Most recent papers:

• How Routine Patient‐Centered Monitoring Relates to Therapeutic Gains in Family Therapy: A Single‐Case Study.
  Célia M. D. Sales, Sofia Ferreira, Paula Mena Matos.
  Journal of Marital and Family Therapy. October 16, 2018
  --- - |2 As routine outcome monitoring systems develop, questions emerge about how therapists incorporate feedback into their practice, and how this relates to therapeutic gains. A case of covert grief was monitored in each session with the Personal Questionnaire and the Helpful Aspects of Therapy instruments. At 4 months follow‐up, the Change Interview was administered. Individualized items facilitated access to the private views and needs of each member, which was useful for case formulation and ongoing personalization of the intervention. Qualitative feedback of treatment experiences helped therapists confirm the impacts of interventions, monitor therapeutic alliance, reformulate clinical hypothesis, and plan sessions. Therapists followed a critical triangulation process to decide the clinical meaning of feedback, according to his/her intervention model, expertise, and case‐specific context. - Journal of Marital and Family Therapy, EarlyView.
  

  October 16, 2018   doi: 10.1111/jmft.12359   open full text
• Black–White Marriages: The Moderating Role of Openness on Experience of Couple Discrimination and Marital Satisfaction.
  Joyce Baptist, Brianna Craig, Bornell Nicholson.
  Journal of Marital and Family Therapy. October 16, 2018
  --- - |2 This study examined how open communication between spouses may buffer against discrimination experienced by Black–White couples. Results from 178 couples analyzed using a combination of common‐fate and actor–partner interdependence models, indicated that for Black partners, marital satisfaction was not contingent on the level of openness when experiences of couple discrimination were low. When experiences of couple discrimination were high, levels of marital satisfaction were maintained among partners who reported high openness and reduced among partners who reported low openness. Moderation effects were not found for White partners. The results suggest that because Black partners are more aware of and sensitized to discrimination, White partners’ abilities to attune to their partners’ needs for support could help enhance their relationships. - Journal of Marital and Family Therapy, EarlyView.
  

  October 16, 2018   doi: 10.1111/jmft.12362   open full text
• Faust, J. (2017). Reunification family therapy: A treatment manual. Boston, MA: Hogrefe, 148 pp., $59.00.
  Ashley L. Landers.
  Journal of Marital and Family Therapy. October 05, 2018
  --- - - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 740-741, October 2018.
  

  October 05, 2018   doi: 10.1111/jmft.12335   open full text
• Johansson, T., & Andreasson, J. (2017). Fatherhood in transition: Masculinity, identity, and everyday life. London, UK: Palgrave Macmillan, 238 pp., $84.99.
  David H. Tefteller.
  Journal of Marital and Family Therapy. October 05, 2018
  --- - - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 741-742, October 2018.
  

  October 05, 2018   doi: 10.1111/jmft.12341   open full text
• Issue Information.
  
  Journal of Marital and Family Therapy. October 05, 2018
  --- - - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 559-560, October 2018.
  

  October 05, 2018   doi: 10.1111/jmft.12274   open full text
• JMFT Annual Report 2017.
  Steven M. Harris, Aimee K. Hubbard.
  Journal of Marital and Family Therapy. October 05, 2018
  --- - - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 730-739, October 2018.
  

  October 05, 2018   doi: 10.1111/jmft.12360   open full text
• Associations Between Romantic Relationship Factors and Body Mass Index Among Weight Loss Surgery Patients.
  Megan Ferriby, Keeley Pratt, Sabrena Noria, Bradley Needleman.
  Journal of Marital and Family Therapy. September 26, 2018
  --- - |2 The current study utilized a sample of 183 patients, in romantic relationships, who were either pre‐ or post‐weight loss surgery (WLS), to assess (a) associations between romantic relationship factors and pre‐ and post‐surgery body mass index (BMI), (b) the positive and negative influences of obesity in romantic relationships, and (c) the influence of romantic relationship factors on BMI and the reciprocal. Correlations, confirmatory factor analysis, and multiple linear regression were conducted. Patients endorsed greater negative influence of obesity in their romantic relationships compared to positive influences, and their romantic relationship quality was predicted by several variables, including BMI, in pre‐ and post‐surgery patient groups. - Journal of Marital and Family Therapy, EarlyView.
  

  September 26, 2018   doi: 10.1111/jmft.12357   open full text
• Conversations for Connection: An Outcome Assessment of the Hold‐Me‐Tight Relationship‐Education Program, and Recommendations for Improving Future Research Methodology in Relationship Education.
  Nikki Kennedy, Susan M. Johnson, Stephanie A. Wiebe, John B. Willett, Giorgio A. Tasca.
  Journal of Marital and Family Therapy. September 24, 2018
  --- - |2 The Hold Me Tight (HMT) program is a new approach to relationship education based on Emotionally‐Focused Therapy (Johnson, ), an evidence‐based approach to couple therapy. In this exploratory longitudinal research, we examined individual growth in relationship satisfaction and trust for partners in 95 couples in 16 HMT groups across four occasions of measurement: Baseline, Pre‐Program, Post‐Program and at either 3‐ or 6‐month Follow‐Up. We found that relationship satisfaction and trust increased during program participation, and declined during follow‐up. We believe our findings provide support for the short‐term effectiveness of the HMT program, and suggest a longer period of program delivery may result in improved retention of gains. Finally, we present recommendations for improving the design of future longitudinal research in relationship education. - Journal of Marital and Family Therapy, EarlyView.
  

  September 24, 2018   doi: 10.1111/jmft.12356   open full text
• Stressful Life Events and Physical and Psychological Health: Mediating Effects of Differentiation of Self in a Spanish Sample.
  Martiño Rodríguez‐González, Maria Schweer‐Collins, Elizabeth A. Skowron, Rafael Jódar, Virginia Cagigal, Sofia O. Major.
  Journal of Marital and Family Therapy. September 21, 2018
  --- - |2 The pathways between differentiation of self and health remain only partly elucidated. This cross‐cultural study sought to test Bowen's hypothesis about the associations between differentiation, stressful life events, and physical and psychological health, in a sample of 466 Spanish adults. Results show that people with higher levels of differentiation were less prone to physical ailments (e.g., heart disease, cancer, or blood disorders) and psychological symptoms (e.g., depression or anxiety). Further, differentiation mediated the association between stress (i.e., perceived negativity of stress in the past year and number of stressful events across the lifetime) and physical and psychological health. The current research provides cross‐cultural empirical evidence for the links between differentiation and mind and body health in a Mediterranean culture. - Journal of Marital and Family Therapy, EarlyView.
  

  September 21, 2018   doi: 10.1111/jmft.12358   open full text
• The Implementation of Functional Family Therapy (FFT) as an Intervention for Youth Probationers in Singapore.
  Daniel Z. Q. Gan, Yiwei Zhou, Eric Hoo, Dominic Chong, Chi Meng Chu.
  Journal of Marital and Family Therapy. September 07, 2018
  --- - |2 Family functioning is predictive of youth recidivism in Singapore. However, there is a lack of family based interventions for youth offenders on community probation. Evidence‐based family interventions developed in Western populations, such as Functional Family Therapy (FFT), have been found to be effective in mitigating subsequent youth criminal behavior. However, no study has examined whether such interventions can be implemented and adapted for use in Eastern cultures. Thus, this paper sought to detail the implementation of FFT in Singapore. Rationale for the adoption of FFT is discussed, and key activities undertaken during the first 18 months of implementation are described. Preliminary data suggest that initial implementation efforts were successful. Challenges encountered, and implications in relation to the broader literature are discussed. - Journal of Marital and Family Therapy, EarlyView.
  

  September 07, 2018   doi: 10.1111/jmft.12353   open full text
• Baby with the Bathwater? Examining the Relationship between Video Game Use and Relationship Outcomes and the Moderating Effects of Attachment Behaviors among Married Casual Gamers.
  Angela B. Bradford, Stella Dobry, Jonathan G. Sandberg, Sarah M. Coyne.
  Journal of Marital and Family Therapy. September 05, 2018
  --- - |2 We examined whether time together as a problem mediates the link between frequency of video game use and relational outcomes (relationship quality, relational aggression, physical aggression) among 431 married couples. We also examined the moderating effect of couple attachment behaviors on the association between time together as a problem and outcomes. There was no support for a direct or indirect relationship between gaming and outcomes; however, time together as a problem was consistently related to outcomes. Additionally, husband's and wife's attachment behaviors moderated the association between women's reports of time together as a problem and men's relational aggression. Clinical implications are discussed. - Journal of Marital and Family Therapy, EarlyView.
  

  September 05, 2018   doi: 10.1111/jmft.12355   open full text
• The Long Arm of Trauma During Childhood: Associations with Resources in Couple Relationships.
  Alyssa Banford Witting, Dean Busby.
  Journal of Marital and Family Therapy. August 31, 2018
  --- - |2 Traumatic experiences within and outside the family of origin in childhood may disrupt couple functioning later in life. Using a sample of 3,958 couples assessed through the Relationship Evaluation Questionnaire (RELATE), an actor–partner independence model was fit to test direct and indirect associations between negative impact from one's family of origin (accounting for physical violence and sexual abuse) and resources in couple relationships. Resources were defined using intervention principles derived from the Conservation of Resources (COR) theory. Actor and partner effects suggested negative family impact associates with relationship instability and is mediated through negative couple communication. Actor effects suggested negative family impact associates with less calmness in one's self and is also mediated through negative couple communication. - Journal of Marital and Family Therapy, EarlyView.
  

  August 31, 2018   doi: 10.1111/jmft.12354   open full text
• Adult Attachment Security and Different Types of Relational Violence Victimization Among College‐Age Couples.
  Gunnur Karakurt, Kathleen Whiting, Alyssa Banford Witting.
  Journal of Marital and Family Therapy. August 20, 2018
  --- - |2 This study aims to understand the associations between adult attachment security and different types of intimate partner violence victimization including that of emotional abuse, physical violence, and sexual coercion among heterosexual couples. Participants included 87 couples with the mean age 22.3 years. An actor–partner interdependence model was fit to the data. Findings indicated that adult attachment security accounted for 15% of the variance in the emotional abuse victimization of females, 9% of the variance in the sexual coercion victimization of females, and 7% of the variance in minor physical victimization of males. This may significantly impact risk factor assessment, and contribute to improved therapeutic intervention and increased understanding of the development and progression of relationship violence. - Journal of Marital and Family Therapy, EarlyView.
  

  August 20, 2018   doi: 10.1111/jmft.12352   open full text
• Randomized controlled trial of emotionally focused couple therapy compared to treatment as usual for depression: Outcomes and mechanisms of change.
  Andrea K. Wittenborn, Ting Liu, Ty A. Ridenour, E. Megan Lachmar, Erica A. Mitchell, Ryan B. Seedall.
  Journal of Marital and Family Therapy. August 14, 2018
  --- - |2 This randomized controlled trial examined the effectiveness of Emotionally Focused Therapy (EFT) for depression and relationship satisfaction versus usual care (i.e., couple therapy other than EFT), and explored mechanisms of change. Mixed model trajectory analyses of 16 couples indicated EFT was associated with greater improvement in relationship satisfaction among men and women. Men receiving EFT reported greater improvements in depressive symptoms compared to usual care. Unified structural equation modeling revealed changes in relationship satisfaction preceded changes in depressive symptoms in one cluster of partners, while changes in depression preceded changes in relationship satisfaction in a second cluster. Two other clusters reported simultaneous changes in satisfaction and depression. This study provides encouraging results on the effectiveness of EFT for depression, and insight into mechanisms of change. - Journal of Marital and Family Therapy, EarlyView.
  

  August 14, 2018   doi: 10.1111/jmft.12350   open full text
• A Tool for Connection: Using the Person‐of‐the‐Therapist Training (POTT) Model in Emotionally Focused Couple Therapy Supervision.
  Senem Zeytinoglu‐Saydam, Alba Niño.
  Journal of Marital and Family Therapy. August 14, 2018
  --- - |2 Emotionally Focused Couple Therapy (EFT) was developed based on the premise that couples get stuck in negative cycles fueled by their underlying primary emotions and unmet attachment needs (Johnson [2004], Creating connection: The practice of Emotionally Focused Couple Therapy). EFT therapists need to stay in touch with and regulate their own emotions when the tension rises in the sessions, while still staying open and vulnerable to their clients. Person‐of‐the‐Therapist Training model (Aponte & Kissil [2016], The person of the therapist training model: Mastering the use of self) aims to increase therapists' understanding, awareness, and acceptance of their own personal issues to create a more empathic connection with their clients. In this manuscript, the authors create a roadmap for EFT supervisors to use the POTT model in supervision as a tool to enhance their supervisees' connection to their clients and effectiveness of their interventions. - Journal of Marital and Family Therapy, EarlyView.
  

  August 14, 2018   doi: 10.1111/jmft.12349   open full text
• Brief Emotion Focused Family Therapy: An Intervention for Parents of Children and Adolescents with Mental Health Issues.
  Mirisse Foroughe, Amanda Stillar, Laura Goldstein, Joanne Dolhanty, Eric T. Goodcase, Adele Lafrance.
  Journal of Marital and Family Therapy. August 13, 2018
  --- - |2 This study evaluated the 2‐day intensive modality of Emotion Focused Family Therapy (EFFT). The intervention attempts to prepare parents to take a primary role in their child's recovery from a range of mental health issues. One hundred and twenty‐four parents completed the intervention and provided data a week prior to intervention, post‐intervention and at 4‐month follow‐up. Results include significantly reduced parent blocks and increased parental self‐efficacy in relation to involvement in their child's recovery, as well as significant improvement in child symptomatology. The findings confirm positive results from an earlier pilot study involving eating disorders and demonstrate the potential for EFFT as an intervention for a range of clinical problems in children and youth. - Journal of Marital and Family Therapy, EarlyView.
  

  August 13, 2018   doi: 10.1111/jmft.12351   open full text
• Relationship Help‐Seeking in a Danish Population Sample.
  Tea Trillingsgaard, Trine K. Sørensen, Hanne N. Fentz.
  Journal of Marital and Family Therapy. August 07, 2018
  --- - |2 Empirically supported couple interventions often transfer from the US to several other parts of the world yet we have little data on their final reach. This study investigated relationship help‐seeking in a random population sample of 1,371 individuals living with a partner in Denmark, a European high income – high divorce country. Only a small fraction of respondents had ever sought couple education (3%) or counseling/therapy (7%) with their partner. Among respondents experiencing a severe relationship crisis, individual types of help‐seeking were the most prevalent. Both women (38.9%) and men (27.8%) with a recent relationship crisis sought information online, and mostly women (19.4%) also sought individual therapy. Findings can inform strategies for increasing the reach of couples in new cultural contexts. - Journal of Marital and Family Therapy, EarlyView.
  

  August 07, 2018   doi: 10.1111/jmft.12347   open full text
• Traumatic Experiences in Childhood and Adult Substance Use in a Nonclinical Sample: The Mediating Role of Arousal/Reactivity.
  Heather A. Love, Chelsey N. Torgerson.
  Journal of Marital and Family Therapy. July 16, 2018
  --- - |2 The vast majority of adults in the United States experience at least one traumatic event during childhood. According to the self‐medication hypothesis of substance use disorders, adult survivors of childhood trauma may cope with trauma‐related symptoms via alcohol or drug use. The purpose of this study is to identify through which specific PTSD symptom clusters childhood trauma exposure are associated with adult substance use. Participants of this study (N = 627) were not recruited based on substance use or traumatic exposure. Results of this study demonstrate that arousal/reactivity partially mediates the association between childhood trauma and current substance use. Implications for treatment include recommendations for trauma‐informed approaches that aim to decrease arousal/reactivity and subsequently substance use. - Journal of Marital and Family Therapy, EarlyView.
  

  July 16, 2018   doi: 10.1111/jmft.12348   open full text
• The State of Sex Research in MFT and Family Studies Literature: A Seventeen‐Year Content Analysis.
  Adam C. Jones, Natalie C. Johnson, Sydney Wenglein, Sara T. Elshershaby.
  Journal of Marital and Family Therapy. July 15, 2018
  --- - |2 The ability to conceptualize and treat sexual problems has been widely accepted as a crucial skill to master the MFT training. However, clients’ sexual relationships are often ignored by clinicians because of a lack of experience or training, or personal discomfort. In this content analysis, we review sex and sex therapy research within MFT and family studies journals since the turn of the century. Of the 13,919 articles published within the 15 journals, 137 focused on sexuality or sex therapy. The articles were divided into five themes: sexual and relational health, sexual diversity, treatment and contributors of sexual dysfunction, sex therapy practices, and sexual education and development. Implications for clinical practices, sex therapy integration, and future research are discussed. - Journal of Marital and Family Therapy, EarlyView.
  

  July 15, 2018   doi: 10.1111/jmft.12344   open full text
• The risk of Telling: A Dyadic Perspective on Romantic Partners’ Responses to Child Sexual Abuse Disclosure and Their Associations with Sexual and Relationship Satisfaction.
  Laurence Montigny Gauthier, Marie‐Pier Vaillancourt‐Morel, Alessandra Rellini, Natacha Godbout, Véronique Charbonneau‐Lefebvre, Frédérique Desjardins, Sophie Bergeron.
  Journal of Marital and Family Therapy. July 14, 2018
  --- - |2 Among 70 community couples who reported childhood sexual abuse (CSA) and disclosure to their partner, this study examined associations between survivors’ perception of partner responses to their disclosure, and both partners’ sexual and relationship satisfaction. Participants completed self‐report questionnaires online. Results of path analyses within an actor–partner interdependence model indicated that survivors’ perceived partner responses of emotional support to disclosure were associated with their own and their partners’ higher sexual satisfaction. Survivors’ perceived responses of being stigmatized/treated differently by the partner were associated with their own and their partners’ poorer relationship satisfaction. Findings suggest that survivor‐perceived partner responses to the disclosure of CSA can have a positive and a negative impact on the sexual and relationship satisfaction of both partners. - Journal of Marital and Family Therapy, EarlyView.
  

  July 14, 2018   doi: 10.1111/jmft.12345   open full text
• A Circumplex Model of Couple Configurations in Relational Trauma Context: An Example of Practice‐Based Model Development.
  Mark H. Butler, Travis J. Spencer.
  Journal of Marital and Family Therapy. July 14, 2018
  --- - |2 We propose a circumplex model and typology of patterns of couple engagement to help therapists assess and shape positive couple engagement, prerequisite to successful resolution of relational trauma. View or value of self in relation to other (VSIRO) is conceived as a primary engine organizing couple relationships and patterns of engagement. VSIRO is conceptualized along a continuum anchored at opposite poles by inflated (self‐aggrandizing) versus collapsed (self‐negating) VSIRO, with a balanced (egalitarian) VSIRO as the target position, consisting of self and other mutuality, respect, and equality. Two axes (one for each partner) form the circumplex model of five couple configurations—four quadrants plus a balanced, mid‐axes region. Using couple configuration conceptualization to address patterns of engagement is an essential prerequisite to resolving couple relational trauma. - Journal of Marital and Family Therapy, EarlyView.
  

  July 14, 2018   doi: 10.1111/jmft.12346   open full text
• Josephs, L. (2017). The dynamics of infidelity: Applying relationship science to psychotherapy practice. Washington, DC: American Psychological Association, 384 pp., $47.88.
  Adam R. Fisher.
  Journal of Marital and Family Therapy. July 10, 2018
  --- - - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 557-558, July 2018.
  

  July 10, 2018   doi: 10.1111/jmft.12327   open full text
• Stephens‐Davidowitz, S. (2017). Everybody lies: Big data, new data, and what the Internet can tell us about who we really are. New York, NY: HarperCollins, 352 pp., $27.99.
  Eugene L. Hall.
  Journal of Marital and Family Therapy. July 10, 2018
  --- - - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 556-557, July 2018.
  

  July 10, 2018   doi: 10.1111/jmft.12325   open full text
• Issue Information.
  
  Journal of Marital and Family Therapy. July 10, 2018
  --- - - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 373-374, July 2018.
  

  July 10, 2018   doi: 10.1111/jmft.12272   open full text
• Perceived Marital Support and Incident Mental Illness: Evidence from the National Comorbidity Survey.
  Kenneth A. Feder, Laurie Heatherington, Ramin Mojtabai, William W. Eaton.
  Journal of Marital and Family Therapy. June 26, 2018
  --- - |2 Social support in marriage may be associated with reduced risk for mental illness. Past studies are limited by short follow up and a focus on depression. A two‐wave nationally representative survey in the United States (n = 2,503) is used to examine whether social support in marriage is associated with the onset of each of four clusters of disorders—internalizing, externalizing, phobic, and bipolar—10 years later. Results indicate that higher levels of perceived marital support were protective against internalizing, fear, and bipolar disorders, and against incident externalizing disorders for women. Protective effects of social support in marriage against mental illness are long‐lasting, and sometimes differ by gender. Findings suggest the importance of mental health assessment in clinical practice. - Journal of Marital and Family Therapy, EarlyView.
  

  June 26, 2018   doi: 10.1111/jmft.12343   open full text
• “I'm Still Fighting for the Two of Us”: How Partners of UK Veterans Construct Their Experience of Living with Combat‐Related Trauma.
  Emily Doncaster, Syd Hiskey, Susan McPherson, Leanne Andrews.
  Journal of Marital and Family Therapy. June 07, 2018
  --- - |2 There has been little qualitative research into the experiences of UK partners of veterans with PTSD. This study therefore aimed to explore how partners constructed their experiences of living with the condition. Fifteen female partners of male UK veterans were recruited and interviewed. Using a social constructionist thematic analysis, five themes were constructed: the women's need to subdue own emotional and behavioral responses; dilemmas about whether the veteran was unwell or ‘bad’; attempts at negotiating multiple roles; challenging the narrative of veterans as heroes; and the relational struggle with the transition to nonmilitary life. This study highlighted the importance of considering the veteran as existing within a relational and cultural context, and the need to include partners in therapeutic interventions. - Journal of Marital and Family Therapy, EarlyView.
  

  June 07, 2018   doi: 10.1111/jmft.12340   open full text
• Strengthening Clinical Research in Marriage and Family Therapy: Challenges and Multilevel Solutions.
  Andrea K. Wittenborn, Adrian J. Blow, Kendal Holtrop, José R. Parra‐Cardona.
  Journal of Marital and Family Therapy. June 04, 2018
  --- - |2 There is a critical need for high‐quality and accessible treatments to improve mental health. Yet, there are indications that the research being conducted by contemporary marriage and family therapy (MFT) scholars focuses less on advancing and disseminating clinical interventions than in previous decades. In this article, we describe challenges to increasing rigorous clinical research in MFT. We use systems mapping and the intervention‐level framework to identify strategic goals designed to drive innovation in clinical research in the field. It is our hope this article encourages dialog and action among MFT stakeholder groups to support clinical science that will improve the health and functioning of families. - Journal of Marital and Family Therapy, EarlyView.
  

  June 04, 2018   doi: 10.1111/jmft.12338   open full text
• Microaggressions and Islamophobia: Experiences of Muslims Across the United States and Clinical Implications.
  Afshana Haque, Carolyn Y. Tubbs, Emily P. Kahumoku‐Fessler, Matthew D. Brown.
  Journal of Marital and Family Therapy. June 01, 2018
  --- - |2 This mixed methods exploratory study illustrates the influence of pervasive misconceptions about Islam on the experiences of 314 adult Muslims across the United States. Quantitative results suggest that Muslim stress levels are comparable to the stress levels of other marginalized groups in the United States. Qualitative analysis revealed four themes that highlight the challenges faced by Muslims as well as their resiliency in the face of microaggressions and marginalization. Family therapists may utilize these personal accounts to expand their understanding of Muslim experiences, and to reflect on their own implicit biases toward Muslims in order to reduce chances of premature termination. Clinical implications include using resiliency‐based models and creating collaborative partnerships with community leaders when working with this religious minority group. - Journal of Marital and Family Therapy, EarlyView.
  

  June 01, 2018   doi: 10.1111/jmft.12339   open full text
• Expanding Systems Thinking: Incorporating Tools from Medical Sociology into MFT Education and Research.
  Joy Heafner, Laura Mauldin.
  Journal of Marital and Family Therapy. May 22, 2018
  --- - |2 The field of marriage and family therapy has historically focused on dynamics within family systems, and at times the role of social and cultural factors external to the family. To date, however, little scholarship has examined how therapists themselves are embedded within a mental healthcare system. The purpose of this article is to demonstrate how structural components of the mental healthcare system shape the practice of therapy. We draw from the field of medical sociology to illustrate how three dominant structures—managed care, diagnosis, and evidence‐based models—are intertwining and mutually reinforcing systems that have significant and long‐term implications for systemic therapists and researchers. We recommend incorporating a sociological understanding of such structures into MFT education and research. - Journal of Marital and Family Therapy, EarlyView.
  

  May 22, 2018   doi: 10.1111/jmft.12337   open full text
• The Efficacy of Emotionally Focused Couples Therapy and Behavioral Couples Therapy: A Meta‐Analysis.
  Maren Rathgeber, Paul‐Christian Bürkner, Eva‐Maria Schiller, Heinz Holling.
  Journal of Marital and Family Therapy. May 21, 2018
  --- - |2 Behavioral couple therapy (BCT) and emotionally focused couples therapy (EFCT) are well‐established treatments to reduce couple distress. This meta‐analysis summarizes the current state of knowledge on the efficacy of these two therapy methods by focusing on randomized controlled trials only. A literature search revealed 33 suitable primary studies (2,730 participants in total), all of them measuring relationship satisfaction. Robust‐variance random‐effects meta‐analysis revealed medium effect sizes at post‐test (overall: g = 0.60; BCT: g = 0.53; EFCT: g = 0.73) and small effect sizes of 6 months after treatment (overall: g = 0.44; BCT: g = 0.35; EFCT: g = 0.66), but these gains were not maintained after 12 months (BCT only: g = 0.06). Between the two therapy methods, no significant effect size differences could be found. Results have to be interpreted with caution due to potential publication bias. - Journal of Marital and Family Therapy, EarlyView.
  

  May 21, 2018   doi: 10.1111/jmft.12336   open full text
• Reflecting on the Past: A Content Analysis of Family Therapy Research from 2000‐2015.
  Jennifer J. Lambert‐Shute, Hoa N. Nguyen, Paul W. Peterson, Annisa B. Pirasteh.
  Journal of Marital and Family Therapy. May 16, 2018
  --- - |2 In this content analysis, researchers examine articles published from 2000 to 2015 in three family therapy journals, yielding a total of 948 empirical articles. The purpose is to provide an overview of the research being published, assess who is publishing, and investigate the current state of clinical effectiveness research in marriage and family therapy (MFT). Most first authors were affiliated with MFT programs and primarily included diversity and couples in their research. There was a significant increase of research on clinical process—though the number of clinical outcome studies held steady. There were no significant changes with regard to research funding. Implications support the use of innovative research methods to provide evidence of clinical effectiveness. - Journal of Marital and Family Therapy, EarlyView.
  

  May 16, 2018   doi: 10.1111/jmft.12334   open full text
• Marriage and Family Therapy Students’ Experience with Common Factors Training.
  Stephen T. Fife, Carissa D'Aniello, Sarah Scott, Erin Sullivan.
  Journal of Marital and Family Therapy. April 27, 2018
  --- - |2 With the increased empirical and theoretical support for common factors in the psychotherapy literature, marriage and family therapy (MFT) scholars have begun discussing the inclusion of common factors in MFT training. However, there is very little empirical research on common factors training or how to include common factors in MFT curricula. The purpose of this phenomenological study was to investigate MFT students’ experience with common factors training. Seventeen master's degree students who received training in common factors participated in the study. Data was comprised of participants’ journal reflections and focus group interviews on their experience learning about common factors and how this influenced their work with clients. Participants’ responses to the training were overwhelmingly positive and highlighted the ways in which studying common factors enhanced their confidence, understanding of MFT models, conceptual abilities, and clinical practice. Additional results and discussion about incorporating common factors in MFT training are presented - Journal of Marital and Family Therapy, EarlyView.
  

  April 27, 2018   doi: 10.1111/jmft.12333   open full text
• Integrative Systemic Therapy: Lessons on Collaboration and Training for the 21st Century.
  Nathan R. Hardy, Matthew W. Brosi, Kami L. Gallus.
  Journal of Marital and Family Therapy. April 23, 2018
  --- - |2 The field of couple, marital, and family therapy (CMFT) is at an important juncture of identity development and synthesis. Integrative Systemic Therapy (IST) is a problem‐centered metaframeworks approach that meets the growing needs of family therapists working with diverse and complex family systems and restores the field to its original focus on collaboration. This paper describes the process by which IST developed featuring anecdotes from live interviews with the founders. We briefly outline IST's theoretical pillars and the essential way IST practitioners deliver treatment including a blueprint for therapy. Finally, we propose that IST is a comprehensive, systemic guide uniquely beneficial to CMFT training and discuss our approach to integrating IST into our training of students in a COAMFTE accredited program. - Journal of Marital and Family Therapy, EarlyView.
  

  April 23, 2018   doi: 10.1111/jmft.12332   open full text
• WHITE PRIVILEGE: What's a Family Therapist To Do?
  Gene Combs.
  Journal of Marital and Family Therapy. April 23, 2018
  --- - |2 Privilege is the freedom to ignore things that other people are forced to confront; dramatic things like being gunned down by a vigilante on the way home from a convenience store or less urban and visible things like having to live on secluded parcels of land that no one else wants. Most family therapists enjoy the freedom not to experience such events. Many of the people who come to us for help don't have that freedom. My intent here is to increase felt awareness of the injustice of institutional racism and to suggest some actions that White family therapists can take to bring forth a more just society in terms of education, housing, access to wealth, and basic safety. - Journal of Marital and Family Therapy, EarlyView.
  

  April 23, 2018   doi: 10.1111/jmft.12330   open full text
• A contextual perspective on associations between reported parental infidelity and relational ethics of the adult children.
  Codina Kawar, Jennifer Coppola, Rashmi Gangamma.
  Journal of Marital and Family Therapy. April 17, 2018
  --- - |2 This study's aim was to apply a Contextual theory lens on exploring whether knowledge of parental infidelity affects the Relational Ethics (RE) of adult children. The Relational Ethics Scale (RES) was used to capture horizontal (partner) and vertical (family of origin) relational ethics in a clinical sample of 195 participants. A repeated measures ANOVA tested the differences in RES scores among the participants who reported knowledge of parental infidelity and the participants who did not. Results showed that knowledge of parental infidelity is significantly associated with lower scores on the RES, which indicates problematic relationships, both in partners and with family of origin. Clinical implications on how parental infidelity can affect relational ethics are discussed. - Journal of Marital and Family Therapy, EarlyView.
  

  April 17, 2018   doi: 10.1111/jmft.12331   open full text
• Why do couples seek relationship help online? Description and comparison to in‐person interventions.
  McKenzie K. Roddy, Karen Rothman, Larisa N. Cicila, Brian D. Doss.
  Journal of Marital and Family Therapy. April 02, 2018
  --- - |2 Couples are increasingly utilizing newly developed online adaptations of couple therapy; however, different presenting problems could drive couples to seek either online or in‐person services. This study compared the presenting problems of 151 couples seeking an online couple intervention for relationship distress (OurRelationship) with responses from 147 couples seeking in‐person couple therapy. Presenting problems were generally consistent across gender and whether or not the respondent was the initial help‐seeker. Online and in‐person samples frequently endorsed difficulties with communication and emotional intimacy; however, they differentially endorsed trust, time together, and child/parenting difficulties. Therefore, while basing online interventions on existing couple therapies is generally supported, efforts should be made to tailor online services to meet the unique needs of this population. - Journal of Marital and Family Therapy, EarlyView.
  

  April 02, 2018   doi: 10.1111/jmft.12329   open full text
• Sexual Portrait of Couples Seeking Relationship Therapy.
  Katherine Péloquin, E. Sandra Byers, Melissa Callaci, Nadine Tremblay.
  Journal of Marital and Family Therapy. March 26, 2018
  --- - |2 This study sought to provide information about the sexual well‐being of 298 mixed‐sex couples seeking relationship therapy and determined the extent to which problems with sexual functioning and dyadic adjustment of both partners are associated with sexual satisfaction. Partners completed measures of dyadic adjustment, sexual satisfaction, and sexual functioning. Thirty percent of couples reported a clinically significant sexual problem. Compared to their male partners, the women were more likely to report a sexual problem as well as lower dyadic adjustment, sexual satisfaction, and overall sexual functioning. Path analysis indicated that relationship adjustment uniquely predicted individuals' own sexual satisfaction; problems in sexual functioning uniquely predicted own and partner sexual satisfaction. Findings underscore the need to address sexual problems in relationship therapy. - Journal of Marital and Family Therapy, EarlyView.
  

  March 26, 2018   doi: 10.1111/jmft.12328   open full text
• Couple Differentiation: Mediator or Moderator of Depressive Symptoms and Relationship Satisfaction?
  Suzanne Bartle‐Haring, Megan Ferriby, Randal Day.
  Journal of Marital and Family Therapy. March 09, 2018
  --- - |2 The purpose of this investigation was to determine whether differentiation at the couple level would act as a moderator or a mediator in the association between marital satisfaction and depressive symptoms over time. In a sample of 412 couples, a latent profile analysis was performed to determine how couple differentiation scores were clustered. An Actor/Partner Interdependence Model was then estimated via a group comparison procedure in structural equation modeling. There was no evidence of a moderating effect of differentiation. A mediating model was then estimated and there was evidence that differentiation mediated the association between depressive symptoms and relationship satisfaction via actor and partner effects. - Journal of Marital and Family Therapy, EarlyView.
  

  March 09, 2018   doi: 10.1111/jmft.12326   open full text
• Discursive Methodologies for Couple and Family Therapy Research: Editorial to Special Section.
  Eleftheria Tseliou, Maria Borcsa.
  Journal of Marital and Family Therapy. March 08, 2018
  --- - |2 In this article, we aim to introduce the special JMFT section on discursive research methodologies for couple and family therapy research. These are qualitative research methodologies which resonate with the systemic emphasis on the semantics and the pragmatics of therapy discourse. First, we provide a brief overview of such methodologies and their use in the family therapy field. We then introduce the context and the content of the special section, where four approaches, including conversation analysis, discursive psychology type of discourse analysis, poststructurally informed discourse analysis (subject positioning analysis), and semantic analysis, are introduced by means of analyzed extracts from a Tom Andersen consultation session with a couple in distress and their therapist. We conclude with implications for the field. For Tom and Michael - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 375-385, July 2018.
  

  March 08, 2018   doi: 10.1111/jmft.12308   open full text
• Issuing and Responding to Unusual Questions: A Conversation Analytic Account of Tom Andersen's Therapeutic Practice.
  Olga Smoliak, Amanda Le Couteur, Christopher Quinn‐Nilas.
  Journal of Marital and Family Therapy. March 08, 2018
  --- - |2 Tom Andersen is considered one of the key contributors to the development of postmodern practice. Little is known, however, about the ways in which his ideas and practices are routinely carried out in situ. We used Conversation Analysis (CA) to investigate a session of couple therapy facilitated by Andersen. We show how Andersen and client participants oriented to and addressed problems of understanding that occurred between them. The source of this trouble was Andersen's use of unusual question formulations. We offer preliminary evidence that such unusual formulations served particular interactional and institutional (i.e., therapeutic) functions in their local contexts of use. We conclude by considering some implications of this analysis—and of conversation analytic inquiry more generally—for the practice of family therapy. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 393-408, July 2018.
  

  March 08, 2018   doi: 10.1111/jmft.12306   open full text
• Constructing Unfinalizability: A Subject Positioning Analysis of a Couple's Therapy Session Hosted by Tom Andersen.
  Michael Guilfoyle.
  Journal of Marital and Family Therapy. March 08, 2018
  --- - |2 The notion of subject positions is a useful tool in thinking through therapeutic interactions. In this article, I discuss positioning as an everyday phenomenon, and highlight the relational and social power dynamics that shape the subject positions persons may inhabit. Analysis is presented of the positional dynamics that play out in the couple's therapy session facilitated by Tom Andersen. Analysis suggests that Andersen adopts a not‐knowing, uncertain, and curious position, while constructing the couple as competent, unfinalizable persons able to negotiate the choice‐points that arise in front of them. However, if subject positions are grounded in social power dynamics, the session leaves a particular question unanswered: How will these emergent positions take hold outside of the consulting room? - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 426-437, July 2018.
  

  March 08, 2018   doi: 10.1111/jmft.12305   open full text
• The legacy of Tom Andersen: The ethics of reflecting processes.
  Diane R. Gehart.
  Journal of Marital and Family Therapy. March 08, 2018
  --- - |2 Tom Andersen and his pioneering work with reflecting conservations has had a lasting influence on the field of family therapy and mental health more broadly. Most family therapists are familiar with his contributions related to reflecting teams; however, fewer are familiar with his conceptualization of reflecting processes, which offer practical ways to approach therapeutic conversations to address challenging problems. This article provides a brief history of Andersen's career and reviews four key elements of his approach, including: (a) his way of being in relationship, (b) appropriately unusual comments, (c) inner and outer dialogs, and (d) ethics of dialogical relating. Finally, this article introduces readers to the context of the video that will be analyzed in the articles that follow in this special section. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 386-392, July 2018.
  

  March 08, 2018   doi: 10.1111/jmft.12289   open full text
• Discursive psychology as a method of analysis for the study of couple and family therapy.
  Michelle O'Reilly, Nikki Kiyimba, Jessica N. Lester.
  Journal of Marital and Family Therapy. March 08, 2018
  --- - |2 The field of couple and family therapy has benefitted from evidence generated from qualitative approaches. Evidence developed from approaches relying on language and social interaction using naturally occurring recordings of real‐world practice has the benefit of facilitating practice‐based recommendations and informing practice. The aim of this article is to provide an overview of one approach to discourse analysis, Discursive Psychology (DP), demonstrating how a social constructionist framework and focus on discourse can provide an important contribution to the field of therapy. To illustrate the methodological decision‐making process for researchers and/or practitioners who utilize DP, we draw upon a video‐recorded therapeutic session involving Tom Andersen. To conclude, we make recommendations for practitioners using DP to explore and examine therapeutic practice. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 409-425, July 2018.
  

  March 08, 2018   doi: 10.1111/jmft.12288   open full text
• Discursive Research and Clinical Realities, or the Eye of the Beholder.
  Paolo Bertrando.
  Journal of Marital and Family Therapy. March 07, 2018
  --- - |2 The comparison of four discursive and conversational analysis studies performed on the same couple consultation session, held by Tom Andersen, show a diversity of results. It can be argued the results are so varied that they constitute different realities, often incompatible with each other. This, far from being a shortcoming of these studies, can be seen as the true richness they can offer to the practicing therapist, who can use research to investigate the different perspectives we can adopt in viewing our clinical activity. The comparison of the four studies raises questions about the role of the therapist in such process. Clinical implications of this are also discussed. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 461-466, July 2018.
  

  March 07, 2018   doi: 10.1111/jmft.12307   open full text
• Toward Valuing Research: Reflections Inspired by Special Section Contributors.
  Harlene Anderson.
  Journal of Marital and Family Therapy. March 07, 2018
  --- - - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 467-469, July 2018.
  

  March 07, 2018   doi: 10.1111/jmft.12309   open full text
• Discursive Research Methodologies and Couple and Family Therapy Research: Reflections.
  Jay L. Lebow.
  Journal of Marital and Family Therapy. March 07, 2018
  --- - - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 458-460, July 2018.
  

  March 07, 2018   doi: 10.1111/jmft.12290   open full text
• A Couple in Love Entangled in Enigmatic Episodes: A Semantic Analysis.
  Valeria Ugazio, Stella Guarnieri.
  Journal of Marital and Family Therapy. March 07, 2018
  --- - |2 The article presents a semantic analysis inspired by the theory of family semantic polarities developed by Ugazio (, ) applying two versions of a coding system, the Family Semantic Grid (FSG), to a couple session with Tom Andersen as a consultant. One version (FSG II) detects the narrated semantic polarities (NSPs) emerging during the session from the transcript, whereas the other (FSG III) identifies the interactive semantic polarities (ISPs) from the video recording. Both the NSPs and the ISPs are classified according to four sets of meaning called the semantic of freedom, goodness, power, and belonging. The analysis puts forward some hypothesis about the pattern that entangles the couple and highlights Andersen's contributions to overcome the problem troubling the couple. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 438-457, July 2018.
  

  March 07, 2018   doi: 10.1111/jmft.12321   open full text
• “How, of All The Millions of People…”: Re‐Examination of a Question From an Early MRI Research Project.
  Carlos E. Sluzki.
  Journal of Marital and Family Therapy. February 22, 2018
  --- - |2 “How, of all the millions of people in the world, did the two of you get together?”, a question to be addressed conjointly to a couple, part of a Structure Family Interview developed during the early heydays of the Mental Research Institute at Palo Alto, California, is analyzed in terms of structure, process and outcome of responses to it, and discussed as a powerful research and clinical tool with current potentials, as it provides in a succinct fashion remarkable insights into a narrative that is constitutive of the couple and, by omission or commission, revealing in terms of the couple's evolution. - Journal of Marital and Family Therapy, EarlyView.
  

  February 22, 2018   doi: 10.1111/jmft.12320   open full text
• Using Attachment to Better Understand the Therapy Alliance: The Attachment Based Alliance Questionnaire.
  Lee N. Johnson, Scott A. Ketring, Jennifer Espino.
  Journal of Marital and Family Therapy. February 21, 2018
  --- - |2 Questionnaires on the therapeutic alliance are available, but most show inflated scores, limited variability, and few significant findings on the bonds domain. Results of a study of 251 clinical couples, on the development of an Attachment Based Alliance Questionnaire (ABAQ), are presented. Factor analysis (EFA and CFA), show that a one‐factor or two‐factor structure fit the data, with more support for a one‐factor model. Both models map closely with attachment constructs. Results also show that the ABAQ is predictive of changes couples make early in therapy and demonstrated adequate reliability and validity. The ABAQ provides a tool for clinicians as they learn how to attune to relationships in couple therapy and is helpful to researchers in understanding the alliance. - Journal of Marital and Family Therapy, EarlyView.
  

  February 21, 2018   doi: 10.1111/jmft.12324   open full text
• Sexual Minority Adults: A National Survey on Depression, Religious Fundamentalism, Parent Relationship Quality & Acceptance.
  Katie Heiden‐Rootes, Ashley Wiegand, Danielle Bono.
  Journal of Marital and Family Therapy. February 15, 2018
  --- - |2 Sexual minority persons from religious families may experience low acceptance by parents, however, little is known about the relationship of religiosity and parent relationships on mental health into adulthood. This study sought to test a moderated mediation model predicting depression based on religious fundamentalism, parent acceptance, and parent‐child relationship quality. Sexual minority adult participants (n = 384) from across the U.S. completed a web‐based, anonymous survey. Results found a conditional indirect effect of religious fundamentalism on depression through parent acceptance with the parent‐child relationship quality moderating the relationship between parent acceptance and depression. This was significant up to age 52. Clinical implications and future research with sexual minority adults and their families are explored. - Journal of Marital and Family Therapy, EarlyView.
  

  February 15, 2018   doi: 10.1111/jmft.12323   open full text
• Remembering the Good Times: The Influence of Relationship Nostalgia on Relationship Satisfaction Across Time.
  Allen B. Mallory, Chelsea M. Spencer, Jonathan G. Kimmes, Amanda M. Pollitt.
  Journal of Marital and Family Therapy. February 11, 2018
  --- - |2 We conducted two studies to understand if reminiscing about early parts of a romantic relationship can increase positive affect and relationship satisfaction. In Study 1, we examined the psychometrics of an adapted relationship nostalgia measure, if relationship nostalgia changes positive affect, and if relationship nostalgia and relationship satisfaction are associated. In Study 2, we tested the longitudinal link between relationship nostalgia and relationship satisfaction. Rather than increasing positive affect, relationship nostalgia is associated with a movement toward emotional homeostasis. Additionally, relationship nostalgia is positively associated with relationship satisfaction at the same time point but in the short term, the association is negative—long term, this association disappears. Implications for using a relationship history in therapy are discussed. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 561-574, October 2018.
  

  February 11, 2018   doi: 10.1111/jmft.12311   open full text
• Do Parent Preferences for Child Conduct Problem Interventions Impact Parenting Outcomes? A Pilot Study in Community Children's Mental Health Settings.
  Yaliu He, Abigail H. Gewirtz, Susanne Lee, Gerald August.
  Journal of Marital and Family Therapy. February 09, 2018
  --- - |2 A pilot, doubly randomized preference trial was conducted to investigate the impact of providing parents preferences on parenting outcomes. Families with children having conduct problems were randomly assigned to a choice group in which they received their preferred treatment among the four intervention options or a no‐choice group in which they were randomized assigned to one of the four options. Results of mixed‐effects models showed that parents in the choice group who selected Parent Management Training‐Oregon Model (PMTO) had better parenting outcomes over time compared to parents in the choice group who selected child therapy. It highlights the importance of incorporating parent preferences in the delivery of evidence‐based treatments. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 716-729, October 2018.
  

  February 09, 2018   doi: 10.1111/jmft.12310   open full text
• Nurturing Nature: Exploring Ecological Self‐of‐the‐Therapist Issues.
  Tracey A. Laszloffy, Sean D. Davis.
  Journal of Marital and Family Therapy. February 08, 2018
  --- - |2 Much has been written about the systemic effects of families and culture on individual well‐being. Seldom discussed, however, are the systemic effects of our relationship with the larger ecological system in which all families and cultures are embedded. A case is made for the importance of nature in family therapy. Furthermore, before therapists can effectively address ecological issues in therapy, they need to address various ecological self‐of‐the‐therapist issues that will influence their clinical practice. A series of questions are asked to help guide therapists in this exploration, and practical suggestions for incorporating nature into MFT clinical practice, training, and research are made. - Journal of Marital and Family Therapy, EarlyView.
  

  February 08, 2018   doi: 10.1111/jmft.12312   open full text
• Evaluating Scholarship Productivity in COAMFTE‐Accredited Doctoral Programs: An Update.
  W. Jared DuPree, Roy A. Bean.
  Journal of Marital and Family Therapy. February 06, 2018
  --- - |2 Scholarly productivity continues to be used as a significant factor when universities make decisions about granting tenure to faculty, allocating resources, and supporting program goals. In 2009, DuPree, White, Meredith, Ruddick, and Anderson reviewed research productivity in faculty from COAMFTE‐accredited PhD programs. As an update, the purpose of this article is to re‐examine scholarly productivity trends among COAMFTE‐accredited doctoral programs through the use of several evaluation methods. Specifically, productivity was examined in the following areas: (a) family therapy journal publications; (b) publications in any type of peer‐reviewed journal; (c) h‐factor index scores; and (d) historic and recent journal publication trends. - Journal of Marital and Family Therapy, EarlyView.
  

  February 06, 2018   doi: 10.1111/jmft.12318   open full text
• Integrating Spirituality into MFT Training: A Reflexive Curriculum and Qualitative Evaluation.
  Jacqueline M. Williams‐Reade, Elsie Lobo, Gabriela Gutierrez.
  Journal of Marital and Family Therapy. January 25, 2018
  --- - |2 When clients enter the therapy room they bring unique spiritual beliefs and values in with them; however, marital and family therapists (MFTs) often lack training to assist in this important area of diversity. Current training recommendations encourage therapists to explore their own spirituality to identify personal limitations that may occlude positive client outcomes; however very little information exists on the implementation and usefulness of this type of training. This article will describe a curriculum and report results from a qualitative study of students who participated in a reflexive spirituality practicum course offered in a COAMFTE accredited doctoral program at a private, religious institution. Through this, we hope to provide a training model to further spiritual integration activities in MFT. - Journal of Marital and Family Therapy, EarlyView.
  

  January 25, 2018   doi: 10.1111/jmft.12314   open full text
• Clinical and Ethical Considerations for Delivering Couple and Family Therapy via Telehealth.
  Elizabeth R. Wrape, Meghan M. McGinn.
  Journal of Marital and Family Therapy. January 23, 2018
  --- - |2 Studies have generally supported telehealth as a feasible, effective, and safe alternative to in‐office visits. Telehealth may also be of particular benefit to couples/families interested in relational treatments, as it addresses some of the barriers that may be more prominent for families, such as childcare and scheduling difficulties. Therapists interested in expanding their practice to include telehealth should understand ethical and practical considerations of this modality. This article discusses areas unique to the delivery of telehealth to couples and families. Each broad domain is then elaborated upon with case examples from actual clinical practice and specific recommendations for addressing potential difficulties. Authors recommend further empirical research examining differences in modality outcome, as well as feasibility of the suggestions proposed here. - Journal of Marital and Family Therapy, EarlyView.
  

  January 23, 2018   doi: 10.1111/jmft.12319   open full text
• “Thank You for Including Us!” – Introducing a Community‐Based Collaborative Approach to Translating Clinic Materials.
  J. Maria Bermúdez, Bertranna Muruthi, Lisa M. Zak‐Hunter, Morgan A. Stinson, Desiree M. Seponski, Joshua L. Boe, Narumi Taniguchi.
  Journal of Marital and Family Therapy. January 23, 2018
  --- - |2 When working with clients in another language, having culturally relevant and properly translated clinic materials is vital to effective clinical practice. Not having them presents a barrier for bilingual therapists and their clients. This paper reviews common translation methods and introduces a multi‐level, community‐based approach for translating clinic materials for non‐English speaking clients. Informed by decolonizing practices, this five‐tier method includes members from the target community as cultural brokers to verify the accuracy and nuances of language for their cultural group, as well as a constant comparative method to ensure methodological rigor in the process of inclusion. We present community member's feedback and recommendations, as well as discuss advantages and challenges of using this collaborative culturally responsive translation method. - Journal of Marital and Family Therapy, EarlyView.
  

  January 23, 2018   doi: 10.1111/jmft.12317   open full text
• Using Difference Scores to Inform Therapy Practice: Differences in Perceptions of Attachment Behaviors between Partners in a Clinical Sample.
  Joshua R. Novak, Jonathan G. Sandberg, Dean M. Busby.
  Journal of Marital and Family Therapy. January 16, 2018
  --- - |2 Using clinically relevant research methodology, this study focuses on differences (cross‐partner difference scores) in perceptions of attachment behaviors (emotional accessibility, responsiveness, and engagement) between partners in couples therapy. In general, findings suggest that higher levels of self‐enhancement attachment behaviors (participant perceives self as demonstrating more attachment behaviors than the partner's ratings of the participant) are associated with lower relationship satisfaction and greater relationship instability. The association between attachment behavior difference scores and measures of relationship health is mediated through partner perceived positive communication. These results suggest that differences in perceptions between partners’ level of attachment behaviors are an important clinical construct for therapy. As such, clinical recommendations for addressing self‐enhancing attachment behaviors, and the mediating role of positive communication, are discussed with recommendations for researchers. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 624-639, October 2018.
  

  January 16, 2018   doi: 10.1111/jmft.12303   open full text
• Sexual and Relationship Satisfaction associated with Shifts in Dyadic Trajectories of Depressive Symptoms in German Couples across Four Years.
  Preston C. Morgan, Jared A. Durtschi, Jonathan G. Kimmes.
  Journal of Marital and Family Therapy. December 21, 2017
  --- - |2 Depression is a pervasive mental health concern; thus, it is important to identify modifiable factors associated with reducing depressive symptoms across time. Using 1,876 heterosexual couples assessed annually across 4 years from the Panel Analysis of Intimate Relationships and Family Dynamics (Pairfam) study, time‐varying covariate growth models tested if sexual and relationship satisfaction were linked with shifts in trajectories of depressive symptoms across time. For both men and women, higher sexual and relationship satisfaction scores were significantly associated with decreasing their own depressive symptom trajectories, but only relationship satisfaction was linked with their partners’ depressive symptom trajectories. Potential clinical implications include the treatment of depressive symptoms by making changes across time in their own relationship satisfaction and sexual satisfaction. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 655-670, October 2018.
  

  December 21, 2017   doi: 10.1111/jmft.12302   open full text
• Examining Differentiation of Self as a Mediator in the Biobehavioral Family Model.
  Jacob B. Priest.
  Journal of Marital and Family Therapy. December 06, 2017
  --- - |2 The Biobehavioral Family Model (BBFM) is a biopsychosocial model of health. This model proposes that biobehavioral reactivity mediates the association between the family emotional climate and disease activity. To improve the clinical relevance of the BBFM, variables that mediate the association between family emotional climate and biobehavioral reactivity need to be tested. This study examined differentiation of self as a mediator. Using data from the Midlife Development in the United States study (n = 854), results suggested that differentiation of self mediated the association between the family and intimate partner emotional climate and mental health symptoms. These findings suggest that including differentiation of self into the BBFM may help interventions based on the model target factors that could improve health outcomes. - Journal of Marital and Family Therapy, EarlyView.
  

  December 06, 2017   doi: 10.1111/jmft.12301   open full text
• A Grounded Theory Study of How Couples Desist from Intimate Partner Violence.
  Lisa V. Merchant, Jason B. Whiting.
  Journal of Marital and Family Therapy. December 01, 2017
  --- - |2 Intimate partner violence is a common and damaging experience for many couples, and therapists struggle to address it adequately (Johnson, 2008). Despite its negative effects, many violent couples stay together, with some stopping their violent behaviors. Unfortunately, we know little about the systemic factors affecting violence desistance. This study used grounded theory methods to analyze the process of desistance in formerly violent couples. A model of desistance consisting of three categories was developed, which for most couples included a (a) Turning Point, (b) Decision to Change, and (c) Doing Things Differently. Therapists are encouraged to use the model to better understand the varied and systemic nature of violence and desistance, and to make more sophisticated decisions about referral and treatment. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 590-605, October 2018.
  

  December 01, 2017   doi: 10.1111/jmft.12278   open full text
• Clinical and Supervisory Considerations for Transgender Therapists: Implications for Working with Clients.
  Daran Shipman, Tristan Martin.
  Journal of Marital and Family Therapy. November 28, 2017
  --- - |2 Transgender therapists have unique and valuable perspectives into how gender organizes the therapeutic process. Currently, in the MFT field, there is discussion of the cisgender therapist's experience in the therapy room, but no known articles on the transgender therapist's experience. This article provides insight into the experiences of transgender therapists around issues of self‐disclosure, social locations of both therapist and client, and clinical supervision. Drawing from our clinical experiences as transmen, we highlight special considerations for working with cisgender, queer, and transgender clients. Implications for supervision of transgender therapists are also discussed. As more gender diverse students seek MFT training, there is an urgent need to acknowledge their perspectives. This article is a call for beginning conversations in this direction. - Journal of Marital and Family Therapy, EarlyView.
  

  November 28, 2017   doi: 10.1111/jmft.12300   open full text
• From Knowing to Doing: Guidelines for Socioculturally Attuned Family Therapy.
  Carmen Knudson‐Martin, Teresa McDowell, J. Maria Bermudez.
  Journal of Marital and Family Therapy. November 10, 2017
  --- - |2 Family therapists know that clinical concerns are not separate from larger sociopolitical contexts. Attunement to clients’ sociocultural experience is foundational to good practice, yet few guidelines integrate attention to the larger societal processes or address social equity. The purpose of this article is to help therapists move from knowing about sociocontextual issues to doing socioculturally attuned practice. We offer an overarching framework that returns to Bateson and the roots of family therapy through a call for third order transformation. The approach is responsive to societal context and an analysis of power while working through enduring concepts of major family therapy models. Transtheoretical guidelines that can be integrated across practice models to promote third order change are illustrated with case examples. - Journal of Marital and Family Therapy, EarlyView.
  

  November 10, 2017   doi: 10.1111/jmft.12299   open full text
• The Profession of Couple, Marital, and Family Therapy (CMFT): Defining Ourselves and Moving Forward.
  Karen S. Wampler, Adrian J. Blow, Lenore M. McWey, Richard B. Miller, Richard S. Wampler.
  Journal of Marital and Family Therapy. November 07, 2017
  --- - |2 The field of Couple, Marital, and Family Therapy (CMFT) has evolved and strengthened, but we still have work to do when it comes to identity, comprehensive scholarly resources, empirical support, and name brand recognition. We explore the reasons for these challenges and propose ways to address them: embracing the interdisciplinary nature of the field, consistently organizing treatment effectiveness by problem rather than by intervention model, continuing innovation in theory development, and utilizing more diverse and meaningful research methods. This approach provides a more accurate representation of the scope of practice of CMFTs, the range of mental and physical health problems we address, and the depth and extent of the existing research on the effectiveness of relational therapies. - Journal of Marital and Family Therapy, EarlyView.
  

  November 07, 2017   doi: 10.1111/jmft.12294   open full text
• A Randomized Controlled Trial Assessing the Efficacy of Cognitive Behavioral Therapy for Substance‐Dependent Domestic Violence Offenders: An Integrated Substance Abuse‐Domestic Violence Treatment Approach (SADV).
  Caroline J. Easton, Cory A. Crane, Dolores Mandel.
  Journal of Marital and Family Therapy. November 06, 2017
  --- - |2 The current study evaluates a therapy for substance‐dependent perpetrators of partner violence. Sixty‐three males arrested for partner violence within the past year were randomized to a cognitive behavioral substance abuse‐domestic violence (SADV; n = 29) or a drug counseling (DC; n = 34) condition. Seventy percent of offenders completed eight core sessions with no differences between SADV and DC conditions in the amount of substance or aggression at pretreatment. SADV participants had fewer cocaine‐positive toxicology screens and breathalyzer results during treatment, were less likely to engage in aggressive behavior proximal to a drinking episode, and reported fewer episodes of violence than DC participants at posttreatment follow‐up. SADV shows promise in decreasing addiction and partner violence among substance‐dependent male offenders. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 483-498, July 2018.
  

  November 06, 2017   doi: 10.1111/jmft.12260   open full text
• Family Rituals in Low‐Income African American Families at Risk for Trauma Exposure and Associations with Toddlers’ Regulation of Distress.
  Erika L. Bocknek.
  Journal of Marital and Family Therapy. October 26, 2017
  --- - |2 This study included 75 mother‐father‐toddler triadic low‐income families. Mothers and fathers reported separately on their own posttraumatic stress disorder (PTSD) symptoms and family rituals while children were rated by an independent observer during an emotionally eliciting task on key indicators of regulation of distress. Regression analyses supported a significant association between key dimensions of family rituals and Toddlers’ regulation of distress: occurrence, continuation, and spirituality. Effect sizes of tested relationships were strong, ranging from 25% to 36% of variance in children's distress explained. Family rituals are a salient intervention target in families and specifically help support children's developing emotion regulation competencies. Certain dimensions of family rituals may be particularly relevant to African American families, considering cultural resiliency factors. Clinical implications are discussed. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 702-715, October 2018.
  

  October 26, 2017   doi: 10.1111/jmft.12293   open full text
• Humility, Forgiveness, and Emerging Adult Female Romantic Relationships.
  Chance A. Bell, Frank D. Fincham.
  Journal of Marital and Family Therapy. October 26, 2017
  --- - |2 Among a sample of emerging adult females (N = 152) we empirically examined the role of humility and forgiveness in romantic relationships. We specifically tested a model linking perceived humility to relationship satisfaction with self‐forgiveness and partner‐forgiveness. Participants in a romantic relationship completed measures of self‐reported humility, self‐forgiveness, partner‐forgiveness, and relationship satisfaction. Serial mediation analyses were conducted using path analysis to test the following sequence, humility self‐forgiveness partner‐forgiveness relationship satisfaction. Findings indicate that humility was related to relationship satisfaction via a serially mediated path of self‐forgiveness and partner‐forgiveness, which was not reducible to impression management. We consider implications for research and clinical practice. - Journal of Marital and Family Therapy, EarlyView.
  

  October 26, 2017   doi: 10.1111/jmft.12292   open full text
• Mindfulness in the Context of Romantic Relationships: Initial Development and Validation of the Relationship Mindfulness Measure.
  Jonathan G. Kimmes, Matthew E. Jaurequi, Ross W. May, Sapna Srivastava, Frank D. Fincham.
  Journal of Marital and Family Therapy. October 26, 2017
  --- - |2 Trait mindfulness and mindfulness in the context of romantic relationships may not be completely overlapping constructs. This study adapted an existing measure of trait mindfulness to assess the tendency to be mindful in romantic relationships, the Relationship Mindfulness Measure (RMM). Using data from 185 young adults, the results supported the RMM's internal consistency, test–retest reliability, and concurrent and predictive validity. The RMM accounted for a significant portion of variance in positive relationship quality, negative relationship quality, and anxious and avoidant attachment, even after controlling for trait mindfulness. Based on these findings, assessing relationship mindfulness may improve research exploring the role of mindfulness in romantic relations and therefore facilitate the development and refinement of mindfulness training programs for couples. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 575-589, October 2018.
  

  October 26, 2017   doi: 10.1111/jmft.12296   open full text
• The Role of Sexual Communication in Couples’ Sexual Outcomes: A Dyadic Path Analysis.
  Adam C. Jones, W. David Robinson, Ryan B. Seedall.
  Journal of Marital and Family Therapy. October 16, 2017
  --- - |2 In a study of 142 couples, we gathered survey data to show how sexual communication influences sexual and relationship satisfaction as well as sexual and orgasm frequency. In two dyadic data path analyses, we observed the significant paths of influence that sexual communication has on sexual and relationship satisfaction, as well as sexual and orgasm frequency. Our findings revealed greater amounts of sexual communication were associated with increased orgasm frequency in women and greater relationship and sexual satisfaction in both sexes. We also observed important differences in the associations of sexual communication and general communication on satisfaction levels. With these analyses, we expand the current literature to broaden our understanding of the role that sexual communication plays in committed relationships. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 606-623, October 2018.
  

  October 16, 2017   doi: 10.1111/jmft.12282   open full text
• The Impact of Blamer‐softening on Romantic Attachment in Emotionally Focused Couples Therapy.
  Melissa Burgess Moser, Susan M. Johnson, Tracy L. Dalgleish, Stephanie A. Wiebe, Giorgio A. Tasca.
  Journal of Marital and Family Therapy. October 08, 2017
  --- - |2 Emotionally Focused Couples Therapy (EFT; Johnson, ) treats relationship distress by targeting couples' relationship‐specific attachment insecurity. In this study, we used hierarchical linear modeling (Singer & Willett, ) to examine intercept and slope discontinuities in softened couples' trajectories of change in relationship satisfaction and relationship‐specific attachment over the course of therapy from a total sample of 32 couples. Softened couples (n = 16) reported a significant increase in relationship satisfaction and a significant decrease in attachment avoidance at the softening session. Although softened couples displayed an initial increase in relationship‐specific attachment anxiety at the softening session, their scores significantly decreased across post‐softening sessions. Results demonstrated the importance of the blamer‐softening change event in facilitating change in EFT. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 640-654, October 2018.
  

  October 08, 2017   doi: 10.1111/jmft.12284   open full text
• Efficacy of a Web‐based Intervention for Concerned Spouses of Service Members and Veterans with Alcohol Misuse.
  Karen Chan Osilla, Thomas E. Trail, Eric R. Pedersen, Kristie L. Gore, Anagha Tolpadi, Lindsey M. Rodriguez.
  Journal of Marital and Family Therapy. October 03, 2017
  Concerned partners (CPs) of service members and veterans who misuse alcohol face help‐seeking barriers and mental health problems. We used multiple regression to evaluate the efficacy of Partners Connect, a four‐session web‐based intervention (WBI) to address military CPs’ mental health and communication. We randomized 312 CPs to the WBI or a control group. Five months later, WBI CPs reported significant reductions in their anxiety and increases in their social support compared to control CPs. Intervention dose was also associated with improved WBI CP outcomes. Partners Connect appears to fill a need for families who face help‐seeking barriers and provides an alternative to traditional care for those who may not otherwise seek help.

  October 03, 2017   doi: 10.1111/jmft.12279   open full text
• The Effects of a Family Systems Intervention on Co‐Occurring Internalizing and Externalizing Behaviors of Children with Substance Abusing Mothers: A Latent Transition Analysis.
  Jing Zhang, Natasha Slesnick.
  Journal of Marital and Family Therapy. October 03, 2017
  --- - |2 Children of substance abusing parents are at heightened risk to develop problem behaviors, yet little is known about the co‐occurring patterns of internalizing and externalizing behaviors among this population. With 183 children (M age = 11.54 years, SD = 2.55, range 8–16) whose mothers were diagnosed with a substance use disorder, the current study identified subgroups/classes of children that were clinically distinct in their co‐occurring patterns of internalizing and externalizing behaviors, and examined how children in different clinical subgroups responded to a family systems intervention. Latent class analyses identified four classes of internalizing and externalizing behaviors: internalizing only, externalizing only, comorbid, and normative. Latent transition analyses showed that participation in family systems therapy resulted in an increased likelihood of transitioning from the externalizing class at baseline to the normative class at 18 months post‐baseline, and from the comorbid class at baseline to the internalizing class at 18 months post‐baseline as well. The findings support the effectiveness of family systems therapy in interrupting the stability of children's problem behaviors and improving children's behavioral outcomes. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 687-701, October 2018.
  

  October 03, 2017   doi: 10.1111/jmft.12277   open full text
• Benefits to Children Who Participate in Family Therapy with their Substance‐Using Mother.
  Suzanne Bartle‐Haring, Natasha Slesnick, Aaron Murnan.
  Journal of Marital and Family Therapy. September 26, 2017
  --- - |2 It is rare that family members other than the identified patient are followed over time in studies of therapy effectiveness. Family therapy is believed to be effective because it targets processes within the system that maintain symptoms. If these processes are changed, then all family members can benefit. Using a sample of 183 mother–child dyads from a study comparing family therapy for adult substance use versus an attention control, change in child's substance use (tobacco, alcohol, and marijuana) was estimated. Children who participated in family therapy with their mothers showed greater decreases in alcohol and tobacco use and were less likely to begin using compared to children whose mothers participated in the attention control condition. - Journal of Marital and Family Therapy, Volume 44, Issue 4, Page 671-686, October 2018.
  

  September 26, 2017   doi: 10.1111/jmft.12280   open full text
• Family and Couple Variables Regarding Adherence in Type 2 Diabetes Patients in the Initial Stages of the Disease.
  M. Graça Pereira, Susana Pedras, Gabriela Ferreira, José C. Machado.
  Journal of Marital and Family Therapy. September 25, 2017
  --- - |2 This study analyzed which family and couple variables predicted adherence to standard care treatment, in patients recently diagnosed with type 2 diabetes. The sample comprised 224 dyads assessed during the first year of diagnosis (T1) and 4 months later (T2). The results showed that family stress, dyadic adjustment, family coping, and positive support assessed by patients at T1 predicted medication adherence and glucose monitoring at T2. Positive support and dyadic adjustment, assessed by partners at T1, predicted patients' adherence to glucose monitoring and diet at T2. This study highlights the important role of the partner in patient`s adherence. Therefore, standard care in type 2 diabetes should be offered in the context of the dyad. - Journal of Marital and Family Therapy, EarlyView.
  

  September 25, 2017   doi: 10.1111/jmft.12281   open full text
• Results of Gottman Method Couples Therapy with Gay and Lesbian Couples.
  Salvatore Garanzini, Alapaki Yee, John Gottman, Julie Gottman, Carrie Cole, Marisa Preciado, Carolyn Jasculca.
  Journal of Marital and Family Therapy. September 20, 2017
  The results of an uncontrolled study of Gottman Method Couples Therapy in changing relationship satisfaction with 106 gay and lesbian couples is reported in this paper. Measurement of relationship satisfaction was conducted at five separate time points. The data show significant improvements in relationship satisfaction following eleven sessions of therapy for both gay male and lesbian couples. Effect sizes suggest that this therapy was highly effective, compared to the usual 0.5 standard deviation effect size in couples therapy. Initial co‐morbidities did not affect the size of the changes; in fact, some changes were significantly larger for three initial co‐morbidities.

  September 20, 2017   doi: 10.1111/jmft.12276   open full text
• Transnational Intersectionality in Family Therapy With Resettled Refugees.
  Rashmi Gangamma, Daran Shipman.
  Journal of Marital and Family Therapy. September 04, 2017
  In this article, we discuss incorporating the transnational intersectionality framework in family therapy with resettled refugees. Transnational intersectionality is an extension of the framework of intersectionality which helps to better understand complexities of power and oppression across national contexts and their influence on refugees' lives. Adopting this framework alerts family therapists to: (a) develop critical awareness of refugee's transnational contexts; (b) understand differences in experiences of social identities across contexts; (c) acknowledge postmigration factors of oppression affecting resettlement; and (d) critically reflect upon therapist–interpreter–client intersectionalities. This shifts our conceptualization of therapy with refugees to actively consider transnational contexts which refugees uniquely occupy. We describe the framework and provide two case illustrations to highlight its usefulness.

  September 04, 2017   doi: 10.1111/jmft.12267   open full text
• The Role of Parental Posttraumatic Stress, Marital Adjustment, and Dyadic Self‐Disclosure in Intergenerational Transmission of Trauma: A Family System Approach.
  Rahel Bachem, Yafit Levin, Xiao Zhou, Gadi Zerach, Zahava Solomon.
  Journal of Marital and Family Therapy. September 04, 2017
  --- - |2 Research indicates that posttraumatic stress symptoms (PTSS) induced by war trauma may be transmitted to veterans’ wives and offspring (secondary traumatic stress; STS). However, the interplay between family members’ characteristics has not been accounted for in such processes. Taking a family systems perspective, we examine the contributions of fathers’ PTSS, mothers’ STS, marital adjustment, and self‐disclosure of both parents to offspring's STS and test whether marital quality applies as a mechanism of parent–child transmission. Combat veterans and former prisoners of war (N = 123), their spouses, and adult offspring were investigated in a multiple‐step mediation analysis. The results highlight the mother's crucial role in trauma transmission and suggest that strengthening the marital relationship may buffer the transmission of fathers’ PTSS to offspring. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 543-555, July 2018.
  

  September 04, 2017   doi: 10.1111/jmft.12266   open full text
• Applying the Paradigm of Relational Ethics into Contextual Therapy. Analyzing the practice of Ivan Boszormenyi‐Nagy.
  Jaap van der Meiden, Martine Noordegraaf, Hans van Ewijk.
  Journal of Marital and Family Therapy. September 04, 2017
  --- - |2 Ivan Boszormenyi Nagy introduced with his contextual therapy a challenging theory into the world of family therapy. It is rooted in a relational ethical perspective on human relations and shifts the focus of therapy from pathology to evoking reciprocal care and a genuine dialogue, based on the conviction that inter‐human relations are resources for individual growth and health. This article presents a research project on the practice of the founder himself, to describe how the principles of the contextual theory and therapy can be integrated into concrete therapeutic interventions. Using the Constant Comparison Method, the authors found six clusters of interventions representing methodical elements through which Ivan Boszormenyi‐Nagy applies the paradigm of his approach. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 499-511, July 2018.
  

  September 04, 2017   doi: 10.1111/jmft.12262   open full text
• Family Subsystems Predicting Adolescents’ Perceptions of Sibling Relationship Quality Over Time.
  Saralyn C. Ruff, Jared A. Durtschi, Randal D. Day.
  Journal of Marital and Family Therapy. September 04, 2017
  --- - |2 This study examined associations between parents’ relationship conflict and parent–adolescent triangulation, and changes in adolescents’ perceptions of sibling affection and hostility. The goal was to learn whether conflict in parents’ relationships spills over to siblings’ relationships, or whether siblings compensate by becoming less hostile and more affectionate. Using a subsample (N = 400) from the Flourishing Families Project (FFP), we found a trend for mother–adolescent triangulation predicting an increase in sibling hostility across 2 years. Fathers’ reports of relationship conflict were related to increased levels of initial sibling hostility, but predicted a marginal decrease in hostility over time. Findings support increased understanding of parenting dynamics associated with changes in sibling relationship quality, and have the potential to inform clinical practice. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 527-542, July 2018.
  

  September 04, 2017   doi: 10.1111/jmft.12265   open full text
• The Case for Insurance Reimbursement of Couple Therapy.
  Robb E. Clawson, Stephanie Y. Davis, Richard B. Miller, Tabitha N. Webster.
  Journal of Marital and Family Therapy. August 22, 2017
  --- - |2 A case is made for why it may now be in the best interest of insurance companies to reimburse for marital therapy to treat marital distress. Relevant literature is reviewed with a considerable focus on the reasons that insurance companies would benefit from reimbursing marital therapy – the high costs of marital distress, the growing link between marital distress and a host of related physical and mental health problems, as well as the availability of empirically supported treatments for marital distress. This is followed by a focus on the major reasons insurance companies cite for not reimbursing marital therapy, along with a discussion of advances in several growing bodies of research to address these concerns. Main arguments include the direct medical offset costs of couple and family therapy (including for high utilizers of health insurance), and the fact that insurance companies already find it cost effective to reimburse for prevention of other health and psychological problems. This is followed by implications for practitioners and researchers. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 512-526, July 2018.
  

  August 22, 2017   doi: 10.1111/jmft.12263   open full text
• Alcohol Use Among Concerned Partners of Heavy Drinking Service Members and Veterans.
  Lindsey M. Rodriguez, Karen Chan Osilla, Thomas E. Trail, Kristie L. Gore, Eric R. Pedersen.
  Journal of Marital and Family Therapy. August 07, 2017
  Heavy drinking in relationships is complex and we focus on an understudied sample of concerned partners (CPs) worried about their U.S. service member/veteran partner's drinking. We evaluated the link between CP drinking and their own mental health, and how CP drinking moderated the efficacy of a web‐based intervention designed to address CPs' mental health and communication. CPs (N = 234) were randomly assigned to intervention or control and completed assessments at baseline and 5 months later. CP drinking was associated with greater CP depression, anxiety, and anger independent of partner drinking. Moreover, the intervention was more efficacious in reducing depression for heavy drinking CPs. CPs are often an overlooked population and resources to help support them are needed.

  August 07, 2017   doi: 10.1111/jmft.12261   open full text
• Dyadic Supervision Evaluation: An Actor–Partner Relational Model.
  Adrian Avila, Brian Distelberg, Ana Estrada, Lauren Foster, Mary Moline, Douglas Huenergardt.
  Journal of Marital and Family Therapy. August 07, 2017
  --- - |2 This article contributes to research practices in marital and family therapy, specifically the dyadic and development over time in clinical supervision, and describes and applies methodological strategies to develop measurements congruent with the systemic and developmental principles of the field. This project evaluates the psychometric properties of the dyadic supervision evaluation (DSE) in terms of measurement equivalence and causality. A structural equation analysis is conducted utilizing the actor–partner interdependent model resulting in a goodness of fit. This study presents a longitudinal model for evaluating the supervisory relationship and proposes a model of clinical supervision evaluation. The relationship among latent constructs in the DSE and its limitations related to inference and application are discussed. - Journal of Marital and Family Therapy, Volume 44, Issue 3, Page 470-482, July 2018.
  

  August 07, 2017   doi: 10.1111/jmft.12259   open full text
• Hope, Coping, and Relationship Quality in Mothers of Children With Down Syndrome.
  Jessica D. Cless, Briana S. Nelson Goff, Jared A. Durtschi.
  Journal of Marital and Family Therapy. August 02, 2017
  Parenting a child with Down syndrome may pose unique challenges for parents’ relationship quality. This study used structural equation modeling with a sample of 351 mothers of children with Down syndrome to test if hope mediated the association between mothers’ various coping behaviors and mothers’ relationship quality. Hope was defined as a generalized positive state that comes from a personal sense of agency. Results indicated a greater degree of religious coping and internal coping were each significantly associated with more hope, whereas support seeking was not related with more hope. Higher hope was significantly associated with greater relationship quality. Bootstrapped indirect effects from both religious coping and internal coping to hope, and then hope to relationship quality, were identified. Implications for therapists and future research are described.

  August 02, 2017   doi: 10.1111/jmft.12249   open full text
• “Being a Therapist Doesn't Exclude You From Real Life”: Family Therapists’ Beliefs and Barriers to Political Action.
  Lorien S. Jordan, Desiree M. Seponski.
  Journal of Marital and Family Therapy. August 02, 2017
  A crucial and overlooked facet of social justice in family therapy is political and policy advocacy. Family therapists have unique insight into how social policies and political discourse shapes clients’ lives and the life of our profession. Such knowledge can inform policymakers and political debate, yet few family therapists are trained to engage in political action. In this randomized, national survey of licensed family therapists’ (N = 174), we explore beliefs about and barriers to engagement in political and policy processes. The findings suggest that there are significant barriers and uncertainties surrounding family therapists’ engagement, including time, feelings of efficacy, and interest. Given these barriers we discuss practical suggestions for clinicians and family therapy training programs.

  August 02, 2017   doi: 10.1111/jmft.12244   open full text
• Do the Constructs of the FACES IV Change Based on Definitions of “Family?” A Measurement Invariance Test.
  Jacob B. Priest, Elizabeth O. Parker, Sarah B. Woods.
  Journal of Marital and Family Therapy. July 31, 2017
  The Family Adaptability and Cohesion Scale (FACES) IV does not provide instructions about which family members respondents should think about while answering questions. This study examined which family members respondents thought about while completing the FACES IV, and if this changed measurement invariance and population heterogeneity of the measure. Using a sample of n = 511 individuals, a latent class analysis showed three distinct classes: Nuclear Family, Family of Origin, and All of the Above. The FACES IV demonstrated measurement invariance across classes on the majority of subscales; however, population heterogeneity tests suggested that the means and variances of the subscales varied across classes. The findings suggest further examination of how the measure functions with unique family constellations is warranted.

  July 31, 2017   doi: 10.1111/jmft.12257   open full text
• Army Soldiers and Suicidal Thoughts: The Impact of Negative Relationship Dynamics Moderated by the Dissolution of Romantic Relationships.
  Heather A. Love, Jared A. Durtschi, Lauren M. Ruhlmann, Briana S. Nelson Goff.
  Journal of Marital and Family Therapy. July 18, 2017
  Suicide among United States active‐duty Army soldiers rapidly increased over the past two decades. Using a sample of 322 soldiers from the Army STARRS study, the researchers examined if romantic relationship factors (i.e., hostile disagreements and relationship distress) were linked with suicidal thoughts in Army soldiers, and if these associations were moderated by a recent separation or divorce. Hostile disagreements and relational distress were both significantly associated with higher rates of suicidal ideation. These associations were significantly amplified in magnitude when in the context of a recent separation or divorce. Implications include novel assessment, prevention, and treatment efforts focused on romantic relationships that may reduce the likelihood of soldiers experiencing thoughts of suicide.

  July 18, 2017   doi: 10.1111/jmft.12252   open full text
• Commitment, Forgiveness, and Relationship Self‐Regulation: An Actor Partner Interdependence Model of Relationship Virtues and Relationship Effort in Couple Relationships.
  Joshua R. Novak, Heather M. Smith, Jeffry H. Larson, D. Russell Crane.
  Journal of Marital and Family Therapy. July 18, 2017
  Dyadic data from 679 committed couples were used to examine associations between commitment, forgiveness, and perceptions of partner's relationship self‐regulation (RSR) behaviors—that is effort and strategies that partners exert to maintain the relationship. We found that for both partners, higher self‐reports of commitment and forgiveness were associated with higher perceptions of their partner's RSR. For females, higher commitment and forgiveness were associated with higher male perceptions of her RSR, and higher male forgiveness was associated with higher female perceptions of his RSR. These findings demonstrate the importance of marital virtues and relationship work and give credence to the marital competence model of “other‐centeredness” by Carroll et al. (2006, Journal of Family Issues, 27(7), 1001). Clinical implications are discussed.

  July 18, 2017   doi: 10.1111/jmft.12258   open full text
• Group Couples' Intervention to Improve Sexual Health Among Married Women in a Low‐Income Community in Mumbai, India.
  Shubhada Maitra, Stephen L. Schensul, Benjamin D. Hallowell, Marie A. Brault, Bonnie K. Nastasi.
  Journal of Marital and Family Therapy. July 06, 2017
  This article describes the design and implementation of a group couples' intervention focused on improving women's sexual health as a component of a multilevel community, clinical, and counseling intervention project conducted in association with a gynecological service in a municipal urban health center in a low‐income community in Mumbai, India. The group couples' intervention involved four single‐gender and two mixed‐gender sessions designed to address the dynamics of the marital relationship and establish a more equitable spousal relationship as a means to improve women's sexual and marital health. Involvement of men presented a major challenge to couple's participation. For those couples that did participate, qualitative findings revealed significant changes in couple and family relations, sexual health knowledge, and emotional well‐being.

  July 06, 2017   doi: 10.1111/jmft.12248   open full text
• A Phenomenological Study of Family Experiences of Resettled Iraqi Refugees.
  Rashmi Gangamma.
  Journal of Marital and Family Therapy. July 05, 2017
  Using a cross‐sectional, phenomenological design, this qualitative study sought to explore Iraqi refugees’ experiences of family relationships resettled in a northeastern city in the United States after the start of the 2003 war. Participants’ experience of family relationships was situated within the context of their displacement, which included fear and uncertainty during displacement, and experiences of safety and isolation during resettlement. Themes related to family relationships were as follows: shared experiences of losses; increased trust between family members; shifts in communication and gender roles; and constructing a family legacy. Findings from this study indicate that family relationships play a central role in making meaning of forced displacement and resettlement experiences, which have significant clinical implications for family therapists working with refugees.

  July 05, 2017   doi: 10.1111/jmft.12251   open full text
• The Effects of Briefly Interrupting Marital Conflict.
  John M. Gottman, Amber Tabares.
  Journal of Marital and Family Therapy. June 28, 2017
  This study examined couples’ (N = 94) behavior resulting from two proximal change interventions. One was a spousal “compliments intervention” to increase positivity, and the other was a “criticize intervention” to increase negativity. Participants were randomly assigned to one of the two intervention conditions or a control group. There was no main effect in affect from the pretest conflict discussion to the posttest conflict discussion between the interventions or control group. However, a manipulation check on how couples acted during either intervention produced a significant interaction effect. Pretest affect during conflict and marital satisfaction significantly predicted couples’ construal of the intervention. Professionals may need to monitor how couples use specific interventions and direct the processes how the intervention is construed by the couple.

  June 28, 2017   doi: 10.1111/jmft.12243   open full text
• Short‐Term‐Effectiveness of a Relationship Education Program for Distressed Military Couples, in the Context of Foreign Assignments for the German Armed Forces. Preliminary Findings From a Randomized Controlled Study.
  Christoph Kröger, Sören Kliem, Peter Zimmermann, Jens Kowalski.
  Journal of Marital and Family Therapy. June 26, 2017
  This study examines the short‐term effectiveness of a relationship education program designed for military couples. Distressed couples were randomly placed in either a wait‐list control group or an intervention group. We conducted training sessions before a 3‐month foreign assignment, and refresher courses approximately 6‐week post‐assignment. We analyzed the dyadic data of 32 couples, using hierarchical linear modeling in a two‐level model. Reduction in unresolved conflicts was found in the intervention group, with large pre–post effects for both partners. Relationship satisfaction scores were improved, with moderate‐to‐large effects only for soldiers, rather than their partners. Post‐follow‐up effect sizes suggested further improvement in the intervention group. Future research should examine the long‐term effectiveness of this treatment.

  June 26, 2017   doi: 10.1111/jmft.12250   open full text
• Computer‐Mediated Communication in Intimate Relationships: Associations of Boundary Crossing, Intrusion, Relationship Satisfaction, and Partner Responsiveness.
  Aaron M. Norton, Joyce Baptist, Bernie Hogan.
  Journal of Marital and Family Therapy. June 15, 2017
  This study examined the impact of technology on couples in committed relationships through the lens of the couple and technology framework. Specifically, we used data from 6,756 European couples to examine associations between online boundary crossing, online intrusion, relationship satisfaction, and partner responsiveness. The results suggest that participants’ reports of online boundary crossing were linked with lower relationship satisfaction and partner responsiveness. Also, lower relationship satisfaction and partner responsiveness were associated with increased online boundary crossing. The results suggest that men, but not women, who reported greater acceptability for online boundary crossing were more likely to have partners who reported lower relationship satisfaction in their relationships. Implications for clinicians, relationship educators, and researchers are discussed. Video abstract accessible by clicking here. Video abstract accessible by clicking here.

  June 15, 2017   doi: 10.1111/jmft.12246   open full text
• Exploring Partner Intimacy Among Couples Raising Children on the Autism Spectrum: A Grounded Theory Investigation.
  Jake Johnson, Fred P. Piercy.
  Journal of Marital and Family Therapy. June 13, 2017
  In this study, we explored how couples raising children with autism spectrum disorder negotiate intimacy, including what contextual and temporal factors influence these processes. We conducted conjoint interviews with 12 couples, employing grounded theory methodology to collect and analyze the data. Our results indicated that fostering intimacy in these couples' relationships involves partners working together to make key cognitive and relational shifts. Couples are aided or hindered in making these shifts by the degree to which they experience various contextual and environmental factors as resources or roadblocks. We also found that intimacy is not a fixed point at which couples one day arrive, but is an iterative process taking place over time and requiring work to develop and maintain.

  June 13, 2017   doi: 10.1111/jmft.12247   open full text
• Religious Coping and Glycemic Control in Couples with Type 2 Diabetes.
  Frank D. Fincham, Gregory S. Seibert, Ross W. May, Colwick M. Wilson, Zephon D. Lister.
  Journal of Marital and Family Therapy. June 07, 2017
  This study examines the role of religious coping in couples’ diabetes management processes. Eighty‐seven couples where one spouse had type 2 diabetes were surveyed. The relationships between religious coping (positive and negative), shared glycemic control activities (e.g., planning a healthy diet), and glycemic control were examined using repeated measures ANOVA and SEM. Findings show spousal engagement in shared activities is significantly associated with glycemic control. Furthermore, the use of negative religious coping by the diabetic spouse, and positive religious coping by the nondiabetic spouse, related to lower levels and higher levels of shared glycemic control activities, respectively. Religious coping and shared glycemic control activities appear integral to couples managing type 2 diabetes and, may serve as useful points of intervention.

  June 07, 2017   doi: 10.1111/jmft.12241   open full text
• Public Participation: Moving Beyond the Four Walls of Therapy.
  Lorien S. Jordan, Desiree M. Seponski.
  Journal of Marital and Family Therapy. June 05, 2017
  Family therapists have an ethical responsibility for public participation, to work toward creating a better society. Serving the public interest and developing laws to promote the profession and the public good can be achieved through policy advocacy and political participation. Political and policy work are important but overlooked aspects of family therapy, which is significant given the consequences differing policies have for clients and the profession. This paper reports on results from a random, national survey of licensed family therapists’ (N = 174) advocacy actions. Findings indicate family therapists have overarching policy concerns yet lack proactive legislative and activist engagement. The exploration of therapists’ actions and beliefs presented in this paper, serves as a springboard for therapists’ movement into the public arena. Video abstract accessible by clicking here. Video abstract accessible by clicking here.

  June 05, 2017   doi: 10.1111/jmft.12240   open full text
• Male‐Partnered Bisexual Women's Perceptions of Disclosing Sexual Orientation to Family Across the Transition to Parenthood: Intensifying Heteronormativity or Queering Family?
  Abbie E. Goldberg, Katherine R. Allen, Themal Ellawala, Lori E. Ross.
  Journal of Marital and Family Therapy. May 24, 2017
  Drawing from queer and communication privacy management frameworks, this study examines the narratives of 22 bisexual, male‐partnered women who were interviewed during the perinatal period and one year postnatally about their disclosures of sexual identity to family of origin. Most women rarely discussed their sexual identity with family; participants who had disclosed described such disclosures as provoking discomfort. Some women stated that their parental status seemed to invalidate the need to talk about their sexual history or identity with family, due its declining salience and increased concerns about judgment. This study reveals how partnership and parenthood statuses contribute to the intensification of heteronormative pressures in relation to family. Therapists should attend to the role of heteronormative values regarding partnering, family‐building, and parenting.

  May 24, 2017   doi: 10.1111/jmft.12242   open full text
• The Systemic Interaction of Attachment on Psychophysiological Arousal in Couple Conflict.
  Nathan C. Taylor, Ryan B. Seedall, W. David Robinson, Kay Bradford.
  Journal of Marital and Family Therapy. May 15, 2017
  Attachment in adult romantic relationships has long been linked to conflict styles. Psychophysiological measures have provided additional insight into this association by accessing less conscious and controlled responses to conflict. The aim of this study was to explore the relationship between attachment anxiety, attachment avoidance, and the interaction between attachment styles on skin conductance responses during conflict and recovery from conflict. Using dyadic analysis of 50 heterosexual couples, we found evidence of a systemic effect of attachment, where psychophysiological arousal increased when one partner had higher levels of attachment anxiety and the other partner had higher levels of attachment avoidance. Attachment avoidance was also negatively associated with increased levels of arousal. Relationship and clinical implications of these findings are discussed.

  May 15, 2017   doi: 10.1111/jmft.12239   open full text
• The Marriage and Family Therapy Practice Research Network (MFT‐PRN): Creating a More Perfect Union Between Practice and Research.
  Lee N. Johnson, Richard B Miller, Angela B. Bradford, Shayne R. Anderson.
  Journal of Marital and Family Therapy. April 20, 2017
  This article describes the Marriage and Family Therapy Practice Research Network (MFT‐PRN). The MFT‐PRN is designed to build a professional community based on practice‐informed research and research‐informed practice, increase the diversity of participants in MFT research, and unify researchers and clinicians. Clinics choose measures from a list that best represent their clinic needs. Clients' outcomes are assessed regularly, and therapists receive immediate graphical feedback on how clients are progressing or digressing. Data are pooled to create a large and diverse database, while improving client outcomes. We will discuss advantages of the MFT‐PRN for researchers, therapists, clients, and agencies, and provide one model that we hope will inform other collaborative clinical‐research models in the field of marriage and family therapy. Video Abstract is found in the online version of the article. Video Abstract is found in the online version of the article.

  April 20, 2017   doi: 10.1111/jmft.12238   open full text
• Emotionally Focused Couple Therapy for Parents Raising a Child with an Autism Spectrum Disorder: A Pilot Study.
  Nicholas A. Lee, James L. Furrow, Brent A. Bradley.
  Journal of Marital and Family Therapy. April 17, 2017
  Many couples raising children diagnosed with an Autism Spectrum Disorder (ASD) are often resilient in confronting unique parental demands, while others experience greater risk for relational distress. Research has shown that Emotionally Focused Couple Therapy (EFT) is efficacious with couples raising chronically ill children and relevant to the relational demands of parents of children diagnosed with an ASD. This pilot study tested the effectiveness of EFT with seven couples presenting with moderate to severe distress, who were also parents of a child diagnosed with an ASD. Results demonstrated significant decreases in marital distress at posttreatment and 6‐month follow‐up. The study also identified several unique themes associated with couple distress and the parenting experiences of this population.

  April 17, 2017   doi: 10.1111/jmft.12225   open full text
• Perceptions and Experiences of Marriage Preparation Among U.S. Muslims: Multiple Voices from the Community.
  Amal Killawi, Elham Fathi, Iman Dadras, Manijeh Daneshpour, Arij Elmi, Hamada Altalib.
  Journal of Marital and Family Therapy. April 17, 2017
  Although Muslims in the United States are a growing population, there is limited research on their relational patterns and how they prepare for marriage. We conducted in‐depth interviews with 32 members of the Muslim community in Southeast Michigan including married individuals, divorced individuals, therapists, and imams (Muslim religious leaders) to explore their perceptions and experiences of marriage preparation. Our analysis revealed that marriage preparation varies but is less likely to involve a requirement of premarital counseling, with imams being the primary providers, not therapists. Barriers to participation include stigma, lack of awareness, logistical and financial challenges, and parental influence. Partnerships between imams and therapists, and family and community efforts are necessary to address barriers and increase participation in premarital education programs.

  April 17, 2017   doi: 10.1111/jmft.12233   open full text
• A Brief Report on the Ethical and Legal Guides For Technology Use in Marriage and Family Therapy.
  Michael Pennington, Rikki Patton, Amber Ray, Heather Katafiasz.
  Journal of Marital and Family Therapy. April 12, 2017
  Marriage and family therapists (MFTs) use ethical codes and state licensure laws/rules as guidelines for best clinical practice. It is important that professional codes reflect the potential exponential use of technology in therapy. However, current standards regarding technology use lack clarity. To explore this gap, a summative content analysis was conducted on state licensure laws/rules and professional ethical codes to find themes and subthemes among the many aspects of therapy in which technology can be utilized. Findings from the content analysis indicated that while there have been efforts by both state and professional organizations to incorporate guidance for technology use in therapy, a clear and comprehensive “roadmap” is still missing. Future scholarship is needed that develops clearer guidelines for therapists.

  April 12, 2017   doi: 10.1111/jmft.12232   open full text
• Psychodynamic Couple Therapy: A Practical Synthesis.
  Arthur C. Nielsen.
  Journal of Marital and Family Therapy. April 12, 2017
  This essay reviews the most significant contributions of psychodynamic thought to the field of couple therapy. It distills the work of numerous clinicians and researchers who, though writing from diverse perspectives, share fundamental assumptions and concerns. Rather than emphasizing differences between schools of thought, this paper mines their best contributions in a discussion of five central therapeutic targets: underlying issues, divergent subjective experiences, transferences, projective identification, and acceptance. Two detailed cases illustrate the benefits and techniques for targeting these five therapeutic domains. Video Abstract is found in the online version of the article. Video Abstract is found in the online version of the article.

  April 12, 2017   doi: 10.1111/jmft.12236   open full text
• Moving Between Dialogic Reflexive Processes In Systemic Family Therapy Training: An Interpretative Phenomenological Study of Trainees’ Experience.
  Dimitra Givropoulou, Eleftheria Tseliou.
  Journal of Marital and Family Therapy. April 12, 2017
  In this article, we present a qualitative research study concerning the ways that systemic family therapy trainees experience reflexivity while in training. There is inadequate theorizing and limited research concerning reflexivity in family therapy, particularly from trainees’ perspective. In our study, we used Interpretative Phenomenological Analysis to analyse transcripts of semistructured interviews with 10 systemic family therapy trainees. Here, we present one of the four superordinate analytic themes, entitled “Moving between reflexive processes”. Our analysis suggests that trainees seem to experience reflexivity as a multifaceted, dialogic process, which occurs both at an inner and at an outer space and both synchronically but also subsequently to the therapeutic/training process. We conclude by raising implications for family therapy training. Video abstract accessible by clicking here. Video abstract accessible by clicking here.

  April 12, 2017   doi: 10.1111/jmft.12237   open full text
• Integrative Intensive Retreats for Veteran Couples and Families: A Pilot Study Assessing Change in Relationship Adjustment, Posttraumatic Growth, and Trauma Symptoms.
  J. Kale Monk, Lauren M. Oseland, Briana S. Nelson Goff, Brian G. Ogolsky, Kali Summers.
  Journal of Marital and Family Therapy. April 10, 2017
  We assessed a brief, systemic retreat‐style intervention that was developed to address concerns about the utilization of services for veterans coping with traumatic stress. A total of 76 dyads (N = 152) were assessed before and after a 4‐day retreat, which included psychoeducation, group and conjoint therapeutic sessions, and recreational relaxation components. Overall, participants reported a reduction in trauma symptoms, but only support persons experienced a significant increase in posttraumatic growth from pretest to posttest. Both veterans and their romantic partners reported an increase in relationship adjustment after the retreat. Opportunities to address the needs of this population by removing barriers to treatment and reducing feelings of isolation, as well as implications for similar treatments are discussed.

  April 10, 2017   doi: 10.1111/jmft.12230   open full text
• “We will never be normal”: The Experience of Discovering a Partner Has Autism Spectrum Disorder.
  Laura F. Lewis.
  Journal of Marital and Family Therapy. April 10, 2017
  Online forums and lay literature suggest that partners of individuals with Autism Spectrum Disorder (ASD) experience depression, distress, and trauma in their everyday lives, exacerbated during the time surrounding diagnosis. In this content analysis, 29 participants were provided with an online open‐ended statement asking them to describe in writing their experiences of discovering that their partners had ASD during their relationships. Six themes emerged, including: facing unique challenges within relationships; insisting partners seek diagnosis; initial shock and relief; losing hope for normalcy; making accommodations within relationships; and wishing for professional support. Marriage and family therapists should help couples minimize blaming and promote self‐awareness, appropriate relationship expectations, and mutual understanding. Future research should explore the overall experience of neuro‐mixed relationships for both partners.

  April 10, 2017   doi: 10.1111/jmft.12231   open full text
• Treatment For Suicidal Thoughts and Behavior: A Review of Family‐Based Interventions.
  Laura M. Frey, Quintin A. Hunt.
  Journal of Marital and Family Therapy. April 10, 2017
  The purpose of this article is to review the scientific evidence on the effects of family based interventions for suicidal ideation and behavior. We conducted an extensive search of electronic databases using a comprehensive search strategy. This search resulted in 16 studies that tested 13 interventions for treating suicidal ideation and behavior using family based interventions. Of the interventions identified, three yielded an overall improvement in suicidal ideation and behavior while an additional three interventions produced partial improvement in mental health symptoms. These studies targeted suicidal ideation and behavior in youth or adolescents while no studies examined family interventions for adults with suicidal ideation and behavior. The limitations of these studies and the need for additional research are examined.

  April 10, 2017   doi: 10.1111/jmft.12234   open full text
• Vulnerable Emotional Expression In Emotion Focused Couples Therapy: Relating Interactional Processes To Outcome.
  Jacqueline M. McKinnon, Leslie S. Greenberg.
  Journal of Marital and Family Therapy. March 24, 2017
  This study examined whether interactions characterized by high expression of emotional vulnerability in one partner followed by a highly supportive response style by the other partner predicted greater improvement on domains of forgiveness, unfinished business, trust, and relationship satisfaction in a sample of 32 couples presenting for Emotion Focused Couples Therapy with unresolved emotional injuries. For each outcome measure, two separate hierarchical regression models were tested (injured partner vulnerability and offending partner supportiveness; offending partner vulnerability and injured partner supportiveness). Both models significantly predicted improvement on the majority of outcome measures. Practice suggestions for working with emotionally injured couples are provided in light of the findings.

  March 24, 2017   doi: 10.1111/jmft.12229   open full text
• Actor and Partner Effects of Attachment on Relationship Satisfaction and Sexual Satisfaction Across the Genders: An APIM Approach.
  Henk Jan Conradi, Arjen Noordhof, Pieter Dingemanse, Dick P. H. Barelds, Jan H. Kamphuis.
  Journal of Marital and Family Therapy. March 20, 2017
  Previous studies found gender differences in relationship satisfaction and sexuality. We tested gender differences in associations between attachment, a lasting relationship determinant, and two outcomes, relationship and sexual satisfaction. This study improves on earlier research by examining these associations in one Actor‐Partner‐Interdependence‐Model, making direct statistical testing between outcomes possible. Furthermore, a community and a distressed sample (N = 113 heterosexual couples each) were included to attempt replication across samples and to examine clinical implications. In both genders, actor attachment avoidance negatively affected relationship satisfaction and (with one exception) sexual satisfaction. Also in both genders, partner attachment avoidance negatively affected sexual satisfaction. However, whereas partner attachment avoidance influenced female relationship satisfaction, it did not affect male relationship satisfaction. The findings replicated across samples. Clinical implications are discussed.

  March 20, 2017   doi: 10.1111/jmft.12222   open full text
• Processes that Inform Multicultural Supervision: A Qualitative Meta‐Analysis.
  Nilou B. Tohidian, Karen Mui‐Teng Quek.
  Journal of Marital and Family Therapy. March 16, 2017
  As the fields of counseling and psychotherapy have become more cognizant that individuals, couples, and families bring with them a myriad of diversity factors into therapy, multicultural competency has also become a crucial component in the development of clinicians during clinical supervision and training. We employed a qualitative meta‐analysis to provide a detailed and comprehensive description of similar themes identified in primary qualitative studies that have investigated supervisory practices with an emphasis on diversity. Findings revealed six meta‐categories, namely: (a) Supervisor's Multicultural Stances; (b) Supervisee's Multicultural Encounters; (c) Competency‐Based Content in Supervision; (d) Processes Surrounding Multicultural Supervision; (e) Culturally Attuned Interventions; and (f) Multicultural Supervisory Alliance. Implications for practice are discussed.

  March 16, 2017   doi: 10.1111/jmft.12219   open full text
• Relational Family Therapy as an Aid Toward Resolving the Trauma of Sexual Abuse in Childhood in the Process of Separation in the Couple Relationship.
  Tanja Repič Slavič, Christian Gostečnik.
  Journal of Marital and Family Therapy. March 13, 2017
  Relational family therapy (RFT) is a psycho‐organic therapeutic approach that combines intrapsychic dynamics with interpersonal mechanisms and a systemic perspective. This integrative model is based on the assumption that the repetitive patterns of relationships in early childhood repeat in adulthood. It often happens that a sexually abused individual will later unconsciously be attracted to someone with whom they will relive the abusive atmosphere and dynamics from childhood. The purpose of this contribution is to present the RFT approach for dealing with sexual abuse. We will present a case study with individual segments from therapy with a woman, who previously had been sexually abused and was separated from her partner.

  March 13, 2017   doi: 10.1111/jmft.12212   open full text
• The Role of the Facilitator in Couple Relationship Education.
  Scott A. Ketring, Angela B. Bradford, Stephanie Y. Davis, Francesca Adler‐Baeder, Julianne McGill, Thomas A. Smith.
  Journal of Marital and Family Therapy. March 11, 2017
  While much of the Couple Relationship Education (CRE) research has focused on participant factors, unexpectedly little research has considered how characteristics of those providing the programming shape its efficacy. The current study draws upon a diverse sample of 225 couples who received CRE from community educators to examine how facilitation alliance is related to relationship outcomes for men and women and whether having a facilitator with similar demographic characteristics is related to the alliance. Results suggest that the facilitation alliance is related to some—though not all—postprogram outcomes and these effects were uniform across gender and relationship status (married vs. unmarried). Having a facilitator of the same gender was associated with a stronger alliance. Implications are discussed.

  March 11, 2017   doi: 10.1111/jmft.12223   open full text
• A Systematic Review of Gay, Lesbian, and Bisexual Research Samples in Couple and Family Therapy Journals.
  Erica E. Hartwell, Julianne M. Serovich, Sandra J. Reed, Danielle Boisvert, Teresa Falbo.
  Journal of Marital and Family Therapy. March 11, 2017
  The purpose of this study is to review samples from research on gay, lesbian, and bisexual (GLB) issues and to evaluate the suitability of this body of research to support affirmative and evidence‐based practice with GLB clients. The authors systematically reviewed the sampling methodology and sample composition of GLB‐related research. All original, quantitative articles focusing on GLB issues published in couple and family therapy (CFT)‐related journals since 1975 were coded (n = 153). Results suggest that within the GLB literature base there is some evidence of heterocentrism as well as neglect of issues of class, race, and gender. Suggestions to improve the diversity and representativeness of samples—and, thus, clinical implications—of GLB‐related research in CFT literature are provided.

  March 11, 2017   doi: 10.1111/jmft.12220   open full text
• Barriers and Facilitators to Implementing Functional Family Therapy in a Community Setting: Client and Practitioner Perspectives.
  Kerri E. McPherson, Susan Kerr, Beth Casey, John Marshall.
  Journal of Marital and Family Therapy. March 09, 2017
  While Functional Family Therapy (FFT) is known to be effective in addressing adolescent behavioral problems, there has been little exploration of issues relevant to its transport from the tightly controlled setting of clinical trials into routine service delivery. This study sought the views of key stakeholders, clients, and practitioners, on barriers and facilitators to the successful implementation of FFT. Undertaken in a community setting in Scotland, interviews were carried out with 12 adolescents, 14 parents/caregivers, and 6 practitioners. Results focus on: Referral process and pre‐intervention contact; Engagement of families; Structure and delivery; Organizational factors. Although barriers to engagement were identified, FFT was viewed as an acceptable, appropriate and feasible intervention with the potential to improve adolescent wellbeing in ‘real‐world’ settings.

  March 09, 2017   doi: 10.1111/jmft.12221   open full text
• A Contextual Therapy Framework for MFT Educators: Facilitating Trustworthy Asymmetrical Training Relationships.
  Michael E. Sude, Laura Eubanks Gambrel.
  Journal of Marital and Family Therapy. March 06, 2017
  This article provides a conceptual framework for asymmetrical relationships between family therapy educators and trainees. Our framework is based on contextual family therapy, and we apply the concepts of trust, entitlement, self‐validation, and loyalty to training relationships. We highlight the value of educators modeling responsible uses of power in addition to teaching trainees clinical concepts and skills. We propose that training can be a process where trainers earn constructive entitlement through their interactions with trainees, who then give to future clients, supervisees, and trainees to continue the cycle of intergenerational trustworthiness. We also provide examples that illustrate the application of contextual therapy skills such as multidirected partiality, I‐Thou relating, acknowledgment, validation, and accountability to family therapy training.

  March 06, 2017   doi: 10.1111/jmft.12224   open full text
• Common Factors' Role in Accredited MFT Training Programs.
  Carissa D'Aniello, Stephen T. Fife.
  Journal of Marital and Family Therapy. March 06, 2017
  Common factors proponents discuss the benefits and methods of including common factors in marriage and family therapy (MFT) training; yet there are no empirical investigations of how common factors are incorporated into MFT curricula. The purpose of this study was to obtain a baseline understanding of common factors' role in MFT training. Thirty‐one directors of COAMFTE‐ and CACREP‐accredited MFT training programs responded to a survey about the inclusion of common factors in their training program, as well as the benefits, challenges, and students' reactions to common factors training. Findings show that common factors are regularly included in MFT training programs and have garnered largely positive responses. Additional results are discussed regarding the implications of common factors in MFT training.

  March 06, 2017   doi: 10.1111/jmft.12218   open full text
• The use of Theory in Family Therapy Research: Content Analysis and Update.
  Ruoxi Chen, Alexandria C. Hughes, Jason P. Austin.
  Journal of Marital and Family Therapy. February 22, 2017
  In this study, we evaluated 275 empirical studies from Journal of Marital and Family Therapy and Family Process from 2010 to 2015 on their use of theory, and compared our findings to those of a similar previous analysis (Hawley & Geske, 2000). Overall, theory seems to have become much better incorporated in empirical family therapy research, with only 16.4% of the articles not using theory in either their introductory or discussion sections. Theory appeared better incorporated in the introductory sections than in the discussion sections. Systems theory remained the most commonly used conceptual framework, followed by attachment theory. We discuss areas for improving theory incorporation in family therapy research, and offer suggestions for both family therapy researchers and educators.

  February 22, 2017   doi: 10.1111/jmft.12217   open full text
• Posttraumatic Growth in Relationally Betrayed Women.
  Deb Laaser, Heather L. Putney, Matthew Bundick, David L. Delmonico, Elizabeth J. Griffin.
  Journal of Marital and Family Therapy. February 20, 2017
  The research literature on relational betrayal in a committed relationship has focused on the resulting trauma from the betrayal; however, few studies investigated the potential for posttraumatic growth following a relational betrayal. This study investigated the presence of posttraumatic growth in relationally betrayed women. The research focused on women's perceptions of the relational betrayal, and factors that facilitated posttraumatic growth. Results indicated relationally betrayed women perceived the betrayal as a traumatic event, to the extent that some met criteria for PTSD diagnosis. The passage of time was significant corollary to posttraumatic growth when moderated by a PTSD diagnosis. Finally, certain resources were reported to be more helpful than others in the development of posttraumatic growth. Clinical implications are presented.

  February 20, 2017   doi: 10.1111/jmft.12211   open full text
• Human Sexuality Education in Marriage and Family Therapy Graduate Programs.
  Brian D. Zamboni, Samantha J. Zaid.
  Journal of Marital and Family Therapy. February 20, 2017
  Given the likelihood that marriage and family therapists will encounter clients with sexual concerns, it is important to know how graduate training programs are preparing future clinicians to work with this domain of life. Sixty‐nine marriage and family therapy (MFT) program directors completed an online survey to examine how sexual health education is integrated into graduate training programs. Findings indicate that while the majority of program directors value sexuality curriculum, and most programs require at least one course in this area, there are barriers to privileging sex topics in MFT graduate programs. Barriers include few MFT faculties with expertise in human sexuality and marginalized sexual health topics. Implications for training MFT graduate students and their work with future clients are discussed.

  February 20, 2017   doi: 10.1111/jmft.12214   open full text
• Coupling Processes and Experiences of Never Married Heterosexual Black Men and Women: A Phenomenological Study.
  Christiana I. Awosan, Kenneth V. Hardy.
  Journal of Marital and Family Therapy. February 16, 2017
  Over the past decades, the decline in Black marriages and the upsurge of never‐married Blacks have stimulated much theoretical focus, but researchers conducted few studies on never‐married heterosexual Black adults' coupling unions. Guided by an integrated framework of Africana womanism and symbolic interactionism, this qualitative hermeneutic phenomenological study used comprehensive individual interviews to explore the experiences of 26 never‐married heterosexual Black men and women between the ages 25 and 35 about their attempts to cultivate and maintain intimate romantic relationships as well as their desire for marriage. Findings revealed mixed emotions from participants' lived experiences in developing and sustaining romantic relationships. Clinical implications highlighted the need to effectively attend to Black romantic relationships and experiences in their sociohistorical and sociocultural contexts.

  February 16, 2017   doi: 10.1111/jmft.12215   open full text
• Does the Person‐of‐the‐Therapist Training (POTT) Promote Self‐Care? Personal Gains of MFT Trainees Following POTT: A Retrospective Thematic Analysis.
  Karni Kissil, Alba Niño.
  Journal of Marital and Family Therapy. February 13, 2017
  As we recognize how taxing our profession can be, therapist's self‐care has become a salient topic in mental health. However, we are still discerning how to promote self‐care in our practice and in training. In this paper, we present a study on the personal gains that MFT students experienced after participating in the Person‐of‐the‐Therapist Training (POTT). We propose that the reported changes (better understanding of self, change to self, relational changes, and change as a process) constitute improvements in the trainees’ well‐being, and can therefore be considered self‐caring behaviors and practices. We state that models like POTT, that focus on embracing our vulnerability, can help clinicians be more caring toward ourselves. We conclude this paper by presenting clinical and training recommendations.

  February 13, 2017   doi: 10.1111/jmft.12213   open full text
• Two‐Year Follow‐up Outcomes in Emotionally Focused Couple Therapy: An Investigation of Relationship Satisfaction and Attachment Trajectories.
  Stephanie A. Wiebe, Susan M. Johnson, Marie‐France Lafontaine, Melissa Burgess Moser, Tracy L. Dalgleish, Giorgio A. Tasca.
  Journal of Marital and Family Therapy. December 20, 2016
  Emotionally Focused Couple Therapy (EFT; The practice of emotionally focused couple therapy: Creating connection. New York, NY: Brunner‐Routledge) is an evidence‐based couple therapy that aims to create lasting change for couples (Clinical Psychology: Science and Practice, 6(1), 67–79). Although studies have demonstrated strong results in follow‐up (Journal of Marital and Family Therapy, 28(4), 391–398), less is known about relationship functioning across time after therapy has ended. We modelled change in relationship satisfaction and attachment from pre‐therapy through 24 months follow‐up in 32 couples. HLM results confirmed a significant growth pattern demonstrating increases in relationship satisfaction and secure base behaviour and decreases in relationship specific attachment anxiety over the course of therapy and across follow‐up at a decelerated rate. These findings support the theoretical assumption that EFT helps couples engaged in therapy create lasting relationship satisfaction and attachment change.

  December 20, 2016   doi: 10.1111/jmft.12206   open full text
• Therapists’ Assessments in Treating “Sex Addiction” and Their Relationship to Clients’ Gender, Relationship Status, and Exclusivity Status.
  Geoffrey T. Reddick, Katie M. Heiden‐Rootes, Andrew S. Brimhall.
  Journal of Marital and Family Therapy. December 07, 2016
  A total of 208 therapists and therapists‐in‐training were surveyed to better understand if clinical assessments and recommendations regarding “sex addiction” changed based upon a client's gender, relationship status, or exclusivity status. Using clinical vignettes, this study examined the clinical assessment and recommendations of licensed mental health providers (n = 92) and mental health providers in‐training (n = 116). Results indicated that professional ratings differed based on relationship exclusivity and gender; specifically, female nonmonogamous behavior was rated more negatively than male nonmonogamous behavior, while male monogamous behavior was rated more negatively than female monogamous behavior. Recommendations for treatment varied, with higher addiction ratings leading to greater odds of recommending individual, group, and community support over relational therapy. Clinical and training implications are discussed. Video abstract accessible by clicking here. Video abstract accessible by clicking here.

  December 07, 2016   doi: 10.1111/jmft.12210   open full text
• It's About Time! Examining Received Dosage and Program Duration as Predictors of Change Among Non‐Distressed and Distressed Married Couple and Relationship Education Participants.
  Angela B. Bradford, Lauren Drean, Francesca Adler‐Baeder, Scott A. Ketring, Thomas A. Smith.
  Journal of Marital and Family Therapy. December 02, 2016
  Although Couple and Relationship Education (CRE) programs were intended to be preventive in nature, an emerging reality is that relationally distressed couples are attending programs. This has raised questions about both its general usefulness and what is known regarding predictors of change in CRE for distressed couples particularly. Previous work has identified dosage and duration as important moderators of changes, and there are myriad program contexts offered, highlighting the need to examine these among distressed couples. This study utilized a sample of community CRE participants and examined received dosage and program duration as predictors of change. Comparing results for distressed and non‐distressed participants, we found several group differences. Findings suggest that it is important to consider distress level and time spent in programs when placing participants. In addition, research should continue to examine these groups separately (or comparatively) to find out what works for whom.

  December 02, 2016   doi: 10.1111/jmft.12209   open full text
• Predicting Follow‐up Outcomes in Emotionally Focused Couple Therapy: The Role of Change in Trust, Relationship‐Specific Attachment, and Emotional Engagement.
  Stephanie A. Wiebe, Susan M. Johnson, Melissa Burgess Moser, Tracy L. Dalgleish, Giorgio A. Tasca.
  Journal of Marital and Family Therapy. November 22, 2016
  Emotionally Focused Couple Therapy (EFT), an evidence‐based couple therapy (Johnson, Hunsley, Greenberg, & Schindler, 1999), strives to foster lasting change through the creation of secure attachment bonds in distressed couples. Although studies have demonstrated lasting change in follow‐up (Wiebe et al., in press), research is needed to investigate predictors of long‐term outcomes. Our goal was to investigate predictors of long‐term outcomes in relationship satisfaction. Relationship satisfaction was assessed across 24 months in a sample of 32 couples who received an average of 21 EFT sessions. Decreases in attachment avoidance were most predictive of higher relationship satisfaction across follow‐up. These findings support the theoretical assumption that EFT helps couples foster lasting change in relationship satisfaction through the facilitation of secure attachment bonds.

  November 22, 2016   doi: 10.1111/jmft.12199   open full text
• Couple Forgiveness and its Moderating Role in the Intergenerational Transmission of Veterans’ Posttraumatic Stress Symptoms.
  Xiao Zhou, Yafit Levin, Jacob Y. Stein, Gadi Zerach, Zahava Solomon.
  Journal of Marital and Family Therapy. November 18, 2016
  This study examined the moderating effect couple forgiveness (as perceived by the wives/mothers) may have on the intergenerational transmission of posttraumatic stress symptoms (PTSS) among families of combat veterans and former prisoners of war (ex‐POWs). The sample included 123 (79 ex‐POWs and 44 control combatants) Israeli father–mother–adult offspring triads. Self‐report measures were administered at 2008 to veterans, at 2010–2011 to wives, and at 2013–2014 to offspring. The findings indicated that ex‐POWs’ PTSS were positively related to their offspring's PTSS, while couple forgiveness buffered this effect, particularly, and detrimentally, when couple forgiveness was low. These findings imply that apprehending the quality of the forgiving atmosphere within the marital relationship may be important for understanding the apparatus of intergenerational transmissions of trauma.

  November 18, 2016   doi: 10.1111/jmft.12200   open full text
• Global Mental Health in Action: Reducing Disparities One Community at a Time.
  Richard J. Bischoff, Paul R. Springer, Nathan Taylor.
  Journal of Marital and Family Therapy. November 17, 2016
  There are great disparities in mental health care around the world. Traditional approaches to mental health care have not been found to be transferrable to many parts of the world and are inadequate to address these disparities. Unconventional approaches are needed that match the traditions of care‐seeking and care‐giving within the communities where they are delivered. The authors review the global mental health literature and discuss how marriage and family therapists are in a particularly good position to have worldwide impact on mental health disparities. Five principles of global mental health are presented along with an example of how these principles are applied through the Reducing Mental Health Disparities One Community at a Time (RD1CT) model.

  November 17, 2016   doi: 10.1111/jmft.12202   open full text
• “Family Matters”: A Systematic Review of the Evidence For Family Psychoeducation For Major Depressive Disorder.
  Pamela Brady, Maria Kangas, Katherine McGill.
  Journal of Marital and Family Therapy. November 16, 2016
  The first aim of this systematic review was to evaluate the evidence for family psychoeducation (FPE) interventions for major depressive disorder (MDD). A second aim was to compare the efficacy of different modes of delivering face‐to‐face FPE interventions. Ten studies (based on nine distinct samples) were identified comprising four single‐family studies, four multifamily studies, one single versus multifamily comparative study, and one peer‐led, mixed‐diagnosis study. Seven studies measured patient functioning and six reported positive outcomes. Six studies measured carer's well‐being and four reported positive outcomes. Results provide preliminary evidence that FPE leads to improved outcomes for patient functioning and family–carer's well‐being for persons with depression. The implications for future development and delivery of FPE interventions for MDD are discussed.

  November 16, 2016   doi: 10.1111/jmft.12204   open full text
• Integrating Social Justice into the Practice of CBFT: A Critical Look at Family Schemas.
  Elizabeth O. Parker, Teresa McDowell.
  Journal of Marital and Family Therapy. November 16, 2016
  Many families come to therapy struggling with the negative consequence of social inequity. Family therapy modalities have been developed to address these negative consequences and attend to power and social equity (Transformative family therapy: Just families in a just society. Boston, MA: Pearson Education; Socio‐emotional relationship therapy. New York, NY: Springer). We argue that many family therapy modalities can be adapted to include social equity (Applying critical social theory in family therapy practice. AFTA Springer Series. New York, NY: Springer Publishing). Specifically, cognitive behavioral family therapy can be used to address the inequality in social systems that negatively affect the family system. We focus on schema formation and suggest an emphasis on societal schemas within the therapy milieu as a tool to help families see how societal inequality can affect the problems faced in family life.

  November 16, 2016   doi: 10.1111/jmft.12205   open full text
• Clinical Training and Practice Patterns of Medical Family Therapists: A National Survey.
  Max Zubatsky, Steven M. Harris, Tai J. Mendenhall.
  Journal of Marital and Family Therapy. November 07, 2016
  Medical family therapy (MedFT) has gained momentum as a framework in healthcare for individuals and families. However, little is known about what background training and clinical experiences Medical Family Therapists (MedFTs) have in everyday practice. This study investigated the clinical training of MedFTs and their practices in a variety of care settings. A survey was completed by 80 participants who use a MedFT framework in practice, with descriptive data on curriculum, clinical training, and treatment characteristics. Results reflect that many MedFTs lack formal coursework in key content areas of their graduate training and work primarily with psychological and relational concerns. Future research is needed to explore how MedFTs practice around specific mental health and chronic health conditions.

  November 07, 2016   doi: 10.1111/jmft.12203   open full text
• The Role of Attachment Behaviors in the Link between Relationship Satisfaction and Depression in Clinical Couples: Implications for Clinical Practice.
  Joshua R. Novak, Jonathan G. Sandberg, Stephanie Y. Davis.
  Journal of Marital and Family Therapy. November 04, 2016
  Using dyadic, clinical data from 104 couples in committed relationships, the purpose of this study was to determine whether relationship satisfaction was associated with depression through perceived partner attachment behaviors—accessibility, responsiveness, and engagement—for both men and women. We found that one's satisfaction in the relationship was the lens through which they viewed their partner's attachment behaviors and—women's relationship satisfaction was the lens through which her male partner viewed her attachment behaviors. Finally, women's relationship satisfaction is associated with both individuals' depression through her perceived partner's accessibility, responsiveness, and engagement. The findings from this study are important because they provide clinically relevant and mutable constructs in which clinicians can intervene at an attachment level in distressed marriages with depressed partners.

  November 04, 2016   doi: 10.1111/jmft.12201   open full text
• Solution Focused Brief Therapy: A Systematic Review and Meta‐Summary of Process Research.
  Cynthia Franklin, Anao Zhang, Adam Froerer, Shannon Johnson.
  Journal of Marital and Family Therapy. October 19, 2016
  This article presents a systematic review of the process research on solution‐focused brief therapy (SFBT). We searched published and unpublished studies in English across five databases, five major journals, two book chapters, and four websites to locate studies that investigate why and how SFBT works. Thirty‐three studies that used various research methods were located and included for further analysis using a meta‐summary approach. The findings supported the significance of the co‐construction process within SFBT and the effects of specific types of SFBT techniques. The most empirical support was found for the strength‐oriented techniques in comparison to the other techniques and for the co‐construction of meaning. Current studies require replications with larger samples and experimental designs that study SFBT process in relationship to outcomes.

  October 19, 2016   doi: 10.1111/jmft.12193   open full text
• Are we there yet? Faculty Members’ Beliefs and Teaching Practices Related to the Ethical Treatment of Lesbian, Gay, and Bisexual Clients.
  Christi R. McGeorge, Thomas Stone Carlson, Candice A. Maier.
  Journal of Marital and Family Therapy. October 17, 2016
  The purpose of this study was to explore (a) faculty members' beliefs about the ethics of reparative therapy and referring lesbian, gay, and bisexual (LGB) clients, (b) course content related to reparative therapy and referral of LGB clients, and (c) positions taken by programs associated with reparative therapy and referral of LGB clients. A total of 117 faculty members from accredited family therapy programs completed an online survey for this study. While the vast majority of faculty members reported that reparative therapy is unethical, there was less agreement related to the ethics of referring LGB clients, which may highlight the need for clearer ethical guidelines to regulate this potentially harmful practice. Implications for clinical training and future research are discussed.

  October 17, 2016   doi: 10.1111/jmft.12197   open full text
• Multi‐Family Therapy with a Reflecting Team: A Preliminary Study on Efficacy among Opiate Addicts in Methadone Maintenance Treatment.
  Miguel Garrido‐Fernández, Juan A. Marcos‐Sierra, Ana López‐Jiménez, Iñigo Ochoa de Alda.
  Journal of Marital and Family Therapy. October 17, 2016
  In this study, we evaluate the efficacy of multi‐family therapy at reducing the addiction severity and at improving the psychological and family dynamics of opiate addicts receiving methadone treatment at a public treatment center. The study compares multi‐family therapy with a reflecting team (MFT‐RT) and a standard treatment following a methadone maintenance treatment program. The results show that multi‐family therapy with a reflecting team effectively reduces the addiction severity in several of the areas evaluated and noted that this effect is superior to standard treatment. The psychotherapy patients showed improvement in the areas of employment and social support; their drug use diminished and their psychiatric condition improved. At the same time, they needed a lower daily dose of methadone. In addition, the group undergoing standard treatment showed a noteworthy deterioration in their medical condition. Both groups showed a significant increase in their alcohol use. When applied to family treatments, the systemic‐constructivist approach by the reflecting team offers combined techniques that can help improve care for the families of patients with addiction problems.

  October 17, 2016   doi: 10.1111/jmft.12195   open full text
• Broken Promises and Lost Dreams: Navigating Asylum in the United States.
  Damir S. Utržan, Andrea K. Northwood.
  Journal of Marital and Family Therapy. October 14, 2016
  Nearly 65 million people around the world have been displaced by war, conflict, and persecution since 2014 (UNHCR; United Nations High Commissioner for Refugees, 2015). This yields an average of 42,000 people refugees, asylum seekers, or internally displaced every day. Displacement has adverse and disruptive consequences, including mental health problems (e.g., anxiety, depression), impaired interpersonal relationships, and heightened conflict. These consequences are compounded by profound ambiguity associated with navigating asylum in the United States. In this article, we describe the treatment of a couple from Syria who is seeking asylum in the United States. Informed by personal and professional experience, this case illustrates how ambiguous loss theory and awareness of relevant legal processes enhance our understanding of working with asylum seekers.

  October 14, 2016   doi: 10.1111/jmft.12188   open full text
• The Association between the Parent–Child Relationship and Symptoms of Anxiety and Depression: The Roles of Attachment and Perceived Spouse Attachment Behaviors.
  Angela B. Bradford, Kayla L. Burningham, Jonathan G. Sandberg, Lee N. Johnson.
  Journal of Marital and Family Therapy. October 14, 2016
  Research shows that the parent–child relationship affects attachment security, which correlates with anxiety and depression in adulthood. Additional research shows that romantic attachment behaviors may supersede individual attachment security and buffer against negative processes. Using data from 680 married couples in the general population, we examined whether attachment mediates the link between the parent–child relationship and depressive and anxiety symptoms in adulthood. In addition, we tested whether perceived spouse attachment behaviors moderate the effects of attachment insecurity. There was an indirect effect of poor parent–child relationships on symptoms via insecure attachment. Perception of spouse's attachment behaviors was related to depression for both spouses, and they moderated the effect of attachment insecurity on depressive symptoms for husbands. Clinical implications are discussed.

  October 14, 2016   doi: 10.1111/jmft.12190   open full text
• Dissemination and Implementation Research in Marriage and Family Therapy: An Introduction and Call to the Field.
  Mathew C. Withers, Jamila E. Reynolds, Kayla Reed, Kendal Holtrop.
  Journal of Marital and Family Therapy. October 04, 2016
  Despite the considerable resources allocated to research to promote public health, interventions capable of benefiting individuals and families are not finding their way into regular practice. An important avenue for addressing this problem is through dissemination and implementation (D&I) science, a burgeoning research area focusing on translating empirical knowledge into everyday practice. This article begins by suggesting ways in which MFTs are uniquely equipped to contribute to and benefit from D&I research. We will then provide an overview of D&I research, outlines key D&I models, and highlight examples of family intervention research relevant to MFTs using the key models. Finally, we conclude by providing the field with important next steps to advance the presence of MFT research within D&I scholarship.

  October 04, 2016   doi: 10.1111/jmft.12196   open full text
• Checking up on Couples—A Meta‐Analysis of the Effect of Assessment and Feedback on Marital Functioning and Individual Mental Health in Couples.
  Hanne N. Fentz, Tea Trillingsgaard.
  Journal of Marital and Family Therapy. August 12, 2016
  The primary aim of the current meta‐analysis was to investigate the overall effect of a relationship checkup (RC), a couple‐oriented assessment, and feedback intervention. Systematic literature searches revealed 12 eligible randomized trials published between 1995 and 2015. Results showed significant overall pre–post effect of an RC on marital functioning (Hedge's g = 0.20) and individual mental health (g = 0.44). The between‐group controlled effect size was significant at postassessment (g = 0.23) and up to six‐month follow‐up (g = 0.23). Characteristics of the RC format, therapist‐guided versus self‐directed, or the study samples, distressed versus healthy, did not moderate the overall effect of the RC. Thus, our results suggest an RC to improve couples' marital functioning up to six‐month follow‐up, while the effect on individual mental health and repeated delivery of a RC awaits further research.

  August 12, 2016   doi: 10.1111/jmft.12185   open full text
• Cultural Attunement in Therapy With Mexican‐Heritage Couples: A Grounded Theory Analysis of Client and Therapist Experience.
  Marco A. Elias‐Juarez, Carmen Knudson‐Martin.
  Journal of Marital and Family Therapy. August 10, 2016
  There is a need for culturally attuned approaches for couple therapy with Mexican/Mexican‐Americans. This qualitative grounded theory study utilized interviews with 11 client couples of Mexican heritage and 14 marital and family therapists to shed light on how Latino and non‐Latino therapists co‐construct positive experiences of cultural attunement with Mexican and Mexican‐American couple clients. Analysis identified a model of cultural connection through personal engagement with four interrelated phases: (a) mutual invitation, (b) shared engagement, (c) expanding personal connection, and (d) creating cultural connections. Clients in this study valued professionalism and expertise of the therapist, but felt attuned to and respected when therapists demonstrated humility, shared personal stories and emotion, and engaged in a collaborative process.

  August 10, 2016   doi: 10.1111/jmft.12183   open full text
• The Efficacy of Internal Family Systems Therapy in the Treatment of Depression Among Female College Students: A Pilot Study.
  Shelley A. Haddock, Lindsey M. Weiler, Lisa J. Trump, Kimberly L. Henry.
  Journal of Marital and Family Therapy. August 08, 2016
  College women are vulnerable to depression due to developmental and transitional life changes. Early diagnosis and effective treatment is critically important. Empirical support exists for the effectiveness of select treatment options (i.e., antidepressant medication, cognitive‐behavioral therapy [CBT], and interpersonal psychotherapy [IPT]), yet a significant percentage of those treated do not benefit. In this pilot study, Internal Family Systems (IFS) therapy was tested as an alternative approach. College women (N = 37) were randomly allocated to IFS treatment or treatment as usual (CBT or IPT). Results demonstrated a decline in depressive symptoms for both conditions and no significant differences in the magnitude or rate of change. The results provide preliminary evidence for the efficacy of IFS in the treatment of depressive symptoms.

  August 08, 2016   doi: 10.1111/jmft.12184   open full text
• Development and Validation of the Marital Metaphor Questionnaire (MMQ‐10) for Urban Chinese Women.
  Ruth D. H. Zhou, Marcus Y. L. Chiu, Wing‐Yip Chui.
  Journal of Marital and Family Therapy. July 20, 2016
  Metaphors have long been applied to marital counseling and couple therapy. This pioneering study measures marital conceptualization through metaphors. It reports the validation of the Marital Metaphor Questionnaire (MMQ‐10), designed to measure the marriage conceptualization of Chinese women through marital metaphors. The MMQ‐10 was found to have favorable psychometric properties including reliable internal consistency, a good discriminative prediction of marriage at risk and moderate correlation with a Chinese indigenous multidimensional marital satisfaction inventory. Factor analysis reveals that the MMQ‐10 is composed of three dimensions: conjugal relationship, marital anguish, and marital conviction. The MMQ‐10 appears to be suitable for the use with Chinese women in premarital or marital counseling sessions. The present researchers hope that this study may support the use of metaphors in future research and clinical practice in other nations and cultures.

  July 20, 2016   doi: 10.1111/jmft.12181   open full text
• Experiences of Couples Caring for a Child Born with Cleft Lip and/or Palate: Impact of the Timing of Diagnosis.
  Senem Zeytinoğlu, Maureen P. Davey, Canice Crerand, Kathleen Fisher, Yudum Akyil.
  Journal of Marital and Family Therapy. July 08, 2016
  Raising a child born with cleft lip and/or palate (CL/P) can be challenging for parents. Few researchers have examined how having a child born with CL/P impacts couples. The purpose of this descriptive qualitative study was to examine how a child's CL/P diagnosis affects couples’ relational adjustment and coping. We conducted interviews with 17 couples (10 prenatal and seven postnatal) caring for children born with CL/P. After conducting thematic content analysis, six overarching themes emerged: (a) relationship growth, (b) challenges, (c) roles and responsibilities, (d) sources of support, (e) talking about cleft, and (f) lessons learned. Findings suggest that couples should be routinely assessed for psychosocial issues and prevention programs should be tailored to preexisting stressors and timing of the diagnosis.

  July 08, 2016   doi: 10.1111/jmft.12182   open full text
• Couples Therapy for Intimate Partner Violence: A Systematic Review and Meta‐Analysis.
  Gunnur Karakurt, Kathleen Whiting, Chantal Esch, Shari D. Bolen, Joseph R. Calabrese.
  Journal of Marital and Family Therapy. July 05, 2016
  Intimate partner violence is a serious public health problem accompanied by substantial morbidity and mortality. Despite its documented impact on health, there is no widely recognized treatment of choice. Some studies indicate that couples suffering from situational violence may benefit from couples therapy, but professionals are cautious to risk the possibility of violent retaliation between partners. After a comprehensive literature search of 1,733 citations, this systematic review and meta‐analysis compiles the results of six studies to investigate the effectiveness of couples therapy as a treatment for violence. Preliminary data suggest that couples therapy is a viable treatment in select situations.

  July 05, 2016   doi: 10.1111/jmft.12178   open full text
• An Interpretive Phenomenological Inquiry of Family and Friend Reactions to Suicide Disclosure.
  Laura M. Frey, Jason D. Hans, Julie Cerel.
  Journal of Marital and Family Therapy. July 02, 2016
  Suicide attempt survivors’ interpretations of reactions to attempts are understudied, yet could inform prevention efforts concerning subsequent attempts. Interviews with 40 attempt survivors about family and friend reactions were analyzed using interpretive phenomenological techniques. Three distinct patterns emerged as follows: (a) Stigmatizing statements and emphasis on reactor's feelings were interpreted as signs that attempt survivors were a burden to others, (b) avoidant reactions and excessive monitoring were interpreted as cues that suicidal behavior must remain hidden to not be a burden, and (c) asking questions and projecting strength were interpreted as signs that attempt survivors belonged and were not a burden. These findings highlight the importance of working with family and friends to encourage reactions that reduce the risk of future attempts.

  July 02, 2016   doi: 10.1111/jmft.12180   open full text
• Unique Characteristics of Cohabiters Seeking Therapy.
  Samuel Shannon, Suzanne Bartle‐Harring.
  Journal of Marital and Family Therapy. June 14, 2016
  There is limited information on cohabiters presenting for therapy. The authors examined the characteristics of 143 married and 54 cohabiting, young (m = 30.39), Caucasian, couples presenting for therapy. We hypothesized that cohabiters presenting for therapy would be more satisfied and committed than married couples and that they would be similarly emotionally differentiated. We conducted a repeated‐measures MANOVA to test the hypothesis. Significant effects between partners and between dyads were found, indicating a difference between clients based on relationship status. Cohabiting clients presented earlier in their relationship and were more satisfied and committed. Cohabiting male partners were less emotionally reactive. Without the institutionalized rules of marriage, cohabiting couples may perceive threats to their relationship earlier than married couples.

  June 14, 2016   doi: 10.1111/jmft.12169   open full text
• Forgiveness in Romantic Relationships: The Roles of Attachment, Empathy, and Attributions.
  Jonathan G. Kimmes, Jared A. Durtschi.
  Journal of Marital and Family Therapy. June 14, 2016
  Therapists can benefit from a more nuanced understanding of underlying processes associated with romantic partners forgiving one another. Greater understanding of the processes linked with forgiveness has the potential to improve therapists' facilitation of forgiveness between partners. Departing from the status quo, the purpose of this investigation was to explore benign attributions and empathy as mechanisms linking attachment with forgiveness. After conducting a longitudinal structural equation model with a sample of young adults in romantic relationships (N = 171), the results showed that benign attributions mediated the association between anxious attachment and forgiveness, and empathy mediated the association between avoidant attachment and forgiveness. Clinically, targeting working models of attachment that underlie benign attributions and empathy may facilitate forgiveness.

  June 14, 2016   doi: 10.1111/jmft.12171   open full text
• Talking or Keeping Silent About Parental Mental Health Problems—A Grounded Theory of Parents' Decision Making and Experiences with Their Children.
  Lizette Nolte, Bernadette Wren.
  Journal of Marital and Family Therapy. June 13, 2016
  This grounded theory study explored parents' experiences of responding to their children's need for understanding parental mental health concerns. Fifteen parents with severe and enduring mental health difficulties participated in the study. The findings suggest four main social processes that influence parents' talk with their children about parental mental health issues, namely “Protecting and being protected,” “Responding to children's search for understanding,” “Prioritizing family life,” and “Relating to others.” Implications of the findings for clinical practice and future research are considered. In particular, the need for more family‐orientated services where parents experience parental mental health problems is highlighted.

  June 13, 2016   doi: 10.1111/jmft.12177   open full text
• Nonviolent Resistance: Helping Caregivers Reduce Problematic Behaviors in Children and Adolescents.
  Haim Omer, Eli R. Lebowitz.
  Journal of Marital and Family Therapy. June 13, 2016
  In this review, the principles of nonviolent resistance (NVR) and studies examining its acceptability and efficacy are reviewed. Originating in the sociopolitical field, NVR has been adapted for numerous settings including parents of youth with externalizing and other problems, foster parents, teachers and school personnel, and caregivers of psychiatric inpatients. NVR has also been applied to reduce accommodation of highly dependent adult children and to improve novice driving habits. The principles of NVR include refraining from violence, reducing escalation, utilizing outside support, and maintaining respect for the other.

  June 13, 2016   doi: 10.1111/jmft.12168   open full text
• Spatial Statistics for Dyadic Data: Analyzing the Relationship Landscape.
  Nathan D. Wood, Ilya A. Okhotnikov.
  Journal of Marital and Family Therapy. June 13, 2016
  Spatial statistics has a rich tradition in earth, economic, and epidemiological sciences and has potential to affect the study of couples as well. When applied to couple data, spatial statistics can model within‐ and between‐couple differences with results that are readily accessible for researchers and clinicians. This article offers a primer in using spatial statistics as a methodological tool for analyzing dyadic data. The article will introduce spatial approaches, review data structure required for spatial analysis, available software, and examples of data output.

  June 13, 2016   doi: 10.1111/jmft.12179   open full text
• The Family System and Depressive Symptoms during the College Years: Triangulation, Parental Differential Treatment, and Sibling Warmth as Predictors.
  Sujata Ponappa, Suzanne Bartle‐Haring, Eugene Holowacz, Megan Ferriby.
  Journal of Marital and Family Therapy. June 10, 2016
  Guided by Bowen theory, we investigated the relationships between parent–child triangulation, parental differential treatment (PDT), sibling warmth, and individual depressive symptoms in a sample of 77 sibling dyads, aged 18–25 years, recruited through undergraduate classes at a U.S. public University. Results of the actor–partner interdependence models suggested that being triangulated into parental conflict was positively related to both siblings’ perception of PDT; however, as one sibling felt triangulated, the other perceived reduced levels of PDT. For both siblings, the perception of higher levels of PDT was related to decreased sibling warmth and higher sibling warmth was associated with fewer depressive symptoms. The implications of these findings for research and the treatment of depression in the college‐aged population are discussed.

  June 10, 2016   doi: 10.1111/jmft.12175   open full text
• Most and Least Meaningful Learning Experiences in Marriage and Family Therapy Education.
  Fred P. Piercy, Ryan M. Earl, Renu K. Aldrich, Hoa N. Nguyen, Sarah M. Steelman, Emily Haugen, Dana Riger, Ruvi T. Tsokodayi, Jamie West, Yesim Keskin, Emily Gary.
  Journal of Marital and Family Therapy. June 10, 2016
  Marriage and family therapy educators increasingly emphasize training competencies. What we know less about is what makes family therapy education meaningful to marriage and family therapy (MFT) graduate students and what does not. In this study, through an Internet survey, we explored the most and least meaningful learning experiences of 68 MFT graduate students and recent graduates of Commission on Accreditation for Marriage and Family Therapy Education—accredited programs. We used thematic analysis to identify and illustrate resulting themes, which included the importance of experiential and personal components to learning, the professor‐student alliance, tying theory to practice, and the experiences of students with their clients, among others. We discuss the implications of these findings to support family therapy education and offer tentative suggestions for formative discussions both within and across programs. Video Abstract is found in the online version of the article. Video Abstract is found in the online version of the article.

  June 10, 2016   doi: 10.1111/jmft.12176   open full text
• Avoid falling for a jerk(ette): Effectiveness of the Premarital Interpersonal Choices and Knowledge Program among Emerging Adults.
  Kay Bradford, J. Wade Stewart, Roxane Pfister, Brian J. Higginbotham.
  Journal of Marital and Family Therapy. June 10, 2016
  Premarital education may help emerging adults form healthy relationships, but evaluation research is needed, particularly with community samples. We studied emerging adults in the Premarital Interpersonal Choices and Knowledge (PICK) program, using a pre‐ to post‐ and a posttest‐then‐retrospective‐pretest design to examine change in perceived relationship skills, partner selection, relational patterns, and relationship behaviors and attitudes. Mixed models analyses showed that scores for the treatment group (n = 682) increased from pre to post on all four outcomes. Changes in scores for the nonequivalent comparison group (n = 462) were nonsignificant. In addition, significant differences between pre‐ and retrospective prescores demonstrated evidence for response shift bias. The results suggest that the PICK program helps participants increase their knowledge regarding the components of healthy relationship formation.

  June 10, 2016   doi: 10.1111/jmft.12174   open full text
• A Cost–Benefit Analysis of a Family Systems Intervention for Managing Pediatric Chronic Illness.
  Brian J. Distelberg, Natacha D. Emerson, Paul Gavaza, Daniel Tapanes, Whitney N. Brown, Huma Shah, Jacqueline Williams‐Reade, Susanne Montgomery.
  Journal of Marital and Family Therapy. June 10, 2016
  Despite recent increases of psychosocial programs for pediatric chronic illness, few studies have explored their economic benefits. This study investigated the costs–benefits of a family systems‐based, psychosocial intervention for pediatric chronic illness (MEND: Mastering Each New Direction). A quasi‐prospective study compared the 12‐month pre–post direct and indirect costs of 20 families. The total cost for program was estimated to $5,320. Families incurred $15,249 less in direct and $15,627 less in indirect costs after MEND. On average, medical expenses reduced by 86% in direct and indirect costs, for a cost–benefit ratio of 0.17. Therefore, for every dollar spent on the program, families and their third payers saved approximately $5.74. Implications for healthcare policy and reimbursements are discussed.

  June 10, 2016   doi: 10.1111/jmft.12166   open full text
• A Model of Engagement Promotion in a Professionally Facilitated Online Intervention for Couples Affected by Breast Cancer.
  Iana Ianakieva, Karen Fergus, Saunia Ahmad, Alberta Pos, Amanda Pereira.
  Journal of Marital and Family Therapy. May 28, 2016
  Professionally facilitated web‐based interventions for couples affected by an illness such as cancer are growing in popularity. Attrition rates for such online programs, however, are substantially higher than what is observed in face‐to‐face therapeutic contexts, and lower levels of participant engagement are associated with poorer outcomes. In the present investigation, a task analysis was employed to develop a model of engagement promotion in an online intervention for couples affected by breast cancer called “Couplelinks.” Results indicated that facilitators utilized a variety of meta‐processes, such as humanizing the technology, and associated “eBehaviors,” to maintain three relationships involved in promoting online engagement: (a) between the facilitator and couple; (b) between the intervention and couple; and (c) between the partners within the couple.

  May 28, 2016   doi: 10.1111/jmft.12172   open full text
• Stepfather Involvement and Stepfather–Child Relationship Quality: Race and Parental Marital Status as Moderators.
  Todd M. Jensen, Garrett T. Pace.
  Journal of Marital and Family Therapy. May 10, 2016
  Stepparent–child relationship quality is linked to stepfamily stability and children's well‐being. Yet, the literature offers an incomplete understanding of factors that promote high‐quality stepparent–child relationships, especially among socio‐demographically diverse stepfamilies. In this study, we explore the association between stepfather involvement and stepfather–child relationship quality among a racially diverse and predominately low‐income sample of stepfamilies with preadolescent children. Using a subsample of 467 mother–stepfather families from year 9 of the Fragile Families and Child Wellbeing Study, results indicate that stepfather involvement is positively associated with stepfather–child relationship quality. This association is statistically indistinguishable across racial groups, although the association is stronger among children in cohabiting stepfamilies compared to children in married stepfamilies.

  May 10, 2016   doi: 10.1111/jmft.12165   open full text
• Training for Connection: Students' Perceptions of the Effects of the Person‐of‐the‐Therapist Training on Their Therapeutic Relationships.
  Alba Niño, Karni Kissil, Laura Cooke.
  Journal of Marital and Family Therapy. May 10, 2016
  The Person‐of‐the‐Therapist Training (POTT) is a program designed to facilitate clinicians' ability to consciously and purposefully use their selves to effectively connect, assess, and intervene with clients. This study explored CFT students' perceptions of the effects of POTT on their ability to create positive therapeutic relationships. Course papers and final reflections were collected from 70 CFT students. Directed content analysis looking for evidence‐supported elements of positive therapeutic relationships revealed 5 elements: empathy, management of countertransference, balancing multiple alliances, positive regard, and bond. Findings support the idea that a structured program focused on the training of the personal aspects of the therapists, like POTT, can promote the evidence‐supported elements that make a therapeutic relationship effective.

  May 10, 2016   doi: 10.1111/jmft.12167   open full text
• Enhancing the Relationship Adjustment of South Asian Canadian Couples Using a Systemic‐Constructivist Approach to Couple Therapy.
  Saunia Ahmad, David W. Reid.
  Journal of Marital and Family Therapy. April 06, 2016
  The effectiveness of systemic‐constructivist couple therapy (SCCT) in improving the relationship adjustment of South Asian Canadian couples in ways that attend to their culture was evaluated. The SCCT interventions engage partners in reflexive processing of both their own and their partner's ways of construing, and the reciprocity between these two. A core change mechanism of SCCT, couple identity (“we‐ness”), that connotes the ability for thinking and experiencing relationally, was coded from verbatim transcripts of partners' within‐session dialogue. As predicted, South Asian partners' relationship adjustment improved significantly from the first to final session of SCCT, and concurrent increases in each partner's couple identity mediated such improvements. The implications for considering culture and couple identity in couple therapy are discussed. Video Abstract is found in the online version of the article. Video Abstract is found in the online version of the article.

  April 06, 2016   doi: 10.1111/jmft.12161   open full text
• Therapist Differentiation and Couple Clients' Perceptions of Therapeutic Alliance.
  Suzanne Bartle‐Haring, Samuel Shannon, David Bowers, Eugene Holowacz.
  Journal of Marital and Family Therapy. February 29, 2016
  Therapeutic alliance has been acknowledged as one of the catalysts for change within a therapeutic relationship. The contributions of therapists' characteristics to alliance are not often studied. From a Bowen System's Theory perspective, the therapist's level of differentiation would be highly relevant to the development of a therapeutic alliance. The hypothesis for this study was that therapists who are able to take a more differentiated stance in therapy will build a stronger therapeutic alliance. To test this hypothesis, multilevel modeling procedures were performed, using data from nine therapists and 93 couple cases collected at a large, Midwestern university. Therapist differentiation of self was found to be weakly associated with the clients' perception of therapeutic alliance across the early sessions of therapy, but not in the expected direction. Although the results were unexpected, this study provides an example of the potential of examining therapist characteristics from within one model of therapy, that can be applied across various clients and various models of therapy.

  February 29, 2016   doi: 10.1111/jmft.12157   open full text
• Harnessing the Power of Play in Emotionally Focused Family Therapy With Preschool Children.
  Amber B. Willis, Darryl R. Haslam, J. Maria Bermudez.
  Journal of Marital and Family Therapy. February 29, 2016
  Emotionally focused family therapy (EFFT) is an attachment‐based therapy model that has been used with older children and adolescents. More recently, it has been suggested for use with young children. EFFT holds promise as a clinical treatment for young children coping with attachment problems, but more detailed guidelines are needed for implementing the model with this age‐group. Whereas preschool and kindergarten age children are less able to participate in talk therapy than older children, accommodations need to be made to this approach when the identified patient is a young child. This article offers a variety of play therapy activities that may be incorporated within an EFFT framework to strengthen the emotional bonds in families with children ages four to six.

  February 29, 2016   doi: 10.1111/jmft.12160   open full text
• Adult Sexual Outcomes of Child Sexual Abuse Vary According to Relationship Status.
  Marie‐Pier Vaillancourt‐Morel, Natacha Godbout, Stéphane Sabourin, John Briere, Yvan Lussier, Marsha Runtz.
  Journal of Marital and Family Therapy. January 25, 2016
  This study tested a moderation model in which the association between child sexual abuse severity and negative sexual outcomes (i.e., sexual avoidance and compulsivity) differed as a function of relationships status (i.e., single, cohabiting, and married individuals). A sample of 1,033 adults completed self‐report questionnaires online, and 21.5% reported childhood sexual abuse. Path analyses indicated that child sexual abuse severity was associated with higher sexual compulsivity in single individuals, both higher sexual avoidance and compulsivity in cohabiting individuals, and higher sexual avoidance in married individuals. The moderation model was invariant across men and women. These results suggest that the time course of negative sexual outcomes associated with child sexual abuse may follow distinct patterns of expression according to relationship status.

  January 25, 2016   doi: 10.1111/jmft.12154   open full text
• Life After Bariatric Surgery: Perceptions of Male Patients and Their Intimate Relationships.
  Darren D. Moore, Clinton E. Cooper.
  Journal of Marital and Family Therapy. January 25, 2016
  This study explores the experiences of 20 men who have had bariatric surgery, focusing on their couple or marital relationships. The researcher concentrates on men's perspectives regarding relationship satisfaction, sexual intimacy, and social support after surgical intervention. Phenomenology and family systems theory were used to guide the study from which emerged three themes: (a) Unintended consequences (unpredicted problems occurring within intimate relationships); (b) Intimacy as bittersweet (experiencing increasing levels of intimacy, while still desiring more); and (c) Inconsistent social support (experiencing instances where social support is provided, while simultaneously experiencing other areas where social support is not provided). The study includes a rich description of the data, critical analysis, and discussion of clinical implications for therapists and other healthcare professionals.

  January 25, 2016   doi: 10.1111/jmft.12155   open full text
• Development of the Gay and Lesbian Relationship Satisfaction Scale.
  Christopher K. Belous, Richard S. Wampler.
  Journal of Marital and Family Therapy. January 25, 2016
  This article describes the development and evaluation of the Gay and Lesbian Relationship Satisfaction Scale (GLRSS) as a measure of individuals' gay and lesbian same‐gender relationship satisfaction and social support. Clinicians and researchers administer relationship satisfaction scales to persons in gay and lesbian relationships with a heteronormative assumption that scales developed and validated with opposite‐gender couples measure identical relationship issues. Gay and Lesbian couples have unique concerns that influence relationship satisfaction, most notably social support. Using online recruitment and data collection, the GLRSS was evaluated with data from 275 gay and lesbian individuals in a same‐gender relationship.

  January 25, 2016   doi: 10.1111/jmft.12158   open full text
• What Novice Family Therapists Experience During a Session… A Qualitative Study of Novice Therapists' Inner Conversations During the Session.
  Gianina Frediani, Peter Rober.
  Journal of Marital and Family Therapy. January 20, 2016
  “What do novice family therapists experience during a session with a couple or family?” This is the central question in this article. A videotape‐assisted recall procedure was used to study novice family therapists’ inner conversations. The therapists' reflections were analyzed using thematic analysis. This resulted in a coding system that distinguishes four main domains: (a) reflections concerning the self; (b) reflections about the therapy process; (c) reflections on emotions about the family members; and (d) managing the session as well as own emotions. The study furthermore revealed that during a session, novice family therapists experience strong emotions, such as self‐criticism and irritation. Both emotions may encompass dangers, as well as opportunities for the therapeutic alliance and the process.

  January 20, 2016   doi: 10.1111/jmft.12149   open full text
• Sympathetic Nervous System Synchrony in Couple Therapy.
  Anu Karvonen, Virpi‐Liisa Kykyri, Jukka Kaartinen, Markku Penttonen, Jaakko Seikkula.
  Journal of Marital and Family Therapy. January 08, 2016
  The aim of this study was to test whether there is statistically significant sympathetic nervous system (SNS) synchrony between participants in couple therapy. To our knowledge, this is the first study to measure psychophysiological synchrony during therapy in a multiactor setting. The study focuses on electrodermal activity (EDA) in the second couple therapy session from 10 different cases (20 clients, 10 therapists working in pairs). The EDA concordance index was used as a measure of SNS synchrony between dyads, and synchrony was found in 85% of all the dyads. Surprisingly, co‐therapists exhibited the highest levels of synchrony, whereas couples exhibited the lowest synchrony. The client–therapist synchrony was lower than that of the co‐therapists, but higher than that of the couples. A Video Abstract is available next to the online version of this article on the JMFT web site. A Video Abstract is available next to the online version of this article on the JMFT web site.

  January 08, 2016   doi: 10.1111/jmft.12152   open full text
• Experiencing Couple Relationships in the Line of Fire.
  Michal Shamai, Saray Fogel, Dvorit Gilad.
  Journal of Marital and Family Therapy. January 06, 2016
  The study aims to explore the way civilians living in the line of fire experience the impact of exposure to warfare on their couple relationships. Semistructured interviews were conducted with 14 couples living on the Israeli side of the border with the Gaza Strip. Four themes emerged: Overall perception of the security situation's impact on the dyadic relationships, dyadic intimacy, role division and decision‐making, and Couple's emotional coping: partnership versus separateness. The findings were organized along a continuum between impacted and not‐impacted relationships. Couple's position on this continuum was not fixed and could change as a result of to the security situation or marital therapy. The findings were framed in concepts from Dialectic Theory and from the Family Adaptation Models. Implications for couple therapy in these situations were specified.

  January 06, 2016   doi: 10.1111/jmft.12147   open full text
• The Relationship Between Nonsuicidal Self‐Injury and Family Functioning: Adolescent and Parent Perspectives.
  Lauren Kelada, Penelope Hasking, Glenn Melvin.
  Journal of Marital and Family Therapy. January 04, 2016
  We explored parent and adolescent reports of family functioning, how this differed if the parent was aware that their child self‐injured, and how parental awareness of self‐injury was related to self‐injury frequency, self‐injury severity, and help seeking. Participants were 117 parent–adolescent dyads, in 23 of which the adolescent self‐injured. Adolescents who self‐injured reported poorer family functioning than their parents, but parents who did not know about their child's self‐injury reported similar functioning to parents whose children did not self‐injure. Parents were more likely to know that their child self‐injured when the behavior was severe and frequent. Help‐seeking was more likely when parents knew about self‐injury. Family‐based interventions which emphasize perspective‐taking could be used to effectively treat self‐injury.

  January 04, 2016   doi: 10.1111/jmft.12150   open full text
• To Refer or Not to Refer: Exploring Family Therapists' Beliefs and Practices Related to the Referral of Lesbian, Gay, and Bisexual Clients.
  Christi R. McGeorge, Thomas Stone Carlson, Molly Farrell.
  Journal of Marital and Family Therapy. December 30, 2015
  This study explored how negative beliefs toward lesbian, gay, and bisexual (LGB) individuals and LGB clinical competence influenced family therapists' beliefs and practices regarding referring based on the sexual orientation of the client. The sample consisted of 741 experienced clinicians. The results of this study indicated that the majority of the participants believe it is ethical to refer LGB clients; however, most had never made such a referral. Furthermore, participants who had referred based solely on the client's sexual orientation reported higher levels of negative beliefs toward LGB individuals and lower levels of LGB clinical competence. Finally, negative beliefs toward LGB persons not only predicted the practice of referring, but also the belief that it is ethical to refer an LGB client.

  December 30, 2015   doi: 10.1111/jmft.12148   open full text
• Internalizing and Externalizing Symptoms and Marital Relationship Functioning: The Mediating Role of Demand–Withdraw Communication Processes.
  Amber M. Jarnecke, Meghan S. Reilly, Susan C. South.
  Journal of Marital and Family Therapy. December 30, 2015
  Marital outcomes are associated with internalizing and externalizing symptoms; however, the processes by which these domains are associated with marital outcomes are not well understood. This study examined how demand–withdraw (DW) couple communication accounts for the association between symptoms of mental illness and marital distress. A mediational model was tested in a sample of 100 newlywed couples to determine: (a) whether internalizing and externalizing symptoms influenced own and partner's level of DW communication, and (b) whether this communication pattern was associated with relationship outcomes, including lower marital satisfaction and presence of conflict. Results suggested that DW communication had significant effects on both partner's marital outcomes and mediated the association between externalizing symptoms (for husbands) and marital distress.

  December 30, 2015   doi: 10.1111/jmft.12153   open full text
• Attachment Change in the Beginning Stages of Therapy: Examining Change Trajectories for Avoidance and Anxiety.
  Ryan B. Seedall, Mark H. Butler, Justin P. Zamora, Chongming Yang.
  Journal of Marital and Family Therapy. December 28, 2015
  The purpose of this study was to investigate the nature of self‐reported attachment change (avoidance and anxiety) in the context of six sessions of couple therapy designed to emphasize both therapist‐centered and couple‐centered (i.e., enactment‐based) clinical process during the beginning stages of therapy. A total of 48 couples with at least one partner who reported clinically significant relationship dissatisfaction participated in this study. Findings confirmed that some couples experience positive attachment‐related change (anxiety or avoidance), while also identifying a subset of individuals who may not experience optimal levels of attachment‐related change. In addition, findings point toward both differences and similarities between change trajectories for avoidance and anxiety. Finally, there was evidence that socio‐demographic factors may be associated with attachment change.

  December 28, 2015   doi: 10.1111/jmft.12146   open full text
• Culture‐ and Immigration‐Related Stress Faced by Chinese American Families with a Patient Having Schizophrenia.
  Winnie W. Kung.
  Journal of Marital and Family Therapy. November 19, 2015
  The impact of culture and immigration on the experience of Chinese American families with a member having schizophrenia is explored within the frameworks of family systems and stress and coping. This qualitative study was conducted within an intervention study of family psychoeducation using therapists’ session notes from 103 family sessions and 13 relatives’ group sessions from nine patients and 19 relatives. The high stigma attached to mental illness leading to social isolation, and families’ devotion to caregiving exacerbated caregiver burden. Taboo against discussing dating and sexuality and the consideration of arranged marriages caused unique stress. The insecurity as immigrants and shortage of bilingual services were related to greater enmeshment within these families. Implications on research methodology and practice are discussed.

  November 19, 2015   doi: 10.1111/jmft.12145   open full text
• It Takes Two? An Exploration of Processes and Outcomes in a Two‐Session Couple Intervention.
  Kay Bradford, D. Jim Mock, J. Wade Stewart.
  Journal of Marital and Family Therapy. November 02, 2015
  Although relationship distress is common, couples often forego professional help due to concerns such as time constraints, financial costs, and stigma. The two‐session relationship checkup is an alternative format of couple intervention developed to address these concerns. In this qualitative study, we interviewed 20 coupled participants and six clinicians to examine the checkup's processes and outcomes. The phenomenological themes that emerged revealed sequential processes by which this format works. Couple themes included client motivation, the therapeutic relationship, and therapeutic change in terms of perceptions and behaviors—particularly with regard to communication. Clinician data largely mirrored these themes. The results suggest the intervention addressed barriers to help‐seeking and may be a viable selective option for at‐risk couples.

  November 02, 2015   doi: 10.1111/jmft.12144   open full text
• Changes in Relationship‐Specific Attachment in Emotionally Focused Couple Therapy.
  Melissa Burgess Moser, Susan M. Johnson, Tracy L. Dalgleish, Marie‐France Lafontaine, Stephanie A. Wiebe, Giorgio A. Tasca.
  Journal of Marital and Family Therapy. October 29, 2015
  Emotionally focused couple therapy (EFT; Johnson, The practice of emotionally focused couple therapy (1st/2nd edition). Brunner‐Routledge, New York, 2004) is an effective treatment of relationship distress (Johnson et al., Clinical Psychology: Science and Practice, 1999; 6, 67). However, less is known about EFT's impact on couples' relationship‐specific attachment bond. Using hierarchical linear modeling with a sample of 32 couples, we examined session‐by‐session changes in couples' relationship‐specific attachment anxiety and avoidance and pre‐ to posttherapy changes in their relationship‐specific attachment behaviors. Couples significantly decreased in relationship‐specific attachment avoidance, and those who completed a blamer softening significantly decreased in relationship‐specific attachment anxiety. Couples' attachment behavior significantly increased toward security. Finally, session‐by‐session decreases in relationship‐specific attachment anxiety and avoidance were significant associated with increases in relationship satisfaction across sessions. These results provide empirical support for the attachment‐based assumptions of EFT. Video abstract accessible by clicking here Video abstract accessible by clicking here

  October 29, 2015   doi: 10.1111/jmft.12139   open full text
• Motivating Action and Maintaining Change: The Time‐Varying Role of Homework Following a Brief Couples' Intervention.
  Matt Hawrilenko, C. J. Eubanks Fleming, Alana S. Goldstein, James V. Cordova.
  Journal of Marital and Family Therapy. October 12, 2015
  Studies regarding the effectiveness of homework assignments in cognitive‐behavioral treatments have demonstrated mixed results. This study investigated predictors of compliance with homework recommendations and the time‐varying relationship of recommendation completion with treatment response in a brief couples' intervention (N = 108). More satisfied couples and couples with more motivation to change completed more recommendations, whereas couples with children completed fewer. The association between recommendation completion and treatment response varied with the passage of time, with the strongest effect observed 6 months after the intervention, but no discernible differences at 1 year postintervention. Couples that completed more recommendations experienced more rapid treatment gains, but even those couples doing substantially fewer recommendations ultimately realized equivalent treatment effects, although they progressed more slowly. Implications are discussed.

  October 12, 2015   doi: 10.1111/jmft.12142   open full text
• The Effect of Solution‐Focused Versus Problem‐Focused Questions: A Replication.
  Marie‐Carmen Neipp, Mark Beyebach, Rosa M. Nuñez, Marie‐Carmen Martínez‐González.
  Journal of Marital and Family Therapy. September 20, 2015
  In therapeutic conversations, questions can be considered as interventions in their own right. This study is a cross‐cultural replication of Grant (Journal of Systemic Therapies, 2012, 31, 2, 21) study on the effects of different types of questions on various clinically relevant variables. A total of 204 students of a Spanish university described a real‐life problem that they wanted to solve and were then randomly assigned to either a solution‐focused or a problem‐focused questions condition. Before and after answering the questions, they completed a set of measures that assessed positive and negative affect, self‐efficacy, and goal attainment. Solution‐focused questions produced a significantly greater increase in self‐efficacy, goal approach, and action steps than problem‐focused questions, and a significantly greater decrease in negative affect, providing further empirical support to solution‐focused practices.

  September 20, 2015   doi: 10.1111/jmft.12140   open full text
• Examining Attachment Avoidance and Attachment Anxiety Across Eight Sessions of Couple Therapy.
  Lee N. Johnson, Rachel B. Tambling, Kayla D. Mennenga, Scott A. Ketring, Megan Oka, Shayne R. Anderson, Scott C. Huff, Richard B. Miller.
  Journal of Marital and Family Therapy. August 10, 2015
  This study examined initial levels of attachment anxiety and avoidance, as well as their patterns of change, across eight sessions of couple therapy. Participants were 461 couples in a treatment‐as‐usual setting. Dyadic latent growth modeling was used to determine whether couples started therapy at similar levels of attachment anxiety and avoidance and whether attachment anxiety and avoidance changed. An actor partner interdependence model was used to see whether partner attachment anxiety was related to avoidance. Results showed relative stability of attachment anxiety and avoidance over the course of therapy, with the only change being a slight decline in attachment anxiety among women. Results showed that a person's attachment anxiety was not related to their partner's avoidance and vice versa.

  August 10, 2015   doi: 10.1111/jmft.12136   open full text
• Confiding About Problems in Marriage and Long‐Term Committed Relationships: A National Study.
  Kirsten Lind Seal, William J. Doherty, Steven M. Harris.
  Journal of Marital and Family Therapy. July 22, 2015
  This study examined confiding patterns in a national sample of 1000 U.S. adults aged 25–70 to inform the development of an educational program for confidants, called Marital First Responders. Results showed that 73% of U.S. adults have been a confidant to someone with a problem in a marriage or long‐term committed relationship. The most common confiding relationship was between friends, followed by siblings. Confidants reported a wide range of problems brought to them, ranging from everyday complaints to serious issues such as infidelity and divorce. Confiders identified the most and least helpful responses. Findings suggest that naturally occurring confiding relationships have considerable potential to be the first level of help for troubled couple relationships.

  July 22, 2015   doi: 10.1111/jmft.12134   open full text
• Reciprocal Influence of Couple Dynamics and Eating Disorders.
  Deanna Linville, Erin Cobb, Fei Shen, Suzie Stadelman.
  Journal of Marital and Family Therapy. July 20, 2015
  Little research has focused on the ways that eating disorder processes and adult couple dynamics influence one another. The purpose of this study was to investigate the reciprocal influence of couple dynamics and eating disorder illness and recovery processes. We conducted 51 interviews with 17 couples where one member identified as currently suffering or having recovered from an eating disorder. Using grounded theory analytical methods, findings include the systemic interplay of the eating disorder and relationship, both partners' perspectives on the eating disorder and its role in the relationship, the noneating disorder partner's impact on the eating disorder, and coping strategies for recovery as a couple. Clinical implications for supporting couples experiencing eating disorder illness and recovery are discussed.

  July 20, 2015   doi: 10.1111/jmft.12133   open full text
• Discernment Counseling for “Mixed‐Agenda” Couples.
  William J. Doherty, Steven M. Harris, Jason L. Wilde.
  Journal of Marital and Family Therapy. July 20, 2015
  This article describes discernment counseling, an approach to working with couples where one partner is leaning toward divorce and the other wants to preserve the relationship and work on it in couples therapy. These “mixed‐agenda” couples are common in clinical practice but have been neglected in the literature. The goal of discernment counseling is clarity and confidence regarding the next steps for the relationship, based on a deeper understanding of each partner's contributions. Sessions emphasize individual conversations with each partner. An analysis of 100 consecutive cases found that about half of the couples chose to start couples therapy in order to reconcile, with most of the rest choosing the divorce path. Longer term follow‐up information is also presented.

  July 20, 2015   doi: 10.1111/jmft.12132   open full text
• Testing the Clinical Implications of Planned Missing Data Designs.
  Scott C. Huff, Shayne R. Anderson, Rachel B. Tambling.
  Journal of Marital and Family Therapy. June 11, 2015
  Assessment is a core element of evidence‐based practice, but thorough formal assessment can place a significant burden on clients. We evaluated the clinical viability of using planned missing data designs to reduce client burden. Data come from an archival dataset with 1342 participants. Although significant differences were found in scores with planned missing data versus real scores, the effect sizes for the differences were generally small. Scores with missing data had sensitivity and specificity scores generally above .90 when predicting real scores over clinical cutoffs and improvement in real scores. These findings offer useful information to agencies and researchers looking for ways to collect more data without losing its immediate clinical utility.

  June 11, 2015   doi: 10.1111/jmft.12129   open full text
• Changes in Family Relationships among Substance Abusing Runaway Adolescents: A Comparison between Family and Individual Therapies.
  Xiamei Guo, Natasha Slesnick, Xin Feng.
  Journal of Marital and Family Therapy. May 16, 2015
  Eligible adolescents (12–17 years old) were recruited from a short‐term crisis shelter for runaway adolescents in a large Midwestern city. Adolescents (N = 179) were randomly assigned to Ecologically‐Based Family Therapy (EBFT, n = 61), the Community Reinforcement Approach (CRA, n = 57), or brief Motivational Enhancement Therapy (MET, n = 61) with the primary focus on substance abuse. A significant increase in perceived family cohesion and a significant reduction in perceived family conflict were found among all treatment conditions from baseline to the 24‐month follow‐up. Adolescents who received EBFT demonstrated more improvement in family cohesion after treatment than those who received CRA or MET, and more reduction in family conflict during treatment than those who received MET.

  May 16, 2015   doi: 10.1111/jmft.12128   open full text
• Determinants and Long‐Term Effects of Attendance Levels in a Marital Enrichment Program for African American Couples.
  Allen W. Barton, Steven R. H. Beach, Tera R. Hurt, Frank D. Fincham, Scott M. Stanley, Steven M. Kogan, Gene H. Brody.
  Journal of Marital and Family Therapy. April 27, 2015
  Although most efficacious marital enrichment programs are multisession, few studies have explored whether outcomes differ according to session attendance, particularly among minority groups with lower than average participation in prevention programs. This study therefore investigates attendance levels and long‐term improvements in couple functioning among 164 couples participating in the Promoting Strong African American Families program. Structural equation models indicated session attendance predicted 2‐year changes for men's reports of communication, commitment, and spousal support (marginally) but not for women's. Individual and couple characteristics that predicted attendance levels were also identified. Results highlight distinct gender differences in the effects of sustained attendance as well as characteristics that provide early identifiers for African American couples at increased risk of low program attendance.

  April 27, 2015   doi: 10.1111/jmft.12126   open full text
• Adaptation and Evaluation of a Nonviolent Resistance Intervention for Foster Parents: A Progress Report.
  Frank Van Holen, Johan Vanderfaeillie, Haim Omer.
  Journal of Marital and Family Therapy. April 24, 2015
  Foster care faces serious challenges, such as behavioral problems in foster children and parental stress and ineffective parenting behavior in foster parents. The results of a pilot study that evaluated a training program for foster parents based on nonviolent resistance are described. In a pretest–posttest design, data were collected from 25 families. Significant reductions in externalizing, internalizing, and total problem behavior in the foster children and in parenting stress were found. Using a reliable change index, significant improvements in externalizing, internalizing, and total problem behavior were found in, respectively, 72, 44, and 80% of the cases. Most improvements proved to be clinically relevant. Effect sizes ranged from medium to large for problem behavior, and from small to medium for parenting stress.

  April 24, 2015   doi: 10.1111/jmft.12125   open full text
• Varied Patterns of Family Resilience in Challenging Contexts.
  Michael Ungar.
  Journal of Marital and Family Therapy. April 10, 2015
  While we know much about patterns of family resilience, most of our research and clinical discussion has focused on microsystemic, intrafamilial protective processes. We have far fewer maps of the bidirectional interactions between families and other systems that contribute to successful family adaptation in challenging contexts. The purpose of this article is to address this gap in knowledge and present a map of family resilience that is both systemic and contextually and culturally responsive. Seven specific patterns of family resilience are reviewed. Combined, they account for the varied adaptational patterns families use to nurture and sustain resilience. The article concludes with reflection on how we can assess family resilience and the application of this map to family therapy. Video Abstract

  April 10, 2015   doi: 10.1111/jmft.12124   open full text
• Battling Against Interfaith Relations in Israel: Religion, Therapy, and Social Services.
  Yohai Hakak.
  Journal of Marital and Family Therapy. April 08, 2015
  One of the less studied aspects of the Israeli–Palestinian conflict is its demography. On the Jewish side, active steps are taken by the state to encourage Jewish immigration and Jewish births and discourage Jewish assimilation. As part of these efforts, the “problematic relationships” between Arab men and Jewish women from low socioeconomic background have become a high agenda item in public discussions in Israel during the last decade. I will examine here how the diagnostic category “girls at risk” and a therapeutic intervention employed by social services dealing with these couples helps maintaining the delicate balance between Jewish and democratic values. I will analyze these practices as a solution to a structural problem of the Jewish enclave in Israel. Video Abstract

  April 08, 2015   doi: 10.1111/jmft.12123   open full text
• Typology of Couples Entering Alcohol Behavioral Couple Therapy: An Empirical Approach and Test of Predictive Validity on Treatment Response.
  Benjamin O. Ladd, Barbara S. McCrady.
  Journal of Marital and Family Therapy. March 23, 2015
  This study aimed to examine whether classification of couples in which one partner has an alcohol problem is similar to that reported in the general couples literature. Typologies of couples seeking alcohol behavioral couple therapy (ABCT) were developed via hierarchical cluster analysis using behavioral codes of couple interactions during their first ABCT session. Four couples types based on in‐session behavior were established reliably, labeled avoider, validator, hostile, and ambivalent‐detached. These couple types resembled couples types found in previous research. Couple type was associated with baseline relationship satisfaction, but not alcohol use. Results suggest heterogeneity in couples with alcohol problems presenting to treatment; further study is needed to investigate the function of alcohol within these different types.

  March 23, 2015   doi: 10.1111/jmft.12121   open full text
• The Gap Between Couple Therapy Research Efficacy and Practice Effectiveness.
  W. Kim Halford, Christopher A. Pepping, Jemima Petch.
  Journal of Marital and Family Therapy. March 20, 2015
  Meta‐analyses of randomized controlled trials of couple therapy find large improvements in couple adjustment, but published evaluations of the effectiveness of couple therapy in routine practice find only small‐to‐moderate effects. The current study analyzes possible explanations for the research‐efficacy to practice‐effectiveness gap and offers suggestions for enhancing couple therapy effectiveness. Major recommendations are that therapists should clarify whether couples’ therapy goal is to clarify commitment to the relationship or to improve the relationship; use standardized assessment of the individual partners and the relationship; and use systematic monitoring of therapy progress and the therapeutic alliance. It is also possible that the greater use of evidence‐based therapies when treating couple relationship distress could enhance couple therapy outcome.

  March 20, 2015   doi: 10.1111/jmft.12120   open full text
• Marriage and Family Therapy Trainees' Reports of Explicit Weight Bias.
  Keeley J. Pratt, Elizabeth Palmer, Jaclyn D. Cravens, Megan Ferriby, Elizabeth Balk, Yin Cai.
  Journal of Marital and Family Therapy. February 28, 2015
  Discrimination based on an individual's weight has been observed in health care, education, retail, and other public sectors (Puhl & Huer, Obesity, 17, 941, 2007). Such inequity, known as “weight bias,” generates negative short‐term and long‐term consequences for the individuals that experience it (Puhl & Brownell, Weight bias in health care settings, 2007). Past research has shown that healthcare trainees exhibit weight bias (Phelan et al., Obesity, 22, 1201, 2014; Wigton & McGaghie, Journal of General Internal Medicine, 16, 262, 2001), yet little focus is given to weight bias in marriage and family therapy (MFT) education. The purpose of this study was to survey MFT students (N = 162) to explore weight bias and how contextual factors associate with weight bias. Participants in MFT programs reported explicit weight bias, with specific contextual factors associating with more bias. Female participants reported more fear of gaining weight, and individuals who identified as overweight had higher rates of explicit weight bias. Contextual differences and implications for training programs are discussed.

  February 28, 2015   doi: 10.1111/jmft.12116   open full text
• Strategies Used by Foreign‐Born Family Therapists to Connect Across Cultural Differences: A Thematic Analysis.
  Alba Niño, Karni Kissil, Maureen P. Davey.
  Journal of Marital and Family Therapy. February 16, 2015
  With the growing diversity in the United States among both clinicians and clients, many therapeutic encounters are cross‐cultural, requiring providers to connect across cultural differences. Foreign‐born therapists have many areas of differences to work through. Thus, exploring how foreign‐born family therapists in the United States connect to their clients can uncover helpful strategies that all therapists can use to establish stronger cross‐cultural therapeutic connections. A thematic analysis was conducted to understand strategies 13 foreign‐born therapists used during therapeutic encounters. Four themes were identified: making therapy a human‐to‐human connection, dealing with stereotypes, what really matters, and flexibility. Findings suggest that developing a deep therapeutic connection using emotional attunement and human‐to‐human engagement is crucial for successful cross‐cultural therapy. Clinical and training implications are provided. Video Abstract

  February 16, 2015   doi: 10.1111/jmft.12115   open full text
• Therapeutic Alliance and Retention in Brief Strategic Family Therapy: A Mixed‐Methods Study.
  Alyson H. Sheehan, Myrna L. Friedlander.
  Journal of Marital and Family Therapy. January 31, 2015
  We explored how the therapeutic alliance contributed to retention in Brief Strategic Family Therapy by analyzing videotapes of eight‐first sessions in which four therapists worked with one family that stayed in treatment and one family that dropped out. Although behavioral exchange patterns between clients and therapists did not differ by retention status, positive therapist alliance‐related behavior followed negative client alliance behavior somewhat more frequently in the retained cases. In the qualitative aspect of the study, four family therapy experts each viewed two randomly assigned sessions and commented on their quality without knowing the families’ retention status. A qualitative analysis of the audiotaped commentaries revealed 18 alliance‐related themes that were more characteristic of either the retained or the nonretained cases.

  January 31, 2015   doi: 10.1111/jmft.12113   open full text
• Internalized Other Interviewing in Relational Therapy: Three Discursive Approaches to Understanding its Use and Outcomes.
  Tanya E. Mudry, Tom Strong, Inés Sametband, Marnie Rogers‐de Jong, Joaquín Gaete, Samantha Merritt, Emily M. Doyle, Karen H. Ross.
  Journal of Marital and Family Therapy. January 28, 2015
  For over 20 years, family therapist Karl Tomm has been engaging families and couples with a therapeutic intervention he calls Internalized Other Interviewing (IOI). The IOI (cf. Emmerson‐Whyte, 2010; Hurley, 2006) entails interviewing clients, from the personal experiences of partners and family members as an internalized other. The IOI is based on the idea that through dialogues over time, one can internalize a sense of one's conversational partner responsiveness in reliably anticipated ways. Anyone who has thought in a conversation with a family member or partner, “Oh there s/he goes again,” or anticipates next words before they leave the other's mouth, has a sense of what we are calling an internalized other. For Tomm, the internalized anticipations partners and family members may have offers entry points into new dialogues with therapeutic potential—particularly, when their actual dialogues get stuck in dispreferred patterns.

  January 28, 2015   doi: 10.1111/jmft.12110   open full text
• Stories of the Accused: A Phenomenological Inquiry of MFTs and Accusations of Unprofessional Conduct.
  Jacey S. Coy, Jessica E. Lambert, Marianne M. Miller.
  Journal of Marital and Family Therapy. January 14, 2015
  Interviews were conducted with 10 MFTs (six females and four males) who had received a formal accusation of unprofessional conduct and went before state licensure boards in three different states. Accusations included dual relationships, financial fraud/errors, receiving DUIs, sexual misconduct, and emotionally harming a client. Utilizing Moustakas’ (1994, Phenomenological research methods, Thousand Oaks, CA: Sage) transcendental phenomenology, five essential themes emerged: (a) The experience of being formally accused of unprofessional conduct is life‐changing, (b) state MFT licensing boards are more punitive than rehabilitative, (c) obtaining support is vital, (d) making accusations creates stigma, (e) therapists were unprepared to handle accusations of unprofessional conduct. Clinical implications include the importance of supervision, personal therapy, and strategies for prevention and rehabilitation with this population.

  January 14, 2015   doi: 10.1111/jmft.12109   open full text
• Trajectories of Early Binge Drinking: A Function of Family Cohesion and Peer Use.
  Kristy L. Soloski, J. Kale Monk, Jared A. Durtschi.
  Journal of Marital and Family Therapy. January 14, 2015
  Using the National Longitudinal Study of Adolescent Health, we tested latent growth models examining whether the number of friends using alcohol and family cohesion was linked with trajectories of binge drinking (N = 3,342) from adolescence (average age 15.06) into young adulthood (average age 27.93). Adolescents with higher family cohesion had lower rates of binge drinking in adolescence (b = −.07, p < .05), while those with more friends drinking alcohol were more likely to binge drink in adolescence (b = .51, p < .001), young adulthood (b = .22, p < .001), and had increasing trajectories of binge drinking across 14 years (b = −.29, p < .001). Clinically, we discuss Multiple‐Family Group Interventions as a potential approach.

  January 14, 2015   doi: 10.1111/jmft.12111   open full text
• The State of Lesbian, Gay, and Bisexual Affirmative Training: A Survey of Faculty from Accredited Couple and Family Therapy Programs.
  Christi R. McGeorge, Thomas Stone Carlson.
  Journal of Marital and Family Therapy. December 16, 2014
  This study explored the state of lesbian, gay, and bisexual (LGB) affirmative training in the couple and family therapy field. LGB affirmative refers to holding positive views of LGB identities and relationships. A total of 117 faculty members completed the online survey for this study. Participants were asked to respond to items on the following topics: LGB affirmative stances, LGB affirmative program environment, LGB affirmative course content, self‐of‐the‐therapist work, and professional opportunities to work with LGB topics and clients. The findings of this study were encouraging as participants reported holding positive beliefs about LGB individuals, that their training programs had fairly affirmative program environments, and that LGB affirmative course content was included in their program curriculum.

  December 16, 2014   doi: 10.1111/jmft.12106   open full text
• Targeting Threats to the Therapeutic Alliance: A Primer for Marriage and Family Therapy Training.
  Eli A. Karam, Douglas H. Sprenkle, Sean D. Davis.
  Journal of Marital and Family Therapy. November 10, 2014
  Although theory and research highlight the importance of the client–therapist relationship, marriage and family therapy (MFT) training has historically centered on specific models, consisting of proprietary language and techniques, instead of common factors like the therapeutic alliance. In this article, we begin by making an argument for explicitly focusing on the therapeutic alliance in MFT training programs. Next, we highlight common alliance threats experienced by both faculty members and student therapists. We then integrate research‐informed principles with clinical wisdom to outline specific recommendations and concrete skill‐building exercises for MFT educators and supervisors to use with their students to address these threats and advance training on the therapeutic alliance.

  November 10, 2014   doi: 10.1111/jmft.12097   open full text
• The Multisystemic and Multilevel Investigation of the Expanded Therapeutic Alliance‐Psychological Functioning Relationship in Individual Therapy.
  Eli A. Karam, Mei‐Ju Ko, Bill Pinsof, Daniel Mroczek, Douglas Sprenkle.
  Journal of Marital and Family Therapy. November 07, 2014
  The expanded therapeutic alliance, consisting of multiple interpersonal alliance relationships, is a common factor inherent to the practice of all systemic therapies. The following study has three specific aims: (a) Bring an expanded, multisystemic emphasis to the study of the therapeutic alliance in individual therapy; (b) Understand better the session‐by‐session relationship between alliance and psychological functioning, including distinguishing within‐person from between‐person variability by using multilevel modeling techniques; and (c) Explore the role of early attachment relationships and family‐of‐origin experiences in moderating the alliance‐psychological functioning relationship. Instead of taking only one or two alliance measurements throughout treatment like in the majority of previous research, we measured both alliance and psychological functioning continuously at each session for 296 subjects.

  November 07, 2014   doi: 10.1111/jmft.12094   open full text
• Medical Family Therapists in Action: Embracing Multiple Roles.
  Stephanie I. Falke, Elizabeth D'Arrigo‐Patrick.
  Journal of Marital and Family Therapy. October 30, 2014
  Medical family therapy (MedFT) is a growing area of interest within the field of marriage and family therapy. Its practice necessitates a shift from conventional family therapy practices to include diverse ways of providing care. Literature highlights approaches for patients with specific illnesses and for particular healthcare contexts. Less is understood about frameworks for treating patients with different illnesses across settings. Contributing to the growing discourse surrounding MedFT, we present a role‐based practice framework that identifies six consistent roles, Therapist, Brief Interventionist, Health Coach, Patient Advocate, Consultant to Health Professionals, and Trainer specific tasks associated with each. We describe the skills needed to perform each role and describe how we move fluidly between roles to provide comprehensive care.

  October 30, 2014   doi: 10.1111/jmft.12104   open full text
• Attachment‐Based Family Therapy With a 13‐Year‐Old Girl Presenting With High Risk for Suicide.
  E. Stephanie Krauthamer Ewing, Suzanne A. Levy, Linda Boamah‐Wiafe, Roger Kobak, Guy Diamond.
  Journal of Marital and Family Therapy. October 20, 2014
  This article describes the application of Attachment‐Based Family Therapy (ABFT) to the treatment of a 13‐year‐old female adolescent presenting with high risk of suicide, complicated by a history of depression and sexual trauma. The article begins with an overview of ABFT, including (a) how attachment theory guides treatment; (b) the structure of the clinical model; and (c) the data that provide empirical support. A case example is then presented that exemplifies the primary clinical procedures used to reach therapeutic goals in ABFT, including attachment repair and autonomy/competence promotion. Weekly changes in suicide ideation and depression scores are presented. The article concludes with a discussion about implications for family‐based treatment of suicidal youth.

  October 20, 2014   doi: 10.1111/jmft.12102   open full text
• The Norway Couple Project: Lessons Learned.
  Jacqueline A. Sparks.
  Journal of Marital and Family Therapy. September 21, 2014
  Couple therapists in routine practice may find it difficult to apply findings from an increasingly expanding and complex body of couple therapy research. Meanwhile, concerns have been raised that competency in evidence‐based treatments is insufficient to inform many practice decisions or ensure positive treatment outcomes (American Psychological Association Presidential Task Force on Evidence‐Based Practice, American Psychologist, 2006, 271). This article aims to narrow the research/practice gap in couple therapy. Results from a large, randomized naturalistic couple trial (Anker, Duncan, & Sparks, Journal of Consulting and Clinical Psychology, 2009, 693) and four companion studies are translated into specific guidelines for routine, eclectic practice. Client feedback, the therapeutic alliance, couple goals assessment, and therapist experience in couple therapy provide a research‐informed template for improving couple therapy outcomes.

  September 21, 2014   doi: 10.1111/jmft.12099   open full text
• Closing The Gap between Two Countries: Feasibility of Dissemination Of An Evidence‐Based Parenting Intervention in México.
  José Rubén Parra‐Cardona, Elizabeth Aguilar Parra, Elizabeth Wieling, Melanie M. Domenech Rodríguez, Hiram E. Fitzgerald.
  Journal of Marital and Family Therapy. September 21, 2014
  In this manuscript, we describe the initial steps of an international program of prevention research in Monterrey, México. Specifically, we present a feasibility study focused on exploring the level of acceptability reported by a group of Mexican mothers who were exposed to a culturally adapted parenting intervention originally developed in the United States. The efficacious intervention adapted in this investigation is known as Parent Management Training, the Oregon Model (PMTO®). Following a description of our international partnership, we describe the implementation of the pilot study aimed at determining initial feasibility. Qualitative data provided by 40 Mexican mothers exposed to the culturally adapted parenting intervention illustrate the participants’ high level of receptivity toward the intervention, as well as the beneficial impact on their parenting practices.

  September 21, 2014   doi: 10.1111/jmft.12098   open full text
• The Development of a Physician Vitality Program: A Brief Report.
  Barbara Couden Hernandez, Tamara L. Thomas.
  Journal of Marital and Family Therapy. August 11, 2014
  We describe the development of an innovative program to support physician vitality. We provide the context and process of program delivery which includes a number of experimental support programs. We discuss a model for intervention and methods used to enhance physician resilience, support work‐life balance, and change the culture to one that explicitly addresses the physician's biopsychosocial‐spiritual needs. Recommendations are given for marriage and family therapists (MFTs) who wish to develop similar support programs for healthcare providers. Video Abstract

  August 11, 2014   doi: 10.1111/jmft.12085   open full text
• Psychological Flexibility as a Framework for Understanding and Improving Family Reintegration Following Military Deployment.
  Emily K. Sandoz, Danielle N. Moyer, Aaron P. Armelie.
  Journal of Marital and Family Therapy. August 07, 2014
  Postdeployment reintegration may present an exceptional challenge to service members and their families; yet, overcoming this challenge seems to strengthen family relationships through a shared sense of purpose. Navigating family reintegration may be an important determinant of long‐term psychological well‐being. If the needs of military families are to be answered effectively, it is of critical importance to identify the skills that facilitate positive reintegration following deployment. This article proposes psychological flexibility as a group of interrelated skills that could be directly intervened on to facilitate not only resilience but also positive growth and development. This paper focuses on the conceptualization of family reintegration in terms of psychological flexibility, including common deficits observed in this population and potential goals of treatment. Video Abstract

  August 07, 2014   doi: 10.1111/jmft.12086   open full text
• Condoms and Connection: Parents, Gay and Bisexual Youth, and HIV Risk.
  Michael C. LaSala.
  Journal of Marital and Family Therapy. August 07, 2014
  The family has long been considered a powerful influence on youth's high‐risk behaviors. However, little is known about preventive family influences for gay and bisexual youth, a group at high risk for HIV infection. For this study, qualitative interviews from a sample of 38 gay and bisexual youth and their parents/guardians underwent a thematic analysis. Youth described parent–child closeness, parental warnings, and urgings to use condoms as influences. Youth denying family influence came from families in which parent–child relationships were disrupted or HIV‐related discussion was lacking. Most families reported discomfort discussing HIV risk. These findings, along with a case example, suggest how family therapists can enhance parental influence by helping these families strengthen their relationships and discuss this important topic. Video Abstract

  August 07, 2014   doi: 10.1111/jmft.12088   open full text
• Associations Between Family of Origin Climate, Relationship Self‐Regulation, and Marital Outcomes.
  Nathan R. Hardy, Kristy L. Soloski, G. Cole Ratcliffe, Jared R. Anderson, Brian J. Willoughby.
  Journal of Marital and Family Therapy. July 25, 2014
  Using dyadic data from 961 married couples from the Relationship Evaluation Questionnaire project, the current study explored the direct association between family of origin climate and marital outcomes and the indirect association via relationship self‐regulation (RSR). Results from the actor–partner interdependence model analysis indicated that family of origin climate was positively associated with marital stability directly and indirectly via the effects of RSR and marital satisfaction for both men and women. Results suggest that the experience one has in their family of origin is associated with their marital outcomes through their RSR. Actor–partner direct and indirect effects indicate that spouses' RSR may have important consequences for both partner's evaluation of the marriage. Implications for intervention and future research are discussed.

  July 25, 2014   doi: 10.1111/jmft.12090   open full text
• Toward Understanding the Child's Experience in the Process of Parentification: Young Adults' Reflections on Growing up With a Depressed Parent.
  Hanna Van Parys, Anke Bonnewyn, An Hooghe, Jan De Mol, Peter Rober.
  Journal of Marital and Family Therapy. July 22, 2014
  This article reports on a qualitative study with 21 young adults who grew up with a depressed parent. We examined how young adults make sense of their childhood experiences of parental depression and how their retrospective reflections help us to understand the experiences of children and the processes of parentification. Participants recounted that their childhood consisted mainly of actions in the service of family well‐being. At that time, they reflected on their own experiences only rarely. In adolescence, there was an evolution toward a greater consideration for oneself and a repositioning within the family. In the discussion, we explore the therapeutic implications of this study—and in particular—the meaningfulness of silence in the family process of parentification.

  July 22, 2014   doi: 10.1111/jmft.12087   open full text
• Competencies for Addressing Gender and Power in Couple Therapy: A Socio Emotional Approach.
  Carmen Knudson‐Martin, Douglas Huenergardt, Ketsia Lafontant, Les Bishop, Johannes Schaepper, Melissa Wells.
  Journal of Marital and Family Therapy. May 20, 2014
  Power imbalances between partners are intrinsic to relationship distress and intricately connected to emotional experience, couple communication processes, and socio cultural contexts such as gender. The ability to work with the power dynamics between partners is thus critical to the practice of couple therapy. However, few practical guidelines for dealing with this issue are available. The authors present seven clinical competencies regarding gender and power issues that they identified by examining their own work: (a) identify enactments of cultural discourse, (b) attune to underlying socio cultural emotion, (c) name underlying power processes, (d) facilitate relational safety, (e) foster mutual attunement, (f) create a model of equality, and (g) facilitate shared relationship responsibility. Each competency is illustrated through a case example. The competencies represent an over‐arching guide to practice that may be integrated with other clinical approaches and is particularly useful for training and supervision.

  May 20, 2014   doi: 10.1111/jmft.12068   open full text
• Stress From Daily Hassles in Couples: Its Effects on Intradyadic Stress, Relationship Satisfaction, and Physical and Psychological Well‐Being.
  Mariana K. Falconier, Fridtjof Nussbeck, Guy Bodenmann, Hulka Schneider, Thomas Bradbury.
  Journal of Marital and Family Therapy. May 08, 2014
  According to the systemic‐transactional stress model (STM; G. Bodenmann, European Review of Applied Psychology, 1997; 47: 137), extradyadic stress from daily hassles can have a negative impact on the individual psychological and physical health and the couple's relationship. This study is the first one to test the STM propositions in a model that includes both partners’ individual and relational outcomes simultaneously. The model also includes actor and partner effects as well as the interdependence between partners’ processes. Cross‐sectional, self‐report data were collected from 110 community couples in Switzerland. Consistent with STM predictions, results from the path model analysis indicate that for actor effects extradyadic stress from daily hassles relates directly to lower psychological (increase in anxiety symptoms) and physical well‐being and only indirectly to lower relationship satisfaction through increased intradyadic stress from relationship problems and also through more depressive symptomatology in men. The female extradyadic stress and intradyadic stress had partner effects on the male intradyadic stress and the male relationship satisfaction, respectively. Limitations as well as research and clinical implications for marriage and family therapists are discussed.

  May 08, 2014   doi: 10.1111/jmft.12073   open full text
• Multiple‐Family Group Intervention for Incarcerated Male Adolescents Who Sexually Offend and Their Families: Change in Maladaptive Emotion Regulation Predicts Adaptive Change in Adolescent Behaviors.
  Margaret K. Keiley, Ali Zaremba‐Morgan, Christiana Datubo‐Brown, Raven Pyle, Milira Cox.
  Journal of Marital and Family Therapy. May 08, 2014
  The multiple‐family group intervention is an effective, yet affordable, 8‐week treatment that is conducted in a juvenile correctional institution in Alabama with adolescents who sexually offend and their families. Data from 115 incarcerated male adolescents and their male and female caregivers collected at pre‐, post‐, and 1‐year follow‐up were used to determine that problem behaviors (internalizing, externalizing) decreased over pre‐ and posttest and the significant decreases in maladaptive emotion regulation predicted those changes. Adolescent‐reported anxiety over abandonment and attachment dependence on parents increased significantly; these changes were predicted by decreases in maladaptive emotion regulation. Linear growth models were also fit over the 3 time points and indicate decreases in adolescent problem behavior and maladaptive emotion regulation.

  May 08, 2014   doi: 10.1111/jmft.12078   open full text
• Relationship Education for Stepcouples Reporting Relationship Instability—Evaluation of the Smart Steps: Embrace the Journey Curriculum.
  Mallory Lucier‐Greer, Francesca Adler‐Baeder, Kate Taylor Harcourt, Kimberly D. Gregson.
  Journal of Marital and Family Therapy. May 06, 2014
  Smart Steps: Embrace the Journey is a research‐based educational curriculum for stepfamily couples (“stepcouples”). The curriculum is designed to build couple strengths while addressing the unique challenges of repartnering with a child or children from a previous relationship. This study evaluated the effectiveness of this curriculum with 151 individuals in relationally less stable stepcouple relationships who either engaged in the Smart Steps curriculum (n = 97) or were part of the comparison group (n = 54). This study represents methodological and conceptual advances in the study of stepfamily programs with the use of a comparison group, a racially and economically diverse sample, and a relationally at‐risk population. Results indicated that those who participated in Smart Steps reported significant increases in individual empowerment, couple quality, family harmony, and parenting efficacy while these measures were unchanged for those who did not receive the program. Implications for future research and for practitioners are provided.

  May 06, 2014   doi: 10.1111/jmft.12069   open full text
• Relational Ethics, Depressive Symptoms, and Relationship Satisfaction in Couples in Therapy.
  Rashmi Gangamma, Suzanne Bartle‐Haring, Eugene Holowacz, Erica E. Hartwell, Tatiana Glebova.
  Journal of Marital and Family Therapy. May 05, 2014
  The purpose of this study was to examine depressive symptoms and relationship satisfaction as problems related to relational ethics in one's family of origin and current partner relationships in a sample of 68 other‐sex couples seeking therapy at a large university clinic. We used the Actor Partner Interdependence Model to analyze dyadic data collected prior to beginning therapy. Specifically, we found significant actor effects between relational ethics in one's family of origin and depressive symptoms, as well as between depressive symptoms and low relationship satisfaction for both male and female partners. We also found significant partner effects for relational ethics in current partner relationship, depressive symptoms, and low relationship satisfaction. Clinical application of contextual therapy theory is discussed.

  May 05, 2014   doi: 10.1111/jmft.12070   open full text
• Individual Therapy for Couple Problems: Perspectives and Pitfalls.
  Alan S. Gurman, Mark Burton.
  Journal of Marital and Family Therapy. April 29, 2014
  Despite the demonstrated efficacy of conjoint couple therapy, many clients seeking help for couple problems ultimately find themselves in individual therapy for these concerns. Individual therapy for couple problems (ITCP) may evolve from a partner's refusal of conjoint therapy or from the treatment format preferences of either the client or therapist. Having acknowledged the role of partner refusals, we offer some perspectives about the idiosyncratic personal factors and professional background factors that may lead therapists to provide ITCP and discuss the significant pitfalls in its practice. We emphasize five central areas of concern in the ongoing practice of ITCP: structural constraints on change; therapist side‐taking and the therapeutic alliance; inaccurate assessments based on individual client reports; therapeutic focus; and ethical issues relevant to both attending and nonattending partners. We conclude by urging that this very important but largely neglected topic be paid greater attention in psychotherapy research, training and continuing education.

  April 29, 2014   doi: 10.1111/jmft.12061   open full text
• Mindfulness‐Based Relationship Education for Couples Expecting their First Child—Part 2: Phenomenological Findings.
  Laura Eubanks Gambrel, Fred P. Piercy.
  Journal of Marital and Family Therapy. January 21, 2014
  This phenomenological study is the second phase of a larger mixed methods study of a relationship‐enhancement program for couples expecting their first child (see Gambrel & Piercy, this issue). The 4‐week Mindful Transition to Parenthood Program uses mindfulness practices and interpersonal activities to develop skills of internal and interpersonal attunement. Based on semi‐structured interviews with thirteen couples, four overarching themes emerged: (a) positive changes for self, (b) improvements in couple relationship, (c) more prepared for baby, and (d) male involvement. Participants stated that the program increased their acceptance and awareness, deepened connections with their partners, and led them to be more confident about becoming parents. Male participants felt they became more identified as fathers. The authors discuss the clinical implications of these findings.

  January 21, 2014   doi: 10.1111/jmft.12065   open full text
• Deciding Not to Un–Do the “I Do:” Therapy Experiences of Women Who Consider Divorce But Decide to Remain Married.
  Erica J.W. Kanewischer, Steven M. Harris.
  Journal of Marital and Family Therapy. January 17, 2014
  This study explores women's experience of marital therapy while they navigated decision making around divorce. A qualitative method was used to gain a deeper understanding of the participants' therapy and relationship decision‐making experiences. How are women's decisions whether or not to exit their marriage affected by therapy? The researchers interviewed 15 women who had considered initiating divorce before they turned 40 and had attended at least five marital therapy sessions but ultimately decided not to divorce. In general, participants reported that the therapy was helpful to them, their decision‐making process and their marriages. Five main themes emerged from the interviews: Women Initiated Therapy, Therapist Was Experienced as Unbiased, Therapy was Helpful, Importance of Extra‐therapeutic Factors, and Gradual Process.

  January 17, 2014   doi: 10.1111/jmft.12064   open full text
• Mindfulness‐Based Relationship Education For Couples Expecting Their First Child—Part 1: A Randomized Mixed‐Methods Program Evaluation.
  Laura Eubanks Gambrel, Fred P. Piercy.
  Journal of Marital and Family Therapy. January 17, 2014
  This article is Part 1 of a two‐part series, in which we report on our evaluation of a mindfulness‐based relationship enhancement program for couples who are expecting their first child. In this mixed‐methods randomized clinical trial, we assigned 33 couples to the 4‐week Mindful Transition to Parenthood Program treatment group (n = 16 couples) or to a waitlist control condition (n = 17 couples). Men in the treatment group significantly improved in relationship satisfaction, mindfulness, and negative affect; women had no significant treatment effects. Small to large effect sizes were present for treatment group men and women in multiple areas. Mixed‐methods analyses demonstrated that this intervention may be especially helpful for men because of differences in social support needs, effects of program enrollment, and relational processes in the prenatal period.

  January 17, 2014   doi: 10.1111/jmft.12066   open full text
• A Bowen Family Systems Model of Generalized Anxiety Disorder and Romantic Relationship Distress.
  Jacob B. Priest.
  Journal of Marital and Family Therapy. December 21, 2013
  Many individuals with generalized anxiety disorder (GAD) do not respond well to currently available treatments. Moreover, treatments are less effective when GAD is accompanied by romantic relationship distress. In order to develop effective treatments for GAD and relationship distress, it is necessary to conduct theory‐based research to identify links common to both GAD and romantic relationship distress. Drawing on Bowen's family systems theory, the roles of family abuse/violence and differentiation in GAD and romantic relationship distress were examined using existing data from the National Comorbidity Survey Replication (n = 2,312; 2005). As predicted, family abuse/violence was directly linked to both GAD and romantic relationship distress. Differentiation mediated the relationship between family abuse/violence and GAD, and partially mediated the relationship between family abuse/violence and romantic relationship distress. Findings suggest that current and past relationship processes may help maintain chronic anxiety and that Bowen's theory may be a useful framework for developing couple therapy treatment of GAD and romantic relationship distress.

  December 21, 2013   doi: 10.1111/jmft.12063   open full text
• Experiences of Family Therapists Working with Families in a Transitional Homeless Community.
  DeAnna E. Harris‐McKoy, Sarah B. Woods, Cicely W. Brantley, Heather M. Farineau.
  Journal of Marital and Family Therapy. December 21, 2013
  The purpose of this study was to explore the experiences and observations of marriage and family therapists (MFTs) conducting an empirically supported parenting program at a transitional homeless community. A diary method was used in recording five MFTs' observations and reactions to implementing the psychoeducational groups. Fifty‐one recordings were collected from three different parenting groups over the course of 20 weeks. Constant comparative method was used to identify themes related to MFTs' experiences of conducting the parenting program. These themes included the needs of at‐risk families, confidentiality, and role ambivalence and boundary ambiguity. We provide recommendations for best practices and an example of therapists' decision‐making process using Kitchener's () model.

  December 21, 2013   doi: 10.1111/jmft.12062   open full text
• Perceptions of Partners' Attributions for Depression in Relation to Perceptions of Support and Conflict in Romantic Relationships.
  Rebecca K. Blais, Keith D. Renshaw.
  Journal of Marital and Family Therapy. December 14, 2013
  People's attributions for their own psychological problems are linked to their interpersonal behaviors and attitudes. However, depressed individuals' inferences about their romantic partners' attributions for their depressive symptoms have yet to be studied in relation to their perceptions of relationship quality. This study examined perceived support from and conflict with partners in relation to perceptions of partners' attributions for depression in 165 individuals experiencing at least mild depressive symptoms. After controlling for relevant demographic characteristics, perceived internal/controllable psychological attributions were related to greater perceived conflict and lower perceived support, and perceived controllable biological attributions were related to greater perceived conflict. Perceived external/uncontrollable psychological and uncontrollable biological attributions were unrelated to perceived support and conflict. Findings suggest that perceived attributions may help explain the link between depression, support, and conflict in romantic relationships.

  December 14, 2013   doi: 10.1111/jmft.12055   open full text
• Up and Down or Down and Up? The Process of Change in Constructive Couple Behavior during Traditional and Integrative Behavioral Couple Therapy.
  Mia Sevier, David C. Atkins, Brian D. Doss, Andrew Christensen.
  Journal of Marital and Family Therapy. December 04, 2013
  Observed positive and negative spouse behavior during sessions of Traditional (TBCT) and Integrative Behavioral Couples Therapy (IBCT) were compared for couples with successful outcomes and their unsuccessful counterparts. One hundred and thirty‐four married chronically and seriously distressed couples (on average in their forties and 80% Caucasian) were randomly assigned to TBCT or IBCT. Trained observers made ratings of 1224 segments from approximately 956 sessions sampled from the course of up to 26 sessions. Multilevel modeling was used to examine change over time. TBCT treatment responders demonstrated a boost‐drop pattern, increasing in constructive behaviors early (more positive behaviors and less negative behaviors) but decreasing later. IBCT responders demonstrated an opposite, drop‐boost pattern, decreasing in constructive behaviors early and increasing later. Patterns were significant for positive behaviors (p < .05) and approached significance for negative behaviors (p = .05). In both treatments, nonresponders showed a significant pattern of decline in positive and increase in negative behaviors over time, although a trend (p = .05) indicates that TBCT nonresponders initially declined in negative behaviors. This study helps clarify the different process of change in two behavioral couple therapies, which may assist in treatment development and provide a guide for therapists in considering behavioral markers of change during treatment.

  December 04, 2013   doi: 10.1111/jmft.12059   open full text
• Assessing Lesbian, Gay, and Bisexual Affirmative Training in Couple and Family Therapy: Establishing the Validity of the Faculty Version of the Affirmative Training Inventory.
  Christi R. McGeorge, Thomas S. Carlson, Russell B. Toomey.
  Journal of Marital and Family Therapy. November 06, 2013
  This study established the validity and factor structure of the Faculty Version of the Affirmative Training Inventory (ATI‐F), which assesses faculty members’ perceptions of the level of lesbian, gay, and bisexual (LGB) affirmative training that occurs in clinical programs. Additionally, this study examined the latent associations among the subscales of the ATI‐F and three convergent validity items utilizing a sample of 117 faculty members from accredited family therapy programs. The findings provide empirical support for the relationship between including classroom content on LGB affirmative therapy and faculty members’ beliefs about LGB individuals and relationships. Specifically, faculty members who report more positive beliefs about LGB clients appear to be more likely to include LGB affirmative therapy content in the courses they teach.

  November 06, 2013   doi: 10.1111/jmft.12054   open full text
• Perceived Professional Gains of Master's Level Students Following a Person‐of‐the‐Therapist Training Program: A Retrospective Content Analysis.
  Alba Niño, Karni Kissil, Florina L. Apolinar Claudio.
  Journal of Marital and Family Therapy. October 24, 2013
  The Person‐of‐the‐Therapist Training (POTT) is a program designed to facilitate clinicians' ability to consciously and purposefully use themselves at the moment of contact with their clients in order to connect, assess, and intervene effectively. This qualitative study explored the experiences of 54 master's‐level students who were enrolled in an accredited marriage and family therapy program in the United States and examined their perceived professional gains following a 9‐month POTT course. Content analysis of trainees' reflections which they wrote at the end of the training revealed 6 primary themes: (a) increased awareness, (b) emotions, (c) improved clinical work, (d) humanity and woundedness, (e) meta‐awareness, and (f) factors that contributed to the learning process. Findings suggest that key outcomes of this training curriculum are congruent with its stated goals. Clinical and training recommendations are additionally provided.

  October 24, 2013   doi: 10.1111/jmft.12051   open full text
• “It's a Struggle but I Can Do It. I'm Doing It for Me and My Kids”: The Psychosocial Characteristics and Life Experiences of At‐Risk Homeless Parents in Transitional Housing.
  Kendal Holtrop, Sharde' McNeil, Lenore M. McWey.
  Journal of Marital and Family Therapy. October 21, 2013
  Families experiencing homelessness face a number of risks to their psychosocial health and well‐being, yet few studies have examined the topic of parenting among homeless families. The purpose of this multimethod, descriptive study was to acquire a better understanding of the psychosocial status and life experiences of homeless parents residing in transitional housing. Quantitative data were collected from 69 parents and primary caregivers living in a transitional housing community, with a cohort of 24 participants also contributing qualitative data. The quantitative results suggest risk associated with depression, parenting stress, and negative parenting practices. The qualitative findings highlight five themes that convey both the challenges faced by homeless parents as well as the resilience they display in spite of such adversity. These results extend current scholarship on homeless families with children and can better inform how couple and family therapists work with this at‐risk population.

  October 21, 2013   doi: 10.1111/jmft.12050   open full text
• Assessing Play‐Based Activities, Child Talk, and Single Session Outcome in Family Therapy with Young Children.
  Amber B. Willis, Lynda H. Walters, D. Russell Crane.
  Journal of Marital and Family Therapy. October 03, 2013
  This exploratory, observational study was designed to reveal descriptive information regarding therapists' actual practices with preschool‐ and school‐aged children in a single session of family therapy and to investigate change mechanisms in family play therapy that have been proposed to make this approach effective. A purposive sample of 30 families receiving family therapy was recruited and video‐taped during a family session where at least one child between the ages of 4 and 12 was present. Following the session, the therapist and parent(s) completed questionnaires while one of the children (aged 4–12) was interviewed. Session recordings were coded, minute‐by‐minute, for participant talk time, visual aids or props used, and therapy technique type (e.g., play‐based/activity vs. talk‐only techniques). Hierarchical regression and canonical correlational analyses revealed evidence supporting the theory that play‐based techniques promote young children's participation, enhance the quality of the child–therapist relationship, and build positive emotional experiences in family therapy.

  October 03, 2013   doi: 10.1111/jmft.12048   open full text
• Intimate Partner Communication From the War Zone: A Prospective Study of Relationship Functioning, Communication Frequency, and Combat Effectiveness.
  Jeffrey A. Cigrang, G. Wayne Talcott, JoLyn Tatum, Monty Baker, Daniel Cassidy, Scott Sonnek, Douglas K. Snyder, Christina Balderrama‐Durbin, Richard E. Heyman, Amy M. Smith Slep.
  Journal of Marital and Family Therapy. September 23, 2013
  This study examined (a) the association between relationship functioning prior to and during deployment, and the frequency of communication during deployment; and (b) the association between relationship functioning and depression during deployment and their influence on service members’ ratings of duty performance. Participants were 144 partnered Airmen assessed immediately before and during a one‐year high‐risk deployment to Iraq. Results showed an overall high frequency of partner communication during deployment. High relationship distress at predeployment predicted lower frequency of communication during deployment. Changes in relationship distress from before deployment to during deployment independently predicted frequency of communication, above and beyond predeployment distress levels. Level of relationship distress and depression during deployment independently predicted service members’ ratings of impact on duty performance.

  September 23, 2013   doi: 10.1111/jmft.12043   open full text
• Validation of the Chinese Version of Differentiation of Self Inventory (C‐DSI).
  Ching Man Lam, Peggy C. Y. Chan‐So.
  Journal of Marital and Family Therapy. August 29, 2013
  Although the need to develop objective assessment tools in different cultures is well‐recognized, there is a severe lack of objective measures about emotional functioning in the Chinese context. This project conducted three studies to validate the Chinese version of the Differentiation of Self Inventory (DSI). Study 1 looked at the factor structure, internal consistency, concurrent validity, and construct validity of the C‐DSI. Study 2 examined the test–retest reliability of the C‐DSI. Study 3 tested the discriminant validity of the C‐DSI in a clinical sample and in a nonclinical sample and examined its correlations with the General Contentment Scale (GCS). The study results suggested that the C‐DSI possesses good psychometric properties. Findings also indicated implications of divergent cultures and hinted at treatment implications—taking the familistic orientation and the Chinese meaning of self into consideration to understand the differentiation of self in the Chinese culture context.

  August 29, 2013   doi: 10.1111/jmft.12031   open full text
• The Family Context of Relational Aggression in “Difficult to Treat” Female Juvenile Offenders.
  Erin K. Taylor, Charles M. Borduin.
  Journal of Marital and Family Therapy. August 26, 2013
  Female juvenile offenders often engage in socially aggressive behaviors that make them more difficult to treat than male juvenile offenders. This social (i.e., relational) aggression may be developed or maintained through transactions with family members. To investigate this issue, we measured relational aggression in the family interactions of 140 adolescents divided by gender and offender status into four equal‐sized groups (female juvenile offenders, male juvenile offenders, female nonoffenders, and male nonoffenders). Adolescents and caregivers completed a family discussion task, and raters coded relationally aggressive behaviors at the dyadic level. Results showed that female juvenile offenders and their mothers directed more relational aggression toward each other than did mother–adolescent dyads in the other groups. Implications of these results for treatment and research are discussed.

  August 26, 2013   doi: 10.1111/jmft.12038   open full text
• Differentiation and Healthy Family Functioning of Koreans in South Korea, South Koreans in the United States, and White Americans.
  Hyejin Kim, Anne M. Prouty, Douglas B. Smith, Mei‐ju Ko, Joseph L. Wetchler, Jea‐Eun Oh.
  Journal of Marital and Family Therapy. August 26, 2013
  Inconsistent results have been found in prior research on the Bowen Family Systems Theory concept of differentiation of self and its application to individuals, couples, and families of different cultural backgrounds. In this regard, this study examined the impact of differentiation of self on healthy family functioning, family communication, and family satisfaction with 277 participants including South Koreans living in South Korea, South Korean‐born citizens living in the United States, and White Americans living in the United States. Multigroup confirmatory factor analysis identified the measurement invariance of a differentiation scale (DSI‐R) used for the three study groups. An analysis of covariance (ANCOVA) found significant differences between White Americans and South Koreans with regard to the level of differentiation. Results of multigroup structural equation modeling (SEM) analyses found a significant association between differentiation of self and healthy family functioning across the three groups with the American group having significantly higher differentiation than the two South Korean groups.” Implications for clinical practice and future research are discussed.

  August 26, 2013   doi: 10.1111/jmft.12049   open full text
• Participant Supervision: Supervisor and Supervisee Experiences of Cotherapy.
  Stephanie I. Falke, Lindsey Lawson, Mayuri L. Pandit, Elizabeth A. Patrick.
  Journal of Marital and Family Therapy. July 30, 2013
  Participant supervision is a unique application of live supervision in which a supervisor and supervisee see clients conjointly. Although minimally discussed in the family therapy literature, it has notable advantages, chief among them being a shared clinical experience that increases attunement to supervisee skill and development, the modeling of skillful intervention, and a higher degree of collegiality. However, it is not without its challenges, including supervisee vulnerability and anxiety, diffusion of responsibility, and limited time for case discussion. This article highlights the experience of one supervisor and three doctoral‐level supervisees engaging in participant supervision over the course of a 2‐year period. Using illustrative examples, we discuss our experience of the advantages and challenges of participant supervision, and provide recommendations for establishing a collaborative relational context within which supervisory benefits can be maximized.

  July 30, 2013   doi: 10.1111/jmft.12039   open full text
• The Therapeutic Pyramid: A Common Factors Synthesis of Techniques, Alliance, and Way of Being.
  Stephen T. Fife, Jason B. Whiting, Kay Bradford, Sean Davis.
  Journal of Marital and Family Therapy. July 30, 2013
  Common factors in therapy such as the therapeutic alliance and client motivation have been found to account for more change than therapy models. But common factors have been critiqued as only lists of variables that provide little practical guidance. Some researchers have demonstrated that certain common elements (e.g., the therapeutic alliance) account for more variance than others (e.g., techniques), suggesting that some factors should be emphasized over others. Such findings suggest the need for alternatives to model‐based therapy, with one alternative being meta‐models, or “models of models,” that focus on how therapeutic factors interact with each other to produce change. The purpose of this article is to propose a meta‐model describing the relationship between two specific common factors—the therapeutic alliance and interventions. We also propose a new factor—a therapist's way of being—that we believe is foundational to effective therapy. The model is proposed in pyramid format, with techniques on top, the therapeutic alliance in the middle, and therapist way of being as the foundation. The hierarchical relationships between these three concepts are discussed, along with implications for training, research, and therapy.

  July 30, 2013   doi: 10.1111/jmft.12041   open full text
• An Exploration of Family Therapists' Beliefs about the Ethics of Conversion Therapy: The Influence of Negative Beliefs and Clinical Competence With Lesbian, Gay, and Bisexual Clients.
  Christi R. McGeorge, Thomas Stone Carlson, Russell B. Toomey.
  Journal of Marital and Family Therapy. July 30, 2013
  The majority of the literature on conversion therapy has focused on clients' experiences and rationales for seeking such therapy. This study sought to explore differences in the beliefs and clinical competence of therapists who practice and believe in the ethics of conversion therapy and those who do not. The sample for this study included 762 family therapists who were members of the American Association of Marriage and Family Therapy. Data were collected using electronic surveys that assessed participants' negative beliefs about and perceived clinical competence with lesbian, gay, and bisexual (LGB) individuals. Results indicate that those who believe in the ethics of and/or practice conversion therapy report statistically higher levels of negative beliefs about LGB individuals and lower levels of clinical competence working with LGB clients. Implications for clinical practice and organizational policy are discussed.

  July 30, 2013   doi: 10.1111/jmft.12040   open full text
• The Impact of the Within My Reach Relationship Training on Relationship Skills and Outcomes for Low‐Income Individuals.
  Becky Antle, Bibhuti Sar, Dana Christensen, Eli Karam, Fran Ellers, Anita Barbee, Michel van Zyl.
  Journal of Marital and Family Therapy. July 16, 2013
  A federal grant was awarded to provide the Within My Reach healthy relationships curriculum to low‐income, at‐risk individuals involved with various social service agencies. The effectiveness of this curriculum was evaluated for 202 participants through measures of training and relationship outcomes pre‐, immediately post‐ and 6 months posttraining. Participants experienced high levels of training satisfaction; significant increases in knowledge, communication/conflict resolution skills, and relationship quality; as well as a trend in the reduction of relationship violence. An important implication of this research is that MFTs may broaden their service delivery to at‐risk individuals by collaborating with community agencies to adapt established relationship enhancement programs, evidence‐based tools, and principles that complement traditional couples therapy.

  July 16, 2013   doi: 10.1111/j.1752-0606.2012.00314.x   open full text
• The Divide Between “Evidenced‐Based” Approaches and Practitioners of Traditional Theories of Family Therapy.
  Frank M. Dattilio, Fred P. Piercy, Sean D. Davis.
  Journal of Marital and Family Therapy. July 01, 2013
  Evidenced‐based approaches continue to grow in the field of family therapy. However, practicing family therapists do not always embrace these approaches. In this article, we explore factors contributing to practitioners' concerns with evidence‐based treatments and suggest a broader, more clinically palatable view of evidenced‐based treatment. We also suggest how family therapy researchers, practitioners, and educators might begin to close the researcher–clinician divide in the best interest of all concerned.

  July 01, 2013   doi: 10.1111/jmft.12032   open full text
• Functions and Factions: A Reflection on Possibilities for Couple Therapy Integration.
  Alan S. Gurman.
  Journal of Marital and Family Therapy. July 01, 2013
  There is no abstract available for this paper.

  July 01, 2013   doi: 10.1111/jmft.12037   open full text
• From Scared to Repaired: Using an Attachment‐Based Perspective to Understand Situational Couple Violence.
  Christine Schneider, Andrew S. Brimhall.
  Journal of Marital and Family Therapy. May 07, 2013
  Situational couple violence (SCV) is a common problem in couples presenting for therapy. SCV, as seen through the lens of attachment, can be viewed as a result of an insecure attachment system within the couple. Although several authors have discussed individual attachment styles as predictors of both the receipt and perpetration of violence, in this article we seek to portray the attachment system as a relational and changing construct. As such, we argue for conjoint treatment for SCV as a way to restructure a more secure attachment system within the couple. Cautions for the appropriateness of couples counseling with ongoing violence are included. Finally, we discuss the use of an attachment‐based safety plan and time‐out strategy to use with couples experiencing SCV.

  May 07, 2013   doi: 10.1111/jmft.12023   open full text
• An Attachment Primer for Couple Therapists: Research and Clinical Implications.
  Ryan B. Seedall, Karen S. Wampler.
  Journal of Marital and Family Therapy. May 07, 2013
  According to attachment theory, humans are relational beings and even a child's earliest experiences with caregivers have a profound effect on emotional development and an overall approach to relationships. With increasing regularity, couple therapy has utilized attachment language as a conceptual tool, but more work is needed to understand the full clinical implications of attachment theory. These include understanding the intergenerational nature of attachment and adapting the delivery, timing, and pace of interventions to client attachment strategies. In this article, we summarize the origins of attachment theory, its measurement, the role of attachment in couple relationships, attachment stability and change, and ways that attachment informs therapy process and intervention. We hope that this article will provide an impetus for couple therapists to expand their conceptualization and use of attachment in their clinical work and for couple researchers to conduct more clinically relevant, attachment‐oriented process research.

  May 07, 2013   doi: 10.1111/jmft.12024   open full text
• The Impact of Behavioral Couple Therapy on Attachment in Distressed Couples.
  Lisa A. Benson, Mia Sevier, Andrew Christensen.
  Journal of Marital and Family Therapy. April 25, 2013
  Emotion‐focused therapy (EFT; Greenberg & Johnson, Emotionally focused therapy for couples. New York: Guilford Press) is anchored in attachment theory (Johnson, 2003 Attachment processes in couples and families. New York: Guilford) and considers change in attachment schemas essential in the process of improving satisfaction in relationships (Johnson, 1999, Research and couples therapy: Where do we go from here? American Family Therapy Academy Newsletter). However, there are little data on how measures of attachment change over the course of EFT or any other couple therapy. The current study examines whether increases in attachment security predict improvements in marital satisfaction during behavioral couple therapy, which would suggest that change in attachment style is a key process variable even for a non‐attachment‐focused treatment. Multilevel models of data from 134 couples participating in a randomized clinical trial of integrative behavioral couple therapy and traditional behavioral couple therapy (Christensen et al. Journal of Consulting and Clinical Psychology, 72, 2004, 176) indicate that although there is a trend for early change in attachment‐related anxiety and avoidance to predict later change in marital satisfaction, early change in marital satisfaction strongly predicts change in attachment‐related anxiety through the end of treatment and 2‐year follow‐up. These findings suggest that changes in satisfaction may lead to changes in attachment rather than the reverse and that change in attachment may not be the mechanism of change in all efficacious couple therapy.

  April 25, 2013   doi: 10.1111/jmft.12020   open full text
• The Alliance in Relationship Education Programs.
  Kelley Quirk, Jesse Owen, Leslie J. Inch, Tiffany France, Carrie Bergen.
  Journal of Marital and Family Therapy. April 25, 2013
  Couple relationship education (CRE) programs are associated with positive romantic relationship outcomes; however, the mechanisms by which these gains occur are less understood. The current study (122 couples) utilized actor–partner modeling to examine the association between the therapeutic alliance and dedication and negative and positive communication for racial/ethnic minority couples. Additionally, we examined whether gender and delivery format moderated these relationships. Results demonstrated that both men's and women's alliance scores were significantly related to their own outcomes. Higher ratings of alliance were related to partner outcomes for men only. The association between partners' alliance and dedication outcomes was stronger within the group format as compared to the couple format. Implications for leaders of CRE programs are offered.

  April 25, 2013   doi: 10.1111/jmft.12019   open full text
• Young Adult Romantic Couples’ Conflict Resolution and Satisfaction Varies with Partner's Attention–Deficit/Hyperactivity Disorder Type.
  Will H. Canu, Lindsey S. Tabor, Kurt D. Michael, Doris G. Bazzini, Alexis L. Elmore.
  Journal of Marital and Family Therapy. April 25, 2013
  Attention‐deficit/hyperactivity disorder (ADHD) has previously been associated with less satisfaction and success in romantic relationships. This study compares conflict resolution and problem‐solving behaviors in young adult romantic couples either having one partner with ADHD combined type (C‐couples), having one partner identified with ADHD inattentive type (IA‐couples), or in which neither partner has an ADHD diagnosis (nondiagnosed [ND] couples). Self‐reports of current and childhood ADHD symptoms corroborated diagnostic status and speaker and listener behaviors, coded via the Rapid Couples Interaction Scoring System (Gottman, 1996), were the primary dependent variables. Analyses revealed greater negativity and less positivity in C‐couples’ behavior during a conflict resolution task, relative to IA and ND couples, and this corresponded with couples’ relational satisfaction. IA‐couples emitted relational behavior that was largely similar to ND couples. Findings support that relational impairment exists in C‐couples, and to some degree, contrast with previous research suggesting that individuals with predominant inattention experience greater social impairment in adulthood than those with other types of ADHD.

  April 25, 2013   doi: 10.1111/jmft.12018   open full text
• Psychometric Properties of the Differentiation of Self Inventory‐Revised in Turkish Adults.
  Erkan Işık, Sabiha Bulduk.
  Journal of Marital and Family Therapy. April 24, 2013
  The purpose of the current study was to examine the validity and reliability of (Journal of Marital and Family Therapy 2003, 29, 209) Differentiation of Self Inventory‐Revised (DSI‐R; Skowron & Schmit, 2003) in Turkish adults. The DSI‐R was translated, independently back‐translated, and revised. Two independent samples of adults over the age of 25 were used. The original 46‐item DSI‐R was not supported by the data derived from Sample 1 (n = 221). However, a revised 20‐item, four‐factor model fit the data well. This 20‐item model was subsequently cross‐validated with a second sample of Turkish adults (n = 187). Scale scores showed adequate internal consistency, 5‐week test–retest reliability, and satisfactory convergent and criterion‐related validity. It was concluded that Turkish DSI‐R (DSI‐T) is a valid and reliable measure to assess an individual's differentiation level. In light of the findings, implications for the use of the DSI‐T and ideas for future research are discussed.

  April 24, 2013   doi: 10.1111/jmft.12022   open full text
• Commentary on Studying Circular Questioning “In Situ”.
  Ronald J. Chenail.
  Journal of Marital and Family Therapy. April 18, 2013
  In their discursive study of circular questioning in a systemic family therapy session, the authors raise some interesting perspectives on the original Milan therapy team's guidelines for the therapist as the conductor of therapy. By emphasizing circularity from a discourse point of view, they suggest these guidelines can be used to help family members hypothesize about their own perspectives on themselves and the other family members in circular terms, and, drawing upon Cecchin's notion of neutrality, by creating a state of curiosity in their talk and maybe in their minds. Their emphasis on circularity also helps us to become more sensitive to ways in which the natural recursion in language can help us to appreciate the new guiding lines circular questions can suggest with previously spoken elements. If we follow this line of argument, then circular questions can be seen as a critical part of a therapy we can call recursive family therapy in which we use the recursive element of all natural living languages to help our clients to recursively change their language and lives naturally.

  April 18, 2013   doi: 10.1111/jmft.12003   open full text
• How Many Bytes Does It Take? A Content Analysis of Cyber Issues in Couple and Family Therapy Journals.
  Markie L. C. Blumer, Katherine M. Hertlein, Justin M. Smith, Harrison Allen.
  Journal of Marital and Family Therapy. April 18, 2013
  In the fifteen years since the explosion of the Internet, using cyber technology for work and social functions has exponentially increased. Yet, questions around how to manage such changes remain elusive in family therapy literature. In this investigation, we conducted a content analysis to determine to what extent marriage/couple and family therapy (M/CFT) journals have responded to the integration of the Internet in couple and family life. We found 79 of 13,274 articles across seventeen journals focused on the Internet in some capacity. Implications for clinical practice, training, and future research are discussed.

  April 18, 2013   doi: 10.1111/j.1752-0606.2012.00332.x   open full text
• Family Intervention and Health Care Costs for Kansas Medicaid Patients with Schizophrenia.
  Jacob D. Christenson, D. Russell Crane, Katherine M. Bell, Andrew R. Beer, Harvey H. Hillin.
  Journal of Marital and Family Therapy. April 16, 2013
  Despite a number of studies investigating the effect of pharmacotherapy on treatment costs for schizophrenia patients, there has been little attention given to the effect of family intervention. In this study, data from the Kansas Medicaid system were used to analyze healthcare costs for 164 schizophrenia patients who had participated in family intervention. Structural equation modeling was used to test two competing views of the role of family intervention in treatment. The results showed that a model including direct and indirect effects of family intervention provided a better fit to the data. Family intervention had a significant indirect effect on general medical costs (through other psychological treatment) that showed a savings of $586 for each unit increase in the provision of these services. In addition, the total indirect effects for family intervention showed a $580 savings for general medical costs and $796 for hospitalization costs (for each unit increase).

  April 16, 2013   doi: 10.1111/jmft.12021   open full text
• Female Adoptees’ Experiences Balancing Relationships With Biological and Adoptive Mothers Post‐Reunification.
  Angelle Richardson, Maureen P. Davey, Phyllis A. Swint.
  Journal of Marital and Family Therapy. April 02, 2013
  Using a feminist postmodern perspective and the sensitizing concept of split loyalties from Contextual Theory, the primary purpose of this qualitative study was to develop a better understanding of how adult female adoptees from closed adoptions negotiate relationships with their adoptive and biological mothers post‐reunion. We conducted semi‐structured individual interviews with nine adult female adoptees, ages 28–52, who were adopted prior to the age of two. Six were Caucasian, three were African American, and the average age at reunion was 29. Grounded theory techniques were used to code the qualitative data, in particular the constant comparative method of analysis. Four main categories emerged: (a) Negotiating Mother–Daughter Relationships, (b) Relating to Mothers Equitably, (c) Loyalty, and (d) Adoptees’ Emotional Needs. Our findings suggest the adoptive mother–daughter relationship has a salient effect on adoptees’ relationships with biological mothers post‐reunion. Loyalty to the adoptive mother seems to influence the evolving relationship and closeness displayed toward the birth mother. Adult female adoptees from closed adoptions described struggling with managing their two mother–daughter relationships and need clinical help addressing their own emotional needs.

  April 02, 2013   doi: 10.1111/j.1752-0606.2012.00321.x   open full text
• Validation of Fear of Partner Scale.
  K. Daniel O'Leary, Heather Foran, Shiri Cohen.
  Journal of Marital and Family Therapy. April 02, 2013
  Therapists have a responsibility to ascertain if psychological aggression, physical aggression, sexual aggression exist, and if there is fear of the partner. A fear of partner measure was evaluated in 100 couples who sought relationship feedback. Fear of partner's psychological, physical, and sexual aggression was related to actual reports of such behavior. For both men and women, fear of speaking in front of partner and fear of being in therapy with partner were related to reports of psychological aggression perpetrated by the partner, dominance, and isolation by the partner, and one's own marital dissatisfaction. Among respondents who were aggressed against, more men than women reported fear of participating in therapy with their partner. The measure herein can be used to determine the extent of fear of aggression by partners and to assist in the decision‐making about the appropriateness of marital therapy and divorce mediation.

  April 02, 2013   doi: 10.1111/j.1752-0606.2012.00327.x   open full text
• Predictors and Processes Associated with Home‐Based Family Therapists' Professional Quality of Life.
  C. R. Macchi, Matthew D. Johnson, Jared A. Durtschi.
  Journal of Marital and Family Therapy. March 29, 2013
  This study examined whether home‐based family therapists' (HBFT) workload and clinical experience were associated with therapists' professional quality of life directly and indirectly through self‐care activities and frequency of clinical supervision. Hypotheses were tested using structural equation modeling with a sample of 225 home‐based therapists. Results suggested that therapists' workload and HBFT experience significantly predicted therapists' professional quality of life. These associations between therapists' workload and HBFT experience were partially mediated through participation in self‐care and frequency of clinical supervision. Implications for improving therapists' quality of life are discussed as a function of therapists' workload, clinical experience, self‐care, and supervision.

  March 29, 2013   doi: 10.1111/jmft.12016   open full text
• Examining the Impact of Child Parent Relationship Therapy (CPRT) on Family Functioning.
  Nick Cornett, Sue C. Bratton.
  Journal of Marital and Family Therapy. March 07, 2013
  Research supports that child parent relationship therapy (CPRT), a filial therapy approach, has strong effects on participating parents and children. Some speculate that filial therapy improves the family system; however, minimal research exists to support this claim. Using a single‐case design, researchers examined CPRT's impact on the functioning of 8 families. Results revealed that 6 families experienced statistically significant improvements in targeted areas of family functioning. Results from self‐reported measures indicated that 7 families improved in family satisfaction, 4 in cohesion, 3 in communication, and 1 in flexibility. Observational measures also revealed improvements: 5 families in flexibility, 4 families in cohesion, and 4 families in communication. The results support that the benefits of CPRT may extend to the family system.

  March 07, 2013   doi: 10.1111/jmft.12014   open full text
• Military‐Related Posttraumatic Stress Disorder and Intimate Relationship Behaviors: A Developing Dyadic Relationship Model.
  April A. Gerlock, Jackie Grimesey, George Sayre.
  Journal of Marital and Family Therapy. March 02, 2013
  The protracted conflict in Iraq and Afghanistan and an all‐volunteer military has resulted in multiple war zone deployments for many service members. While quick redeployment turnaround has left little time for readjustment for either the service member or family, dealing with the long‐term sequelae of combat exposure often leaves families and intimate partners ill‐prepared for years after deployments. Using a modified grounded theory approach, digitally recorded couple interviews of 23 couples were purposefully selected from a larger sample of 441 couples to better understand the impact of war zone deployment on the couple. The veteran sample was recruited from a randomly selected cohort of men in treatment for posttraumatic stress disorder (PTSD). Overall, it was found when veterans experiencing deployment‐related PTSD reenter or start new intimate relationships they may bring with them a unique cluster of interrelated issues which include PTSD symptoms, physical impairment, high rates of alcohol and/or drug abuse, and psychological and physical aggression. These factors contributed to a dynamic of exacerbating conflict. How these couples approached relationship qualities of mutuality, balanced locus of control and weakness tolerance across six axes of caregiving, disability, responsibility, trauma, communication, and community impacted the couple's capacity to communicate and resolve conflict. This dyadic relationship model is used to help inform implications for clinical practice.

  March 02, 2013   doi: 10.1111/jmft.12017   open full text
• Diversity, Social Justice, and Intersectionality Trends in C/MFT: A Content Analysis of Three Family Therapy Journals, 2004–2011.
  Ryan B. Seedall, Kendal Holtrop, José Ruben Parra‐Cardona.
  Journal of Marital and Family Therapy. February 28, 2013
  In this study, we analyzed the amount of attention given to diversity, social justice, and an intersectional approach to social inequalities over an 8‐year period (769 articles) in three family therapy journals. Overall, 28.1% of articles addressed at least one diversity issue, and a social justice framework was utilized in 48.1% of diversity articles. A systemic, intersectional approach to conceptualizing and analyzing multiple social inequalities was utilized in 17.6% of diversity articles. The most common goals addressed in diversity articles, articles using a social justice framework, and articles using an intersectional approach are also identified. Findings indicate that, despite important work being carried out, more work remains to further identify how addressing diversity issues can improve client outcomes.

  February 28, 2013   doi: 10.1111/jmft.12015   open full text
• Implementation of Multi‐Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting.
  Heather A. MacPherson, Jarrod M. Leffler, Mary A. Fristad.
  Journal of Marital and Family Therapy. January 24, 2013
  Despite advances in evidence‐based treatments (EBTs), research suggests these interventions are not utilized in practice settings. This study examined implementation of multi‐family psychoeducational psychotherapy (MF‐PEP), an EBT for childhood mood disorders, in two outpatient community clinics. Fifteen community therapists facilitated MF‐PEP. Twenty community clinicians referred 40 children ages 8–12 with mood disorders and their parents who participated in MF‐PEP. Preliminary descriptive findings based on observations and self‐report questionnaires demonstrated implementation outcomes of acceptability, adoption, appropriateness, feasibility, implementation cost, penetration, and sustainability of MF‐PEP at these clinics. Parents also demonstrated significant improvement in knowledge of mood disorders posttreatment. Preliminary results support implementation of MF‐PEP in practice settings and suggest community‐based MF‐PEP may be associated with improvement in clinical outcomes.

  January 24, 2013   doi: 10.1111/jmft.12013   open full text
• Multisystemic Therapy for Disruptive Behavior Problems in Youths With Autism Spectrum Disorders: A Progress Report.
  David V. Wagner, Charles M. Borduin, Stephen M. Kanne, Micah O. Mazurek, Janet E. Farmer, Rachel M. A. Brown.
  Journal of Marital and Family Therapy. January 04, 2013
  Youths with autism spectrum disorders (ASD) often engage in serious disruptive behaviors that interfere with their ability to successfully manage day‐to‐day responsibilities and contribute to relationship problems with caregivers, peers, and teachers. Effective treatments are needed to address the factors linked with disruptive behavior problems in this population of youths. Multisystemic therapy (MST) is a comprehensive family‐ and community‐based treatment approach that has been effective with other difficult‐to‐treat populations of youths and holds promise for youths with ASD. In this article, we review the broad range of factors associated with disruptive behaviors among youths with ASD and discuss how MST interventions can be adapted to address those factors. We also present a framework for our adaptation of the MST model for youths with ASD. This framework includes a recently completed pilot study as well as an ongoing efficacy trial that together have served to identify key interventions for our adaptation of the MST model.

  January 04, 2013   doi: 10.1111/jmft.12012   open full text
• “If I Can Grapple With This I Can Truly Be Of Use In The Therapy Room”: Using The Therapist's Own Emotional Struggles To Facilitate Effective Therapy.
  Harry J. Aponte, Karni Kissil.
  Journal of Marital and Family Therapy. December 17, 2012
  This study premises that self‐of‐the‐therapist work is pivotal in the development of effective therapists. However, therapy models vary in their goals for this work and the means of accomplishing them. This study presents the perspective of the person‐of‐the‐therapist Training (POTT) model that prioritizes the ability to consciously and purposefully use the self‐as‐is at the moment of contact with the client over the traditional goal of therapists working to resolve their issues. A key underlying assumption of the model proposes that therapists' core issues (referred to as “signature themes”) are potent resources that can be tapped into to connect, assess and intervene effectively with clients. The study presents the model and illustrates the use of signature themes in clinical work.

  December 17, 2012   doi: 10.1111/jmft.12011   open full text
• Changes following Premarital Education for Couples with Differing Degrees of Future Marital Risk.
  Allen W. Barton, Ted G. Futris, Renay C. Bradley.
  Journal of Marital and Family Therapy. December 05, 2012
  The present study explored changes in individuals' relationship cognitions and behaviors following premarital education for couples with different risk profiles. The sample consisted of 63 couples who completed the PREPARE program and were classified for future marital risk based on dyadic information. A significant interaction effect was found between risk and time, with individuals in relationships classified as high risk exhibiting greater change at 4 weeks postprogram compared to low‐risk individuals. Perceived helpfulness of topics also varied by couple type. Findings provide support for adapting premarital education programs for high‐risk couples and offer clinicians and educators specific insights for areas of emphasis when working with different types of couples.

  December 05, 2012   doi: 10.1111/jmft.12006   open full text
• Relationship Effort, Satisfaction, and Stability: Differences Across Union Type.
  Kevin Shafer, Todd M. Jensen, Jeffry H. Larson.
  Journal of Marital and Family Therapy. November 26, 2012
  Relationship satisfaction and stability are two commonly studied outcomes in marriage and family research. Majority of studies address socio demographic variability and differences across union type in these outcomes. We extend this literature by addressing how the amount of effort one puts into their relationship is associated with stability and satisfaction. Specifically, we focus on how effort impacts these measures of quality in four union types: premarital cohabitation, first marriage, post‐divorce cohabitation, and second marriage following divorce. Furthermore, we make union type comparisons in the strength of effort's association with satisfaction and stability. Using data from 8,006 respondents in the Relationship Evaluation Survey, our results show that effort was strongly and positively associated with satisfaction and stability in all four unions. Although effort is more strongly associated with satisfaction in first marriage than cohabiting relationships, no union type differences in the role of effort on stability were observed. Clinical and research implications of these findings are discussed.

  November 26, 2012   doi: 10.1111/jmft.12007   open full text
• Studying Circular Questioning “In Situ”: Discourse Analysis of A First Systemic Family Therapy Session.
  Maria Diorinou, Eleftheria Tseliou.
  Journal of Marital and Family Therapy. November 24, 2012
  The present article focuses on the study of circular questioning “in situ,” that is, in the context of the discursive arena of an actual first systemic family therapy session. Two typical circular questions are selected, and discourse analysis heavily drawing from the discursive action model is deployed with the aim to highlight their function in the context of therapist and family members' problem talk. The analysis demonstrates the gradual building of two respective patterns, which both exhibit signs of shifts toward the instillment of a systemic epistemology in relation to problem talk: a shift from homogeneity to heterogeneity in family members' voices, which legitimizes the existence of different viewpoints within a system, and a shift from the construction of an accusation toward its deconstruction, which challenges the linear perception of causality underlying the accusation, thus introducing a more circular perspective. Implications are discussed in relation to contemporary, constructionist systemic family therapy practice, and reference is made to the methodological “promises” and challenges of the deployment of discourse analysis for the scrutiny of systemic family therapy therapeutic techniques and tools under a discursively informed light.

  November 24, 2012   doi: 10.1111/jmft.12005   open full text
• The No Conclusion Intervention For Couples In Conflict.
  Lieven Migerode.
  Journal of Marital and Family Therapy. November 20, 2012
  Dealing with difference is central to all couple therapy. This article presents an intervention designed to assist couples in handling conflict. Central to this approach is the acceptance that most conflicts cannot be solved. Couples are in need of a different understanding of couples conflict. This understanding is found in the analysis of love in context and in relational dialectics. Couples are guided through different steps: deciding on the valence of the issue as individuals, helping them decide which differences can be resolved and which issues demand new ways of living with the inevitable, and the introduction in the suggested no conclusion dialogue. This article briefly describes the five day intensive couple therapy program, in which the no intervention is embedded. The theoretical foundation of the intervention, followed by the step by step description of the intervention forms the major part of the article. A case vignette illustrates this approach.

  November 20, 2012   doi: 10.1111/jmft.12004   open full text
• Costs of Treating Depression With Individual Versus Family Therapy.
  D. Russell Crane, Jacob D. Christenson, Sareta M. Dobbs, G. Bruce Schaalje, Adam M. Moore, Fu Fan Chiang Pedal, Jamie Ballard, Elaine S. Marshall.
  Journal of Marital and Family Therapy. October 13, 2012
  Depression is one of the most common concerns that bring clients to treatment. Although marriage and family therapy has been shown to be an effective treatment, little research exists regarding the cost‐effectiveness of related services. In this study, we examined claims data for 164,667 individuals diagnosed with depression to determine (a) differences in the cost of treating depression according to type of therapy and license type, (b) differences in recidivism rates by age, gender, type of therapy, and type of mental health professional, and (c) differences in cost‐effectiveness by therapy modality and type of professional. The results showed that services provided by marriage and family therapists resulted in the lowest recidivism rate, and family therapy services were the least expensive.

  October 13, 2012   doi: 10.1111/j.1752-0606.2012.00326.x   open full text
• Family Dynamics and Self‐Injury Behaviors: A Correlation Analysis.
  Ruth Ogden Halstead, Thomas W. Pavkov, Lorna L. Hecker, Michelle M. Seliner.
  Journal of Marital and Family Therapy. September 29, 2012
  This study tested the relationship between family dynamics and self‐injury. A total of 189 participants responded to a web‐based survey collecting information related to previous self‐injury behaviors and family dynamics. Participants were over 18 years old who had used self‐injury (intentionally harming themselves physically to relieve painful emotions without suicidal intent), but who had not used self‐injury for over a year. Results indicated that healthy family dynamics were negatively correlated and associated with higher scores of self‐injury behaviors. This study offers some evidence that family dynamics influence self‐injury behaviors. The implications for family therapy are discussed.

  September 29, 2012   doi: 10.1111/j.1752-0606.2012.00336.x   open full text
• Effects of Sex, Sexual Orientation, Infidelity Expectations, and Love on Distress related to Emotional and Sexual Infidelity.
  Olivia Leeker, Al Carlozzi.
  Journal of Marital and Family Therapy. September 25, 2012
  The purpose of this study was to investigate the influence of participant sex, sexual orientation, infidelity expectations, and love on emotional responses to emotional and sexual infidelity. Participants (72 lesbian women, 114 heterosexual women, 53 gay men, and 57 heterosexual men) completed a demographic form, continuous emotion ratings in response to hypothetical infidelity scenarios, the Infidelity Expectations Questionnaire (IEQ), and the Triangular Love Scale. Sex, sexual orientation, and commitment and intimacy among partners were significant predictors of various emotional responses to sexual and emotional infidelity. Alternatively, passion among partners and expectations about a partner's likelihood of committing infidelity were not significant predictors of emotional reactions to infidelity. Across participants, sexual infidelity elicited more distressing feelings than emotional infidelity. Group differences were also found, with women responding with stronger emotions to emotional and sexual infidelity than men, and heterosexuals rating emotional and sexual infidelity as more emotionally distressing than lesbian and gay individuals. Sex and sexual orientation differences emerged regarding the degree to which specific emotions were reported in response to sexual and emotional infidelity. Clinical implications are offered, including how mental health professionals might use these findings to help clients cope with the negative effects of infidelity on romantic relationships.

  September 25, 2012   doi: 10.1111/j.1752-0606.2012.00331.x   open full text
• Responsive Persistence Part I: Therapist Influence in Postmodern Practice.
  Olga Sutherland, Jean Turner, Anna Dienhart.
  Journal of Marital and Family Therapy. September 15, 2012
  Feminist and social constructionist developments in family therapy highlighted the importance of attending to therapist–client power relations and incorporating clients' understandings and preferences as a part of therapy. Significantly, less attention has been given to how postmodern therapists do use their power and influence. This is an important topic because it is therapists who have the major responsibility for guiding the interaction with clients and persisting in this so that change is facilitated. Therapist persistence in various forms and across dimensions of therapy process is examined to expand understanding of therapist influence in postmodern and collaborative work. An analysis of responsive persistence in a session with Karl Tomm as the therapist is presented to illustrate this conceptual framing.

  September 15, 2012   doi: 10.1111/j.1752-0606.2012.00333.x   open full text
• Interpersonal Forgiveness in Emotion‐Focused Couples' Therapy: Relating Process to Outcome.
  Catalina Woldarsky Meneses, Leslie S. Greenberg.
  Journal of Marital and Family Therapy. September 08, 2012
  The objective of this study was to relate the in‐session processes involved in interpersonal forgiveness to outcome. The sample consisted of 33 couples who received 10–12 sessions of Emotion‐focused couple therapy with the aim of resolving various forms of emotional injuries (i.e., transgression that violates the expectations of a close relationship, which leaves one partner feeling hurt and angry). The results of the present study were based on the analyses of 205 video‐taped segments from 33 couples' therapies. Hypotheses relating the role of three in‐session components of resolution, the injurer's “expression of shame”; the injured partner's “accepting response” to the shame, and the injured partner's “in‐session expression of forgiveness”, to outcome were tested using hierarchical linear regression analyses. Outcome measures included the Enright Forgiveness Inventory (The Enright Forgiveness Inventory user's manual. Madison: The International Forgiveness Institute, 2000), the Dyadic Adjustment Scale (Journal of Marriage and Family, 1976; 13: 723) and the The Interpersonal Trust Scale (Trust; Journal of Personality and Social Psychology, 1985; 49: 95).

  September 08, 2012   doi: 10.1111/j.1752-0606.2012.00330.x   open full text
• Responsive Persistence Part II. Practices of Postmodern Therapists.
  Olga Sutherland, Anna Dienhart, Jean Turner.
  Journal of Marital and Family Therapy. September 08, 2012
  This article, a companion to Part I of this series of articles, discusses how therapists informed by social constructionist and postmodern ideas enact persistence in their work with families. Transcripts and video‐recordings of therapy interaction facilitated by selected major champions for three postmodern (collaborative) therapies: Michael White (narrative therapy), Harlene Anderson (collaborative language systems approach), and Bill O'Hanlon (solution‐oriented therapy) were examined for persistence practices. The article offers a range of possible ways in which postmodern therapists may enact their influence in facilitating generative and helpful conversations with families and remain responsive to clients' preferences and understandings. Implications for family therapy practice, training, and supervision are discussed.

  September 08, 2012   doi: 10.1111/j.1752-0606.2012.00334.x   open full text
• Navigating Dual Relationships in Rural Communities.
  Jennifer L. J. Gonyea, David W. Wright, Terri Earl‐Kulkosky.
  Journal of Marital and Family Therapy. September 08, 2012
  The literature examining dual relationships in rural communities is limited, and existing ethical guidelines lack guidelines about how to navigate these complex relationships. This study uses grounded theory to explore rural therapists' perceptions of dual relationship issues, the perceived impact of minority and/or religious affiliation on the likelihood of dual relationships, and the ways rural therapists handle inevitable dual relationship situations. All of the therapists who participated in the study practiced in small communities and encountered dual relationship situations with regularity. The overarching theme that emerged from the data was that of using professional judgment in engaging in the relationship, despite the fact that impairment of professional judgment is the main objection to dual relationships. This overall theme contained three areas where participants felt they most needed to use their judgment: the level of benefit or detriment to the client, the context, and the nature of the dual relationship. Surprisingly, supervision and/or consultation were not mentioned by the participants as strategies for handling dual relationships. The results of this study are compared with established ethical decision‐making models, and implications for the ethical guidelines and appropriate ethical training are suggested.

  September 08, 2012   doi: 10.1111/j.1752-0606.2012.00335.x   open full text
• Getting Comfortable as “Fish Out of Water”: Using Qualitative Research Methods Training to Enhance the Technical Capacity of Family Therapy Trainees.
  Laurie L. Charlés, Paula Moebus, Lisa Beechinor, Tyler Pearce, Heather Putney.
  Journal of Marital and Family Therapy. August 03, 2012
  This article describes a qualitative research methods training project undertaken in a COAMFTE‐accredited family therapy master’s‐level program. Graduate students were trained to collect research data for a qualitative study on the resilience of families displaced to the United States because of war and politically motivated violence in their country of origin. By involving trainees in a research project with refugees, the project was intended to address a gap in clinicians’ training, specific to the refugee population (Miller, Muzurovic, Worthington, Tipping, and Goldman, American Journal of Orthopsychiatry 2002; 72: 341). However, the training process was also a way to increase the students’ skills at interviewing in complex situations, develop their cultural sensitivity beyond awareness, enhance their capacity for routine self‐reflection, and introduce them to basic practices of qualitative research methodology. In this article, we focus on the students’ experience of the training and discuss the potential implications of their feedback for family therapy training.

  August 03, 2012   doi: 10.1111/j.1752-0606.2012.00323.x   open full text
• Toward Mutual Support: A Task Analysis of the Relational Justice Approach to Infidelity.
  Kirstee Williams, Aimee Galick, Carmen Knudson‐Martin, Douglas Huenergardt.
  Journal of Marital and Family Therapy. August 01, 2012
  Gender, culture, and power issues are intrinsic to the etiology of infidelity, but the clinical literature offers little guidance on how to work with these concerns. The Relational Justice Approach (RJA) to infidelity (Williams, Family Process, 2011, 50, 516) uniquely places gender and power issues at the heart of clinical change; however, this approach has not been systematically studied. Therefore a qualitative task analysis was utilized to understand how change occurs in RJA. The findings indicated four necessary tasks: (a) creating an equitable foundation for healing, (b) creating space for alternate gender discourse, (c) pursuing relational responsibility of powerful partner, and (d) new experience of mutual support. Therapists' attention to power dynamics that organize couple relationships, leadership in intervening in power processes, and socio‐cultural attunement to gender discourses were foundational to this work. These findings help clarify the processes by which mutual healing from the trauma of infidelity may occur and offer empirically based actions that therapists can take to facilitate mutual support.

  August 01, 2012   doi: 10.1111/j.1752-0606.2012.00324.x   open full text
• Critical Patriotism: Incorporating Nationality into MFT Education and Training.
  Jason J. Platt, Tracey A. Laszloffy.
  Journal of Marital and Family Therapy. August 01, 2012
  Topics such as national identity, patriotism, nationalism, and international issues often lead to polarization within the United States and as a result, critical dialogue about these complex topics often does not occur in a meaningful way. The lack of critical inquiry and interaction about these topics is manifest at the macro and the micro level, including within the context of marriage and family therapy training and practice. While the field of MFT has devoted greater attention to addressing issues of diversity in recent years, limited attention has been focused on examining nationality and nationalism. This article presents a critical patriotism framework that training programs can use to examine nationality and expand awareness of international issues and perspectives. Special attention is focused on examining how nationalism, a problematic extreme version of patriotism, infiltrates MFT training and practice. Recommendations are provided for how training programs can focus on nationality, expand awareness of international issues and perspectives, and guide trainees in exploring how their national identity, beliefs about patriotism, and nationalistic attitudes may influence their clinical work.

  August 01, 2012   doi: 10.1111/j.1752-0606.2012.00325.x   open full text
• Couple’s Relationship With Diabetes: Means and Meanings for Management Success.
  Ruth A. Houston‐Barrett, Colwick M. Wilson.
  Journal of Marital and Family Therapy. July 28, 2012
  Diabetes is a serious chronic illness that involves individuals, couples, and families in complex reciprocal interactions with the illness and other life dimensions. A major issue in diabetes management is how well the patient is able to follow the established medical regimen of selfcare. Situated within personal, physical, and social contexts, the meaning that a couple creates and the emotions they feel in their adaptation to living with diabetes and its demanding regimen can be viewed as the couple’s relationship with diabetes.

  July 28, 2012   doi: 10.1111/j.1752-0606.2012.00322.x   open full text
• Core Competencies in Social Constructionist Supervision?
  Olga Sutherland, Marshall Fine, Lynda Ashbourne.
  Journal of Marital and Family Therapy. July 03, 2012
  Family therapy is moving increasingly toward evidence‐based practice and competency‐based training. This article explores what might seem to be an unlikely link between social constructionist supervision, which is based on dialogic and fluid processes of meaning‐making, and the increasing reliance on discrete core competencies in the education and training of family therapists. We propose an alternate approach to competencies for supervision with therapists in training that, among other things, invites accountability and provides evaluative props. The approach we propose is based on a set of orientations that we hope reflect the dialogic and contextual nature of social constructionist practice and supervision. These orientations consist of reflexivity and attention to power, fostering polyphony and generativity, collaborative stance, and focus on client resourcefulness. Ideas and questions for supervisors and therapists in training to address the orientations are articulated.

  July 03, 2012   doi: 10.1111/j.1752-0606.2012.00318.x   open full text
• The Self Assessment of Future Events Scale (SAFE): Assessing Perceptions of Risk for Future Violence in Intimate Partner Relationships.
  Douglas B. Smith, Jason B. Whiting, Gunnur Karakurt, Megan Oka, David Servino.
  Journal of Marital and Family Therapy. July 02, 2012
  The purpose of this study was to develop a survey measure, appropriate for use in clinical or research settings, to assess respondent’s perceptions that their partner will engage in future physical violence, verbal/psychological violence, or controlling behaviors. Data were collected from adults in intimate relationships. Exploratory factor analysis was used to refine the measure and confirmatory factor analysis provided evidence for the fit of the final version of the measure. Scores on the measure indicated less safety for participants in distressed relationships and for participants meeting the study criteria for PTSD. Scores on the measure also indicated significantly decreased safety for participants that reported being the victims of physical violence and participants reporting both victimization and perpetration in their current intimate relationships.

  July 02, 2012   doi: 10.1111/j.1752-0606.2012.00319.x   open full text
• The Lived Experience of Family Members of Persons Who Compulsively Hoard: A Qualitative Study.
  Jennifer M. Sampson.
  Journal of Marital and Family Therapy. June 16, 2012
  The current study took an Interpretive Phenomenological Analysis approach to investigate the lived experiences of 12 family members of persons who hoard to better understand family members’ cognitions, emotions, perceptions, experiences, and responses in their interactions with their loved ones who hoard. Five overarching themes for the participants’ experiences of having a person who hoards in the family emerged: negative feelings toward the persons who hoard; lack of understanding of hoarding behavior; experiences of loss; internal barriers to seeking support; and internal conflicts. Clinical implications and recommendations for future research are discussed, including a proposed application of an ambiguous loss framework for understanding and working with the experiences of family members of persons who hoard.

  June 16, 2012   doi: 10.1111/j.1752-0606.2012.00315.x   open full text
• Liability of Newness: Assessing Couple Social Support When Starting A New Business Venture.
  Sharon M. Danes, Shonda M. Craft, Juyoung Jang, Jinhee Lee.
  Journal of Marital and Family Therapy. May 15, 2012
  Danes, S.M., Craft, S.M., Jang, J. & Lee, J. (2013). Liability of newness: Assessing couple social support when starting a new business venture. Journal of Marital and Family Therapy, 39, 515–529. doi: 10.1111/j.1752‐0606.2012.00308.x Study purpose was to investigate adapted social support instruments of nurturance and affiliation with male and female entrepreneurs and spouses starting a new business. Family Fundamental Interpersonal Relationship Orientation theory was the theoretical grounding. Business structure differed by entrepreneur gender in both direct and indirect spousal involvement. Both couple types were highly connected with their firms having high nurturance and affiliation scores. When couple discrepancies were compared, more male entrepreneur couples had shared meaning on business‐oriented nurturance questions compared with female entrepreneur couples. The opposite was true for shared meaning on relationship‐oriented nurturance. For all affiliation questions, more male entrepreneur couples had shared meaning than did female entrepreneur couples. Clinical applications of resulting instruments are discussed.

  May 15, 2012   doi: 10.1111/j.1752-0606.2012.00308.x   open full text
• Trying to Comfort the Parent: A Qualitative Study of Children Dealing With Parental Depression.
  Hanna Van Parys, Peter Rober.
  Journal of Marital and Family Therapy. May 14, 2012
  In this article, we look at children’s experiences of parentification in families in which one of the parents is hospitalized for depression. Children (7–14 years old) and their parents were invited for a family interview. Using thematic analysis, we constructed a general framework of 14 children’s experiences, guided by the explorative research question: How do children experience parental depression and how do they experience their own caregiving in the family? The thematic analysis revealed eight themes. One of these themes (trying to comfort the parent) was selected for a microanalysis in one family interview. Our study illustrates the process of overt negotiating of caretaking between parent and child with an underlying moral dilemma and related emotions. The dynamic of children hiding their worry can be seen as an answer to the parent’s expressed wish to not burden her children. These dynamics are situated in ongoing debates in family therapy literature, and some suggestions for therapeutic practice are formulated.

  May 14, 2012   doi: 10.1111/j.1752-0606.2012.00304.x   open full text
• Do Therapists Address Gender and Power in Infidelity? A Feminist Analysis of the Treatment Literature.
  Kirstee Williams, Carmen Knudson‐Martin.
  Journal of Marital and Family Therapy. May 03, 2012
  Sociocontextual factors such as gender and power play an important role in the etiology of affairs and in recovery from them, yet it is unclear how current treatment models address these issues. Drawing on feminist epistemology, this study utilized a grounded theory analysis of 29 scholarly articles and books on infidelity treatment published between 2000 and 2010 to identify the circumstances under which gender and power issues were or were not part of treatment. We found five conditions that limit attention to gender and power: (a) speaking (or assuming) as though partners are equal, (b) reframing infidelity as a relationship problem, (c) limiting discussion of societal context to background, (d) not considering how societal gender and power patterns impact relationship dynamics, and (e) limiting discussion of ethics on how to position around infidelity. Analysis explored how each occurred across three phases of couple therapy. The findings provide a useful foundation for a sociocontextual framework for infidelity treatment.

  May 03, 2012   doi: 10.1111/j.1752-0606.2012.00303.x   open full text
• Enactments in Emotionally Focused Couple Therapy: Shaping Moments of Contact and Change.
  Douglas Tilley, Gail Palmer.
  Journal of Marital and Family Therapy. April 26, 2012
  Emotionally focused couple therapy (EFT) uses enactments to shape responsive attachment‐significant contact and to change couple interaction. In this article, we show how EFT enactments differ from enactments in other therapy approaches, present a theory of EFT enactments, a model for creating EFT enactments, and an extended case example of an EFT enactment.

  April 26, 2012   doi: 10.1111/j.1752-0606.2012.00305.x   open full text