1st Edition

Integrative Couple Therapy in Action A Practical Guide for Handling Common Relationship Problems and Crises

By Arthur C. Nielsen Copyright 2022
    300 Pages 2 B/W Illustrations
    by Routledge

    300 Pages 2 B/W Illustrations
    by Routledge

    Integrative Couple Therapy in Action offers a comprehensive, user-friendly guide to handling the most common problems and crisis situations seen by couple therapists.

    Drawing on the latest literature and the author’s experience of over 40 years, Nielsen investigates what makes certain issues, such as sex, or situations, such as extramarital affairs, so stressful for clients and challenging for therapists. Unlike most graduate programs and texts on couple therapy that focus on theory and technique, Integrated Couple Therapy in Action fills in the details. The chapters cover common presenting problems (sex, money, children, and the stresses of time, work, and simply living together) and then discuss catastrophic crisis situations (couples reeling from affairs, contemplating divorce, divorcing, or living in stepfamilies after divorcing).

    Integrative Couple Therapy in Action provides one-stop shopping for readers of all skill levels interested in understanding the subject matter that bedevils so many couples.


    Part I: Synopsis of Integrative Couple Therapy

    1.Couple Therapy 1.0

    2.The First Upgrade: Focus on the Interpersonal Process

    3.Psychodynamic Upgrades

    4.Behavioral/Psychoeducational Upgrades

    5.Sequencing Interventions

    6.The Intimidator and the Novelist: An Illustration of the Integrative Model

    Introduction to Parts II and III: Domain-Specific Knowledge

    Part II: Upgrades to Address Common Problems


    8.Children and Extended Family


    10.Domestic Problems and Division-of-Labor Disputes

    11.Job Stress, Cultural Pressures, and Limited Time

    Part III: Upgrades to Address Common Stressful Situations

    12.Extramarital Affairs

    13.Couples Contemplating Divorce

    14.Divorcing Couples

    15.Stepfamily Couples

    Concluding Remarks




    Arthur C. Nielsen, M.D. is Clinical Associate Professor of Psychiatry at Northwestern’s Feinberg School of Medicine, Associate Director of the Integrative Psychoanalytic Couple Therapy Program at the Chicago Psychoanalytic Institute, and the author of A Roadmap for Couple Therapy: Integrating Systemic, Psychodynamic, and Behavioral Approaches.

    "This is a wonderful book about couple therapy. Saturated with the wisdom of one of America’s most thoughtful and skillful couple therapists, Nielsen provides the sort of practical guide to practice for which couple therapists yearn. Building on a wide-ranging integrative framework, he helps couple therapists understand the intricacies involved in working with couples experiencing common problems and stressful situations such as issues with money, stepfamily issues, and sexuality. This book should be required reading for every graduate course in couple therapy and will be of great value to every couple therapist."

    Jay Lebow, PhD, Editor, Family Process; Professor, The Family Institute at Northwestern University.


    "Art Nielsen has written a tour de force, applying his comprehensive, flexible integrative approach to couple therapy to the common struggles couples present. Blending systemic, psychoeducational/behavioral, and psychodynamic theories and techniques in a systematic manner, Nielsen shows beginning and advanced clinicians how to bring these multiple perspectives to issues of money, issues of division of domestic labor, the balance between work and relationship time, affairs, couples on the brink of divorce or already engaged in that process, and stepfamilies. Based on science, therapeutic craft, and artistic use of metaphor, and with great attention to sustaining a working alliance, Nielsen provides a detailed roadmap for helping couples with these common challenges. This book is an essential text for couple therapists at any level of training and experience. Highly recommended, and highly engaging!"

    Peter Fraenkel, PhD, Associate Professor of Psychology, The City College of New York, former Vice President, American Family Therapy Academy, and author of Last Chance Couple Therapy: Bringing Relationships Back from the Brink.

    "In a comprehensive work that reflects a vast knowledge along with years of wisdom and experience as a couple therapist, Nielsen successfully integrates from across psychotherapy couple treatment models, drawing upon the most up-to-date research and scholarship, and offering all sorts of gems about how to conduct therapy along with helpful tools that will prove indispensable to your practice. Definitely a must have on your bookshelf!"

    Rhonda Goldman, PhD, Professor, The Chicago School of Professional Psychology, Author: Case Formulation in Emotion-Focused Therapy: Co-creating Clinical Maps for Change, and The Clinical Handbook of Emotion-focused Therapy.

    "Art Nielsen has done it again! Like his first book, this sequel is another clear, well-written, user-friendly guide that draws on the author's 40 years of clinical experience, seemingly encyclopedic knowledge of the couple therapy and related literature, and ability to translate complicated concepts into plain English. Both are books I wish I'd had when I saw my first couple, and yet I still learned from them over 30 years later."

    Carla Leone, PhD, Faculty Institute for Clinical Social Work (Chicago); Secretary, International Association of Psychoanalytic Self Psychology; author of numerous papers on the application of self psychology to the treatment of couples and families.

    "Couple therapy is a most difficult field. Art Nielsen’s Integrative Couple Therapy in Action is a master class in how to integrate diverse therapeutic approaches to treating couples. Drawing on decades of experience and from the depth of his thinking about couple therapy, Nielsen integrates lessons from systems, psychodynamic and behavior therapies to produce a guide that is at once practical and wise. The book offers support to therapists with a wide range of approaches and a deeper understanding of the shoals upon which couples frequently flounder. It is a book to keep at hand for moments when therapists need a guide for navigating their way through clinical problems."

    David E. Scharff, MD, Co-Founder and Former Director, International Psychotherapy Institute.Former Chair, International Psychoanalytic Association Committee on Couple and Family Psychoanalysis; co-author, Object Relations Couple Therapy, and co-editor, Psychoanalytic Couple Therapy.

    "Following on Art Nielsen’s landmark, Roadmap for Couple Therapy, which mapped the integrative territory of couple therapy, Nielsen’s new book focuses on the major intersections in that territory—sex, conflict, intimacy, money, etc. Not only does he focus on understanding those intersections, this book is full of his wisdom on how to successfully traverse them. Nielsen’s unique wisdom is his ability to seamlessly move back and forth from the depths of the psyche to the complexities of changing behavior in the here and now. Beginners can use this book to learn "how to" and old folks like me can use it sharpen and expand what we know. Another gift to the field and to the couples we treat."
    William Pinsof, PhD, LMFT, ABPP, Past President, The Family Institute at Northwestern University, Clinical Professor of Psychology Northwestern University, lead author, Integrative Systemic Therapy: Metaframeworks for Problem Solving with Individuals, Couples, and Families.

    "In this second comprehensive text, Art Nielsen again brings his brilliantly integrative mind to the task of teaching the science and art of couple therapy. Whether he is summarizing the major theories that have shaped the field, teaching essential clinical concepts and principles, or offering specific and helpful case illustrations, one senses Nielsen’s scholarly grasp, clinical wisdom, and basic humanity and empathy (including empathy for the reader) on every page. The result is a sophisticated primer that teaches therapists at all levels how to offer distressed couples the complex, often-multidimensional, therapeutic help they actually need."

    Steven Stern, PsyD, Author of Needed Relationships and Psychoanalytic Healing (2017) and Clinical Associate Professor, Department of Psychiatry, Tufts University School of Medicine

    and Maine Medical Center









    "In this generous book, Dr. Nielsen provides a far-ranging view of the most common topics that couples in therapy bring to their therapist—problems with money, job issues, children, sex, affairs and so on. He digs down in each of these broad topics, detailing all the different nuances, subtopics and hidden issues that can be involved as well as providing extensive research references, case vignettes and practical tips for both therapists and couples. For novice therapists, this book is a treasure trove of concentrated expertise and experience. For more experienced clinicians, it is a wonderful tool for refreshing, expanding, and focusing your thinking about the couples who come to you with their problems."

    Prudence Leib Gourguechon, MD, Past President of The American Psychoanalytic Association and Past Dean of The Chicago Psychoanalytic Institute.

    "At a time when our field is riven with narrow partisan advocacy, Art Nielsen has pursued a very different path, He draws from the best of each major line of thought and arrives at an approach marked by both depth and clinical wisdom. An invaluable guide to clinical work with couples."
    Paul L. Wachtel, PhD, Distinguished Professor, Doctoral Program in Clinical Psychology, City College of New York. Co-founder of The Society for the Exploration of Psychotherapy Integration (SEPI).

    "Art Nielsen provides a comprehensive guide to couple therapy, offering both the beginning and more advance clinician a wide array of helpful interventions with couples in distress. Using an integrative lens, and bringing the reader into the therapist's thought process, this book offers concrete suggestions for successfully working with a variety of common couple struggles." 

    Mona Fishbane, PhD, 2017 APA Family Psychologist of the Year (Division 43)
    Author of
    Loving with the Brain in Mind: Neurobiology & Couple Therapy