This double foci is compatible with recent models of treatment which, unlike the previous focus on improving the relationship or family environment
exclusively, target simultaneously improvement in family functioning and individual symptoms (Monson, Fredman & Taft, 2011). Of special importance is helping non-direct victims of traumatic exposure, such as a spouse of an individual diagnosed with PTSD. Sometimes, to shield their loved ones, spouses try to protect them from unpleasant encounters and mitigate the pain involved in treatment. For example, a wife may encourage a husband who struggles with trauma-related problems not to think about the traumatic event and focus on pleasant memories, or she may suggest that the couple refrain from meeting people and going to places associated with the trauma. While well intentioned, such spousal reactions are not helpful because they deprive the partner of the opportunity to learn to cope with the difficulties and may in fact reinforce dysfunctional avoidance and undermine interventions built on exposure (described in Chapter 9 ). The focus of working with the couple in such situations is on discussing strategies for helping the traumatized partner accomplish the tasks required for the intervention rather than encouraging shying away from trauma-related issues. Thus, a wife may be asked to offer encouragement and support to a husband who is going through the pain of exposure rather than offering him a glass of wine or involving him in a discussion of unrelated topics.