Ian Bennun

The golombok rust inventory of marital state (GRIMS)

Abstract The Golombok Rust Inventory of Marital State (GRIMS) is a new short (28 item) questionnaire for the assessment of the quality of a relationship. The GRIMS is a companion test to the Golombok Rust Inventory of Sexual Satisfaction (GRISS) which is in use in sex therapy and sexual dysfunction clinics and research. Its development and construction are described, together with details of item analysis and other psychometric procedures. The scale, which can be used for either men or women, has good reliability (.90 for women and .92 for men). Content and face validity are good. Some evidence of discriminative validity is also given. The GRIMS will have clinical and research application for marriage guidance and marital therapy clinics. Some further consideration is given to various differences between men and women in their perceptions of a good relationship.

Identifying the Mental Health Needs of Looked after Young People

Fifty looked after young people and their carers were interviewed to elicit whether, intuitively, they considered the young person to have a mental health problem and when they would seek professional help. This intuitive judgement of need was compared with responses to a mental health screen, and specific depression and conduct disorder scales. The results suggest that carers perceived 70% of young people to have significant mental health need; high levels of depression (28%) and conduct disorder (34%) were also found. Carers were four times more likely to identify mental health needs, both intuitively and on the mental health screen, than young people did themselves. Two-thirds of carers were intuitively accurate in identifying mental health need in their young people, although fewer than half of those identified as having high needs were being seen by a mental health specialist. Of concern, 23% of carers failed to identify needs, subsequently identified by the mental health screen. Perceived familial burden predicted a high mental health needs screen outcome. Given the established risks to mental health for this population of young people, the utility of a systematic mental health screen is discussed.

Face value: an exploration of the psychological impact of orthognathic surgery

We explored the experiences of a group of participants with craniofacial conditions before, during, and after orthognathic surgery. Semi-structured interviews were conducted, recorded, transcribed, and analysed using interpretative phenomenological analysis, and purposive sampling focused on a homogenous group was selected. Participants described unpleasant experiences related to their appearance, the difficulties they had in adjusting to facial changes as a result of surgery, and the differences these changes had made to their body image. The superordinate themes identified after interpretive phenomenological analysis were: self-awareness of facial appearance; attitudes of others and facial appearance; treatment issues; impact of surgery; and support and coping. The accounts provide information about living with an unusual appearance, medical aspects of facial operations over time, changes in body image before, during, and after operation, and the effects of support and coping styles on resilience.

Delphi survey of opinion on interventions, service principles and service organisation for severe mental illness and substance misuse problems

As the evidence for the efficacy of treatment programmes for substance misuse and severe mental illness is very limited, a national three stage Delphi survey was conducted to try and achieve consensus of views amongst a panel of 154 experts in the UK. The panel reached consensus on the best ways to identify those with severe mental illness and substance misuse problems, on principles essential for a service and on training and research. There was also consensus on interventions/techniques considered the most important, and on those considered less important. There was no consensus on how services should be organised. The survey reflects the best evidence so far as to the views of those in the UK who are involved in this challenging area. The consensus items offer useful and realistic guidance for practitioners on the identification and treatment of those with severe mental illness and substance misuse problems.

Treating the System or Symptom: Investigating Family Therapy for Alcohol Problems

This paper investigates two contrasting family therapy approaches in the treatment of alcoholism. Twelve families were randomly assigned to either a symptom-focused or systems-focused treatment. Measures of marital satisfaction, family satisfaction and alcohol dependency were recorded before treatment commenced, after treatment and at a six-month follow up. The results showed that both treatments were equally effective in producing desired change, thus offering clinicians increased choice in the range of effective family interventions.

The Effects of Marital Therapy on Sexual Satisfaction

Abstract Twenty couples with marital distress and for whom sexual functioning was not the primary referral problem received ten weekly sessions of marital therapy. Both partners completed the Golombok Rust Inventory of Sexual Satisfaction, a measure of sexual functioning, before and after therapy. A significant improvement in the reported quality of the couples sexual functioning was found, particularly for the frequency of sexual intercourse, communication, and sexual satisfaction. It was concluded that behavioural marital therapy alone may be effective in the treatment of sexual problems.

Intensive care units : a systemic perspective

There are no systemic accounts of Intensive Care Units (ICUs) nor is there much to guide the systemic therapist working within these units. This paper attempts to develop an analysis of ICUs and proposes two working models describing the various levels at which the therapist can intervene.

Some Prospects for Couples Therapy

Abstract This paper highlights two specific areas as future prospects for couples therapists. The development of couples therapy has primarily focussed on refining conceptual models for formulating and intervening with couples and on developing adequate methods of assessment. As a result, some areas have been neglected, specifically (i) an appreciation of the dyadic needs of psychiatric patients, handicapped persons and the elderly and (ii) some of the philosophical issues involved in couples therapy.

Systemic marital therapy with one partner: A reconsideration of theory, research and practice

Abstract This paper discusses the literature on systemic marital relationship interventions with one partner only. Increasingly, marital therapists and agencies offering services to distressed couples are seeing just one marital partner and need to consider methods of treating relationship distress within this mode. Some of the empirically established methods are described, as are general clinical issues. Reference is made to systemic and to a lesser extent psychodynamic theory relating to the treatment of one partner alone.

Group marital therapy: A review

Abstract The demand for marital therapy has steadily increased as have divorce rates. Accompanying this phenomenon is the continual enquiry as to how clinicians can offer a cost-effective service for couples in distress. This paper reviews the area of group marital therapy indicating that this form of treatment is widely practised. Attention is given to the role of the therapist, the therapeutic factors operating in group marital therapy, indications and contra-indications and a brief evaluation of the research.