Do couples and families with histories of trauma need tailored therapy?

Categories: Research project completed

Nyhetsartikkel publisert 29/02/24

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A process study examining trajectories and mechanisms of change in residential couple and family therapy. The aim is to gain a better understanding of how couple and family treatment works and what may hinder therapeutic progression.

Kristoffer J.  Whittaker, Ph.D.

Kristoffer J. Whittaker, Ph.D.

Clinical Psychologist

Kristoffer Whittaker is a clinical psychologist specializing in family psychology.  Kristoffer’s area of interests include Integrative Systemic Therapy (IST), Emotional Foucsed Therapy (EFT), dyadic processes, and therapist development. Kristoffer has developed expertise in dyadic analysis, and mixed methods designs.

About the Project

This process–outcome study was conducted within a naturalistic setting at the Family Unit, Modum Bad, Norway. Over the project period (January 2018 to April 2021) a 155 individual constituting 73 couples were recruited. Of the resulting three peer-reviewed and papers two applied quantative methods while one applied merged methods. The project is described as following a sequential mixed methods design.


1) To evaluate the Family Unit’s treatment program by assessing the participants’ degree of mental and relational distress from intake to discharge and changes in distress taking place during treatment.

2) To investigate the predictive relationship of a) therapists’ assessments of patients’ histories of childhood trauma on patient-reported outcome and b) therapists’ assessments of childhood trauma and its association with patient-reported alliance and how it relates to outcome.

3) Apply dyadic analyses as a method of analyses to investigate actor–partner effects related to a) how the actor’s (i.e., the individual) alliance to the therapist predicts his or her relationship satisfaction, b) how the actor’s alliance to the therapist predicts his or her partner’s relationship satisfaction, c) how the actor’s relationship satisfaction predicts his or her alliance to the therapist, and d) how the actor’s relationship satisfaction predicts his or her partner’s alliance to the therapist.


  • In Paper 1, where we examined the predictive associations between childhood trauma and outcome, we found that having a history of childhood trauma predicted poorer relational outcomes compared with patients without such experiences. On assessements of individual symptoms of distress both does with and without histories of trauma improved.
  • Paper 2, aimed to further explore the findings of paper 1 using qualitative methods, and highlighted the relational difficulties that couples in therapy experienced. These difficulties were prominent both regarding the relationship between spouses and between the individual patient and the therapist.
  • Paper 3 which applied dyadic analysis, we further illuminated nuances of the interplay between alliances and relationship satisfaction: Male spouses’ alliance with the therapist is paramount for the female spouses’ perceived relationship satisfaction the following week.


The project is a doctoral research project that began in 2018. The project uses data from the Family Unit at Modum Bad. The unit offers intensive residential couple and family therapy targeting the adult family members relational distress and individual symptoms. The treatment lasts between 6 and 12 weeks dependent on children family members joining their parents during hospitalization or not (i.e., the stay is longer).

All the necessary has presently been included and analyzed for this study. All the findings have been published.


The project is internally funded by Modum Bad.


Bruce Wampold was invloved in the early planning of the study and co-authored the first paper.


The study uses data collected continuously throughout the treatment process at Modum Bad via the feedback instrument M-POQ (Modum Bad Process and Outcome Questionnaire).

Contact Information

Project Manager: Terje Tilden

Project Contact: Kristoffer J. Whittaker

You can also reach us through the Modum Bad telephone service: 32 74 97 00.

Project team at Modum Bad

Kristoffer J.  Whittaker, Ph.D.

Kristoffer J. Whittaker, Ph.D.

Clinical Psychologist

Terje Tilden, Ph.D.

Terje Tilden, Ph.D.

Senior Researcher

Clinical Social Worker, Family Therapist.

Joanna Rzadkowska

Joanna Rzadkowska

Clinical psychologist


Project participants

Kristoffer Whittaker, psykolog, PhD-stipendiat, Modum Bad

Terje Tilden, familieterapeut PhD, seniorforsker, Modum Bad

Sverre Urnes Johnson, psykologspesialist, PhD, Universitetet i Oslo

Ole Andre Solbakken, psykologspesialist, PhD, Universitetet i Oslo

Erik Stänicke, psykologspesialist, PhD, Universitetet i Oslo

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