2020_05_28_ICS_coronadivorcio

Martiño Rodríguez, family therapist and psychologist, presides the association Spanish research and development of Family Therapy (AEI+DTF) and researches at the project 'Education of the affectivity and human sexuality' (EASH) of the Institute for Culture and Society (ICS) of the University of Navarra. 

At ICS he leads the project E(f)FECTS, which is the first randomized clinical essay in Emotionally Focused Therapy in Spanish-speaking countries. He assures that this evidence-based model can be very useful for couples going through a crisis, also for those who are experiencing difficulties in the context of the Covid-19 pandemic.

The association Spanish Family Lawyers (AEAFA) has detected an increase in divorce consultations after confinement. What ingredients have triggered so many 'coronadivorces' during these months?
The pandemic has caused great stress for many couples. To the status of uncertainty have been added a cohabitation for 24 hours, the difficulties in the work (ERTE, loss of employment, teleworking ...) and in many cases, family reconciliation. Sometimes, couples who are not going through good times prefer to avoid the conflict and with their usual rhythm of life can endure for months or years. But being at home for two months has added stress that, first, makes the relationship difficult if there is not a good foundation and, second, generates wear and tear if there are frictions in cohabitation. 

On the other hand, with respect to the number of applications, as will happen with many other aspects during de-escalation, we will resume things that have not been allowed. There will necessarily be peaks of divorces because everything has been at a standstill: consultations could not be made and it was not the right time to propose a separation because the cohabitation could not be terminated. This is probably not the only explanation, but it must be taken into account.

What factors have aggravated during confinement the usual couple problems?
The professionals with whom I have contact as president of the Spanish association of research and Family Therapy and through other institutions or associations to which I belong have perceived difficulties very similar to those they already saw before. What is different is that the pandemic has added elements that make it difficult to management. When a couple has conflicts, or a specific one, there is still the resource to leave the house, go for a walk, chat with other people... Those moments when we can go somewhere else and focus on another task help us to take some distance and see things with perspective. Confinement has not allowed this. A second element is the great uncertainty about work, health, the immediate future... That generates a blockage. There are so many open fronts that we do not find the energy to take steps to face the difficulties in the couple's relationship.

The very decision to go to therapy is harder to make now because many are hopeful that the relationship will improve when status gets back on track. Or they are clear that they need to go, but don't know if they can afford the financial cost because of job uncertainty.  

What are the first signs that a couple should go to therapy?
It is difficult to give a general idea about the exact moment. One clue may be the experience of a difficulty that is generating a lot of suffering and instead of finding a way to resolve it that strengthens and brings the partners closer together, it is driving them further and further apart. Perhaps there have been repeated attempts to fix it and they can't think of any more ways. At that point another step may be taken, resorting to external financial aid . Another sign may be that there are certain signs of disrespect within the relationship that occur frequently. 

And in the specific circumstance of the state of alarm, it is necessary to take the experience of these months with a certain perspective. It is a very particular status and even if the relationship has deteriorated, we should not put ourselves in the worst; perhaps there will be an improvement when the external circumstances normalize. If we see that this is not the case, perhaps there has been damage that does require a professional financial aid . A first enquiry can be made and an assessment made as to whether or not further therapy is needed.

What can couples therapy do for couples who are having a hard time in these uncertain times? Specifically, how financial aid can EBT help them?
Unlike most models and approaches to couples therapy, EBT has a theoretical and empirical foundation, an endorsement that it works if applied well, at position by well-trained professionals. EBT is based on attachment theory and financial aid to make the partners feel secure in the relationship. It seeks to generalize affective and communicative dynamics that strengthen bonds in the face of difficulties. It does not approach therapy as a process of problem solving or improvement of communication techniques, although these are important things, of course. It goes further: it tries to help people to generate a dynamic that makes us feel close to the other person in the face of a stressful circumstance, such as confinement, and to face together that which frightens us and makes us suffer. In this sense, it contributes something very valuable because it can help us to recover from this status and any other future difficulty.

The clinical essay you are developing to validate the TFE in Spanish-speaking countries started in March, shortly before the state of alarm was declared. How has the pandemic affected the study?
It officially started on March 3. We started the partner recruitment process in Guatemala and Argentina. In these countries, the period of confinement has been similar to that of Spain, so in mid-March face-to-face therapies were suspended in the clinics. In view of this status, we decided to continue with online and video-call recruitment. We hoped that in a month or a month and a half we would be able to fill in the procedure as planned.

At the end of April, the local contacts told us that the confinement would be lifted in their countries at the earliest in mid-June or maybe in July, so we decided to stop the process and wait. The reason is, among others, that there is an initial assessment that is done at the time of recruitment that cannot be removed in time from the start of therapy. 

Thus, the start of the study will be slightly delayed. We are now preparing for possible scenarios that may occur. If we have a number of couples when we start it up again, they are assigned to groups, start therapy, and in the middle of that process another wave of the pandemic and another confinement occurs, we may keep the study going through the modality on line.

Related to this, how have new technologies helped to continue therapies during confinement, and are online sessions just as effective?
Almost anyone with a webcam at home can have a enquiry with their therapist. However, the ability to perceive how the other person is and to capture non-verbal expression is more limited through videoconferencing. This is compounded by other circumstances that make it difficult to carry it out in the best conditions. Think of a married couple with several children in a small apartment where everything can be heard: the feeling of intimacy is greatly reduced and this affects the process. Other relevant variables also intervene, such as age: someone in his or her twenties does not have the same experience as a married couple in their sixties. 

The evidence on the effectiveness of these online sessions is very little and we cannot know if they are comparable to face-to-face sessions. There are very few programs of study and there are no clinical trials that have compared them. Nevertheless, I think it is positive to have these tools available to continue therapy.