Lebow, Jay L. (2014): Editorial: New Frontiers for Family Therapy-Family Centered Practice and Neuroscience. In: Family Process 53 (1): 1-2.
Madsen, William C. (2014): Applications of Collaborative Helping Maps: Supporting Professional Development, Supervision and Work Teams in Family-Centered Practice. In: Family Process 53 (1): 3-21.
abstract: Collaborative, family-centered practice has become an influential approach in helping efforts across a broad spectrum of human services. This article draws from previous work that presented a principle-based, practice framework of Collaborative Helping and highlighted the use of Collaborative Helping maps as a tool both to help workers think their way through complex situations and to provide a guideline for constructive conversations between families and helpers about challenging issues. It builds on that work to examine ways to utilize Collaborative Helping maps at worker, supervisory, and organizational levels to enhance and sustain collaborative, family-centered practice and weave its core values and principles into the everyday fabric of organizational cultures in human service agencies and government agencies that serve poor and marginalized families and communities.
Patterson, Jo Ellen & Susanna Vakili (2014): Relationships, Environment, and the Brain: How Emerging Research is Changing What We Know about the Impact of Families on Human Development. In: Family Process 53 (1): 22-32.
abstract: Recent research is providing family therapists with new information about the complex interaction between an individual’s biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child’s biological foundation. Additionally, stress during the early years can have a lasting effect on an individual’s physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development.
Gonzalez, Michelle, Deborah Jones & Justin Parent (2014): Coparenting Experiences in African American Families: An Examination of Single Mothers and their Nonmarital Coparents. In: Family Process 53 (1): 33-54.
abstract: African American youth from single-mother homes continue to be overrepresented in statistics on risk behavior and delinquency, a trend that many be attributed to father-absence, socioeconomic disadvantage, and compromises in parenting more typical of single than two-parent families. Yet, this risk-focused perspective ignores a long-standing strength of the African American community, the involvement and potential protective impact of extended family members in childrearing. This study describes the experiences of 95 African American single mothers and their nonmarital coparents who participated in a study of African American single-mother families with an 11-16-year-old child. Specifically, the study examines: (a) the extent to which nonmarital coparents are involved in childrearing; (b) the relative levels of risk (i.e., depression, mother-coparent conflict) and protective (i.e., parenting) associated with maternal and coparent involvement; and (c) how similarly and/or differently coparent and mother variables operate with regard to youth externalizing problems. Findings reveal that a range of family members and other adults actively participate in childrearing in African American single-mother families, coparents do not differ from mothers on certain study variables (i.e., depression and mother-coparent conflict) but do for others (parenting), and coparent involvement is associated with youth adjustment in ways that are similar to our more established understanding of maternal involvement. The potential clinical implications of the findings are discussed and future research directions are highlighted.
Kim, Lana, Carmen Knudson-Martin & Amy Tuttle (2014): Toward Relationship-Directed Parenting: An Example of North American Born Second-Generation Korean-American Mothers and their Partners. In: Family Process 53 (1): 55-66.
abstract: Historically, parenting has been constructed hierarchically; however, contemporary parenting models frequently emphasize parenting as relationship (Siegel & Hartzell  Parenting from the inside out: How a deeper self-understanding can help you raise children who thrive; Tuttle, Knudson-Martin, & Kim  Family Process, 51, 73-89). Drawing on interviews with 20 North American born second-generation Korean-American mothers and their partners, and sensitized by TP-CRO, a social constructionist framework for conceptualizing parent-child relational orientations, this grounded theory analysis identified three main processes that facilitate relational connection as a parenting orientation rather than the rule-directed approach historically associated with first-generation immigrant Asian families. These include: (a) emphasizing dominant culture values; (b) inviting open communication; and (c) promoting mutuality. Results also show how parents integrate collectivist cultural values of their first generation immigrant parents‘ traditional culture into North American parenting ideals with which they primarily identify. The study demonstrates the usefulness of the TP-CRO for understanding parent-child relationships within multicultural parenting contexts and offers suggestions for working with second-generation Korean families.
Zhou, Ting & Chunli Yi (2014): Parenting Styles and Parents‘ Perspectives on How Their Own Emotions Affect the Functioning of Children with Autism Spectrum Disorders. In: Family Process 53 (1): 67-79.
abstract: The grounded theory method was used to analyze the parenting styles used by caregivers to rear children with autism spectrum disorders (ASD) and to investigate parents‘ experiences regarding how to help their child overcome the symptoms. Thirty-two parents from 28 families of children with ASD in mainland China were interviewed. Analysis of interview transcripts revealed four patterns of parenting styles which varied in affiliation to the roles of caretaker and coach. Based on their experience, a sizable group of parents perceived that their own emotions influence the child’s emotions and his/her symptoms. The results suggest the value of developing intervention programs on emotion regulation and positive parenting for the parents of children with ASD.
Fagan, Jay & Yookyong Lee (2014): Longitudinal Associations among Fathers‘ Perception of Coparenting, Partner Relationship Quality, and Paternal Stress during Early Childhood. In: Family Process 53 (1): 80-96.
abstract: This study examined the longitudinal and concurrent associations among fathers‘ perceptions of partner relationship quality (happiness, conflict), coparenting (shared decision making, conflict), and paternal stress. The sample consisted of 6,100 children who lived with both biological parents at 24 and 48¬†months in the Early Childhood Longitudinal Study-Birth Cohort data set. The results showed that there are significant and concurrent associations between fathers‘ perceptions of the coparenting relationship and paternal stress, and between partner relationship quality and paternal stress. There was also a positive direct longitudinal association between partner relationship conflict and paternal stress. However, we found only one longitudinal cross-system mediation effect: fathers‘ perception of coparenting conflict at 48¬†months mediated the association between partner relationship conflict at 24¬†months and paternal stress at 48¬†months. The family practice implications of these findings are discussed.
Shapiro, Danielle (2014): Stepparents and Parenting Stress: The Roles of Gender, Marital Quality, and Views about Gender Roles. In: Family Process 53 (1): 97-108.
abstract: Previous research suggests that stepparenting can be stressful, although the mechanisms that contribute to the experience of parenting stress in stepfamilies are less clear. This study examines gender, marital quality, and views about gendered family roles as correlates of parenting stress among 310 stepmothers, stepfathers, and biological mothers and fathers. Findings suggest that stepparents, and especially stepmothers, experience higher levels of parenting stress than biological parents. Findings also suggest that less traditional views about gendered family roles and higher dyadic adjustment are associated with lower parenting stress for stepparents, particularly in combination. Stepparents reporting both of these protective factors were indistinguishable in terms of parenting stress from biological parents. These findings indicate potential pathways to mitigate the stress associated with stepparenting.
McNeil, Sharde’ N., Frank D. Fincham & Steven R. H. Beach (2014): Does Spousal Support Moderate the Association Between Perceived Racial Discrimination and Depressive Symptoms among African American Couples? In: Family Process 53 (1): 109-119.
abstract: Social stress theory proposes that stress resulting from one’s social position in society leads to fewer coping resources, and subsequently causes an increase in mental health problems. Guided by this framework, we investigated whether the relationship between perceived discrimination and depressive symptoms was moderated by spousal social support in a sample of 487 African American heterosexual couples. Using the actor-partner interdependence model, findings suggested that female partner’s perceived racial discrimination was predictive of her depressive symptomology irrespective of spousal support and male partner’s perceived racial discrimination was predictive of depressive symptomology only among men with low levels of spousal support. No partner effects were present. The results demonstrate the need to examine variability in social stress and mental health outcomes for those in close relationships.
Murdock, Kyle W., M. Christine Lovejoy & Kate B. Oddi (2014): An Actor-Partner Interdependence Analysis of Associations between Affect and Parenting Behavior among Couples. In: Family Process 53 (1): 120-130.
abstract: Prior studies evaluating associations between parental affect and parenting behavior have typically focused on either mothers or fathers despite evidence suggesting that affect and parenting behavior may be interdependent among couples. This study addressed this gap in the literature by evaluating associations between self-reported affect and parenting behavior using an actor-partner interdependence analysis among a sample of 53 mother-father dyads of 3- to 5-year-old children. Results suggested that mothers‘ and fathers‘ negative affect, as well as mothers‘ and fathers‘ positive affect, were positively associated. Both mothers‘ and fathers‘ negative affect were negatively associated with fathers‘ positive affect. Mothers‘ and fathers‘ harsh/negative parenting behavior, and supportive/engaged parenting behavior, were positively associated. Furthermore, mothers‘ negative affect was positively associated with mothers‘ and fathers‘ harsh/negative parenting behavior while mothers‘ positive affect was negatively associated with mothers‘ harsh/negative behavior and positively associated with mothers‘ supportive/engaged behavior. Fathers‘ negative affect was positively associated with fathers‘ supportive/engaged parenting behavior, while fathers‘ positive affect was positively associated with mothers‘ and fathers‘ supportive/engaged behavior. Results highlight the importance of conceptualizing and measuring characteristics of both mothers and fathers, if applicable, when researching the dynamics of interpersonal relationships within families.
Sher, Tamara, Lynne Braun, Andrea Domas, Albert Bellg, Donald H. Baucom & Timothy T. Houle (2014): The Partners for Life Program: A Couples Approach to Cardiac Risk Reduction. In: Family Process 53 (1): 131-149.
abstract: Morbidity and mortality are reliably lower for the married compared with the unmarried across a variety of illnesses. What is less well understood is how a couple uses their relationship for recommended lifestyle changes associated with decreased risk for illness. Partners for Life compared a patient and partner approach to behavior change with a patient only approach on such factors as exercise, nutrition, and medication adherence. Ninety-three patients and their spouses/partners consented to participate (26% of those eligible) and were randomized into either the individual or couples condition. However, only 80 couples, distributed across conditions, contributed data to the analyses, due to missing data and missing data points. For exercise, there was a significant effect of couples treatment on the increase in activity and a significant effect of couples treatment on the acceleration of treatment over time. In addition, there was an interaction between marital satisfaction and treatment condition such that patients who reported higher levels of marital distress in the individuals condition did not maintain their physical activity gains by the end of treatment, while both distressed and nondistressed patients in the couples treatment exhibited accelerating gains throughout treatment. In terms of medication adherence, patients in the couples treatment exhibited virtually no change in medication adherence over time, while patients in the individuals treatment showed a 9% relative decrease across time. There were no condition or time effects for nutritional outcomes. Finally, there was an interaction between baseline marital satisfaction and treatment condition such that patients in the individuals condition who reported lower levels of initial marital satisfaction showed deterioration in marital satisfaction, while non satisfied patients in the couples treatment showed improvement over time.
Gelkopf, Marc & David Roe (2014): Evaluating Outcome Domains Assessing Caregivers of Individuals with Mental Illness: A Review. In: Family Process 53 (1): 150-174.
abstract: In this article, we describe the properties and consider the outcome dimensions of a collection of self-administered questionnaires that assess caregivers of offspring with mental illness. To this end, we searched the MEDLINE, Web of Science, and PsycINFO databases, as well as reference lists of studies published between 1980 and 2012. We reviewed 43 instruments, and found multiple outcome domains, associated with either objective burden or subjective burden, or both. A number of tools captured additional negative aspects of caregiving (e.g., strain, stress, and worrying) as well as positive aspects (e.g., personal growth, strength, support, rewards, and satisfaction), supplemented by measures assessing caregivers‘ perceptions and attitudes toward their offspring with SMI (e.g., insight, stigma, and efficacy). This current review of existing measures and their specific domains contributes to a more comprehensive understanding of the caregiving experience and allows both clinicians and researchers to select the most appropriate measurement tools for their purposes.
Lebow, Jay L. (2014): Editorial: Overselling Our Findings. In: Family Process 53 (2): 175-178.
George, Jayashree & Sandra M. Stith (2014): An Updated Feminist View of Intimate Partner Violence. In: Family Process 53 (2): 179-193.
abstract: In this article, we explore intimate partner violence (IPV) from an intersectional, feminist perspective. We describe how an updated feminist view guides us to a perspective on IPV that is more strongly grounded in an antioppressive, nonviolent, socially just feminist stance than a second-wave gender-essential feminist stance that suggests that patriarchy is the cause of IPV. At the time we began to work together it seemed that a researcher had to be identified as a „family violence“ researcher or a „feminist“ researcher of violence against women, and that it wasn’t possible to be a feminist researcher who looked beyond patriarchy as the cause of IPV. We advocate critically thinking about essentialist practices in clinical work so that we can maintain an antioppressive, socially just, nonviolent approach to working with clients who experience IPV.
Distelberg, Brian, Jackie Williams-Reade, Daniel Tapanes, Susanne Montgomery & Mayuri Pandit (2014): Evaluation of a Family Systems Intervention for Managing Pediatric Chronic Illness: Mastering Each New Direction (MEND). In: Family Process 53 (2): 194-213.
abstract: Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child’s chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness.
Johnson, Sharon D. (2014): Comparing Factors Associated with Maternal and Adolescent Reports of Adolescent Traumatic Event Exposure. In: Family Process 53 (2): 214-224.
abstract: Existing research indicates that there is very little agreement between youth and their parents on youth trauma exposure and subsequent treatment. Few studies, however, have attempted to examine factors that may contribute to this lack of agreement. This study addressed this gap by examining youth and maternal-reported youth traumatic event exposure using a sample of 100 urban, African American adolescent-maternal dyads. Cumulative report of youth potentially traumatic event exposure (57%) was higher than youth (41%) and maternal (27%) reports. Findings indicate that there was agreement for sexual assault, being shot or stabbed, and auto accidents. Maternal depression was the only factor that was associated with both youth and maternal report of youth qualifying event. Other factors that distinguished youth reports included maternal event exposure, substance use disorder, antisocial personality behaviors, and youth reports of arguments with the mother and running away from home. Implications for reconciling reports of trauma exposure among youth and their mothers are discussed.
Baum, Nehami (2014): Female Receptivity and Secondary Traumatization in the Family. In: Family Process 53 (2): 225-238.
abstract: This paper addresses the question of gendered receptivity to Secondary Traumatic Syndrome (STS) in the family. Unlike other manifestations of distress in the family, where gender comparisons are a matter of course, very few such comparisons are made in studies of STS. Review of the findings of 12 studies, the only studies, to date, that provide data enabling the comparison of STS in males and females, shows that females in the family, whether daughters, wives, or mothers, are consistently more likely than the males, whether sons, husbands, or fathers, to experience the Posttraumatic Stress Disorder (PTSD) symptoms of a traumatized family member without having experienced the traumatic event itself. This pattern pertains to whether the event that precipitated the primary trauma was a collective or individual trauma and whether the STS sufferer was a child or adult or living or not living with the PTSD casualty. The Discussion points out that gender is an important factor in the development of STS, whether in interaction with role, beyond role, or both.
Song, Suzan Joon, Wietse Tol & Joop de Jong (2014): Indero: Intergenerational Trauma and Resilience between Burundian Former Child Soldiers and Their Children. In: Family Process 53 (2): 239-251.
abstract: Since many former child soldiers are aging and having children of their own, this study aimed to understand how the effects of trauma are passed to the next generation. In this qualitative study, semistructured interviews, focus groups, and observations were conducted with 25 former child soldiers and 15 matched civilian parents. Analysis used a grounded-theory approach. Trauma may be transmitted from former child soldiers to their offspring via (a) the effect on indero (how to raise a child); (b) severe parental emotional distress; and (c) community effects. Incorporating themes of indero values on how to raise children, the effects of parental posttraumatic stress and depressive symptoms on offspring, and the stigma associated with the families of former child soldiers may provide key areas of intervention in mental healing.
Sang, Jina, Julie A. Cederbaum & Michael S. Hurlburt (2014): Parentification, Substance Use, and Sex among Adolescent Daughters from Ethnic Minority Families: The Moderating Role of Monitoring. In: Family Process 53 (2): 252-266.
abstract: Guided by structural family systems theory, this study explored the relationship between parentification and adolescent daughters‘ sexual risk engagement and substance use. We also explored how adolescent reports of parental monitoring moderated the relationship between parentification and adolescent risk. Data were from a cross-sectional, cross-generational study of 176 mother-daughter dyads from low-income, inner-city, ethnic minority families. In this sample, which included a subset of mothers with HIV, parental physical symptoms were associated with slightly higher levels of parentification. Parentification was associated with adolescent daughters‘ intention to have sex (but not substance use) in a direction opposite to prediction. Higher parentification was associated with lower intention to have sex. Parental monitoring did not moderate relationships between parentification and adolescent risk. These findings highlight that despite the negative influence hypothesized in structural family systems theory, parentification was not associated with risk engagement of high-risk adolescent daughters in ethnic minority families with low income.
Khafi, Tamar Y., Tuppett M. Yates & Suniya S. Luthar (2014): Ethnic Differences in the Developmental Significance of Parentification. In: Family Process 53 (2): 267-287.
abstract: Using an ecological framework, this 2-wave longitudinal study examined the effects of parentification on youth adjustment across the transition to adolescence in a high-risk, low-income sample of African American (58%) and European American (42%) mother-child dyads (T1 Mage¬†=¬†10.17¬†years, T2 Mage¬†=¬†14.89¬†years; 52.4% female). Children’s provision of family caregiving was moderately stable from early to late adolescence. Emotional and instrumental parentification evidenced distinct long-term effects on adolescents‘ psychopathology and the quality of the parent-child relationship. Ethnicity moderated these relations. Emotional and instrumental parentification behaviors were associated with predominantly negative outcomes among European American youth in the form of increased externalizing behavior problems and decreased parent-child relationship quality, whereas emotional parentification was associated with positive outcomes among African American youth in the form of increased parent-child relationship quality, and instrumental parentification was neutral. These findings support a multidimensional view of parentification as a set of culturally embedded phenomena whose effects can only be understood in consideration of the context in which they occur.
Hunger, Christina, Annette Bornhäuser, Leoni Link, Jochen Schweitzer & Jan Weinhold (2014): Improving Experience in Personal Social Systems through Family Constellation Seminars: Results of a Randomized Controlled Trial. In: Family Process 53 (2): 288-306.
abstract: This study examined the efficacy of family constellation seminars (FCSs) on individuals‘ experience in their personal social systems, especially the experience of belonging, autonomy, accord, and confidence. We conducted a single-blind, stratified and balanced, randomized controlled trial. Participants were 208 adults (M¬†=¬†48¬†years, SD¬†=¬†10, 79% women) who were randomly allocated either to the intervention group (3-day FCSs; 64 active participants, 40 observing participants) or to the wait-list group (64 active participants, 40 observing participants). Change was measured short-term (2-week and 4-month follow-up) using the Experience In Social Systems Questionnaire, personal domain (EXIS.pers). EXIS.pers is a new outcome measure being applied for the first time in evaluation research. In addition, we used interpersonal scales derived from established measures (Outcome Questionnaire, OQ-45; Tool for the Evaluation of the Psychotherapeutic Progress, FEP). The average person in the intervention group showed improved experience in personal social systems, as compared with approximately 73% of the wait-list group after 2¬†weeks (total score: Cohen’s d¬†=¬†.61, p¬†=¬†.000) and 69% of the wait-list group after 4¬†months (total score: d¬†=¬†.53, p¬†=¬†.000). The results were confirmed in per-protocol analyses (n¬†=¬†191) by the results of the EXIS.pers dimensions (Belonging, Autonomy, Accord, and Confidence) and the interpersonal scales derived from the OQ-45 and FEP. No adverse events were reported. This RCT provides first evidence that FCSs tend to positively influence participants‘ experience in their social systems.
Haber, Russell, Ryan G. Carlson & Cristina Braga (2014): Use of an Anecdotal Client Feedback Note in Family Therapy. In: Family Process 53 (2): 307-317.
abstract: To attain information about divergent agendas in family therapy, as well as incorporate client feedback, we present the Client Feedback Note (CFN). The CFN elicits information about each family member’s feelings, learning, dislikes, and wishes for each session. Anecdotal feedback after each session may help the therapist have better insight into the clients‘ perceptions and experience of the therapy and the therapist. Sensitivity to information generated by the CFN can help both therapist and client work to coconstruct a therapeutic process that is relevant to the diverse needs of the client system. This manuscript will (a) discuss literature supporting the use of client feedback in therapy; (b) present the CFN and rationale for its development; (c) discuss our experiences utilizing the CFN along with case examples that illustrate its use; and (d) identify practical applications, limitations, and potential research with using the CFN in systemic therapy.
Reczek, Corinne (2014): Conducting a Multi Family Member Interview Study. In: Family Process 53 (2): 318-335.
abstract: Family researchers have long recognized the utility of incorporating interview data from multiple family members. Yet, relatively few contemporary scholars utilize such an approach due to methodological underdevelopment. This article contributes to family scholarship by providing a roadmap for developing and executing in-depth interview studies that include more than one family member. Specifically, it outlines the epistemological frames that most commonly underlie this approach, illustrates thematic research questions that it best addresses, and critically reviews the best methodological practices of conducting research with this approach. The three most common approaches are addressed in depth: separate interviews with each family member, dyadic or group interviews with multiple family members, and a combined approach that uses separate and dyadic or group interviews. This article speaks to family scholars who are at the beginning stages of their research project but are unsure of the best qualitative approach to answer a given research question.
Huang, Shi, David Cordova, Yannine Estrada, Ahnalee M. Brincks, Lila S. Asfour & Guillermo Prado (2014): An Application of the Complier Average Causal Effect Analysis to Examine the Effects of a Family Intervention in Reducing Illicit Drug Use among High-Risk Hispanic Adolescents. In: Family Process 53 (2): 336-347.
abstract: The Complier Average Causal Effect (CACE) method has been increasingly used in prevention research to provide more accurate causal intervention effect estimates in the presence of noncompliance. The purpose of this study was to provide an applied demonstration of the CACE analytic approach to evaluate the relative effects of a family-based prevention intervention, Familias Unidas, in preventing/reducing illicit drug use for those participants who received the intended dosage. This study is a secondary data analysis of a randomized controlled trial designed to evaluate the relative efficacy of Familias Unidas with high-risk Hispanic youth. A total of 242 high-risk Hispanic youth aged 12-17¬†years and their primary caregivers were randomized to either Familias Unidas or Community Practice and assessed at baseline, 6 months and 12 months postbaseline. CACE models were estimated with a finite growth mixture model. Predictors of engagement were included in the CACE model. Findings indicate that, relative to the intent-to-treat (ITT) analytic approach, the CACE analytic approach yielded stronger intervention effects among both initially engaged and overall engaged participants. The CACE analytic approach may be particularly helpful for studies involving parent/family-centered interventions given that participants may not receive the intended dosage. Future studies should consider implementing the CACE analysis in addition to ITT analysis when examining the effects of family-based prevention programs to determine whether, and the extent to which, the CACE analysis has more power to uncover intervention effects.
Cordova, David, Shi Huang, Meghan Lally, Yannine Estrada & Guillermo Prado (2014): Do Parent-Adolescent Discrepancies in Family Functioning Increase the Risk of Hispanic Adolescent HIV Risk Behaviors? In: Family Process 53 (2): 348-363.
abstract: In the family-based prevention science literature, family functioning, defined as positive parenting, parental involvement, family cohesion, family communication, parental monitoring of peers, and parent-adolescent communication, has been shown to ameliorate HIV risk behaviors in Hispanic youth. However, the majority of studies have relied solely on parent or adolescent reports and we know very little about parent-adolescent family functioning discrepancies. Therefore, the purpose of this study was to examine whether and to what extent parent-adolescent discrepancies in family functioning increased the risk of HIV risk behaviors, including substance use and sexual risk behaviors, and whether these associations vary as a function of acculturation and youth gender. A total of 746 Hispanic 8th grade youth and their primary caregivers were included in the study. Structural equation modeling findings indicate that parent-adolescent family functioning discrepancies are associated with an increased risk of Hispanic adolescent HIV risk behaviors, including lifetime and past 90-day alcohol and illicit drug use, and early sex initiation. In addition, study findings indicate that results vary by acculturation and youth gender. Findings are discussed in the context of existing family-based research and practice in preventing and reducing HIV risk behaviors among Hispanic youth and their families.
Lebow, Jay L. (2014): Editorial: Whither Family Therapy: Alive and Flowering Amidst the Challenges. In: Family Process 53 (3): 365-370.
Imber-Black, Evan (2014): Eschewing Certainties: The Creation of Family Therapists in the 21st Century. In: Family Process 53 (3): 371-379.
abstract: I reflect here on Family Therapy’s origins, our present dilemmas, and future possibilities. Using the lens of training new Family Therapists for current public sector domains, I examine our field’s strengths, vulnerabilities, and contradictions. I critique the current vogue of model certainty and branding. Our responsibilities to trainees, young practitioners, and the families we serve are highlighted.
Madsen, William C. (2014): Taking it to the Streets: Family Therapy and Family-Centered Services. In: Family Process 53 (3): 380-400.
abstract: This article examines the interconnections between family therapy, specifically postmodern and poststructural approaches, and family-centered services. It introduces particular applications of family-centered services such as systems of care, wraparound, family-driven care, the recovery movement, and family group conferencing and then summarizes the heart of family-centered approaches as a shift in how services are provided to families. It examines the „fit“ between the values and principles of family-centered practice and postmodern/poststructural approaches and then offers particular ideas and practices from these approaches that can help frontline workers inhabit a spirit of respect, connection, curiosity and hope in their work.
Dickerson, Victoria C. (2014): The Advance of Poststructuralism and Its Influence on Family Therapy. In: Family Process 53 (3): 401-414.
abstract: Postmodernism began to influence family therapy very early in the 1980s with articles referencing postmodern ideas, focusing on meaning and multiplicity. With the appearance of narrative therapy on the scene in the 1990s there was a shift toward poststructural thinking, which refined the movement and politicized the clinical work. Even with a bit of a backlash, whether because this was a new idea or it somehow threatened a positivistic culture, a poststructural view has continued to have effects on family therapy. This article explores the variety of influences: the expansion of narrative ideas, the innovation of Madsen’s collaborative helping, and also more nuanced effects. I argue that a poststructural view has effectively changed how many family therapists think and may also be subtly influencing how they might work.
Sexton, Thomas L. & Corinne Datchi (2014): The Development and Evolution of Family Therapy Research: Its Impact on Practice, Current Status, and Future Directions. In: Family Process 53 (3): 415-433.
abstract: Science has always been a central part of family therapy. Research by early pioneers focused on studying the efficacy of both couple and family interventions from a systemic perspective. Today we know more now than ever before about the processes of diverse families and the therapeutic outcomes of family therapy practices. Despite the acknowledged importance of family therapy research, there are still questions about its impact on „real life“ practice. Despite all the flaws of each, research and practice are critical interacting elements of a dialectic relationship: High-quality practice combines reliable scientific knowledge with individual clinical judgment made by family therapists in the context of their dynamic transactions with a family or couple. Future research can help uncover the mechanisms we have yet to know and test the ones we have identified while the dynamic interaction of research and practice that can lead to further innovations and developments central to the future of family therapy.
Rohrbaugh, Michael J. (2014): Old Wine in New Bottles: Decanting Systemic Family Process Research in the Era of Evidence-Based Practice. In: Family Process 53 (3): 434-444.
abstract: Social cybernetic (systemic) ideas from the early Family Process era, though emanating from qualitative clinical observation, have underappreciated heuristic potential for guiding quantitative empirical research on problem maintenance and change. The old conceptual wines we have attempted to repackage in new, science-friendly bottles include ironic processes (when „solutions“ maintain problems), symptom-system fit (when problems stabilize relationships), and communal coping (when we-ness helps people change). Both self-report and observational quantitative methods have been useful in tracking these phenomena, and together the three constructs inform a team-based family consultation approach to working with difficult health and behavior problems. In addition, a large-scale, quantitatively focused effectiveness trial of family therapy for adolescent drug abuse highlights the importance of treatment fidelity and qualitative approaches to examining it. In this sense, echoing the history of family therapy research, our experience with juxtaposing quantitative and qualitative methods has gone full circle – from qualitative to quantitative observation and back again.
Baucom, Donald H., Jennifer M. Belus, Caroline B. Adelman, Melanie S. Fischer & Christine Paprocki (2014): Couple-Based Interventions for Psychopathology: A Renewed Direction for the Field. In: Family Process 53 (3): 445-461.
abstract: This article provides a rationale and empirical support for providing couple-based interventions when one partner in a relationship is experiencing individual psychopathology. Several investigations indicate that relationship distress and psychopathology are associated and reciprocally influence each other, such that the existence of relationship distress predicts the development of subsequent psychopathology and vice versa. Furthermore, findings indicate that for several disorders, individual psychotherapy is less effective if the client is in a distressed relationship. Finally, even within happy relationships, partners often inadvertently behave in ways that maintain or exacerbate symptoms for the other individual. Thus, within both satisfied and distressed relationships, including the partner in a couple-based intervention provides an opportunity to use the partner and the relationship as a resource rather than a stressor for an individual experiencing some form of psychological distress. The authors propose that a promising approach to including the partner in treatment involves (a) integrating intervention principles from empirically supported interventions for individual therapy for specific disorders with (b) knowledge of how to employ relationships to promote individual and dyadic change. Based on this logic, the article includes several examples to demonstrate how couple-based interventions can be focused on a specific type of psychopathology, including encouraging empirical findings for these interventions. The article concludes with recommendations for how clinicians and researchers can adapt their knowledge of couple therapy to assist couples in which one partner is experiencing notable psychological distress or diagnosable psychopathology.
Breunlin, Douglas C. & Elizabeth Jacobsen (2014): Putting the „Family“ Back Into Family Therapy. In: Family Process 53 (3): 462-475.
abstract: In this article, we examine the field of family therapy by drawing a distinction between two forms of practice: Whole Family Therapy (WFT), defined as treating the whole family, and Relational Family Therapy (RFT), defined as working with a subsystem of the family or an individual while retaining a systemic lens. Our thesis is that the practice of WFT has been in decline for some time and steps must be taken to keep it from becoming a defunct practice. We consider the trajectory of WFT and RFT throughout the development of family therapy through reference to the people, the literature, training, and practice patterns associated with family therapy. We remind the reader of the many benefits of WFT and suggest that today WFT is likely to be practiced in conjunction with RFT and individual therapy. Since training of family therapists today is largely located in degree-granting programs, we identify constraints to including WFT in such programs. We conclude by offering suggestions that can enhance a program’s ability to train students in WFT.
Combrinck-Graham, Lee (2014): Being a Family Systems Thinker: A Psychiatrist’s Personal Odyssey. In: Family Process 53 (3): 476-488.
abstract: This account traces the development of family systems thinking from early pioneering thinking and practices, through the development of institutions and professional definitions, and through challenges to family systems thinking and practice from the biomedical points of view. Throughout there is a strong conviction that „thinking family“ is an essential core of effective mental health treatment, because families can heal.
Rampage, Cheryl (2014): The Role of Family Institutes in Promoting the Practice of Family Therapy. In: Family Process 53 (3): 489-499.
abstract: Much of the development of family therapy as a discipline was an outcome of the clinical, training, and theory-building activities conducted at family institutes around the United States. Beginning in the 1960s, these institutes were the crucibles in which the concepts and practices of family therapy flourished. The author, a leader at one of the largest family institutes in the United States, discusses the role of family institutes in promoting the practice of family therapy, as well as the challenges of doing so.
Emery, Robert E., Jenna Rowen & Diana Dinescu (2014): New Roles for Family Therapists in the Courts: An Overview with a Focus on Custody Dispute Resolution. In: Family Process 53 (3): 500-515.
abstract: Many legal issues involve conflicts that are at least as much psychological and relational as they are legal in nature. Juvenile and family courts have always embraced a helping philosophy under the parens patriae legal doctrine. These courts address problems where family relationships are central, for example, custody and coparenting disputes, divorce, child abuse and neglect, foster care, intimate partner violence, and juvenile delinquency. Family therapists are playing a growing role in all of these matters. In this article, we use child custody disputes as a more in-depth example for exploring new, potential roles for family therapists, particularly as mediators and parenting coordinators. To show the breadth of the role for family therapists, we also more briefly consider the topics of child abuse and neglect, foster care, juvenile delinquency, and drug and alcohol issues.
Liddle, Howard A. (2014): Adapting and Implementing an Evidence-Based Treatment with Justice-Involved Adolescents: The Example of Multidimensional Family Therapy. In: Family Process 53 (3): 516-528.
abstract: For over four decades family therapy research and family centered evidence-based therapies for justice-involved youths have played influential roles in changing policies and services for these young people and their families. But research always reveals challenges as well as advances. To be sure, demonstration that an evidence-based therapy yields better outcomes than comparison treatments or services as usual is an accomplishment. But the extraordinary complexity embedded in that assertion feels tiny relative to what we are now learning about the so-called transfer of evidence-based treatments to real world practice settings. Today’s family therapy studies continue to assess outcome with diverse samples and presenting problems, but research and funding priorities also include studying particular treatments in nonresearch settings. Does an evidence-based intervention work as well in a community clinic, with clinic personnel? How much of a treatment has to change to be accepted and implemented in a community clinic? Perhaps it is the setting and existing procedures that have to change? And, in those cases, do accommodations to the context compromise outcomes? Thankfully, technology transfer notions gave way to more systemic, dynamic, and frankly, more family therapy-like conceptions of the needed process. Implementation science became the more sensible, as well as the theoretically and empirically stronger overarching framework within which the evidence-based family based therapies now operate. Using the example of Multidimensional Family Therapy, this article discusses treatment development, refinement, and implementation of that adapted approach in a particular clinical context‚Äîa sector of the juvenile justice system‚Äîjuvenile detention.
Doherty, William J., Susan H. McDaniel & Jeri Hepworth (2014): Contributions of Medical Family Therapy to the Changing Health Care System. In: Family Process 53 (3): 529-543.
abstract: Medical family therapy is a form of professional practice that uses a biopsychosocial approach and systemic family therapy principles in the collaborative treatment of individuals and families dealing with medical problems. It emerged out of the experience of family therapists working in primary medical care settings in the 1980s and 1990s. This article describes how contemporary medical family therapy can contribute to a transformed health care system in four areas: the patient experience of health care, the health of the population, the containment of health care costs, and enhanced practice environments.
Roberts, Janine, Khawla Abu-Baker, Cristina Diez Fernández, Nelly Chong Garcia, Glenda Fredman, Hugo Kamya, Yolanda Martín Higarza, Jacqueline Fortes de Leff, Philip Messent, Shin-Ichi Nakamura, Fatma Torun Reid, Timothy Sim, Chitra Subrahmanian & Roxana Zevallos Vega (2014): Up Close: Family Therapy Challenges and Innovations Around the World. In: Family Process 53 (3): 544-576.
abstract: Family therapists from 10 different countries (China, India, Israel including Palestinian citizens, Japan, Mexico, Peru, Spain, Turkey, Uganda, and the United Kingdom) describe systemic therapy in their contexts and current innovative work and challenges. They highlight the importance of family therapy continuing to cut across disciplines, the power of systems ideas in widely diverse settings and institutions (such as courts, HIV projects, working with people forced into exile), extensive new mental health initiatives (such as in Turkey and India), as well as the range of family therapy journals available (four alone in Spain). Many family therapy groups are collaborating across organizations (especially in Asia) and the article presents other ideas for connections such as a clearing house to inexpensively translate family therapy articles into other languages.
Lebow, Jay L. (2014): Editorial: The Passing of a Generation. In: Family Process 53 (4): 577-579.
Beach, Steven R. H., Allen W. Barton, Man Kit Lei, Gene H. Brody, Steven M. Kogan, Tera R. Hurt, Frank D. Fincham & Scott M. Stanley (2014): The Effect of Communication Change on Long-term Reductions in Child Exposure to Conflict: Impact of the Promoting Strong African American Families (ProSAAF) Program. In: Family Process 53 (4): 580-595.
abstract: African American couples (n=331) with children, 89% of whom were married, were assigned to either (a) a culturally sensitive couple- and parenting-enhancement program (ProSAAF) or (b) an information-only control condition in which couples received self-help materials. Husbands averaged 41 years of age and wives averaged 39 years. We found significant effects of program participation in the short term on couple communication, which was targeted by the intervention, as well as over the long term, on self-reported arguing in front of children. Long-term parenting outcomes were fully mediated by changes in communication for wives, but not for husbands. For husbands, positive change depended on amount of wife reported change. We conclude that wives‘ changes in communication from baseline to posttest may be more pivotal for the couples‘ long-term experience of decreased arguing in front of children than are husbands‘ changes, with wives‘ changes leading to changes in both partners‘ reports of arguments in front of children.
Wood, Nathan D. (2014): Location, Location, Location: Applying Spatial Statistics to the Relationship Landscape. In: Family Process 53 (4): 596-607.
abstract: The desire to understand relationships is a passion shared by professionals in research, clinical, and educational settings. Questionnaires are frequently used in each of these settings for a multitude of purposes‚Äîsuch as screening, assessment, program evaluation, or establishing therapeutic effectiveness. However, clinical issues arise when a couple’s answers on questionnaires do not match clinical judgment or lack clinical utility, while statistical problems arise when data from both partners are put into analyses. This article introduces the use of geospatial statistics to analyze couple data plotted on a two-dimensional „relational map.“ Relationship maps can increase assessment sensitivity, track treatment progress, and remove statistical issues typically associated with couple data. This article briefly introduces core assumptions of spatial models, illustrates the use of spatial models in creating a relational landscape of divorce, offers suggestions for the use of relational maps in a clinical setting, and explores future research ideas.
Maybery, Darryl, Melinda Goodyear, Brendan O‘Hanlon, Rose Cuff & Andrea Reupert (2014): Profession Differences in Family Focused Practice in the Adult Mental Health System. In: Family Process 53 (4): 608-617.
abstract: There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross-sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices.
Sheinberg, Marcia & Mary Kim Brewster (2014): Thinking and Working Relationally: Interviewing and Constructing Hypotheses to Create Compassionate Understanding. In: Family Process 53 (4): 618-639.
abstract: In the initial interviews of family therapy sessions, the therapist faces the challenge of obtaining and organizing the information that is most relevant toward understanding the essential concerns that families and couples bring to therapy. This article describes the process of clinical interviewing and case conceptualization used in training family therapists at the Ackerman Institute for the Family. This approach helps the therapist bring forward, and organize, specific information into relational hypotheses, or systemic-relational conceptualizations, that allow both family members and the therapist to understand presenting problems within their relational contexts. While always provisional, relational hypotheses help anchor the therapist in a systemic-relational frame and provide a conceptual through-line to guide the ongoing work of the therapy. The process of interviewing and the construction of clear and complex conceptualizations of presenting problems are illustrated through case examples.
Archambault, Richard, Abigail K. Mansfield, Doug Evans & Gabor I. Keitner (2014): Using the Tenets of the Problem-Centered Systems Therapy of the Family (PCSTF) to Teach the McMaster Approach to Family Therapists. In: Family Process 53 (4): 640-655.
abstract: This article describes the videoconferencing training of a group of family therapists in the McMaster Approach to evaluating and treating families. A discussion of the key tenets of the McMaster Approach lays the groundwork for how these tenets were applied to training in a residential treatment agency for adolescents. The article serves as an example of how videoconference technology can facilitate extended training, even from a distance.
Farr, Rachel H., Holly A. Grant-Marsney & Harold D. Grotevant (2014): Adoptees‘ Contact with Birth Parents in Emerging Adulthood: The Role of Adoption Communication and Attachment to Adoptive Parents. In: Family Process 53 (4): 656-671.
abstract: As adoptees transition to adulthood, their roles in the family may shift, providing them with opportunities to have increasing autonomy in their decisions about contact and initiating conversations about adoption. Research has often focused more on adoptees as children, yet in emerging adulthood, there are important shifts in the life roles and relationships of adoptees during which adoptive parents continue to be meaningful. This study examined associations among attachment and communication within the adoptive family during adulthood with emerging adult adoptees‘ experience of birth family contact (frequency of and satisfaction with birth family contact), in a sample of 167 emerging adults with varied contact with birth family (from no contact to frequent contact). Results suggest that perceptions of secure parent–child attachment relationships, as well as sensitive and open communication with adoptive parents about adoption, continue to be important for emerging adult adoptees and lead to greater satisfaction for adoptees with birth parent contact‚Äîregardless of whether adoptees actually have birth family contact. In particular, positive family communication about adoption during adulthood was predictive of satisfaction with birth parent contact. Limitations and implications are discussed.
Woods, Sarah B., Jacob B. Priest & Tara Roush (2014): The Biobehavioral Family Model: Testing Social Support as an Additional Exogenous Variable. In: Family Process 53 (4): 672-685.
abstract: This study tests the inclusion of social support as a distinct exogenous variable in the Biobehavioral Family Model (BBFM). The BBFM is a biopsychosocial approach to health that proposes that biobehavioral reactivity (anxiety and depression) mediates the relationship between family emotional climate and disease activity. Data for this study included married, English-speaking adult participants (n=1,321; 55% female; M age = 45.2 years) from the National Comorbidity Survey Replication, a nationally representative epidemiological study of the frequency of mental disorders in the United States. Participants reported their demographics, marital functioning, social support from friends and relatives, anxiety and depression (biobehavioral reactivity), number of chronic health conditions, and number of prescription medications. Confirmatory factor analyses supported the items used in the measures of negative marital interactions, social support, and biobehavioral reactivity, as well as the use of negative marital interactions, friends‘ social support, and relatives‘ social support as distinct factors in the model. Structural equation modeling indicated a good fit of the data to the hypothesized model (x2=846.04, p=.000, SRMR=.039, CFI=.924, TLI=.914, RMSEA=.043). Negative marital interactions predicted biobehavioral reactivity (ß≤=.38, p<.001), as did relatives‘ social support, inversely (ß≤=‚–.16, p<.001). Biobehavioral reactivity predicted disease activity (ß≤=.40, p<.001) and was demonstrated to be a significant mediator through tests of indirect effects. Findings are consistent with previous tests of the BBFM with adult samples, and suggest the important addition of family social support as a predicting factor in the model.
Albritton, Tashuna, Meghan Angley, Valen Grandelski, Nathan Hansen & Trace Kershaw (2014): Looking for Solutions: Gender Differences in Relationship and Parenting Challenges Among Low-Income, Young Parents. In: Family Process 53 (4): 686-701.
abstract: The need for parenting and relationship strengthening programs is important among low-income minority parents where the burden of relational and parental stressors contributes to relationship dissolution. We examine these stressors among young parents. Data were collected from four focus groups (N=35) with young parents. Data were audio-recorded and transcribed. Inductive coding was used to generate themes and codes, and analysis was completed using NVivo. Relationship and parenting challenges, values, and areas of need were the three major themes that emerged. Women’s relationship challenges were family interference and unbalanced parenting, and men reported feeling disrespected and having limited finances. Common relationship challenges for women and men were family interference and unbalanced parenting. Both genders valued trust, communication, and honesty in relationships. Areas of need for women and men included: improving communication and understanding the impact of negative relationships on current relationships. Parenting challenges for women were unbalanced parenting, child safety, and feeling unprepared to parent; men reported limited finances. Both genders valued quality time with child to instill family morals. Areas of need for women and men included learning child discipline techniques and increasing knowledge about child development. Finally, women and men have relationship and parenting similarities and differences. Young parents are interested in learning how to improve relationships and co-parent to reduce relationship distress, which could reduce risk behaviors and improve child outcomes.
Antonelli, Paolo, Davide Dèttore, Irene Lasagni, Douglas K. Snyder & Christina Balderrama-Durbin (2014): Gay and Lesbian Couples in Italy: Comparisons with Heterosexual Couples. In: Family Process 53 (4): 702-716.
abstract: Assessing couple relationships across diverse languages and cultures has important implications for both clinical intervention and prevention. This is especially true for nontraditional relationships potentially subject to various expressions of negative societal evaluation or bias. Few empirically validated measures of relationship functioning have been developed for cross-cultural applications, and none have been examined for their psychometric sufficiency for evaluating same-sex couples across different languages and cultures. The current study examined the psychometric properties of an Italian translation of the Marital Satisfaction Inventory – Revised (MSI-R), a 150-item 13-scale measure of couple relationship functioning, for its use in assessing the intimate relationships of gay and lesbian couples in Italy. Results for these couples were compared to data from heterosexual married and unmarried cohabiting couples from the same geographical region, as well as to previously published data for gay, lesbian, and unmarried heterosexual couples from the United States. Findings suggest that, despite unique societal pressures confronting Italian same-sex couples, these relationships appear resilient and fare well both overall and in specific domains of functioning compared to heterosexual couples both in Italy and the United States.
Zhou, Ting, Chunli Yi, Xuxia Zhang & Yuyin Wang (2014): Factors Impacting the Mental Health of the Caregivers of Children with Asthma in China: Effects of Family Socioeconomic Status, Symptoms Control, Proneness to Shame, and Family Functioning. In: Family Process 53 (4): 717-730.
abstract: Caregiver mental health is widely considered to be an important factor influencing children’s asthma symptoms. The present study aimed to examine key factors that contribute to caregiver mental health in pediatric asthma with a Chinese sample. Two hundred participants reported their family socioeconomic status (SES), proneness to shame, asthma symptoms control of their child, family functioning, and their depression and anxiety symptoms. Results suggested that low family SES, low family functioning, and a high level of shame proneness were associated with high levels of anxiety and depression for caregivers. Family functioning mediated the effects of SES and shame on caregiver mental health and also moderated the effects of SES and shame on caregiver depression. This study highlights the importance of reducing experience of shame and enhancing family functioning in families affected by pediatric asthma.