re lationship problems. She and Joana have the skills to endure together. The reflecting team experience creates cognitive dissonance: each couple experiences conflicting emotions through the process. They fear judgment. They are unsure if the reflect ing team understands who they are and what they need. And yet, they are able to work through these fears and doubts to be sufficiently open to the experience that they are able to see another side to
86 their relationship: their relationship strengths. Thro ugh being seen by the reflecting team, they are able to shift their perspective on their relationships sufficiently to experience hope that their relationships will continue and that they have the strengths and the abilities to make that happen. The bo relationship. They feel contradictory emotions about their relationships: while they want to stay, they also wonder what it would be like to leave. They are unsure if thei r respective partners can or desire to understand them. Yet, each couple chose to come to therapy to work through their difficulties in hope of creating an enduring, wholesome relationship with someone they love. Analysis of Superordinate Theme Two: Hop e as a Result of Outside Perspectives This chapter illuminates how the participants attempt to make sense of how their experience of hope for their relationship changed as a result of the reflecting team process. Each member of each couple voices that th eir perspective on their relationship changed as a result of hearing outside perceptions of their relationships. They describe this change as resulting from a number of different interactions with the reflecting team as an outside perspective. The follow ing chapter has been organized according to the emergent themes describing ed their relationship. First, the author discuss es how outside perspectives provided insight i n to each relationship. Then, how each couple interpreted the outside perspectives as affirmation is considered. Finally, the author reviews were instrumental i n engendering hope. To begin, the autho r will provide a brief overview of Sartre (1956) discusses a pupil faced with a moral dilemma and indirectly asserts that if
87 One must let go of control occasionally, and act with hope that what they desire will come to fruition (Sartre, 1956). The reflecting team reminds the couples of their strengths, love, and care, allowing them to let go of their problem saturated narrativ es and enabling them to trust both the Hope as a Result of Outside Pers pectives Bringing Insight in to the Relationship One of the benefits of reflecting teams is their multiple perspectives on relationships (Pender & Stinchfield , 2014). The team is separate from both the couple and the therapist, which allows for the creation of a different, often more positive, story about the relationship (Pender & Stinchfield). Each of the couples reported new thoughts and insights in to the ir relationship as a result of the reflecting team. For example, Cassie explains: I would definitely do it again. Mostly because I think it elicits a really good perspective ould never , switching that mindset from we have this whole long list of stuff we need to improve and hearing from experts, someone who works with people, an outside perspective that d us and just getting this laundry list of things that we are already good at wa s just like so reflecting team is not part of their relationsh ip, they are able to remove themselves from the day The reflecting team is able to find the spark which will ignite hope for the future that the couples ca nnot see while overwhelmed by their problems. by her conviction that she would undergo the process again in addition to her conclusion that the
88 reflecting team w as able to comment on positive aspects of her relationship that she has been behavior with James. The reflecting team is capable of seeing a wider view of Cas relation ship with James: separate from the problem filled mire the couple has found themselves in, they see encouraging aspects of the relationship that have been lost to Cassie and James . Cassie experiences hope because the reflecting team has ho pe for her and James. The able to describe Cassie in such a way that she was capable of internalizing their comments and changing her own thoughts and feelings a bout herself in her relationship. Instead of continuing Cassie views the r person who has a comprehensive and authoritative set of knowledge in a particular area; one is reflecting team has the authority and knowledge to provide insight in to her relationship, especially when discussing the positive qualities of her relationship that she does not often experience. The oothed Cassie: she was able to move from a state of anxiety to a state of tranquility with the knowledge that her relationship does indeed have numerous positive qualities. For Cassie, the outside perspectives from the reflecting team also provided a way to look at their relationship interactions differently. It gave me kind of a more hopeful e, who had never met us, Hearing about the positive qualities of their relationship
89 from the team who had solely observed them once empowers Cassie to become more optimistic about the future of her relationship. She be lieves that if others were able to see these positive qualities then she and James are doing well and can continue to do so in the future. James and Cassie were able to gain the insight that their behaviors stemmed from different motivating factors than t hey previously thought. This in turn enabled them to interact with each other differently. By successfully feeling and behaving differently in their relationship their relationship can be different from their present struggles. This shift is dramatic, such a change from their previous of ways of being that they no longer can despair, their only option is hope. Indeed , Cassie states: And they kind of gave me pe to let him help me and let him in. Not feel guilt for making him do all these things for me. And so that kind of took off a burden for me im to support me through school and asking him to and recognizing that he wants to do those things for me because he cares about me and released that guilt That perspective change was a much more positive one. T he reflecting team empowers Cassie to think differently about her relationship with James, freeing her from the guilt that previously constricted and isolated her from him. Prior to the reflecting team, Cassie believed she was simply a weight James was fo rced to carry. She believed he resented supporting her through medical school and, therefore, felt as though she has failed in her obligations as a wife. Once Cassie is able to accept that she is not encumbering James, the reflecting team helps her reali ze that James supports her out of love, not obligation. As Cassie recognizes she is not a burden on James, a weight is lifted from her life. believed her choice to g o to medical school forced James to create a life he did not want and did
90 not agree to when they first married. Cassie believed her decision to further her career meant that James was left behind; she also could no longer feel like an equal. As such, Cas sie felt haunted by guilt that she could not be enough for James while in medical school. of a simple desire to assist her, rather than because she was neglecting practical matters in favor to furthering her education. This insight and shift in perspective are astonishing for Cassie. The reflecting team permits her to see her relationship in a new way, which encourages her to think more positively about their future. Out of transformation in perspective comes hope. James explores similar feelings when he expresses that he has a deep need for climbing: for James, climbing i to do in any other way. James does not view climbing as a departure from his relationship with Cassie, but rather as something he must do in order to stay grounded within himsel f. For Cassie, of contact. e and heated. However, James states that the reflecting team truly needed climbing as a way to be his best self in other areas of his life. And James finally sa amount of time that they had together would be even more cut down. Once the reflecting team helped Cassie and James shift their perspectives about the reasons they were fighting, both reported that their fights and panic attacks decreased
91 significantly. They were able to see each other needs as both love for each other and self care. actions in more positive and loving ways. Through t and Cassie were able to be vulnerable and uncover their true feelings, which brought forth the love they have for each other and hope for their future. Damien explores how the reflecting team enabled insight in the following statement: foundation and care about each other. We can lose that perspective when we get bogged down in the issues that we are having. And that session sort of helped to remind us that The reflecting team re exposed Damien to the positive qualities of his relationship. Similar to Cassie, it is almost as though these qualities have been k ept secret from him; the strengths of his relationship are veiled by his current struggles. These struggles have weight: Damien cannot feel positively about his relationship when he is so consumed by its problems. Therefore, the outside perspectives prov ided by the reflecting team uncovered the affection Damien and Rebecca share. Damien has memories of more positive times, which leads to longing. He so desperately wants to return what was positive in his relationship. As the reflecting team helps Dami en gain the insight that he and Rebecca do have a secure base, hope for the future emerges. He no longer has to be inundated with problems, but rather remembers that his love for Rebecca enables him to withstand the force of the problems they are facing.
92 I remember the things that they shared back with us were really helpful and insightful. It was really comprehensive, all the things that they said. regarding the reflecting becomes more confident that she and Joana are being successful in their relationship as a result Halona finds th receives comfort knowing that they were able to see and understand numerous aspects of her relationship simply from viewing one therapy session. For Joana, hope stems from the move away from the discussion of problems to the focus on the inherently positive qualities of her relationship with Halona, as demonstrated by this exchange: Jo ana : I think it was just really helpful. Interviewer: Yeah. Jo a na : Yeah. Because I felt like, during our sessions, it was just about talking about our problems and that's what I felt it was supposed to be like. But, once they had that done, it was really insightful, and I felt like we were getting somewhere. Yeah. Although Joana believes that her therapy sessions are focusing on what is needed, she reveals her frustration that there has only been a focus on problems wit hout the incorporation of their relationship strengths. The shift from focusing on problems to strengths was more valuable
93 than solely focusing on problems, as Joana gained understanding and renewed appreciation for what she and Halona do well. Joana act ually gains more from focusing on their strengths, as she believes they are finally making progress toward their goals of creating a lasting, healthy relationship. Outside Perspectives as Affirmation One of the most powerful aspects of the reflecting t eam for all the couples was the affirmation they experienced. As previously discussed, the couples struggled with having a model for healthy relationships and, as such, were uncertain as to whether their attempts to improve their relationships were succes sful or worthwhile. The reflecting team provided each couple with the confirmation that their struggles were worthy of bringing to therapy. Moreover, the reflecting team verified that they did have what they needed to create a secure, lasting relationshi p. Joana demonstrate s how powerful the affirmation from the reflecting team w as in the following statement : sitting right there, just hugging each other because ... It was just reall y helpful, it felt like we were going on the right track. The reflecting team confirms coming to therapy was the right choice for Joana and Halona; they have chosen the correct path to work through their struggles. The team also encourages Halona and Joana to continue to make the effort to deepen and secure thei r connection, as they can easily see how important their relationship is to each other. The potency begins to describe the physical impact of the reflecting team articulate the exact nature of their experience. Yet, Joana indicates that their experience of
94 affirmation rested in the body, not the mind. The reflecting team brought Halona and Joana physically closer, using affir mation to encourage Halona and Joana to deepen their physical and emotional connection. , to you does feel understood by the team, he experience, his struggles , rather than validation of his i dentity . Lost in a world of idealized lives on social media, James could not be sure if what he and Cassie were coping with was normal. enables James to fully kn ow that their struggles are not imaginary, rather they are normal for couples who face similar situations. Fin ally comprehending the truth of the normalcy of their struggles enables James to feel grounded, centered, and calmed. Indeed, this sentiment i i t felt really Cassie was so off kilter, so filled with negative symp toms, that he questioned their san ity. The fighting between himself and Cassie was so aberrant that he was unsure if he was grounded in shared reality . James was isolated and ignorant of what can be normal for other couples in similar situations, resulting in feelings of irrational madne ss. current life circumstances. As such, James feels hope
95 therapists affirm that what he has endured is real and valid? James, calmed by the affirmation regarding his sanity, begins to trust that his relationship can continue. at it was helpful, routine for couples similar to herself and Halona. This uncertainty alludes to doubting the future of their relationship. As such, the affirma tion by the reflecting team is more than beneficial, it is a powerful validation that Joana and Halona can attain homeostasis and will work through their present struggles. Cassie reports feeling renewed hope as a result of the reflecting team affirming her choice hat was kind of reaffirming to me that we are on the right track here. These words signify her feelings of assurance that she and James are doing what is necessary to r. Like they said: that they are making that time for each other now. Also , I think they were just kind o for our decision to come was so hopeful as well. But I also think that they, they pointed us to realize that these are things that we are working on and f or them to notice that kind therapy now as opposed to waiting until their situat ion is potentially worse. Without prioritizing their relationship immediately, they risk further deterioration of their connection to the point work on thei
96 experiences hope as a result of the reflecting team confirming that she and James are doing what is necessary to maintain their connection. Moreover, through the reflecting have made improvements in their interactions. Stunned that others were able to see the progress that they have made, Cassie begins to feel hope. The outside perspective affirming their progress provid es a way for Cassie to be optimistic about their future. They did make a lot of comments like man, they are really going through some stuff and n they said things like they, they see a lot of the same struggles that every married couple does but on top of that they are dealing with so much stress. And so , was really, like, a pat on the back for us. while at the same time affirming both their coping mechanisms and their willingness to come to therapy. Cassie also finds validation in the refl logical that they should be feeling worse than other couples as they are facing more disconnection due to Cassie p ursuing an advanced degree. Therefore, Cassie felt seen and understood by the reflecting team as they could see and appreciate how difficult their life is at present. The reflecting team affirms that, despite everything, Cassie and James are doing wel l. They assure Cassie and James that is remarkable that they have been able to cope as well as they have been. The reflecting team believes that James and Cassie can get through their current difficulties, which assists Cassie to hope for her future. Th e feelings of comfort and affirmation
97 ways of coping in the now and in the future. One of the most affirming aspects of the reflecting team was their ability to truly see the No it was more like affirming to have someone else see how difficult that was to articulate, to brin g to your attention an seated hurt which he had bee n straining to help her understand. Damien and Rebecca go out seeking contact and communicating with each other in very different ways, which often leads to misunderstanding. Unlike Rebecca, the reflecting team is tely. Moreover, they are able to see how hard Damien understands his fears and his efforts with Rebecca. Damien finds both comfort and validation in the abil his partner cannot without great difficulty. Damien expands on his experience by stating: Like, having to go outside of the three of us in therapeutic setting, sor t of offering feedback on what they perceived in our relationship. And sometimes the three of us strengths and care in our relationship. Like Joana, Damien understands t he necessity of talking about problems during their
98 saturated narrative, which has veiled the strong foundation and affection Damien and Rebecca share. For Damien, it is freeing to move from a being overwhelmed by problems to feeling affirmed that there are not only struggles but positive qualities as well. Indeed, he stat es: . that the reflecting team helped both him and Rebecca feel more assured of their future. After pausing and contemplating his experience, he realizes that he cannot speak for Rebecca and changes his evaluation of the process to its effect on him. Damien reveals his uncertainty of how Rebecca experienced the reflecting team; he is afraid she di d not share the same affirming experience as he did. Damien also expresses how much his feelings about his relationship have changed as a indicates the drastic shi ft Damien feels that he has undergone regarding the potential future of his relationship will continue. Reminded of the strengths of his relationship, he is able to feel less weighed down by problems and more optimistic for the future. Halona goes on to say: Oh, I remember, they really talked about how much they could tell about how we cared about each other and wanted to show that we cared about each other and that we wanted to support each other and show that. That just made me feel so good about, we might have problems, but we love each other .... They are able to see that Halona and Joana are making an effort to truly understand and support one another, which is incredibly validating and affirming for Halona. Being recognized in this
99 way is a profound experience for Halona: she accepts that, while she and Joana do struggle, they have a strong foundation to rely on when there are difficulties. While love may not completely hold their relationship together, the other connecting pieces are less important than their willingness to work through their problems. By seeing Halona in this way, the reflecting team affirms that her efforts are worthwhile, their mutual affection, as well as how well she and Joana want to meet the needs of the other. following statement : To me, I just come back to when they were talking about how they could see how much we are dedicated to working on our relationship. I think to me, that just was like, so empowering. The reflecting team affirms H by underscoring their mutual effort to better their relationship. As a result of this affirmation, Halona increasingly feels strong and capable. Moreover, Halona now knows that she has agency to improve her relationship. As a result of the affirmation of her efforts, Halona becomes more hopeful for her future with Joan a. Indeed, Halona finishes with reporting that she feels validated, affirmed, and competent: I think what she said was that it was really reassuring to, and just really, it made me feel really good about our relationship, and really good about where w e're at, and really hopeful about where we're going. That we're doing well, because it really pulled out the positive things about our interaction that I think we don't really think about or see. The reflecting team experience is comforting for Halona; they are affirming that she and Joana are on the right path to creating a deeper, stronger connection. Her use of the word outside perspectives were able to provide c onfirmation that she and Joana are doing well and that they have the right to be hopeful for their future. Seeing the positive aspects of their
100 relationship, which are usually covered by negative experiences, results in a profound shift in how Halona feel s about her future. She is able to imagine a more positive future with Joana, as she is finally able to see the positive aspects of their present. Joana further underscores the powerfully affirmative nature of both therapy and the reflecting team in th is exchange: Jo: Yeah. Yeah. It wasn't really a pat on the back, it was more like ... because with H alona I was against going to therapy for a while until she asked me to just to try it, and so I did. It's come this far where we are working a lot of things out and it's really helpful and it just gave me a sense of, it's okay. It's the best way that I can explain all of that. Interviewer: Okay. Jo: Yeah. Interviewer: That's great. It just sounds so ... when you're saying it kind of in a small way, but it sou nds really really big. Interviewer: Yeah. Jo: Yeah. to therapy as applause, Joana views her experience differently. Joana experiences the ref lecting experience with Halona. Through the reflecting team she is able to accept that she and Halona needed therapy. Joana experiences a sense of momentous tr anquility with these words: she can finally be content with the decisions the two of them have made for their relationship, despite the discomfort these decisions have caused them.
101 s short, choppy uses of the word her feeling a sense of tranquility is within her relationship. This sense of peace is a new experience, one in which she can finally decrease her anxiety around her future with Halona. Feeling secure in their current relationsh ip, Joana can begin to feel certain about their future. Outside Perspectives as a Reminder of Relationship Strengths One of the unique aspects of reflecting teams is their focus on strengths ( Pender & Sti n chfield, 2014 ). Often, during therapy, there is a focus on problems which can leave little room for neutral or positive aspects in relationships ( Pender & Sti n chfield, 2014 ). For each couple, the focus on strengths was one of the most relevant aspects of the reflecting team process: they were able to take a break problems. The reminder of what they do well in their respective relationships confirms that there is hope for their future, as they are still doing well now despite their struggles. Cassie explains: Wel other person was coming from and, like, being open to listening to how they are feeling. I e first came. So , want to know how the other is f we do that now, you Cassie hesitates before explaining what she remembers the reflecting team stating, as though ordering her thoughts so they make sense to both herself and the interviewer. Her use of opposed to an actual memory. Her impression is positive: Cassie believes the reflecting team commented on strengths
102 The reflecting team sees the changes Cassie and James have made in the short time they have been in therapy, affirming their abilities to make changes in their relationship. As the reflecting team was able to recognize the capability that the couple has to deepen their connection, the hope Cassie feels for their future w hen the team points out these strengths is all the more potent. The ability of the reflecting team to see these skills is proof that Cassie and James can work on their relationship and, therefore, have reason to hope for the future. Cassie continues: T and we are both very concerned with what each other wants. I think that that did kind of resonate The r eflecting team easily sees how deeply Cassie and James care about each other; they are able to observe how the couple desires to create a relationship in which both their needs are met. The reflecting team helped Cassie remember that their love and care f or each other was so potent that they could trust each other to be selfless in their relationship despite the hardships they have faced. The theme of how therapy in general, and the reflecting team specifically, helped Cassie and James to establish trust continues: Additionally, at least for me, when we came my trust in him was a little bit damaged. together? ion of whether And I trust in him and his decisions for us, you know? A nd vice versa. And additionally , we trust each other to share those things.
103 nsure if James was reliable or if he was willing to put in the effort to continue their relationship. Now, as , highlighted by her repetitive statements and requests for unde rstanding from the interviewer . She has found a mutual security with James that provides reassurance that their relationship will continue. Their ability to trust one another allows for hope. Furthermore, there is now a safety in their relationship whi ch allows for mutual openness. James and Cassie have created sufficient security within their relationship that they can be utterly vulnerable and know that neither of them will turn away. Rather, their increased vulnerability leads to increased trust, l eading to increased vulnerability, an iterative cycle that deepens and secures their connection to each other. Cassie and James have discovered the strength in vulnerability, which has enabled them to create an enduring, loving, and long lasting relations hip filled with hope for their future. repeatedly comes back to this point throughout the interview. For example: g strengths, which, to us, I think, it gives hope because yo was saying, we really do have the tools. We genuinely do have the fundamental love and care for each other that you need to have to have a stable, strong rela tionship t made us realize, or at least made me realize, that e reflecting team did is slow; she takes her time to fully realize and internalize what the experience of being part of the reflecting process meant for
104 pointed ou t solidify them for her. By stating what they are now able to do in their relationship, Cassie makes it real. She can truly know that she and James do care about each other and are trying to strengthen their connection. skills to deepen their connection as a couple. This word connotes the ability to carry out a particular function. Many couples come to therapy desiring the skills to c ommunicate more effectively, suggesting Cassie believes their struggles stem from a lack of perceived ability to empathize with and understand the other (Jacobson & Christensen, 1996). Cassie and James suggest throughout the interview that, if possessed w ith the right skills to be more effective with each other, they can secure the future of their relationship. The reflecting team helped Cassie to realize that she and James do possess the abilities to strengthen their relationship. Their strengths were s o obscured by problems that they could not see how to move forward. Once the reflecting team helped to lift the veil, it as though their strengths, love, and care for each other are suddenly illuminated. Knowing that they do have the desire and ability t o improve their relationship empowers Cassie to hope. through the enables Cassie to believe that their future is secure. Between having a secure base and the ability to work through problems, Cassie can allow herself to be optimistic and fully hope for their future. One of the most powerful reminders of strengths for Cassie and James was the reflecting
105 remains a solid foundation made of love and care. Love and care are their secure base from which to work through their struggles and explore what they desire their relationship to look like in the future. Cassie explains: that they love each other. And to hear somebody that was just watching us for five minutes or however many minutes it care about each other even though we feel lik e we may not. It may not be as obvious to us. The love Cassie and James share drowns in their problems and is forgotten. The their relationship. Cassie i s, therefore, surprised that their love can be seen by anyone, much less the team who does not know them nor observed them for a long period of time. In realizing their affection was so apparent to the reflecting team, Cassie comprehends that their love s till exists despite being drowned out by their struggles, thereby creating hope. Damien agrees that the reflecting team highlighting their strengths was a powerful moment: ut the strengths of our relationship and the strength of our love for each other. The things that can be hard for us to see. Even when we are in a therapeutic setting we are still talking about problems and issues. And to talk about those connections th Like Cassie, Damien articulates his experience slowly, as though he is just realizing how the reflecting team has impacted him. Damien and Rebecca reported, prior to the reflecting oblems and disconnection, unable to see their way out. Therefore, the reminder that their relationship does
106 possess strengths and not just problems provides Damien with a profoundly different experience: hope. Not only is it the reminder of the relatio nship strengths that creates this profound shift, but the reminder of the strength of their love. It seems as though their love was forgotten, that the problems Damien and Rebecca had were so powerful that their strong foundation was eroded. Reminded of their secure base, Damien can begin to hope again. He reports that their strengths are challenging to uncover even in the therapeutic setting they are consumed by problems, which is saddening and frustrating. Yet, this makes the shift from talking about problems to talking about strengths all the more dramatic and powerful. Damien struggles to articulate what experiencing positivity and hope in his relationship was actually like, as evidenced by him trailing off towards the end of his statement. Damien eventually describes their relationship as being both emotionally and physically closer, something that seems so powerful, yet so alien that he struggles to illustrate how he felt. In rediscover ing their strengths, Damien was able to uncover the foundatio n of his relationship with Rebecca and, feeling stronger, could hope again. of the most significant aspects of their experience, as evidenced by the following exchange: R ebecca : Yeah. The strengths. D amien : Like when we heard them talking about the strengths yeah that was really awesome. R ebecca . we were really stuck. I mean, yeah, we wer e pretty stuck. on that aspect of her experience. Rebecca pauses in this memory. She revels in the fact that she
107 and Damien do have strengths, despite all ha rdship. Damien immediately agrees, affirming welcome. Furthermore, for Damien, the experience of hearing about strengths was overwhelmingly positive, almost beyond the point of believing. Rebecca begins to explain how she and Damien both felt, but realizing she cannot speak for her husband, she pauses and reevaluates her experience. She decides that hearing about the strengths of her relationship helped her to hope. Hearing about what she and Damien can do well was so unlike how they normally experienced her relationship that she had no choice but to strengths were to see, em powered Rebecca to feel a different way about her relationship. This experience happened at a time when Rebecca did not believe she and Damien could make any progress working through their problems. It was as though they were mired in quicksand: the mo re she and Damien tried to fix things, the worse they became, until they were unable to move and began to simply watch their relationship sink. The reflecting team provided a way for Rebecca to escape from drowning . Remembering their strengths, Rebecca c ould finally begin to pull herself out and hope for their future. Rebecca goes on to say: feedback about all these really good things that we had. Like they ha d feedback about you being courageous and like us kind of doing this dance of intimacy where, you know, e time being I just heard a lot of really great feedback about how beautiful our love is together. So that was really great. In examining her experience, Rebecca becomes aware of the essential nature of hearing about her and Damien strengths and positive qualities of their relationship. Rebecca, with the
108 h elp of the reflecting team, frees herself from their problem saturated experiences by reminding herself of their strong foundation and their ability to love one another deeply. One of the Damien is able to risk being vulnerable again and again to try to connect with Rebecca, which she is finally able see through courageously pushes forward, she pulls back in fear of being overwhelmed. Then, sensing position that will allow her to let herself be loved as well as feel independent. Rebecca explains that the refl qualities was substantial. It created a different way to look at and be in her relationship with used to explain the extent of something above normal. With the help of the reflecting team, Rebecca moves from a valley in which she can only feel despair to a peak where she feels strong and capable in her relationship. s love for one another, the reflecting team confirms that the couple does possess qualities that will help them through their st ruggles. Despite being hindered by problems, their lo ve for each other remains strong . Rebecca sees the love they have for eac profoundly moving. Rebecca recognizes that their love is a foundation from which she can draw strength from and begin to hope. Damien agrees, stating: Y eah I think we much we care about each other. I left here feeling like we could figure out the things that are keeping us from being in that part of our relationship. It was really good. Right? And, like,
109 awesome. We know we have trouble seeing these things because of these other things but if we could work through those things and figure out how to deal with them and spend mor e time and in space with them and understand them. We care about each other and The reflecting team helps Damien to recall how strong their love is for each other. Indeed, he leaves the reflecting team fee ling hopeful that he and Rebecca can work through their problems, increase their intimacy, and deepen their connection. It was such a change for Damien to feel as though he could make changes in his relationship that he felt truly ready to work through th eir problems. He so longs for this profound connection with Rebecca that he is willing to learn about, experience, and sit with what causes their problems. Damien loves and cares about Rebecca to the point that he is willing to put everything on the line , put in the effort to work through their struggles and be optimistic about their future; the outside perspectives as a reminder of his strong, loving foundation with Rebecca engenders hope that they can succeed . For Halona and Joana, the most important strength the reflecting team was able to see was how deeply they know each other. While they do love and care about one another, their love is secondary to their deep intellectual and spiritual bond. Despite the t Halona explains: Oh , and that we're willing to work on stuff. That was another thing. They were like, you could just really tell that they w ant to work on this because they care about each other and they care about their relationship. That just made me feel so good that yes, we know a lot about each other, we know that we want to work on it. illingness to work on the relationship
110 value their relationshi p as demonstrative of how well she and Joana know each other. Their h other, despite their problems, is a strength that she can draw on to hope for their future. other was one of the most moving aspects of the experience, as demonstrated by this exchange: Jo ana : I think I went nu I think I was still stuck in that moment where I was really nervous in the corner. Because I didn't know how to, I didn't know the gesture to bring H alona over, and I guess just her realizing how nervous and scared I had on my I don't know, I went numb after that because it was very reassuring that, it was like she knows me. That's the best way that I can describe it. I think it was just when they were talking a bout that particular part. Interviewer: When? Okay. Got it. Jo ana Interviewer: That they saw you. Jo ana Interviewer: Yeah. Jo ana : They saw that H alona Joana was in a moment of extreme dysregulation, as she was completely unsure how to ask for the connection that she needed from Halona. Her fear almost overtaking her, Halona reached for her. Not only did Halona see what Joana needed, the reflecting team was able to see how Halona and Joana were able to sense what each other needed. Halona was able to respond
111 to Joana, which was profoundly soothing and helped Joana to regulate and move out of her place of fear t o a place of safety and comfort. The reflecting team understood what this experience meant for Joana and Halona. They could see Halona and Joana know each other so deeply that they were able to comprehend what each other needed without speaking. Both Halona and the reflecting team were able to see reflecting team enabled Joana to recognize their connection as a strength and, knowing how deep their connection is, Joana is able to hope. Analysis: Hope and Attachment Style Previous studies have indicated that attachment style influences how an individual experiences hope ( Shorey et al., 2003; Simmons, Gooty, Nelson , & Little, 2009). Therefore, the author expected to find both similarities and differences in how each member of the couple experienced hope for their relationship. Each of the couples responded positively to a number of inherent characteristics of the reflecting team, such as new perspectives , positive momentum, highlighting growth, confirmation of strengths, normalizing client experiences, and providing insight (Egeli et al., 2014). Yet, there were distinct differences in the types of support each person responded to in rela tion to their att relationship increased as a result of each of these aspects of the reflecting team process, they experienced hope slightly differently based on their attachment style; as hope differs based on attachment a nxiety and avoidance, this was expected (McDermott et al., 2015). Anxiously Avoidant: Halona and James James and Halona, both of whom used an anxiously avoidant attachment style, responded the most strongly to identification of couple strengths, insig ht, and affirmation of their
112 a strength and feels both validated and gratified that the reflecting team could see how he and gredient for the development and maintenance of happy, well needs (Givertz, Woszidlo, Segrin, & Knutson, 2013; Holmes, 1989; Rempel, Holmes, & Zanna, 1985). Increased trust results in increased felt security, reduced defensiveness, and increased reciprocity of self disclosure (Givertz et al., 2013). Indeed, Cassie and James repo rted increased self a therapeutic context enables increased hope for the future of the relationship (Fishbane, 2012). Reflecting on the outcomes of the re flecting team process, James stated seeing the whole experience, and s eeing C assie commit and, like, both of us like symbiotically seeing the other person commit m ore, you know? And sensing that, for me, really The reflect ing team enabled Cassie and James to increase their trust, mutually commit to one another, and give James a cause for hope by affirming their strengths of care and commitment. The combined use of affirmation and identification of strengths can be a powerf ully hopeful experience when using a reflecting team (Egeli et al, 2014; Pender & Stinchfield, 2012). and Joana have made. In affirming their progress, the reflec ting team confirmed that they are
113 succeeding in their relationship despite their struggles and lack of model for a successful same really pulled out the pos connection, and the ability to compromise (Egeli et al., 2014). The focus on positive q ualities of a relationship encourages both individuals and couples to hope for their future (Egeli et al.; Smith, 2006). While James valued insight in to his relationship, this was a more important aspect for I just, I remember t he things that they shared back with us were really She goes on to be a catalyst for change and one of the beneficial aspects of the reflecting team process ( Murphy & Dillon, 2014; Selles, Smith, Cole, Yoshioka, & Robbins, 1994). The efficacy of reflecting teams is often linked to their ability to provide multiple p erspectives (Chang, 2010; Egeli et al., 2014; Pender & Stinchfield, 2012) . Yet, neither Halona nor James reported the desire for new perspectives on their relationship. While they both nsight and affirmation, they did not seek out varied perspectives unlike other participants in the study. Indeed, Halona only perspectives at all. Despite their mut actively sought different perspectives on their relationship. Anxious: Rebecca and Cassie
114 I mean, I think there was this part of me that was like, maybe multiple perspectives on her relationship as well as insight in to her interactions with Damien. Cassie also voices a desire for multiple kind of a more Rebecca and Cassie both reported an anxious attachment style and mutually responded to the reflecting te provide insight, affirm their current desires for their relationship, and offer multiple perspectives. Both Cassie and Rebecca were more loquacious in their interviews than ei ther James and Damien; as such, the author I had a much richer data set to explore how they experienced hope as a result of the reflecting team. While each type of attachment style responded well to identification of couple strengths, Cassie and Rebecca both labeled the reminders of strengths as t he most influential aspect of the reflecting team process. For example, it gives hope because you realize to conceptualize their strengths as a pathway to hope. ance of being reminded of what she and Damien do well in their relationship. Additionally, both Cassie and Rebecca reacted positively to obtaining insight in to their they had feedback about [Damien] being courageous and like us kind of doing this
115 tied to the belief that the reflecting team Rebecca returns to insights she gained multiple times during the interview, concluding with a Bo treat each other well and we care about each other and that we have each confirmation of her ability to create a meaningful and wholesome relationship enables Rebecca to truly believe she has the power to do so. Ref lecting teams can contribute to client hope when they validate client experiences and identify good intentions (Egeli et al., 2014). The team sees and succes sfully helps Rebecca translate these intentions in to hope. Despite the importance of affirmation, identifying strengths, and insight from multiple current struggles. Neither participant mentioned normalizing in any of their statements regarding what caused them to be hopeful. Individuals who use anxious attachment styles often need ong reaction to both affirmation and the identification of strengths ( Hazan & Selcuk, 2015 ). Avoidant: Joana
116 Like Halona and James, Joana, who identified as avoidantly attached, valued normalizing, affirmation of her current struggles, and comments on the positive momentum she and Halona have gained by attending therapy. Although Joana did not describe how the r eflecting team caused her to hope very frequently, the moments in which she reflected on how she perceived the changes in her relationship were profound. For example, she explains how the reflecting simultaneously normalized her relational experiences as well as affirmed that she was, fact, successful: and I guess that was, it was kind of like a grade. You're doing it right. That's focused on the normalizati on of her experiences and she does not mention the themes of insight, new perspectives, or verification of growth at all throughout the interview. Secure: Damien Damien, who identified as securely attached, also had a relatively limited range of as the most potent part of the reflecting team process, followed by insight in to his relationship. He did not mention normalizing, growth, or positive moment um and only affirmation and I think that it just when I started to see a change in our r Damien generally focused on the encouraging aspects of his relationship, highlighting the difference between their problem focused therapy sessions with the strengths based approach of the reflecting team.
117 CHAPTER 6 DISCUSSION The reflecting team , as explained by the participants, engendered hope in a number of ways, including the use of multiple perspectives to offer insight, provide affirmation, and important theme emerged beyond the expected theme of hope: the idea of what it means to be seen by the reflecting team, which was often simultaneously uncomfortable and empowering. Finally, the experience of hope was both similar and different based on at tach ment style. In this section, the author will place the work in deeper exploration of each of the superordinate themes in light of relevant research. Discus sion: RHS and ECR R Results Relationship Hope Scale relationship as evidenced by both the qualitative and quantitative data ; as stated previously, each participant h increased with the exception of Joana and Cassie, who both voiced increased hope during the scores stayed at 5.2. Rebecca demonstrated the most substantial increase, with her scores moving from 4.2 to 6.0. Of the participants whose scores changed, Damien demonstrated the least amount of change, moving from 6.0 to 6.4. Hope is strongly correlated with reflecting teams. Previous research indicates participants in the process often identify specific categories that res ult in increased hope including seeking new perspectives, maintaining positive momentum, identifying strengths, a nd
118 normalizing difficulties (Egeli, Brar, Larsen, & Yahoni, 2013; Egeli, Brar, Larsen, & Yahoni, 2014). Furthermore, providing insight, providing support, and highlighting growth also t al., 2013; 2014). hope for their relationship. For example, Halona it made me feel really good about our relationship, and really good about where and highlight growth (Egeli et al., 2014). Damien reported the identification of strengths as the m me the most hope...hearing them talk about the strengths of our relationship and the strength of intain the positive momentum thereby causing Damien to hope. James also voiced his appreciation of the normalizing aspect of the reflecting team in this powerful And follo reflecting team process as providing insight, providing support, and identifying strengths, all of which helped to markedly change how hopeful she felt. s remained unchanged, yet both her pre and post scores indicate she has high hope for the future of her relationship (Erickson, 2015). Joana generally reported feeling more hopeful than Halona when using the RHS instrument as well as during their intervie w.
119 describe her level of hope as changing as a result of the process . Rather, she simply describes it positively impacted her as well. t gave me kind of a more hopeful perspective their overall experience in therapy was difficult to differentiate from the reflecting team process. As such, while Cassie does have hope for her relationship, her hope may have been impacted by therapy as a whole rather than the reflecting team process p articularly. relationship. The majority of participants e xperienced an increase in hope, as demonstrated by change, both indicated as part of the interview process that the reflecting team strengthened their belief that their relationship could endu re and thrive. Therefore, while the RHS is a reliable and valid measure, it does not entirely capture an experience, will be explored in more detail as a qualitative expe rience rather than a set numeral . As mixed methods studies inherently allow additional insight from the combined procedures, both the RHS and the interviews combine to capture a more full experience than one method alone ( Watkins & Gioia, 2015). Experiences in Close Relationships
120 The ECR R uses the classifications of secure, anxiously avoidant, anxious, and avoidant to describe attachment styl es. Previously in this paper, the author discussed the different dimensions of attachment styles in alternative terms such as fearful, preoccupied, and dismissive; to link the terms , a secure attachment style remains the same in both classifications as a positive view of both self and other. Anxious and preoccupied both describe an attachment style characterized by striving for self acceptance through gaining the acceptance of valued others (Bartholomew & Horowitz, 1991). Anxiously avoidant and fearful explain attachment as characterized by the lack of close involvement with others as a way to protect oneself against rejection (Bartholomew & Horowitz, 1991). Finally, avoidant and dismissive illustrate someone who is simultaneously dismissive of intimacy and maintains a sense of independence and imperviousness (Bartholomew & Horowitz, 1991). Both Rebecca and Cassie demonstrate a preoccupied attachment style. Individuals with a preoccupied attachment style generally have a positive view of others and a negative view of self (Bartholomew & Horowitz, 1991). They often have a particularly strong need to fit in and feel accepted i n comparison to other attachment styles (Bartholomew & Horowitz, 1991). As a result, individuals with a preoccupied attachment styles can struggle to maintain healthy interpersonal boundaries and maintain individuality in their romantic relationships (M acDonald, Sciolla, Folsom, Bazzo, Searles, Moutier, Thomas, Borton, & Norcross, 2015; Orlans & Levy, 1998). Rebecca demonstrates her difficulties with boundaries with Damien in this statement: almost trying to create boundaries, As preoccupied adults fear abandonment they often demonstrate desires for excessive s & Levy, 1 998). Cassie demonstrates
121 he r struggle to differentiate herself from James throughout the interview. She continually uses when asked specifically about her experience, indicating her strategy for maintaining closene ss to James sometimes prevents her from processing her individual experience. Halona and James both demonstrate a fearful avoidant attachment style. Fearful avoidant adults are more comfortable with independence rather than closeness, maintain emotional distance, and find trust to be challenging ( Bartholomew & Horowitz, 1991). Despite a conscious desire for closeness and relationships, they often are fearful of the potential consequences of being close to someone (Bartholomew & Horowitz). Furthermore, they often have a negative view of both self and others (Bartholomew & Horowitz). Individuals who use a fearful avoidant attachment style often benefit from instrumental, as opposed to emotional, support ( Egeli et al., 2014). James specifically asks for instrument support when he week displays her One thing that we share, that I think is really important to us, is our spirituality and how we support each other in that, and our culture. And I think that could be part of the feedback emotional support surrounding how sh e and Joana interact with each other in their relationship based on their spirituality. While she does voice her appreciation of the emotional support she has received from the reflecting team, like James, she desires more tangible help in specific areas of her relationship. Joana, with a dismissive avoidant style, has a positive view of self, yet a negative view of others (Bartholomew & Horowitz, 1991). Those with a dismissive attachment style have a lack
122 of interest in forming close relationships and struggle to maintain closeness with others (Bartholomew & Horowitz). They maintain high self esteem by investing in abilities and accomplishments as opposed to relationships (Bartholomew & Horowitz). Joana reported reluctance to enter therapy with Halona , potentially indicating her lack of investment in maintaining closeness. Furthermore, those with a dismissing attachment style have trouble reaching for closeness when needed (Johnson, 2004). Joana b ecause I didn't know how to, I didn't know the gesture to bring H alona over struggl es based on her current attachment strategy . Finally, D amien demonstrates a secure attachment style; he finds it easy to get close to and trust romantic partners, is able to open up emotionally, and feels comfortable with interdependence ( Bartholomew & Horowitz, 1991). Damien demonstrates his emotionality and , but I do remember them saying something. And me feeling really emotional about it because it was something that I felt like I had struggled to get you to recognize. able to open up emotionally and trusts that Rebecca can hear him despite their differing communication styles. He, more than care, which underscores his secure a ttachment style. What follows is a qualitative exploration of to relevant literature to develop a rich, contextual understanding of their experiences. Discussion: Superordinate Theme 1 Cognitive Dissonance
123 Egeli and colleagues (2013; 2014) assert clients often experienc e both hope and vulnerability throughout the reflecting team process, creating a duality that can cause psychological tension . Leon Festinger introduced the term cognitive dissonance as a way to explain how people coped with inconsistent experiences or discordant thoughts (Darity, 2008). As the participants simultaneously experienced the uncertainty as to whether their identiti es were understood, the fear of judgment, and hope for the future of their relationship, their feelings about the reflecting team process were both negative and positive. To reduce the psychological tension they experienced, participants used various meth ods to reconcile the both/and nature of being seen by the reflecting team. As psychological arousal is reduced when there are fewer dissonant beliefs and more consonant beliefs, people are motivated to change their discordant feelings by either changing their thoughts or their behaviors (Balcetis & Dunning, 2007; Jomini Stroud, Kim, & Scacco, 2016). When facing two or more beliefs that are discordant, the individual typically alters the one least resistant to change (Jomini Stroud et al., 2016). Indivi duals have a number of options to reduce the psychological tension created by cognitive dissonance, such as change their attitudes, distract themselves or forget, trivialize the discordant belief, deny responsibility, change behavior, add consonant cogniti ons, or rationalize their actions (McGrath, 2017). To make sense of their discordant feelings, the participants engaged in various methods to counteract the both/and nature of the reflecting team process. For example, Halona uses trivialization to co I don't know who they are, we don't know what their experience is to give us feedback around our sp ecific relationship, but it's still, to me, was r
124 reflecting team that cause psychological tension, preferring to simply be grateful for their positive feedback. James also uses trivialization to ma ke sense of his conflicting feelings. When discussing The use of the conflicting fe elings. If James denies his needs it is easier play down what he desires than to take away from the affirmation he experiences. Attitude change is the most common way for in dividuals to reduce dissonance and it is there are more consonant beliefs to support one feeling over aspects of the reflecting team experience: l ike the interviewer, she compiles evidence of a more positive experience rather than a judgmental one. Indeed, by the end of the interview Cassie no longer displays th e dread associated with fear and judgement, but the calm associated with validation, affirmation, and support as demonstrated by her concluding statement: Like, ok, that was really nice. Dissonance can be reduced using distraction, which often leads to forgetting (McGrath, distracted by the positive feedback she received and the overall positive impr ession from the reflecting team , resulting in Joanna forgetting how invalidated she felt when the reflecting team asked her and ion, Joana seems to prefer to
125 remember the more positive and helpful comments from the team, rather than the more invalidating aspects of her experience. The participants reported that they experienced a sharp contrast in being seen by the reflecting team, simultaneously fearing judgment and experiencing affirmation. Andersen (1991) explains this dissimilarity as the contrast between the destructive patterns that couples and families are en trenched in versus the unusual, and usually positive, perspectives of the reflecting team. These differences can create psychological tension, conceiving a both/and experience. Understanding Identity in Therapy One source of vulnerability for clients using a reflecting team is the fear that the team may take sides or provide negative feedback (Egeli et al., 2014). These are common fears of clients in therapy, necessitating the creation of a strong therapeutic alliance (Del Re, Fluckiger, Horva th, Symonds, & Wampold, 2012). When the therapist and client agree on the goals of therapy, how therapy should be structured, and are empathically related, therapy is more likely to be successful (Karam, Ko, Pinsof, Mroczek, & Sprenkle, 2014). At its cor e, therapeutic alliance depends on the client feeling understood by the therapist (Kozart, 2002). Acknowledgement of client identities can create a stronger alliance, whereas making stereotypical assum ptions expresses a viewpoint that can lead to therape utic rupture (Sue & Sue, 2013). Enabling clients to explore how their identities relate to the therapists is conducive to a primary therapist, the identity of seem s
126 to and the potential for misunderstanding; for example, Joana thought that the reflecting team saw them more like seeming to constrict their ability to fully trust and engage with the reflectin g team. A Lack of Successful Relationship Models Merleau Ponty suggests that humans are limited by what they see and, yet, can rarely clearly comprehend something that is familiar to them (Romdenh Romluc, 2011). Many people lack even minimal exposur e to healthy relationships, leading to fear of closeness, increased social isolation, lack of caring in interpersonal relationships, and general psychological distress (Orlans & Levy, 1998). As a result, couples experience uncertainty regarding if their r elationship is normal and healthy and distress can be perceived as normal (Bird, Kuhns, & & Charoensukmongkol, 2016; Wesner, 2008). This deficiency remains especially true for lesbian, gay, and bisexual individuals despite recent advances in the civil rights movement (Bird et al, 2012). James, Joana, and Halona all cite struggling in their relationships due to their uncertainty the idealized relationships he sees portrayed on social media. People who use social media sites
127 often compare themselves to others, which can result in lower self esteem and self worth (Vogel, R ose, Roberts & Eckles, 2014). It is difficult to understand the accuracy behind social media portrayals, as people often present only one side of their lives and relationships, leaving those who do compare themselves feeling deficient and ashamed of their imperfect interpersonal relationships (Nesi & Prinstein, 2015; Vogel et al., 2014). Indeed, James reported that his longer has to be uncertain and ashamed f or their difficulties. Joana and Halona attribute the deficit of models to their non dominant culture identities. The invisibility of gay and lesbian relationships can leave those who do identify as a sexual minority lost as to how to pursue and create healthy relationships (Ristok, 2002). This invisibility increases the likelihood of abuse and intimate partner violence (Ristok), which could I haven't seen and haven't been in positive and happy same sex relationships Society stereotypes lesbian and gay relationships as inherently less healthy than heterosexual relationships, which can result in internalized homophobia and, therefore, difficulty knowing what a healthy relationship looks like (Holley, 2017). Valida tion and affirmation of client strengths are inherent aspects of the reflecting team that enable clients to break out of old patterns and improve the quality of their relationships (Pender & Stinchfield, 2014). The reflecting team is successfully able to counteract the lack of a aware that other couples have similar struggles, their feelings of isolation and failure are lessened. Furthermore, the reflecting team vali dates their ability to be successful in their respective relationships, leading to increased hope. Being Seen: A Highlight of Feelings of Failure
128 Couples inevitably experience some form of dysfunction in their relationships due to the clash of differing needs and personalities as well as conflicting romantic and social expectations (Glick, Rait, Heru, & Ascher, 2015; Gottman, 1999). Problems often occur when couples lose faith in the relationship, a sense of respect for their partner, or experience a loss of intimacy (Glick et al., 2015). Feelings of failure in relationships, while common, can result in distressing symptoms, such as increased risks of anxiety, psychopathology, accidents, and poor health (Gottman, 1999). Sartre (1957) proposes that people only become aware of themselves through the co uple experienced prior to their experience of the reflecting team. Cassie and James report uple experiences their distress as part due to a lack of communication, demand/withdraw patterns, and a lack of emotional affection. on their systemic problems (Cha ng, 2010). These perspectives are not always positive, rather als o assists the couples in perceiving a wider picture of their respective relationships, including Being Seen: Therapy and Efficacy At the outset of therapy, many couples behave as though they lack agency in their relationships and blame their partner for many of their relationship problems (Doss et al., 2004;
129 Jacobson & Christensen, 1996). Therapy has been demonstrated to increase self efficacy, enabling clients to utilize their resources more eff ectively and see choices that once were invisible (Nash, Ponto, Townsend, Nelson, & Bretz, 2013). The reflecting team inherently allows for the creation of alternatives, which empowers clients to consider different perspectives and choose which perspectiv e is best adapted to their couple and family system (Garrido Fernandez, Marcos Sierra, Lopez Jimenez, & Ochoa de Alda, 2016). The ability to consider more alternatives increases self efficacy within relationships (Bandura, 1986). Each couple explained t heir relationship as problem filled prior to the reflecting team process and later voiced feeling as thought they had more agency in their relationship after the reflecting team commented on what they were already doing well. As a result of being able to see their relationships in different ways, the couples reported that they were able to envision different outcomes than they had previously imagined. Each couple stated they were able to take a more flexible position for therapeutic change and simultaneou sly feel able to make those changes, thereby increasing their efficacy within their relationship. Rebecca gives voice to this o ther people recognizing that we can treat each other well and we care about each other and that we hav Throughout the reflecting team process, the couples experience a sense of failure and efficacy, acceptance and judgment, vulnerability and hope. Their experience is neither positive nor negative, but rather a mixture of both states of being. The simultan eous existence of being reconcile their feelings, the ultimate both/and experience.
130 The three research questions asked at the outset of the study re lated to how couples experience hope for their relationship within the context of a reflecting team. While the findings related to hope were expected based on the previous research about reflecting teams, a sig nificant portion had much less to do with hop e and more with how the couples simply experienced the vulnerability of being seen. Reflecting teams often enable insight and help clients to see different ways of being (Andersen, 19 91; Garrido Fernandez, 2016). The author expected the participants to g ain awareness of how they experienced hope and was surprised that they also experienced feelings of fear regarding potential judgment, the deficit of successful models for healthy relationships, misunderstandings of their identity, and how significantly th ey felt as though they were failing in their relationships. The initial experience of the reflecting team was not positive: Halona stated the outset of Bot h of these couples voice discomfort with the process as a result of being watched and potentially prompted to behave in a certain way. Both question whether the reflecting team understands them as well as if the team is passing judgment on how they intera ct. Rebecca increasing her feelings of failure. number of facets of t heir relationship, such as their prior feelings of failure and emerging sense of efficacy. In the process being seen, each couple was able to take a more objective look at their relationship, which enabled them to gain insight and feel capable of making c hanges. Embracing the vulnerability of being a part of the reflecting team process was both challenging
131 and rewarding, which augmented the both/and experience of the reflecting team (Egeli et al., 2014). Discussion: Superordinate Theme Two H ope: A Result of Options, Evidence, Action, and Connection number of ways, such as their readiness for change, symptom severity, an d utilization of client resources (Coppock, Owen, Zagarskas, & Schmidt, 2010; Frank & Frank, 1991; Prochaska & to continue with making positive changes (Coppo ck et al., 2010). The reflecting team, by they have the capabilities to influence and create the outcomes they desire and thereby inflecting them with hope. Wa & Wampler, 2010, p. 216). Hope includes four components: evidence that the desired change could occur, the belief that an individual has the ability to choose a desired op tion, the belief that Wampler, 2010). The reflecting team, through various methods, aids each of the couples creating a felt sense of hope by introducing these four c omponents. Options One of the primary ways the reflecting team aids the couples to believe they have the capability of choosing different options is the use of multiple perspectives. When in distress, people often ask others for help, benefitting from
132 which can aid in emotional regulation and decrease levels of distress (Bishop et al., 2017). The reflecting team inherently provides an outside perspective, decreasing client distress by normalizing, validatin g, and focusing on client strengths (Egeli et al., 2014; Pender & Stinchfield, 2012). An advantage of outside perspectives includes the ability to reframe a ( Robbins, Alexander, Newell, & Turner, 1996). Reframing is particularly important for Cassie, as evidenced by her affective shift from Cassie and James are ab le to reevaluate ref rame of their experiences. from a place of love instead of anger can result in powerful therapeutic changes; helping clients view their struggles differently provides the couple with choices and options that enable hope (Jenkins, 1996; Johnson, 2004; Ward & Wampler, 2010). Ward and Wampler (2010) suggest one of the primary means of a therapist conveying hope to a coupl experience, the therapist conveys that they see and understand the client as well as invite the client to further explore their story and the options they have to change it (Murphy & Dillon, they are doing this now. Like, we are at the beginning of our relationship and we are in a weird medical school, validating that their struggles are reasonable because of their life transitions. In doing so, the reflecti ng team provides Cassie and James with the knowledge that they have
133 various options for the future of their relationship and have the ability to choose the option they desire. Evidence Ward and Wampler (2010) assert that one essential dimension of hope was the perception that the couple had the ability to bring about the desired outcome. This perception often needs to be evidence based; the couple needs to be able to see change within t heir relationship to believe that ongoing change is possible (Ward & Wampler, 2010). Both Damien and Rebecca as well as Cassie and James reported changes in their relationship as a result of the reflecting team: both more intentional about the time that spend with each other. Their ability to make small changes in their relationship provides evidence that there is reason to hope for the future of their relationship. Couples in therapy often ask their therapist if th ere is evidence that they can hope for the future of their relationship; they wonder if the emotional pain and vulnerability inherent to couple therapy is worthwhile (Doss et al., 2004; Ward & Wampler, 2010). Couples are usually comforted if their therapi st sees reason to hope and acknowledges their struggles (Ward & each of the couples do have reason to hope for their future. The team, being on the outside of ea ch relationship, is able to take a more expanded perspective and see the positive aspects of overwhelmed by their struggles. As such, the team is able to simultaneously help the couples to emotionally regulate and provide evidence that there is hope for the future of their relationship. The reflecting team also provides evidence that the couples can reach their desired outcome through validation. When a therapist uses validation correctly, it underscores the nature
134 some stuff believes her assessment of her feelings is justified, another essential part of validation (Linehan, 1997). The feelings of acknowledgment, understanding, and acceptance provide a space in which the client can balance who they are and where they want to go, generating hope (Linehan). The reflecting team also provides evidence that change is possible through affirmation, as it relieves emotional suffering and allows one to access states of calm, well being, and relaxation (Fosha, 2000). Joana, James, and Cassie report feeling as though the reflecting team confirmed come to therapy, they feel calmer, knowing they are making beneficial choices for their that her relationship will endure and, therefore, helps her feel more at peace. Not only does validation and affirmation generate therapeutic change, but normalizing client struggles often help clients to move past a state of fear and anxiety in therapy to a place in which they feel as though they can be vulnerable and make changes (Bradley & Butler, Svinhufvud, Voutilaninen, & Weiste, 2017; Weiste, 2015). Ward and Wampler (2010) assert that the construction of hope in therapy requires therapists to help couples to understand that what is happening to them is normal, that other couples struggle with similar issues, and that other couples have healed from similar problems. Joana and James experience the profound effects of normalizing. Joana is finally a
135 their negative emotions and engender hope. ptions of his experiences. By helping James to understand that what he and Cassie are going through is common for many normalization helps to support each coup le and presents all of their pro blems as workable. The couples reported feeling the most hopeful when hearing the reflecting team talk about their strengths, as the identification of strengths is proof that they have the ability to make changes in their relationship (Smith, 2006; Smith & Barros Gomes, 2015; Ward & Wampler, t hey were like, you could just really tell that they want to work on this because they care about each other and they care about their relationship. By reflecting continue to hope for the future of their relationship. Action The action component of hope indicates that a person is capable and willing to make cha nges in their relationship (Ward & Wampler, 2010). Hope, therefore, is a motivational factor for clients to continue in therapy (Ward & Wampler). Joana strongly demonstrates this a result of the reflecting team. Joana finally believes that she can act to achieve what she desires in her relationship with Halona, thereby furthering her hope for the future of her relationship and her willingness to continue in therapy. The refle cting team uses affirmation to encourage action for each of the couples, as affirmation enables a general awakening of adaptive tendencies (Lazarus, 1991; McCollough
136 Vaillant, 1997; Safran & Segal, 1990). As clients feel more confident in themselves, they are better able to use their internal and external resources to relieve their suffering (Fosha, 2000). Overall, affirmation enables healing by helping clients to access their authentic selves, their strengths, and their beliefs that they are able to make worthwhile changes in their relationships (Fosha). All the couples reported less emotional suffering and feeling more hopeful and confident about the future of their relationship as a result of the affirmation provided by the reflecting team, underscorin Connection The reflecting team process also empowers the couples to hope through encouraging the couples to deepen their intimate connection. One primary tool the reflecting team used to enable this connection was affirmation; affirmation helps to sustain therapeutic change by deepening ity for closeness (Fosha, 2000). Halona and Joana describe holding each other after the reflecting team contemplated on the positives of their relationship, indicating an expanded capacity for interpersonal connection. Rebecca and Damien also reported th post reflecting team, displaying that the affirmation of their struggles and the positive aspects of their relationship strengthened their capacity for intimacy. nd increases empathy between partners (Beavers & Kaslow, 1981; Ward & Wampler, 2010). Indeed, each of the couples reported feeling closer and more hopeful about their relationship after they completed the reflecting team process. They came to the belief that their deeper connection enables them to influence the outcome of their relationship in a more positive way.
137 One of the ways the couples described their deeper connection was increased trust. Couples who display a more secure attachment style also dis play increased ability to trust stronger as a result of the reflecting team process, indicating a strengthening of their attachment bond. Couples with a secure atta chment bond are increasingly likely to be more hopeful about tightens, they can more readily trust their secure base. One of the most powerful changes each c ouple describes experiencing is the realization the strengthening of their attachment relationship as a result of the reflecting team experience. The strengt hening of the attachment relationship indicates the couples are each building a more secure bond (Johnson, 2004). Secure bonds enable increased affect regulation and resilience, rong relationship and have hope for their future. Having a secure base and a safe haven to turn to in times of trouble modifies the perception of threats for both partners in a securely attached relationship and facilitates emotional regulation duri ng times of distress (Bowlby, 1982; Johnson, Burgess Moser, Beckes, Smith, Dalgleish, Halchuk, Hasselmo, Greenman, Merali, & Coan, 2013). Indeed, a secure base is a reciprocal relationship in which both partners believe they are wanted and will be cared f or by their partner while also wanting to care for their partner (Bartholomew & Horowitz, 1991).
138 The creation of secure attachment bonds offers the feeling of felt security (Johnson, 2004). Relationships that have felt security enable couples to be able to reach out and support each other as well as deal with conflict and stress more productively and positively (Johnson). As such, these relationships tend to be more fulfilling and happier (Johnson). As each couple strengthens their attachment bonds, they are better able to support each other and create the type of relationship they desire. The evid As a result of normalizing, affirming, and validating each couple, each couple began to believe they are able t o repair their relationship (Wiebe, Johnson, Burgess Moser, Dalgleish, & Tasca, 2016). They begin to become available and responsive to their partner, as evidenced by their increased capacity for physical and emotional closeness (Feeny & Thrush, 2010). T here is higher trust in each relationship and they believe they can create a relationship based on comfort and closeness as opposed to avoidance (Jang, Smith, & Levine, 2002; Weibe et al., 2016). In short, they are able to hope. The findings related to how couples experience hope in their relationship when using a reflecting team were expected based on the literature (Brownlee et al., 2009; Chang, 2010; Egeli et al., 2014; Pender & Stinchfiled, 2014). As expected, the couples responded positively to the multiple perspectives on their relationship (Brownlee et al.; Pender & Stinchfiled). As a result of multiple perspectives, the couples were presented with an array of ideas which helped them to formulate that other options were possible, creating hope (Ward & Wamper, 2010). affirmed their efforts, which are powerful tools to augment hope (Fosha, 2000; Ward & Wampler).
139 Although a strengths based perspective is intrinsic to the reflecting team, the most powerful reflections by the reflecting team related to the confirmation that the couples had the ability to create a secure attachment bond (Brownlee et al., 2009). While the couples responded well to verific ation of their willingness to work on the relationship, their ability to try to ability to see how the couple saw each other that was the most profound aspect of the process. hope that Ward and Wampler (2010) report being part of successful couple therapy. The couples were able to deepen their intimacy, believe they could in fluence their future, understand that desired outcomes were possible, and see evidence of the changes they wished to see (Ward & Wampler, 2010). For these three couples, hope was experienced in the context of deepening their attachment relationship. Discussion: Attachment and Hope There is a lack of research exploring the relationship between attachment style and hope. The research that has been performed concludes that more securely attached individuals are more hopeful than individuals who use an a nxious or avoidant attachment style but does not go beyond this basic assertion (Blake, Brooks, Greenbaum, & Chan, 2014; Blake & Norton, 2014; Jankowski & Sandage, 2011; Jiang, Huebner, & Hills, 2013; McDermott et al., 2005; Otis, Huebner, & Hills, 2016; S horey et al., 2003). Bowlby (1982) asserted individuals who are securely attached have a greater ability to explore and affect their environment. As such, the caregiver and child bond is essential in the development of hope, as an individual is more lik ely to believe that a desired outcome is possible if they believe they have the ability to alter their current circumstances . Attachment style has
140 been used as a predictor for level of hope: anxious and avoidant attachment styles have subsequently lower l evels of hope than individuals who demonstrate a secure attachment style (Blake & Norton, 2014). People who have experienced one or more consistently supportive relationships in their life are more likely to have a secure attachment style that enables t hem to experience efficacy in their relationships (Jiang et al., 2013). Furthermore, secure attachment is associated with more positive interpersonal relationships as well as positive physical and mental health (Otis et al., 2016). These concepts may exp I construct as hope, has been shown to be correlated with hope (Jiang et al., 2013). Damien and indicating their perceived closeness of the constructs. Jiang et al. (2013) concluded high quality attachment supports hope and lower quality attachment undermines hope. whether or not their relationship will continue when they initially began the reflecting team process. As both James and Cassie demonstrate non secure attachment styles, their less adaptive inte rnal working models may prevent them from believing that what they desire for the future of their relationship is possible (Otis et al., 2016). As Cassie and James meet the goal of felt security through the reflecting team process, their hope increases; C scores . Adult attachment provides a structure for hopeful thinking; individuals with a secure attachment are less likely to experience depression or anxiety (Shorey et al., 2003). As Cassie and James develop a secure bond, they report a decrease in their anxiety symptoms, such as
141 panic attacks. Hope plays a mediating role between attachment anxiety, attachment avoidance and mental health concerns (McDermott, Cheng, et al., 2005). and James are able to build as a result of the reflecting team enables them to improve their Individuals with a secure attachment style possess the positive views of self required to believe a desired outcome is possible (McDermott et al., 2005 Ward & Wampler, 2010). As a made me feel really good about o ur relationship. That we're strong and healthy and just really hopeful that we're go sufficient self efficacy to believe what she desires for the future of her rela tionship is possible. A more s ecure attachment fosters resiliency, thereby enabling Halona to hope for the enduring nature of her relationship with Joana. McDermott et al. (2005) report lower levels of attachment avoidance are linked to higher hope, which may be due to increased support seeking strategies and the amplified ability to see that a desired outcome is possible. Rebecca reported attempting to find boundaries with Damien, as though she was trying to balance her feelings of independence wit h the love and care she desires from him. Despite her struggle to find balance, she reported the increased ability to feel ther people recog nizing that we can treat each other well and we care best for each other empowers Rebecca to hope for their future.
142 Despite the concept that attachment anxiety and avoidance are negatively correlated with statements in t he interview and her RHS scores indicate she is very hopeful for the future of her relationship. She is more hopefu l than even Damien, who exhibited a secure attachment style. As there is a lack of research done specifically exploring avoidant and anxiou s attachment styles and their relationship to hope, this is worth noting. dispositional (Jiang et al., 2013). Therefore, a hopeful disposition may counteract an avoi dant temperament and experiences in past relationships (Blake & Norton, 2014; Shorey et al., 2003; Snyder, 2003). It would be worthwhile in future researc h to explore the relationship between anxious and avoidant attachment styles in more depth. At the outset of this study, the author wondered how anxious and avoidant attachment styles influence the experience of hope in a co uple relationship. Generally, the author found that despite having differing attachment styles, individuals experience hope in their relationship in similar ways when using a reflecting team: they respond the most strongly to the reflecting team identifying strengths, facili tating insight, normalizing, and providing affirmation. Yet, each individual with a different attachment style reacted differently to each hope creating aspect of the reflecting team process. Those who identified as anxiously avoidant, James and Halona, responded the most strongly to affirmation, insight, and the identification of strengths whereas Joana, who had an avoidant attachment style , appreciated affirmation, normalizing, and confirmation of positive momentum. Cassie and Rebecca, who identified a s anxiously attached, also appreciated the identification of strengths, affirmations, and insight.
143 Damien, who identified as having a secure attachment style, solely responded to the confirmation of strengths and insight. Generally, each individual respo nded less to the reflecting team highlight ing growth, new perspectives, and identification of positive momentum. Validity and Reliability Sensitivity to Context Qualitative studies strive to link both the particular to the abstract as well as to the work of others (Yardley, 2000). As the analysis of the findings must be sensitive to the data itself, sensitivity can be shown by linking findings to empirical evidence, focusing on unexpected findings, and the awareness by the researcher of the cultu ral context in which the data is collected (Yardley ). In the discussion section, the author has linked my findings to previous literature, such as the literature regarding hope, cognitive dissonance, therapeutic alliance, and the effects of affirmation. Additionally, one of the superordi nate themes that emerged from the analysis of the data was the unexpected theme of the both/and nature of the reflecting team, whic h has demonstrated the commitment to exploring unexpected findings. One method an IPA researcher can use is to explore the nature of the findings in relation to P henomenology (Yardley, 2000). The use of of being seen as well as his take on hope and despair to find new meaning in the partic experiences of the reflecting team. Sartre (1956) asserts one cannot be aware of oneself until one is observed; as the reflecting team observes the couples they become aware of themselves as both agents of failure and change in the ir relationship. Furthermore, the author explore d how once each couple releases their problem saturated narratives they are able to emancipate
144 find hope. As language, social interaction, and culture are central to the meaning of all phenomena, the awareness of ideological, historical, linguistic, and cultural setting of the study are inherently important (Yardley, 2000). To link the cultural setting of the study and its find ings, the author explored the lack of healthy relationship models, specifically for lesbian, gay, and bisex ual individuals. Furthermore, the author investigated the relationship between uses of social media and the impact of how couples perceive their rel ationship, grounding the study in a historical and cultural context. In qualitative research, the researcher both actively and passively contributes to what is said during an interview (Yardley 2000). Therefore, studies should incorporate and consider the actions and identities of the research ers. Previously in this paper the author has discussed their location within the res earch and journaled about how their specific identity as a cisgender bisexual female may have impacted the two intervie ws I condu cted. Additionally, the author has discussed with their thesis advisor, Dr. Robert Allan, how his identities may have contributed to differing discussions in the interview with Halona and Joana. Commitment and Rigor Commitment, in both qualitative and quantitative studies, refers to the prolonged engagement with the topic. The work on my thesis degree as they began researching attachment as a n undergraduate student and has been motivated to pursue a degr ee in Counseling beginning at age 18 . Commitment also refers to the competence and skill in the methods used (Yardley, 2000). While this is my first di ve in to qualitative research, the author actively engaged in quantitat ive research as an undergraduate
145 student and have pursued additional research opportunities, both quali tative and quantitative, in the program at University of Colorado, Denver . Therefor author has the basic competenc e and skill required to perform this research. Finally, commitment also refers to immersion in the re levant data (Yardley, 2000). The engagement with attachment research h as spanned a number of years and they have pursued attachment research f rom a number of different angles, including relationship to birth order, hope, and culturally adap thesis work ha s covered the three years that they ha ve been a graduate student , spending a minimum of five hours per week engaged in some aspect of this project. Furthermore, IPA requires deeper immersion in the data, including reading and re reading transcriptions, varying levels and types of analysis, as well as journaling (Smith et al., 2009). To fu lly immerse myself in my dat a, the author tran scribed both of the interviews they conducted , repeatedly read and re read the transcriptions, as we thesis advisor, Dr. Robert Allan, reviewed a copy of one of my transcripts to aid with the detecti on of eme rgent themes. He and the author also repeatedly reconnected to discuss the research, the IPA method, and progress throughout the process of data analysis, aiding further immersion. Rigor refers to the completeness of the data to supply all the info rmation necessary for comprehensive analysis (Yardley, 2 000). Often, IPA recommends a m three participants to enable data saturation (Smith et al., 2009). Additionally, intuition and imagination of the analyst can be used to prov ide a lengthy and comprehensive understanding of The process of data analysis, including
146 transcription, case by case analysis, thematic analysis, and bracketing lends itself to a deep understanding of partici Transparency and Coherence Yardley (2000) asserts it is the quality of the narrative that enables clarity and power in qualitative research. As such, the ability of the researcher to construct a meaningful story demonstrates coherence. The author has endeavored to create a meaningful narrative by exploring the simultaneous feelings of vulnerability and hope inherent in the reflecting team process and, moreover, create an accurate narrative of how each participant experiences these n to each superordinate theme, the author thread s the individual narratives together to create a more profound whole. Transparency is achieved by detailing ever y aspect of the data collection process as well as the procedures used to code the data (Yardley, 2000). Additionally, transparency can be accomplished by providing the reader an example of the data (Yardley). IPA research should have a clear focus and p rovide descriptive quotes from at least half of the participants that illustrate the themes and sub themes to demonstrate well conducted research (Smith, 2011). The author has included a table wi thin the narrative describing the analyti c process, provided copies of the data analy sis in the appendices, and has provided thoroughly descriptive quotes from at least half of the participants in each superordinate theme, thereby adhering to the transparency demanded of IPA researchers. Transparency can also refer to the disclosure of the investigative procedures, including participant recruitment, measures used, and how these processes may have influenced the investigation (Yardley, 2000). Often, researchers address their motivation for undertaking a p articular project or how the study was influenced externally. At t he beginning of the narrative,
147 the author discuss my location in this research, inviting the reader to understand my background and how it may influence my understanding of the participant s author addressed in the data collection section the difficulty ob taining a third interview and their relianc attempted to discuss openly each aspect of the research process, the reby demonstrating transparency. Finally, Mason (2012) suggests IPA researchers demonstrate transparency by showing that data analysis is appropriately related to the research questions. As part of the discussion se ction of this narrative, the author h as directly linked the data to the research question s. The author has done their best to be order to maintain transparency (Mason, 2012, p. 188). Impact and importance Qualitative resea rch is judged by its ability to influence, bring insight, or offer a challenging perspective on a particular topic (Yardley, 2000). IPA researchers typically link their work to the overarching phenomenological, hermeneutical, and idiographic base as well as situate their findings in a historical, temporal, and social context (Smith, 2009). The author attempted to bring insight in to how participants with differing attachment styles experience hope as well as challenge the assumption that reflecting teams are a solely positive experience. Furthermore, the author attempted to situate my data in a historical, temporal, and social context through the discussion of social media impacts on relationships and the participants feelings that they lack models for he althy relationships. As such, while there are few global aspects to my research, the author believe s they have provided additional insight in to how hope is experienced by in relation to reflecting teams and attachment style. Implications
148 Multiple studies of reflecting teams support their use to facilitate increased positive 1992; Hoger, Tomme, Reiter & Steiner, 1994; Selles et al., 1994). For couples, reflecting teams are specifically helpful when they offer different perspectives, enable insight, emphasize the positive aspects of the relationship, highlight growth, comment on positive momentum, and normalize (Egeli et al., 2014; Fishel, Ablon, McSheffrey, & Buchs, 2005). However, according to Pender & Stinchfield (2012), there is a lack of clinical research which explores the client experience of t he reflecting team in depth. This study adds to the existing literature by providing an in depth , phenomenological analysis of how six clients experience being seen by a reflecting team, experience hope for their relationship as a result of the reflecting team process, and how hope is experienced depending on attachment styles. Reflecting teams are associated with a number of positive aspects including multiple perspectives, strengths based counseling, and normalizing client experiences (Brownlee et al., 2009; Chang, 2010). Reflecting teams also are correlated with feelings of vulnerability, which is supported by this research (Egeli et al. 2014). As each of the couples attest, the discomfort is worth the risk: the benefits of reframing the relationship, feeling efficacious, and being reminded of their relationship strengths are powerful tools that can create lasting change. The findings of this study suggest that there are important implications for practitioners who use reflecting teams as part of their practice. First, practitioners who use reflecting teams should be attuned to the feelings of v ulnerability surrounding being observed by a group of unfamiliar therapists. The theme of understanding identity was woven throughout participant narratives, indicating that the members of the reflecting may need to keep in mind how client identities impa ct the trust of the reflecting team members. This is underscored in research on
149 therapists understanding identity as an essential component to a strong therapeutic alliance Del Re et al., 2012; Sue & Sue, 2010). Sartre (1956) discusses the creation of identity: by acting we create who we are, thus implying the members of the reflecting team should strive to activity create an identity to which the clients can respond. Therefore, the research indicates that it may decrease participant anxiety about participating in the reflecting team process by addressing their identities and qualifications prior to the onset of their commentary. Furthermore, this research underscores the importance of s of vulnerability which was previously discussed by Egeli and colleagues (2014). Secondly, the research also suggests that, to build an alliance between the reflecting team and the clients, the reflecting should demonstrate awareness of how members of n on dominant cultures walk in the world. Participants described how slight differences in the reflecting team could have increased their feelings of being seen as who they are and what they needed, implying that the identities of both the clients and the m embers of the reflecting team are necessary to address as part of the process. Indeed, the experience of sharing identities with members of a reflecting team may add to the validity and supportive nature of the reflecting team experience. It may be beneficial for practitioners who regularly use reflecting teams to compose the reflec comfort, as research as demonstrated clients prefer a counselor or therapist who matches their identity (Cabral & Smith, 2011). Third, attachment style impacts how each individu al member of a couple experiences hope when using a reflecting team, suggesting reflecting teams may need to alter their strategies regarding how to engender h ope based on attachment style. Participant accounts reveal distinct
150 responses to certain interve ntions used by the reflecting team depending on attachment style. For example, Halona and James, who both identified having an anxiously avoidant or fearful avoidant attachment style, responded most strongly to the reflecting teams focus on their strength s, ability to provide insight, and affirmation of their experiences. Cassie and Rebecca, who identified an anxious or preoccupied attachment style, responded most strongly to the provision of multiple perspectives and insight, identification of strengths, as well as affirmation of their experiences. While each attachment style shares commonalities in their experience of hope, the differences suggest that reflecting teams should tailor their comments based on participant attachment styles. Additionally, practitioners of all sorts who want to engender hope when working with couples may want to modify their approach based on client attachment style. Adapting therapy based on client presenting problem, cultural background, and state of change is expected to provide effective outcomes ( Drinane, Owen, & Kopta, 2016; Hayes, Owen, & Bie schke, 2015; Jones, Lee, Zigarelli, & Nakagawa, 2016; ; Owen, Imel, Adelson, & Rodolfa, 2012 ). This d depending how T his research adds to the literature by providing a deeper understanding of how couples experience hope through the use of a reflecting team, as evide nced by the different perceptions of the reflecting team process . Although each attachment style was associated with different methods a reflecting team uses to engender hope, such as highlighting growth and providing insight, the identification of strengths and affirmation that each couple was succeeding in their
151 rel ationship were the most influential and beneficial aspects of the reflecting team process. By recognizing their strengths, each couple was able to feel more efficacious in the process of creating the relationship they desired and, therefore, more hopeful about their future: they were able to believe the outcome they desired was possible. While the reflecting team does not create the same therapeutic alliance as does a normal therapist, it remains important to understand and consider client identities, especially in relation to the identities of the members of the reflecting team (Brownlee et al., 2009; Chang, 2010; Pender & Stinchfield, 2014). The findings indicate that reflecting teams not only need to have training in couple and family therapy models , but multicultural competency and trauma focused therapies. Furthermore, as recommended by Egeli et al. (2014), it could be beneficial to address client anxieties prior to beginning the reflecting team process, as the team can induce feelings of judgment , being seen as failing in the relationship, and potentially misunderstood identities. Overall , the study supports the continued use of reflecting teams as a tool to engender hope in couple relationships, as each couple reported feeling more hopeful ab out their relationship after the re flecting team session. While the findings also support the exiting literature regarding how clients experience hope as well as the benefits and drawbacks of reflecting teams , each couple underscored the point that, in Ca fear and vulnerability (Brownlee et al., 2009; Chang, 2010; Egeli et al., 2014; Pender & Stinchfield, 2014; Ward & Wampler, 201 0). Limitations By nature, all research presents a narrow view, as one can rarely step out of o understan ding of the world, or, in Merleau . Smith et al.
152 (2000) suggest researchers have an intimate knowledge of the phenomenon under in vestigation . The author is current ly a therapist in training, has only experienced a reflecting te am on one occasion, an d has limited experience doing couples therapy s knowledge of the phenomena under study is more theoretical than pr actical, potentially limiting their ability to fully understand the reflecting team process. The study is also limited by its small scale, as it only presents the experience of six clien ts . These clients were somewhat hetero geneous. It may be valuable to repeat my study i n the future with a less diverse sample, in order to more fully understand experiences like Halona . Participants chose to take part for a number of reason s, which could include free therapy nd also we wanted to just, like, help out with research too. I Recruiting participants who are willing to be vulnerable in front of a reflecting team may be different than participants who would not be willing to take part in the reflecting team process , thereby limiting the full understand of the reflecting team experience . Finally, the interviewers and interview questions were no t the same for each interview. This may limit the ability of the generalizability of the study, as the different interviewers focused on different aspects of the reflecting team process. As such, further researchers may want to focus more on hope or more on attachment style. Directions for Future R esearch The hope based on their attachment style. Future research would benefit from further exploring how the identities of those taking part in a reflecting team relate to the clie nt identities. For example,
153 Additionally, A deeper exploration of how a reflecting team could affect those w ith differing attachment styles may further improve clinical practice . Finally, although multiple studies touch on the challenge of being vulnerable in front of a reflecting team, it may be useful to more fully explore what it means to be vulnerable and b e seen by this group (Brownlee et al., 2009; Pender & Stinchfield, 2014). The cognitive dissonance found in my research was so pervasive that the specific nature of feeling vulnerable in this way may be worthy of being explored in depth. Reflections Smith et al. (2009) suggest that, at the end of a project, an IPA researcher reflect upon what they have done and what they have created. Overall, the author shaped a thesis of which they are proud. Although the author has contributed to oth experience of truly directing and creating a project on their own. And, despite the challenges and hardships the author endured, the resulting creation is not only a culmination of their experience as a master s lev el researc her but an embodiment of a long held desire now fulfilled. Furthermore, the author has developed a deeper understanding of IPA, resulting in a determination to continue to use this methodology as a way of understanding the world. For the auth lived experience goes beyond a way of researching : it has developed in to a way for the author to
154 approach their experience as a counselor. While the author can hang on to the hermeneutic of suspicion regarding processes a client may experience, they are becoming more adept at letting go their preconceived notions about others in order to truly begin to expand their phenomenal field . The author has also come to an understanding of how deeply they value and appreciate research, particularly qualitative research. Each time the author read and re read the t ranscript s , they were met with a moment of awe i n how each person experiences the world differently and can come to similar conclusions based on differing experiences. The author feels privileged that the participants allowed them ac cess to their lifeworl d, particularl y considering romantic intimacy can be a sensitive and sacred place for many couples. Not only has the author began to appreciate qualitative research in a new way, but they have a significantly deeper understanding of how hope can be engen dered. The author is determined to focus more on hope in both their professional and personal development, both intra and interpersonally. The author also has learned how effective the reflecting team can be in providing encouragement , and that this enco uragement looks different depending on attachment based on attachment Psychotherapy Ce nter, the author feels fortunate to have been instrumental in initiating this understanding of how attachment and hope are linked. growth, the author also would make c hanges if they could re start or re do the project. The author began this work as a novice counselor, less than a neophyte, and someone who had worked in the medical field for years. And, in the medical field, one asks questions in which
155 there is often a yes or no answer. Looking back , from a lens of a more experienced counselor and researcher, the author would dramatically shift how they went about interviewing Cassie and James and well as Damien and Rebeca. Primarily, the author would have added sug gestions, probes, and prompts under the interview questions. Again, looking back from a more knowledgeable and experienced lens, the author would have focused more on any implicit or explicit message about attachment, hope, vulnerability, and/or creating a deeper connection. Secondly, the author would have identified key words and, when the key words were mentioned, the author would have asked more explicitly about meaning and bodily feeling. The author also would have been more flexible in that they wou ld have moved around the research questions, prompted by the topic rather than a set script. Finally, the author would have conducted pilot interviews to enable practicing an interview style that was significantly more fluid than any the author had used p reviously. In conclusion, t he author initially began this research expecting to understand hope on a more experiential level. Not only did this occur, but the author began to understand what it truly means to be vulnerable in counseling and how challen ging being vulnerable can be when it is not only in front of the person you love but a whole team of people who may or may not be able to understand that love. For the author , this research has moved from a place of simple interest to a call to action reg arding their work as an intentionally culturally responsive counselor who understands a more nuanced experience of both hope and attachment.
156 REFERENCES American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5 th Ed.) . Washington D.C.: American Psychiatric Association . Andersen, T. (1991). The reflecting team : Dialogues and dialogues about the dialogues . N ew York, NY: W. W. Norton and Company . Balcetis, E. & Dunning, D. (2007 ). Cognitive dissonance and the perception of natural environments. Psychological Science , 18 (10), 917 921. doi: 10.1111/j.1467 9280.2007.02000.x Bally, J. M. G., Duggleby, W., Holtsla nder, L., Mpofu, C., Spurr, S., Thomas, R., & Wright, K. (2013). Keeping hope possible: A grounded theory study of the hope experience of
157 parental caregivers who have children in treatment for cancer. Cancer Nursing, 37 (5), 363 372. doi : 10.097/NCC.0b013e3182a453aa Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Upper Saddle River, NJ: Prentice Hall . Bandura, A. (1997). Self Efficacy: The exercise of control . New York, NY: Freeman. Bartholomew, K. & Horowitz, L. M. (1991). Attach ment st yles among young adults: A test of a four category model. Jo urnal of Personality and Social Psychology , 61 (2), 2 26 244. doi: 10.1037/0022 3522.214.171.124 Beavers, W. R., & Kaslow, F. W. (1981). The anato my of hope . Journal of Marital and Family Therapy , 7 , 119 126. doi:10.1111/j.1752 0606.1981.tb01361.x Beets, M. W., Cardinal, B. J., Alderman , B. L. (2010). Parental social support and activity related behaviors of youth: A review. Health Education and Behavior , 37 , 621 644. doi: 10.1177/1090198110363884 sition and reflexivity i n qualitative research. Qualitative Research , 15 (2), 219 234. doi: 10.1177/ 1468 794112468475 Bifulco, A. & Thomas, G. (2013). Understan d ing Adult Attachment in Family Relationships .New York, NY: Routledge. Bird, J. P. D., Kuhns, L., & Garofalo , R. (2012). The impact of role models on health outcomes for lesbian, gay, bisexual, and transgender youth. Journal of Adolescent Health , 50 (4), 353 357. doi: 10.1016/j.adohealth.2011.08.006 Bishop, S. R., Lau, M., Shapiro, S. , Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey , S., Speca, M., Velting, D., & Devins, G. ( 2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice , 11 (3), 2 30 241. doi:10.1093/clipsy.bph077 Blake, J. & Norton, C. L. (2014). Exa mining the relationship between hope and attachment: A meta analysis. Psychology , 5 , 556 565. doi: 10.4236/psych.2014.56065 Blake, J. Brooks, J., Greenbaum, H., & Chan, F. (2016). Attachment and employment outcomes for peop le with spinal cord injury: The intermediary role of hope. Rehabilitation Counseling Bulletin , 6 (20), 77 87. doi: 10.1177/0034355215621036
158 Blow, A. J., & Sprenkle, D. H. (2001). Common factors across t heories of marriage and family: Journal of Marital and Family Therapy , 27 , 385 401. doi:10.1111/j.1752 0606.2001.tb00333.x Bowlby, J. (1982) Attachment and loss, Vol. 1:Attachment (2 nd ed.). New Yor k, NY: Basic Books. Bowlby, J. (1988). A Secure Base: Clin ical Applications of Attachment Theory . Abingdon, UK: Psychology Press. Bradley, L. & Butler, C. W. (2015). Ma naging and normalizing emotions and behavior: A conversation a nalytic study of ADHD coaching. The Palgrave Handbook of Childhood Mental Health . (pp. 4 80 499). London, UK: Palgrave McMillan . Bresler, L. (1995). Ethical issues in qualitative research methodology. Bulletin for the Council of Research in Music Education , 126 , 29 41. Retrievedfrom http://0www.jst or.org.skyline. ucdenver.edu/sta ble/40318732?pqorigsite=summon &seq=1#page_sc n_tab_contents Brownlee, K, Vis, J., & McKenna, A. ( 2009). Review of the reflecting team process: Strengths, challenges, and clinical implications. The Family Jour nal: Counseling and Therapy for Couples and Families , 17 (2), 139 145. doi: 10.1177/1066480709332713 Burke, S., Schmidt, G. Wagner, S., Ho ffman, R., & Hanlon, N. (2017). Cognitive dissonance in social work. Journal of Public Child Welfare , 11 (3), 299 317. doi: 10.1080/155 48732. 2016.1278068 Burgess, D. J., Van Ryn, M., Dovidio, J., & Saha, S. (2007). Reducing racial bias among health Care providers: Lessons from social cognitive psychology. Journal of General International Medicine , 22 , 882 887. doi: 10.1111/j.1525 1494.2004.30227.x Cabral, R. R. & Smith, T. B. (2011). Racial/ethnic matching of clients and therapists in mental health services: A meta analysis review of preferences, perceptions, and outcomes. Journal of Counseling Psychology , 58 (4), 537 554. doi: 10.1037/a0025266 Cairns, D. & Embree, L. (2012). The transcenden tal p henomenological reduction: concept of the idea of philosophy. The Philosophy of Edmond Husserl , 207 , 1 20. doi: 1 0.1 007/978 94 007 5043 2_1
159 Campbell, R. L., Eisner, S. & Riggs, N. (2010). Sources of self est eem: From theory to measurement and back again. New Ideas in Psychology , 28 (3), 338 349. doi:10.1016/j.newidea.psych.2009.09. 008 Chang, J. (2010). The reflecting tea m: A training method for family counselors. The Family Jour nal: Counseling and Therapy for Couples and Families , 18 (1), 36 44. doi: 10.11 77/1066807935773 1 Chen, Z. C. Y., Fung, Y. L. , & W. T. (2013). Bracketing in phenomenology: Only undert aken in the data collection and analysis process? The Quali tative Report . Retrieved from: http://0 go.galegroup.com.skyline.ucdenver.edu/ps/i.do?p=AONE&u =auraria_main&id = GALE%7CA350065632v=2.1&it=r Christensen, L. L., Russell, C. S., Miller, R . B., & Petersen, C. M. (1998). The process of change in couples therapy: A qualitative investigation. Journal of Marital and Family Therapy , 24 , 177 188. doi: 10.1111/j.1752 0606.1998.tb01074.x &sid=summon&use rGroup=auraria_main# Cognitive Dissonance. (2008). In W. A. Darity, Jr. (Ed.), International Encyclopedia of the Social Sciences (2nd ed., Vol. 1, pp. 599 601). De troit: Macmillan Reference USA. Retrieved from : http://aurarialibrary.idm.oclc.org/login?url=http://link.galegroup .c m /apps/doc/CX3045300 374/WHIC?u=auraria_main&xid=20930f0 Cope, J. (2011). Entrepreneurial learning from failu re: An interpretative phenomenological analysis. Journal of Business Venturing , 26 (6), 604 623. doi : 10.1116/j.busvent. 2010.006.002 Cundy, L. (2015). Love in the Age of the Internet: Attachment in the Digital Era . London, GB: Karnac Books Ltd. Cushman, P. (1995). Constructing the self, co nstructing America: A cultural history of psychotherapy. Boston, MA: Addison Wesley Pub. Dalton, J. E., Greenman, P. S., Classen, C. C., & Johnson, S. M. (2013). Nurturing connections in the a ftermath of childhood trauma: A randomized controlled trial of emotionally focused couple therapy for female survivors of childhood abuse. Couple and Fam ily Psychology: Research and Practice , 2 (3), 209 221. doi: 10.1037/a0032772 Decety, J. & Jackson, P. L. (2004). The f unctional architecture of human empathy. Behavioral and Cognitive Neuroscience Reviews , 3 (2), 71 100. doi: 101177/1534582304267187 Del Re, A. C., Fluckiger, C., Horvath, A. O., Symonds, D. & Wampold, B. E. (2012). Therapist effects in t he therapeutic alliance outcome relationship: A restricted maximum likelihood
160 meta analysis. Clinical Psychology Review , 32 (7) , 642 649. doi: 10.16/j.cpr.2012. 007.002 DiCicco Bloom, B. & Crabtree, B. F. ( 2006). The qualitative research interview. Medical Education , 40 ( 4), 314 321. doi:10.1111/j.1365 2929.2006.02418.x Domingue, R. & Mollen, D. (2009). Attachment and conflict comm unication in adult romantic relationships. Journal of Social and Personal Relationshps , 26 (5),678 696. doi: 10.1177026507 509 347932 Donnellan, M. B., Burt, S. A., Levendosky , A. A., & Klump, K. L. (2008). Genes, personali ty, and attac hment in adults: A mul tivariate behavioral analysis. Personali ty and Social Psychology Bulletin , 34 (1), 3 16. doi: 10.11770146167207309199 Doss, B. D., Simpson, L. E., Christensen, A. (2004). Why do couples seek marital therapy ? Professional Psychology: Research and Practice , 35 (6), 608 614. doi: 10.1037/0735 7026.35.6.608 Doss, B. D., Mitchell, A., Georgia, E. J., Bei sen, J. N., Rowe, L. S. (2015). Improvements in closeness, c ommunication, and psychological distress mediate effe cts of couple therapy for veterans. Journal of Consulting and Clinical Psychology , 83 (2), 405 415. Retrieved from: https://search proquest.com/aurarialibrary.idm.oclc.org/docv iew/1636781056/ fulltext/3 4754AF3A9C9494FPQ/1?accountid=1 506# Doumans, D. M., Pearson, C. L., Elgin, J . E., & McKinley, L. L. (2008). Adult attachment as at risk for intimate partner violence: The Journal Interpersonal Violence , 23 (5), 616 634. doi: 10.1177/0886260507313526 Drinane, J. M., Owen, J., & Kopta, M. (2016). Racial/ethnic dis parities in psychotherapy: Does the outcome matter? Testing, Psychometrics, Methodology in Applied Psychology, 23 , 531 544. doi: 10.4473/TPM23.4.7 Dufault K, & Martocchio, B. C. (1985). Hope: Its spheres and dimensions. The Nursing Clinics of North America, 20 , 379 391. Retrieved from: http://europepmc.org/abstract/med/3846 980 Dwyer, S. C., Piquette, N., Buckle, J. L., & McCaslin, E. (2012). Women gamblers write a voice: Journaling as an effective counseling a nd research tool. Journal of Groups in Addiction and Recovery , 8 (1), 36 50. doi: 10.1080/1556035X.2013.727735 Under standing feelings of anger using interpretative phenomenological analysis. British Journal of Psychology , 97 (4), 483+. Retrieved from: http://0 go.galegroup.com.skyline.ucdenv er.edu/ps/i.do?p=EAIM
161 e &u=auraria_main&id= GALE%7CA156055307&v=2.1&it= &si =su mmon&userGroup=auraria_main&authCount=1 Egeli, N. A., Brar, N., Larsen, D. J., & Yoha ni, S. C. (2014). Intersections between hope and vulnerabilit reflecting team process. Journal of Couple and Relationship Therapy: Innovations in Clinical and Educational Interventions , 13 (3), 198 218. doi: 10.1080/15332691.2013.852494 Egeli, N. A., Brar, N., Larsen, D. experience of hope when participati ng the reflecting team process: A case study. Con temporary Family Therapy , 36 (1), 93 107. doi: 10.1007/s10591 013 9280 4 Erickson, S. E. (2015). Got hope? Measurin g the construct of relationship hope with a nationally r epresentative sample of married i . Evans, T. D., Dedrick, R. F., Epstein , M. J. (1997). Development and initial validation of the encouragement scale (educator form). The Journal of Humanistic Education and Development , 35 , 163 174. doi: 101002/j.2164 4683.1997.tb00366.x Faddis, T. J. & C obb, K. F. (2016 ). Family therapy techniques in residential settings: Family sculptures and reflecting teams. Contemporary Family Therapy , 38 (1), 43 51. doi: 10.1007/s10591 015 9373 3 Fairchild, A. J. & Finney, S. J. (2006). Investigating validity evidence for experiences in close relationships revised questionnaire. Educational and Psychological Measurement , 66 (2), 116 135. doi: 10.1177/0013164405278564 Farrell, A. K., Simpson, J. A., & Overa ll, N. C. (2016). Buffering the responses of avoidantly attached r omantic partners in strain test situations. Journal of Family Psychology. doi: 10.1037/fam0000186 Feldman, D. (2009). Hope and goal attainme nt: Testing a basic predication of hope theory . Journal of Social and Clinical Psychology , 28 (4), 479 497. doi:10.1521 /jscp.2009 .28.479 Finlay, L. (2011). Phenomenology for Th erapists: Researching the Lived World . West Sussex, United Kingdom: Wiley & Sons.
162 Fishbane , M. D. (2012). Relational empowerment in couple therapy. In A. S. Gurman (Ed.). Clinical Casebook of Couple Therapy (208 231). New York, NY: Guilford Press . Fishel, A. K., Ablon, S., McSheffrey, C., & Buchs, T. (2005). What do couples find most helpful about the reflecting team? Journal of Couple and Relationship Therapy , 4 ,23 37. doi: 10.1300/J398v04n 04_02 Fluery, C. A. (2015). Me, myself , and my participant: Rigor and reflexivity in qualitative research. Rheumatolog y , 54 (1), 9+. doi: 10.1093/rheumatology/kev051.002 Fosha, D. (2000). Meta therapeut ic processes and the affects of transformation: Affirmation and the healing affects. Journal of Psychotherapy Integration , 10 (1), 71 97). doi: 10.1023/ A:1009422 511959 Fraley, R. C., Waller, N. G., & Brennan, K. A. (2000). An item re sponse theory analysis of self report measures of adult attachment. Journal of Personality and Social Psychology , 78 , 350 365 Frank, J. D., & Frank, J. B. (1991). Persuasion and healin g: A comparative study of p sychotherapy . Baltimore, MD: John Hopkins University Press . Garrido Fernandez, M., Marcos Sier ra, J. A., Lopez Jimenez, A., & Ochoa de Alda, I. (2016). M ulti f amily therapy with a reflecting team: A preliminary study on efficacy among opiate addicts in a methadone maintenance treatment. Journal of Marital and Family Therapy , 43 (2), 338 351. doi: 10.1111/jmft.12195 Givertz, M., Woszidlo, A., Segrin, C., & Knutson, K. (2013). Direct and indirect effects of attachment orie ntatio n on relationship quality and loneliness in married couples. Journal of Social and Personal Relationships , 30 (8), 1096 1120. doi: 10.1177/02654075 13482445 Gjesdal. K. (2011). Hermeneutics. Oxford Bibliographies in Philosophy . doi: 10.1093/obo/97801 195396577 0054 Glick, I. D., Rait, D. S., Heru, A. M., & Ascher, M. (2015). Couple and family therapy in clinical Practice . Hoboken, NJ: John Wiley and Sons Inc. Gottman, J. M. (1999). The Marriage Clinic . New York, NY: W. W. Norton & Company, Inc.
163 Griffith, J. L., Griffith, M. E., Krejmas, N., McLain, M., Mit tal, D., Rains, J. & Tingle, C. (1992). Reflect ing team consultation and their impact upon fami ly therapy for somatic symptoms as coded by s tructural analysis of social behavior. Family Systems Medicine , 10 , 53 58. doi: 10.1037/h0089083 Gross, J. J. & John, O. P. (2003). Indivi dual differences in two emotion regulation processes: Implications for affect, relationships, and well being. Journal of Personality and Social Psychology , 85 , 348 362. doi: 10.1037/0022 35126.96.36.1998 ialization of lesbian, gay, and bisexual youth: Celebrity and p ersonally known role models. E. Kennedy & A. Thornton (Eds.). Leisure, Media, and Visual Culture: Representations and Contestations . (83 105). Easbourne, UK: LSA Publications . Grzanka, P. R. & Miles, J . R. (2016). The pro blem with the phrase LGBT affirmative therapy, intersectionality, and neoliberalism. Sexuality and Social Policy , 13 (4), 371 389. doi: 10.1007/s13178 016 0240 2 Hayes, J. A., Owen, J., & Bieschke, K. J. (2015). Therapist differences in symptom change with racial/ethnic minority clients. Psychotherapy, 52 , 308 314. doi: 10.1037/a0037957 Hazan, C., & Zeifman, D. (1999). Pairb onds as attachments: Evaluating the evi dence. In J. Cassidy & P. R. Shaver (Eds.). Handbook of attachment: T heory, research , and clinical applications (pp. 336 354). New York, NY: Guilford Press. Hazan, C. & Selcuk, E. (2015). Normative processes in romantic attachment: Introduction and overview . V. Zayas (Ed.). New York, NY: Springer Verlag Publishing . Heffernan, M. E., Fraley, R. C., Vi cary, A. M., & Brumbaugh, C. C. (2012). Attachment fe atures and functions in adult romantic relationships. Journal of Social and Personal Relationships , 29 (5), 671 693. doi: 10.1177/0265407512443435 Hoger, C. Tomme, M., Reiter, L., & Steiner, E. (1994). The reflect ing approach: Convergent results of two exploratory studies. Journal of Family Therapy , 16 , 427 437. doi: 10.1111/ j.1467 .6427.1994.00 807.x Hof, L. (1993). The elusive elixir of hope. The Family Journal , 1 , 220 227. doi:10.1177/ 1066480793013004. Holley, S. R. (2017). Perspectives on healthy lesbian relationships. Journal of Lesbian Relationships , 21 (1), 1 6. doi:10.1080/108 9410 6.2016.1150733
164 Holmes, G. J. (1989). Trust and the appraisal process in close relationships. In W. H. Jones & D. Perlman (Eds.). Advances in Personal Relationships . (pp. 57 104). London, UK: Jessica Kingsley . Holmes, P. & Farnf ield, S . (2014). Ro utledge Handbook of Attachment: Theory . New York, NY: Routled ge. Retrieved from : < http://www.myilibrary.com?ID=621812 > Holtslander, L. F. & Duggleby, W. D. (2009). The hope experience of older bereaved women who c ared for a spouse with terminal cancer. Qualitative Health Research , 19 (3), 388 400. doi: 10.1177/1049732308329682 Horsburgh, D. (2003). Evaluation of qualitative research. Journal of Clinical Nursing , 12 (2), 307 312. doi: 10.1046/j.1365 2702.2003.00683.x Huang, Y. (1996). The father of modern herm eneutics in a postmodern age: A reinterpretation of Philosophy Today, 40 (2), 251. Retrieved from : http://0 sear ch.proquest.com.skyline.ucdenver.edu /docview/1301481243?accountid=14506 Humble, A. M. & Sharp, E. (2012). Share d journaling as peer support in teaching qualitative research methods. The Qualitative Report . Ret rieved from: http://0 go.galegroup.com.sky line.ucdenver.edu/ps/ i.do?p=AONE&u=auraria_main&id= GALE%7CA351081377&v= 2.1&it=r&sid=summon&userGroup=auraria_main# Jacobson, N. S. & Christensen, A. (1996). Acceptance and change in couple therapy: A relationships . New York, NY: W. W. Norton & Company, Inc. Jackson, R., Wernicke, R., & Hagga , D. A. F. (2003). Hope as a predictor of entering substance abuse treatment. Addictive Behaviors , 28 , 13 28. doi: 10.1016/S 030604603(01)00210 6 Jankowski, P. J. & Sandage, S. J. (2011). Meditative prayer, hope, adult attachment, and forgiveness: A prop o sed model. Psychology of Religion and Spirituality , 3 , 115 131. doi: 10.1037/a0021601 Jenkins, D. (1996). A reflecting team appro ach to family therapy: A delphi study. Journal of Marital and Family Therapy , 22 , 219 238. doi: 1 0.1111/j.1752 0606.1996.tb00200.x Jiang, X., Huebner, E. S. and Hills, K. J . (2013), Parent attachment and life satisfaction: The mediating effect of hope. Psychology in the Schools , 50 , 340 352. doi: 10.1002/pits.21680
165 Johnson, S. (2004). The Practice of Emot ionally Focused Couple Therapy: Creating Connection . New York, NY: Routledge Mental Health . Johnson, S. M., Burgess Moser, M., Beckes, L., Smith, A. Dalgleish, T., Halchuk, R., Hasselmo, K., Green man, P. S., Merali, Z., & Coan, J. A. (2013). Soothing the threatened brain: Leveraging contact com fort with emotionally focused therapy. PLoS One , 8 (11), Retrieved from: http://journals.plos.org.aurarialibrary.idm.oclc.org/ plosone/article ?id=10.1371/journal.pone.0079314 Johnson, R. B. & Christensen, L. (2014). Educational research: Quantitative, qua litative, and mixed approaches. Thousand Oaks, CA: Sage Publications. Jomini Stroud, N., Kim, S., & Scacco, J. M . (2016). Cognitive dissonance. Oxford Bibliographies . Retrieved from: http://www.oxfordbibliogr aphies.com.aurarialibrary.idm. oclc.org/view /document/obo 9780199756841/obo 9780199756841 0062.xml#backToTop Jones, J., Lee, L, Zigarelli , J., & Nakagawa, Y. (2016). Culturally responsive adaptations in evidenced based treatment: The impact on client satisfaction. Contemporary School Psychology , 21 (3), 211 222. doi: 10.1007/s406688 016 6 Karam, E. A., Ko, M., Pinsof, B., Mroc zek, D., & Sprenkle, D. (2014). The multisystemic and multileve l investigation of the expanded therapeutic alliance psychological f unctioning relationship in individual therapy. Journal of Marital and Family Therapy , 41 (4), 401 41 4. doi: 10.1111/jmft.12094 Kirst, M., Zerger, S., Wise Harris, D. Plen ert, E. & Stergiopoulos. (2014). The promise of recovery: Na rratives of hope among homeless individuals with mental illness participating in Housing First randomized controlled trial in Toronto , Canada. Biomedical Journal Open , 4 . do i: 10.1136/bmjopen 2013 004379 Larkin, M., & Thompson, A.R. (2012). Interpretative phen omenological analysis in mental health and psych otherapy research. In D. Harper & A. R. Thompson (Eds.) . Qualitative research methods in mental health and psychotherapy : A guide for students and practitioners (p p. 101 116). West Sussex, England: John Wiley & Sons. Lavy, S. & Littman Ovadia, H. (2011). All you need is love? Strengths mediate the negative associations bet ween attachment orientation and life satisfaction. Personality and Individual Differences , 50 (7), 1050 1055. doi: 10.1016/j.paid.2011.01.023 Lazarus, R. S. (1991). Emotion and adaptation . New York, NY: Oxford University Press . LeVasseur , J. J. (2003). Pearls, pith, and provocation : The problem of bracketing in phenomenology. Qualitative Health Research , 13 (3), 408 420. doi: 10.1177 /1049732302250337
166 Levy Gigi, E. & Shamay Tsoory, S. G. (2017). Help me if you can: Evaluating the effectiveness of interpersonal compared to intrapersonal emotion regulation in reducing distress. Journal of Behavior Therapy and Experimental Psychiatry , 55 , 33 40. doi:10.1016/j.btep .2016.11.008 Linehan M. M. (1997). Validation and p sychotherapy. In A. Bohart & L. Greenberg. (Eds). Empathy Reconsider ed: New Directions in Psychotherapy . (pp. 353 392). Washington DC: American Psychological Association . Lynch, W. F. (1965) Images of Hope: Imaginat ion as a Healer of the Hopeless . Chicago,IL: Mentor Omega. Macdonald, K., Sciolla, A. F., Folsom, D., Bazz o, D., Searles, C., Moutier, C. Thomas, M. L., Borton, K. & Norcorss, B. (2015). Individual factors for physician boundary violations: The role of attachment style, childhood trauma, and maladaptive beliefs. General Hospital Psychiatry , 37 (1), 81 88. Doi: 10.1016/j.genhostppsyc.2014.09.001 Markova, I. S. & Berrios, G. E. (1992). The meaning of insight in psychiatry. British Journal of Psychiat ry , 160 , 850 860. Retrieved from: https://www.ncbi.nlm.nih.gov/ pubmed/1617369 Marmarosh, C. L., Whipple, R., Schettl er, M., Pinhas, S., Wolf, J., & Sayit, S. (2009). Adult attachment styles and group psychotherapy attitudes. Group Dynamics: Theory, Research, and Practice , 13 (4), 255 264. doi: 10.1037/a0015957 Marrone, Mario. (2014). Attachment and Interaction . London, UK: Jessica Kingsley Publishers. Retrieved from: Mason, J. (2012). Qualitative Researching. London, UK: Sage Publications . McCuollough Vaillant, L. (1997). Changin g character: Short term anxiety regulating psychotherapy for restr ucturing defenses, affects, and attachments . New York, NY:Basic Books . McDermott, R. C., Cheng, H., Wright, C., Browning, B. R., Upton, A. W., & Sevig, T. D. (2015). Adult at tachment dimensions and college student distress: The mediating role of hope. The Counseling Psychologist , 43 (6), 822 852. doi: 10.1177/0011000015575394 McGrath, A. (2017). Dealing with di ssonance: A review of cognitive dissonance reduction. Social a nd Personality Psychology Compass , 11 (12). doi: 10.1111/spc3.12362 McNally, R. (2011). What is Mental Illness? Cambridge, MA: Harvard University Press .
167 Meirav, A. (2009). The nature of hope. Ratio , 22 (2), 216 233. doi: 10.1111/j. 1467 9329.2009.00427.x Merleau Ponty, M. (2015). Phenomenology of Perception . New Yo rk, NY: Routledge Publishing. Merolla , A. J. (2014), The role of hope in conflict managem ent and relational maintenance. Personal Relationships , 21 , 365 386. doi: 10.1111/pere.12037 . Meyer, I. H. (2003). Prejudice, social stress , and m ental health in lesbian gay, and bisexual p opulations: Conceptual issues and research evidence. Psychological Bulletin , 129 , 674 697. Mitchell, P., Rhodes, P., Wallis, A., & Wilson, V. (2014). A compari son of two systemic family therapy reflecting team interventions. Journal of Family Therapy , 36 , 237 254. doi: 10.1111/1467 6427.12018 Mosalanejad, L., Parandavar, N., Gholami, M. & Abdollahifard, S. (2014). Increasing and decreasing factors of hope i n infertile women with fail ure in infer tility treatment: A phenomenology study. Journal of Reproductive Medicine , 12 (2), 117 124. Mondor, J., McDuff, P., Lussier, Y., & Wright, J. (2011). Couples in therapy: Actor partner analyses of the relationshi ps between adult romantic attachment and marital satisfaction. The American Journal of Family Therapy , 39 (2), 112 123. doi: 10.1080/01926187 .2010.530163 Monteoliva, A., Garcia Martinez, J. M. A., & Salinas, J. M. (2014). Effect of adult attachment style on the prediction of intimate behavior from the theory of planned behavior perspective. Estudios de Psicologia: Studies in Psychology , 35 (2), 266 297. doi: 10.1080/02 109395.2014.922257 Moran, D. (2000). Introduction to phenomenology . London: Routledge . Olafsdittor, H. S., Wik land, M., & Moller, A. (2013). Nordic proce ss during assisted reproductive treatments. Sexual and Reproductive Healthcare , 4 (2), 49 55. doi: 10.1016/j.srhc.2013.04.003 Murphy, B. C. & Dillon, C. (2014). Inter viewing in action in a multicultural world . Boston, MA: Cengage . Nahs, V. R., Ponto, J., Townsend, C., Nel son, P., & Bretz, M. N. (2013). Cognitive behavioral Therapy, s elf efficacy, and depression in persons with chronic pain. Pain Management Nursing , 14 (4), 236 234. doi: 10.1016/j.pmn.2012.02.006 Nesi, J. & Prinstein, M. J. (2015) . Using social media for social comparison and feedback seeking: Gender and popularity moderate associations with depressive symptoms.
168 Journal of Abnormal Child Psychology , 43 (8), 1427 143 8. Retrieved from: https://link springer com.aurarialibrary.idm.oclc.o rg/article/10.1007%2Fs10802 015 0020 0 Nespoor, J. (2000). Anonimity and place in q ualitative inquiry. Qualitative Inquiry , 6 (4), 546 569. doi: 10.1177/107780040000600408 Nongpong, S. & Charoensukmongkol, facebook: Impa cts of social media use of both partners in romantic relationship problems. The Family Journal , 24 (4). Retrieved from: http://journals .sagepub.com.aurarialibrary.i dm.oclc.org/doi/full/10.1177/1066480716663199 Norcross, J. C., Krebs, P. M., & Prochaska, J. O. (2011). Stages of change. Journal of Clinical Psychology , 67 (2), 143 154. doi: 10.1002/jclp.2 0758 Oka, M., Sandberg, J. G., Bradford, A. B. , & Brown, A. (2014). Insecure attachment behavior and partner violence: Incorporating couple percept ions of insecure attachment and relational aggression . Journal of Marital and Family Therapy , 40 (4), 412 429. doi: 10.1111/jmft.12079 Orlans, M. & Levy, T. M. (1998). Attachment, trauma, and healing: Understanding and treating attachment disorders in children and families. Phi ladelphia, PA: Jessica Kingsley Publishers . Offstein, E. H., Larson, M. B., McNeill , A. L., & Mwale, H. M. (2004). Are we doing enough for International Journal of Educational Management, 18 (7), 396 407. doi: 10.1108/09513540410563103 Owen, J., Imel, disparities in client unilateral termination. Journal of Counseling Psychology, 59 , 314 320. doi: 10.1037/a0027091 Panichelli , C. (2013). Humor, joining, and reframing in psychotherapy:Resolving the auto double bind. The American Journa l of Family Therapy , 41 (5), 437 451. doi: 10.1080/01 26187.2012.755393 Parker, M. L., Johnson, L. N., & K etring, S. A. (2011). Assessing attachmen t in couples in th erapy: A factor analysis of the experiences in close relationships scale. Contempora ry Family Therapy , 33 (1), 37 48. Retrieved from: http://0 link.springer.com.s kyline.ucdenver.edu/ar ticle/10.1007%2Fs10591 011 9142 x#/CR3 Perry, B. (2007). The Boy who was Raised as a Dog . New York, NY: Basic Books Publishing.
169 Pender, R. L. & Stinchfield, T. A. (2012). A reflective look at reflecting teams. The Family Journal: Counseling an d Therapy for Couples and Families , 20 (2), 117 122. doi: 10.1177/1066480712438526 Pender, R. L. & Stinchfield, T. A. (20 perspective of the reflecting team process. The Family Journal: Counsel ing and Therapy for Couples and Families , 22 (3), 273 281. doi: 10.1177/1066480714529888. Prochaska, J. O. & DiClemente, C. C. (1992). Stages of change in the modification of problem behaviors. Prog ress in Behavior Modification , 28 , 183 218. doi: 10.1037/0278 6133.13. 1.39 Ratcliffe, M. (2011). What is it to lose hope? Phenomenology and the Cognitive Sciences , 12 (4) 5 97 614. doi: 10.1007/s11097 011 9215 1 Rawdin, B., Evans, C. & Rabow, M. W. (2013). The re lationships among hope, pain, psychological distre ss, and spiritual w ell being in oncology outpatients. Journal of Palliative Medicine , 16 , 167 172. doi: 10.1089/jpm.2012.0223 Reese, C. (2007). Childhood attachment. The British Journal of General Practice , 57 (544) , 920 922. doi: 10.3399/0996016407782317955 Remple, J. K, Holmes, J. G., & Zanna, M. P. (19 85). Trust in close relationships. Journal of Personal and Socal Psychology , 49 , 95 112. doi: 10.1037/0022 35188.8.131.52 Ribeiro, A. P., Bento, T., Salgaodo, J., Stiles, W. B., Gonca lves, M. M. (2011). A dynamic look at a narra tive change in psychotherapy: A case study tracking innovative moments and protonarratives using state space grids. Psychotherapy Research , 21 (1), 54 69. doi: 10.1080/1063307.2010.504241 Ringer, J. M., Buchanan , E. E., Olese k, K., & Lysaker, P. H. (2014). Anxious and avoidant attachment st yles and indicators of recovery in schizo phrenia: Associations with self esteem and hope. Psychology and Psychotherapy , 87 (2), 209 221. doi: 10.1111/papt. 12012 Ristok , J. (2002). No more secrets: Violence in lesbian relationships . London, UK: Routledge . Robbins, M. S., Alexander, J. F., Newell, R. M., & Turner, C. W. (1996). The immediate effect o f reframing on cl ient attitude in famil y therapy. Journal of Family Psychology , 10 (1), 28 34. Retrieved from: https://search proquest.com.aurarialibrary.idm.oclc.org/docv iew /614333199/fulltext/3E C9B27498104462PQ/1?accountid=14 06
170 Rock, E. E., Steiner, J. L., Rand, K. L., & Bigatti, S. M. (201 4). Dyadic influence of hope and optimism on patient marital satisfaction among couples with advanced breast cancer. Su pportive Care in Cancer , 22 (9), 235 1 2359. doi: 10.1007/s00520 014 2209 0 Rodham, K., Fox, F., Doran, N. (2013). Exploring analytical tru stworthiness and the process of reaching consensus in interpretative phe nomenological analysis: Lost in transcription. International Journal of Social Research Methodology , 18 (1), 59 71. doi: 10.1080/13645579.2013.852368 Romdenh Romluc, K. (2011). Ro utledg e Philosophy Guidebook to Merleau Ponty and Phenomenology of Perception . New York, NY: Routledge . Russell, C. K. & Gregory, D. M. (2003). Evaluation of qualitative research studies: EBN guide . Evidenced Based Nursing , 6 (2), 36+. Retrieved from: h ttp://0 go.galegroup.com. skyline. ucdenver.edu/ps/i. go.galegroup.com do?p=HRCA&u=auraria_ mai n&id=GAL %7CA9 696141&v=2.1&it=r&sid=su mmon&userGroup=a uraria_main&au Coun t=1# Ryninks, K., Roberts Col lins, C., M cKenzie experience of conta ct with their stillborn infant: An interpretative phenomenological analysis. BioMed Central Pregnancy and Childbirth , 14 , 203+. doi: 10.1186/ 1471239314 20 3 Sable, P. (2007). What is adult attachment? Clinical Social Work Journal , 36 (1), 21 30. doi: 10.1007/s10615 007 0110 8 Safran, J. D. & Segal, Z. V. (1990). Int erpersonal process in cognitive therapy . New York, NY: Basic Books . Sartre, J. P. (1956). Being and nothingness:An essay on phenomenological ontology . New York, NY: Philosophical Library . Seedall, R. B. & Lachmer, E. M. (2016). Attach ment related dynamics during a positively themed coup le interaction: Implicatio ns of anxi ety and avoidance. Couple and Family Psychology: Research and Practice , 5 (1), 27 42. doi: 10.1037/cfp0000054 Selles, S. P., Smith, T. E., Coe, M. J., Yosh ioka, M., & Robbins, J. (1994). An ethnography of couple and therap ecting team practice. Journal of Marital and Family Therapy , 20 , 247 266. doi: 10.1111/j.1752 0606.1994.tb00114.x Scheier, M. F. & Carver, C. S. (1985). Optimism, copi ng, and health: Assessment and implications of generalized outcome expectancies. Health Psychology , 4 , 219 247. Scioli, A., Ricci, M., Nyugen, T., & Scioli, E. R. (2011). Hope: Its nature and measurement. Psychology of Religion and Spirituality, 3 (2), 78 97. doi:10.1037/a0020903
171 Shorey , H. S., Snyder, C. R., Yang, X., & Lewin, M. (200 3). The role of hope as a mediator in recollected p arenting, adult attachment, and mental health. Journal of Social and Clinical Psychology , 22 (6), 685 715. doi: 10.1521/jscp.22.6.685.22938 Sibley, C. G. & Liu, J. H. (2004). Short ter m temporal stability and factor structure of the Revised Experien ces in Close Relationships (ECR R) measure of adult attachment. Personality and Individual Differences , 36 ( 4), 969 975. doi: 10.1016/S0191 8869 (03)00165 X Sibley, C. G., Fischer, R., & Liu, J. H. (200 5). Reliabi lity and validity of the Revised Experiences in C lose Relationships (ECR R) self report measure of adult relationships. Personality and Social Psychology Bulletin , 31 (11), 1524 1536. doi: 10.1177/0146720527 6865 Simmon, B. L., Gooty, J., Nelson, D. L., & L ittle, L. M. (2009). Secure attachment: Implications for hope, trust, burnout, and performance. Journal of Organizational Behavior , 30 (2), 233 247. Retrieved from: http://0 www.jstor.org.skyline.ucdenver. edu/stable/416827? pq origsite=summon&seq=4#page_scan_tab_contents Simpson, C. (2004). When hope makes us vulnerable: A d iscussion of patient healthcare provider interactions in the context of hope. Bioethics , 18 (5) , 428 447. Retrieved from: http://www.ncbi.nlm.ni h.gov/pubmed/15462025 Simpson, J. A. (2007). Psychological foundations of trust. Curr ent Directions in Psychological Science , 16 , 264 268. doi: 10.1111/ j.1 467 8721.2007.00517.x Sluzki, C. E. (1992). Transformations: A blu eprint for narrative changes in therapy. Family Process , 31 (3), 217 230 . doi: 10.1111/j.1545 5300.1992.00217.x Smedema, S. M., Chan, J. Y., & Phillips, B. N. (2014). Core sel f hope the ory in persons with spinal cord injuries. Rehabilitation Psychology, 59 (4), 399 406. Retrieved from: http://0 dx.doi.org.skyline.ucdenver.edu/ 10.1037/rep000001 5 Smith, E. N., & Barros Gomes W. R. (2015) . Soliciting strengths s ystemically: The use of character strengths in couple and family therapy. Journal of Family Psychotherapy , 26 (1), 42 26. doi:10.10 80/08975353.2015.1002742 Smith, J. A., Harre, R., & Van Langenhove, L. (1995). Rethinking Methods in Ps ychology . Thousand Oaks, CA: Sage Publications . Smith, J. A. (2004). Reflecting on the developm ent of interpretative phenomenological analysis
172 and its contribution to qualitative research in psychology. Qualitative Research in Psychology , 1 (1), 39 54. doi: 10.1191/1478088704qp004oa Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative Phenomenological Analysis: Theory, Method, and Research . Thousand Oaks, CA: Sage Publications . Smith, J. A. (2010). Evaluating the contribution of interp retative phenomenological analysis. Health Psychology Review , 5 (1), 9 27. doi: 10.1080/17437199.2010.510659 Smith, J. A. (2011). Evaluating the contribution of interpretativ e phenomenological analysis. Health Psychology Review , 5 (1), 9 27. doi: 10.1080/17437199.2010.510659 Smith, T. E., Sells, S. P. and Clevenger, T. (1994) Ethnographic content analysis of couple and t herapist setting. Journal of Marital and Family Therapy , 20 , 267 286. Snyder, C.R., Irving, L., & Anderson , J.R. (1991). Hope and health: Measuring the will and the ways . In C.R. Snyder & D.R. Forsyth (Eds.) . Handbook of s ocial and clinical psychology: The health perspective (pp.285 305). Elmsford, NY: Pergamon Press. Snyder, C.R. (2000) . Hypothesis: There is Hope. In C.R. Snyder (Eds.), Handbook of Hope Theory, Measures and Applications (pp.3 21). San Diego, CA: Academic Press. Snyder, C. R. (2002). Hope theory: Rainbows in the mind. Psychological Inquiry , 13 , 249 275. doi: 10.1207/S15327965PLI1304_01 Springer, K. W., Parker, B. K., & Leviten Reid, C. (2009). Ma king space for graduate student parents: Practice a nd politics. Jo urnal of Fami ly Issues, 30(4), 435 457. doi: 10.1177/ 0192513X08329293 Stanley, J. L. (2004). Birac ial women and bisexual women. Women and therapy , 27 (1), 159 171. doi: 10.1300/J015v27n01_11 Sue, D.W. & Sue, D. (2013). Counseling the culturally diverse . Hoboken, NJ: John Wiley & Sons. Svinhufvud, K., Voutilaninen, L. & We iste, E. (2017). Normalizing in student counseling: descriptions. Discourse Studies , 19 (2). Retrieved from:http://journa ls.sagepub.com.aurarialibrary.idm.oclc. org/doi/full/ 10.1177146144 5617691704#_i14 Tidwell, M. C. O., Reis, H. T., & Sh aver, P. R. (1996). Attachment, attractiveness, and social interaction: A diary study. Journal of Personality and Social Psychology , 71 , 729 745. doi: 10.1037 /002 2 35184.108.40.2069
173 Trathen, D. W. (1995). A comparison of the effectiven ess of two Christian premarital cou nseling programs (skills and information based) utilized by Evange lical Protestant churches ( Doctoral dissertation). Retrieved from : http://search.proquest.com /pqdtglobal/ docview/304 192861/abstract/6329556BB29C4BB7PQ/1?accountid=4488 Van Den Hoonaard, W. C. (2002). Walkin g the Tightrope: Ethical Issues for Qualitative Researhcers . Toronto, Canada: University of Toronto Press . Van Rosmalen, L., Van Ijzendoorn, M. , & Bakermans Kranenbu rg, M. J. (2014). ABC+D of Attachmen t Theory; The Strange Situation Pr ocedure as the Gold Standard of Attachment Assessment. Holmes, P. & Farnfield, S. ( Eds.). New York, NY: Routledge. Retrieved from : < http://www.myilibrary.com?ID=621812 > Phen omenology and the Cognitive Sciences , 14 (4), 1145 1163. doi: 10.1007/ s11097 014 9409 4 Villar, F. & Villamizar, D. J. (2012 ). Hopes and concerns in couple relationships across adult hood and their association with relationship satisfaction. International Journal of Aging and Human Development , 75 (2), 115 139. doi: 10.2190/A G.75.2.b Vogel, E. A., Rose, J. P., Roberts, L. R., & Eckles, K. (2014). Social comparison, social media, and self esteem. Psychology of Popular Media Culture , 3 (4), 206 222. doi:10.1037/ppm0 000047 Ward, D. B. & Wampler, K. S. (2010). M oving up the continuum of hope: Developing a theory of hope and understanding its influence in couples therapy. Journal of Marital and Family Therapy , 36 (2), 212 228. doi: 10.1111/j.1752 0606.2009.00173.x Warnke, G. (2011). The hermeneutic circle versus dialogue. The Review of Metaphysics , 65 (1), 91+. Retrieved from : http://go.galegroup.com.skyline.ucdenver.edu/ps/i.do ?p =EAIM&u= auraria_main&id=GAL E%7CA269027768&v=2.1&it= r&sid= summon&userGroup=aurri a= main&authCount=1 Watkins, D. & Gioia, D. (2015). Mixed Method Research . New York, NY: Oxford University Press Waynor, W. R., Gao, N., Dolce, J. N., Hayt as, L. A., & Reilly, A. ( 2012). The relationship between hope and symptoms. Psychiatric Rehabilitation Journal , 35 , 345 348. doi : 10.2975/35.4.2012.345.3 48 Welch, R. D. & Houser, M. E. (2010). Ex tending the four category model of adult attachment: An interpersonal model of friendshi p attachment. Journal of Social and Personal Relationships , 27 (3), 351 366. doi: 10.1177/0265407509349632
174 Wiebe, S. A., Johnson, S. M., Burgess Moser, M., Dalglei sh, T. L., & Tasca, G. A. (2016). P redicting follow up outcomes in Emotionally Focused Couple Therapy: The role of change in trust, relationship spe cific attachment, and emotional engagement. Journal of Marital and Family Therapy , 43 (2), 213 226. doi: 10.1111/jmft.12199 Weiste, E. (2015). Describing therape utic projects across sequences: Balancing between supportive and disagreeing interventions. Journal of Pragmatics , 80 , 22 43. doi: 10.1016/j.pragma.2015.02.0 0 1 Wesmer, K. A. (2008). Social compariso n of romantic relationships the influence of family, friends, and med ia. Retrieved from:http://skyli ine.ucdenver.edu/record=b3343932 Wilson, J. B., Gardner, B. C., Brosi, M. W., Topham, G. L., & Busby, D. M. (2013). Dyadic adult attachm ent style and aggression within romantic relationships. Journal of Couple and Relationship Therapy: Innovations in Clinical and Educational Interventions , 12 (2), 186 205. doi: 10.1080/15332691.2013.779185 Yancey, A. K., Siegel, J. M., & McDaniel, K. L. (2002). Role models, ethnic identity, and health r isk behaviors in urban adolescents. Pediatric Adolescent Medicine , 56 (1), 55 61 . Yardley, L. (2000). Dilemmas in qualitative health research. Psychology and Health , 15 (2), 215 228. doi: 10.1080/08870440008400302 Yeung, D. Y, Ho, S. M. Y., & Mak, C. W. Y. (2015). Brief report: Attention to positive inform ation mediates the relationship between hope and psychosocial well being of adolescents. Journal of Adolescence , 42 , 98 102. doi: 10.101 6/j.adolescence. 2015.04.00 4 Yong, Y. J. (2015). The psychology of e ncouragement: Theory, research, and practice. The Counseling Psychologist , 43 (2), 178 216. doi: 10.1177/0011000014545091 Zarei, E. & Sanaeimanesh, M. (2014). The effect of self disclosure skill training on communication patterns of referred couples to counseling clinics. Iranian Journal of Psychiatry and Behavioral Sciences , 8 ( 3), 50 57. Retrieved from: http://www.ncbi.nih.gov/pm c/articles/PMC4359725/?tool=pmcentrez Zhang, W. (2016). How is a phenomenol ogical refl ection model of self consciousness possible? A Husser semantic approach to self consciousness. Husserl Studies , 32 (1), 47 66. doi: 10.1007 /s10743 015 9185 1
175 APPENDIX Appendix A 1. 2. What hopes, if any, did you have for the reflecting team process before it began ? 3. Tell me about the reflecting team process. 4. What part of the reflecting team process gives you hope , if any, for the future of your relationship? 5. What aspect of the reflecting team process, if any, motivates you to continue your relationship? 6. What happene d in the reflecting team process to provide evidence, if any, that your relationship could or would change? 7. What connections have you built with your partner as a result of the reflecting team process, if any? 8. What impact, if any, did the reflecting team have on your hope for your relationship?
176 9. Has anything about your relationship changed as a result of the re flecting team process? If so, can you tell me more about that? 10. If you did not experience an increase in hope as part of the reflecting team process, please tell me about what you did experience. Appendix B Principal Investigator: Caitlin Edwards COMIRB No: 16 1543 Version Date: 2/16/17 Study Title: The Experience of Hope b y Couples in Counseling Using a Reflecting Team through the Lens of Attachment: An Interpretative Phenomenological Analysis You are being asked to be in a research study. This form provides you with information about the study. A member of the research team will describe this study to you and answer all of your questions. Please read the information below and ask questions abo understand before deciding whether or not to take part. . Why is this study being done? This study plans to learn more about whether reflecting teams have any impact on hope in couple relationships. This study plans to learn more a bout whether reflecting teams have any impact on hope in couple relationships.
177 You are being asked to be in this research study because you and your partner attend counseling at the Denver Family Institute. Up to 6 people will participate in the study. What happens if I join this study? If you join the study and sign the consent form, you and your partner will be asked to complete the sociodemographic questionnaire, the Experiences in Close Relationships Revised questionnaire and the Relationship Hope Scale prior to your counseling session and complete the Relationship Hope Scale after your counseling session. Within one month after your counseling session, you will be invited to participate in a face to face interview about your exper iences with the Reflecting Team. With your permission, the interviews will be recorded as digital audio files and later transcribed. We anticipate that the questionnaires will take between 10 and 15 minutes prior to the first session and less than five mi nutes after your counseling session while the interview will take about 60 minutes. Overall, we anticipate that the study will take two months. What are the possible discomforts or risks? There are risks with any study. To give you the most complete inform ation available, we have listed a number of possible risks, which may appear alarming. We do not want to alarm you but we do want to make sure that if you decide to participate, you have had a chance to think about the risks carefully. You make experience discomfort based on the both the survey questions as well as the questions we ask during the interview. . Please also be aware that there may be risks in participating in this study that we do not know about yet. If you experience any symptoms or possible side effects or other medical problems, please let the Principal Investigator know immediately. Facilitators are present to address any issues that may arise during sessions of the program and also offer references to additional psychological help if requ ired or requested. If needed or requested, participants will be directed to the following resources: your counselor at the Denver family Institute local mental health services What are the possible benefits of the study? We do not know if taking part in this study will help you directly. This study has not been designed to improve either your mental or physical health. Will I be paid for being in the study? Will I have to pay for anything?
178 You will be provided with a free counseling session at th e Denver family Institute. You will receive a second free session with DFI if you decide to participate in the interview. You will need to pay for any costs that you incur such as parking and the fee for the counseling session when you attend other counsel ing sessions at the Denver family Institute. Can I be removed from the study? You may be taken out of this study if your counselor or the interviewer thinks it is not safe for you to be in the study. You can be taken out of the study even if you do not want to leave the study. If you are taken out of this study, you will not lose any of the benefits that you would normally get outside of the study. Being taken out of the study will not affect your employment status or your reputation. Being taken ou t of the study will not change your ability to get government assistance. If you are taken out of the study, the only benefits you will lose are the ones you are getting as part of this study. Is my participation voluntary? Taking part in this study is v oluntary. You have the right to choose not to take part in this study. If you choose to take part, you have the right to stop at any time. If you refuse or decide to withdraw later, you will not lose any benefits or rights to which you are entitled. Who do I call if I have questions? The researchers carrying out this study are Caitlin Edwards and Dr. Robert Allan. You may ask any questions you have now. If you have questions later, you may call Caitlin Edwards at 720 260 2187 or Robert Allan at 303 315 4913. You may have questions about your rights as someone in this study You can also call the Multiple Institutional Review Board (IRB). You can call them at 303 724 1055. Who will see my research information? We will do everything we can to keep your records a secret. It cannot be guaranteed. Both the records that identify you and the consent form signed by you may be looked at by others. Federal agencies that monitor human subject research Human Subject Research Committee The group doing t he study Regulatory officials from the institution where the research is being conducted
179 who want to make sure the research is safe The results from the research may be shared at a meeting. The results from the research may be in published articles. Your name will be kept private when information is presented. Some things we cannot keep private. If you give us any information about child abuse or neglect we have to report that to Denver Health and Human Also, if we get a court order to turn over your st udy records, we will have to do that. Some things we cannot keep private: If you tell us you are going to physically hurt yourself or someone else, we have to report that to the Denver Police Department. Also, if we get a court order to turn over your study records, we will have to do that. We understand that all of the information we gather during this study originates in confidence. As a result, we will do everything possible to ensure that all information or interaction emerging from this study will remain confidential. Names and personal information linking your identity will be removed from the questionnaires. Data to be collected in this research is of a personal and sensitive nature. All data will be collected and stored in a confidenti al manner. To this end, information gathered from all participants will remain confidential to those outside the research team by changing identifying information, placing no identifying information on questionnaires, and keeping these records stored secur ely in the office of Robert Allan at University of Colorado Denver. Any documentation containing identifying information (such as consent forms) will be stored separately from data, again in a securely locked cabinet in a locked room. A list linking coup le identification number and couple names will be stored on a password the study, study data and the identification list will be kept in a separate locked filing c abinet in Participants' anonymity will be protected in publications by never revealing participants' identifying information (i.e., names, residence, occupation) in pu blished works, and by only reporting group data. If individual cases are presented, no identifying information will be revealed and details will be modified as to not make the couple identifiable. For the purposes of confidence, audiocassettes and transcri ptions of our interviews will be marked only with a pseudonym and the date on which the interview took place. This data will be stored in the offices of Robert Allan at CU Denver and be available only to the research team. To further protect your identity, this consent form will be sealed in an envelope and stored separately from the research data. Information from the study will be stored for 7 years, after which time it will be securely destroyed.
180 Agreement to be in this study I have read this paper about the study or it was read to me. I understand the possible risks and benefits of this study. I know that being in this study is voluntary. I choose to be in this study: I will get a copy of this consent form. Signature: Date: Print Name: Consent form explained by: Date: _____ Print Name: Investigator: Date: ________ Appendix C Frequency table of super ordinate themes across participants A substantial discussion B present C barely mentioned Theme: Both/And Experience of RT positive and wonder if they understand their struggles James Cassie Unsure if RT understands specific aspects of identity B C Unsure if RT is able t o understand their struggles C B RT as an overall positive experience B B
181 RT as a potential experience of judgement C B Theme: Both/And Experience of RT positive and wonder if they understand their struggles Damien Rebecca Unsure if RT understands specific aspects of identity C C Unsure if RT is able to understand their struggles C C RT as an overall positive experience B C RT as a potential experience of judgement C C Theme: Both/And Experience of RT positive and wonder if they understand their struggles Joana Halona Unsure if RT understands specific aspects of identity A A Unsure if RT is able to understand their struggles A A RT as an overall positive experience B B RT process as a potential experience of judgement B B Theme: Hope as a Result of Outside Perspectives James Cassie Reframe of current relationship interactions B B Outside perspective s bringing insight into relationship C B Outside perspectives as affirmation C B Theme: Hope as a Result of Outside Perspectives Damien Rebecca Reframe of current relationship interactions B B Outside perspectives bringing insigh t into relationship B B Outside perspectives as affirmation B B Theme: Hope as a Result of Outside Perspectives Joana Halona
182 Reframe of current relationship interactions B B Outside perspectives bringing insight into relationship B B Outside perspectives as affirmation B B Theme: Grading/Evaluation of Relationship James Cassie Failing in relationship B B RT as building efficacy C B Lack of model for successful relationships C C Theme: Grading/Evaluation of Relationship Damien Rebecca Failing in relationship C B RT as building efficacy B B Lack of model for successful relationships C C Theme: Grading/Evaluation of Relationship Joana Halona Failing in relationship B C RT as building efficacy B B Lack of model for successful relationships A A Theme: Hope as a result of RT making strengths/love/care of relationship salient James Cassie RT pointing out strengths A A
183 RT pointing out willingness to work on relationship A A RT affirming relationship is moving in the right di rection B A RT pointing out love/care A B RT as normalizing A C Theme: Hope as a result of RT making strengths/love/care of relationship salient Damien Rebecca RT pointing out strengths A A RT pointing out willing ness to work on relationship A B RT affirming relationship is moving in the right direction B B RT pointing out love/care A A RT as normalizing B C Theme: Hope as a result of RT making strengths/love/care of relationship salient Joana Halona RT pointing out strengths A B RT pointing out willingness to work on relationship A A RT affirming relationship is moving in the r ight direction A B RT pointing out love/care A A RT as normalizing B C Appendix D Frequency Table of Quotes Regarding Hope based on Attachment Style Anxiously Avoidant (13 total quotes) Type of Comment Number of Comme nts
184 New perspectives: 0 Insight: 5 Comments on Positive Momentum: 2 Strengths: 5 Comments on Growth: 2 Normalizing: 2 Affirmation: 4 Avoidant (9 total quotes) Type of Comment Number of Comments New perspectives: 0 Insight: 0 Momentum: 2 Strengths: 1 Growth: 0 Normalizing: 2 Affirmation: 3 Anxious (24 total quotes) Type of Comment Number of Comments New perspectives: 4 Insight: 8 Momentum: 1 Strengths: 11 Growth: 3 Normalizing: 0 Affirmation: 6 Secure (9 total quotes) Type of Comment Number of Comments New perspectives: 1 Insight: 3 Momentum: 0 S trengths: 7 Growth: 0 Normalizing: 0 Affirmation: 1