Panel Discussion 1 - Activating Change in High Conflict Couples: A Transdiagnostic and Transtheoretical Dialogue to Distill Common Factors

This clinical roundtable focuses on identifying common factors of therapeutic interventions designed to address transdiagnostic emotion dysregulation in high conflict couples from a systems approach. Although research has identified numerous potential ramifications of high conflict in couples, both for the relationship itself and for the individuals involved (e.g. increased risk of divorce, aggressive behavior and intimate partner violence, substance abuse, impairments in physical health, and internalizing and externalizing disorders in children and teens), couples presenting to therapy with issues associated with core emotion dysregulation are often underserved in community-based settings. Multiple evidence-based approaches exist to address the range of diagnostic and behavioral patterns in dysregulated couples, yet treatment exclusion and absence of effective containment remain common. Exclusion from treatment and selection of procedures that do not directly target core emotion dysregulation can keep couples entrenched in escalating interactional patterns. A panel of six clinicians and researchers, each bringing expertise in a variety of presentations (trauma and complex trauma, eating disorders, substance use, borderline personality disorder, IPV, and suicidal and self-injurious behavior) and theoretical orientations (IBCT, EFT, DBT, CBCT), discuss the integration of evidence-based strategies to facilitate active containment, skills development, redirection, and targeted behavioral change to shift interpersonal patterns. The panelists will discuss both (a) mechanisms through which these interventions target skills deficits for emotionally dysregulated couples and (b) the active therapeutic stance to apply these interventions effectively. This widely experienced panel will reference pertinent clinical literature and draw on examples from clinical practice to highlight integral elements of intervention for high conflict couples and to propose guidelines that will improve access and treatment outcomes.