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Abstract: This article presents a comprehensive modular pathway for delivering systemic family therapy (SFT) for adolescent behavior problems (ABP). Although SFT is an evidence-based approach for adolescent conduct and substance use disorders, manualized SFT models have not been widely adopted in usual care due to the training and implementation resources required. The article begins by discussing challenges to implementing SFT in routine care and presents the core elements strategy. It then describes the rationale and procedures for developing the SFT for ABP pathway, which provides guidance for clinicians about the sequencing of core practices. The ABP pathway was developed using an iterative approach through the collaboration of family therapy and youth mental health experts with experience in modular therapy development and implementation. The final ABP pathway contains six modules comprised of 25 core practices, each of which are described in detail. The pathway begins with the Family Systems Outreach practice, followed by the Engage the Family module, which contains one submodule focused on engaging parents (Caregiver Collaboration, Love and Commitment, Caregiver Ecosystem) and another on engaging youth (Join with Adolescents, Family Goal Collaboration, Adolescent Ecosystem). Clinicians facilitate the use of the Set the Foundation module (Location of Self, Relational Reframe) in advance of proceeding to two signature SFT modules used in dynamic combination, Change Attributions (Refocus and Reframe, Goal Setting: Family Skills) and Change Interactions (Prepare, Prompt, Coach, Process). The article next describes the Improve Family Skills module that includes Family Problem Solving along with one submodule focused on parenting skills (Caregiver Monitoring, Behavior Management) and another on family communication skills (“I” Statements, Reflective Listening, Reciprocity Awareness, Positive Request, Mutual Validation). Clinicians and families wrap treatment using the Punctuate Gains module (Amplification, Coda). The article concludes with a discussion of implications for implementation, practice, and future research. PubDate: 2025-04-02
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Abstract: Although emotion regulation within romantic couples is considered an important causal factor in keeping the relationship healthy, this topic has not been extensively researched. In this study we investigated the perception and expression of attachment-related emotional needs and the responsiveness of partners to each other’s emotional needs as central elements of emotion regulation in romantic couples. An intensive longitudinal research design with high-frequent measurements was used to study these dynamic processes in romantic relationships. Clinical couples (N = 16) reporting clinically relevant relationship difficulties after cancer treatment were compared with healthy couples (N = 12). At ten times per day during seven consecutive days both partners completed a brief questionnaire about their stress perception, attachment-related emotional needs, and perceived partner responsiveness. When both variables were measured simultaneously, expressed emotional needs were positively related to partners’ responsiveness in the full sample, although more so in clinical couples than in healthy couples. However, greater expressed emotional needs predicted greater partner responsiveness at the next measurement point only in clinical couples, whereas this effect was absent in healthy couples. Furthermore, higher expressed emotional needs predicted lower partner responsiveness in participants with higher level of anxious attachment orientation, whereas this association was absent at mean and low levels. The findings in this study supported several predictions based on the theoretical premises. The unexpected moderation effects of clinical status (clinical vs. healthy couples) on the association of expressed emotional needs and perceived partner responsiveness are discussed. PubDate: 2025-04-01
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Abstract: LGBTQ+ youth are at disproportionate risk for suicidal ideation and behavior (SIB). Family relationships within this population act as both a risk and protector factor for SIB, yet family-based treatments are rarely utilized at LGBTQ+ community centers. Prior research has explored the perceptions of LGBTQ+ youth, caregivers, and treatment providers on the use of family based treatment. Notably, no research has explored perceptions of another key stakeholder group: administrators. The present study used semi-structured interviews with administrators (N = 10) supporting LGBTQ+ community centers regarding implementation of family-based services for LGBTQ+ youth with SIB. Semi-structured interviews explored (1) the needs of LGBTQ+ youth, (2) where a program that includes family-based interventions should be housed, and (3) how a program could be sustained. Interviews were transcribed and analyzed using thematic analysis. Results include nine needs, nine barriers, and 12 facilitators of family-based services for LGBTQ+ youth with SIB. Administrators generally found family-based services to be important, beneficial, and needed. They described missing, necessary factors (needs), existing barriers to implementation, and existing facilitative factors. Administrators generally described a need for additional education on affirmative practice, professionals to examine their own biases, and an improvement in standardization of care. They identified implementation barriers related to youth rejection from caregivers, lack of affirming healthcare, and logistical concerns. Lastly, they described inner-agency collaboration, family interventions, youth driven care, and resources for clinicians as facilitative implementation factors. PubDate: 2025-04-01
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Abstract: Intimate partner violence (IPV) is a pervasive global social and public health issue. While extensive research has been conducted on IPV in various regions, there is a notable gap in understanding IPV in East Asian countries. This systematic review aims to address this gap by examining the prevalence of IPV and its associated factors in East Asia, specifically focusing on Japan, South Korea, China, and Mongolia. Furthermore, this paper will primarily explore male-to-female perpetrated violence, as it is the most extensively covered aspect in existing literature on the subject. The review revealed that while there are similarities in the prevalence and nature of IPV across East Asian countries, there are also notable differences. The review also showed that cultural factors, such as Confucianism and patriarchal norms, play a significant role in shaping attitudes toward IPV in these countries. Socioeconomic factors, including education level, income, and location of residence, also influence IPV rates. Additionally, alcoholism and childhood trauma emerge as significant risk factors for IPV across all countries, highlighting the complex interplay between substance abuse, mental health, and interpersonal violence. Despite these differences, legislative measures and enforcement efforts play a crucial role in shaping the prevalence of IPV in East Asian countries. Moving forward, efforts to address IPV must be comprehensive, evidence-based, and culturally sensitive, aiming to empower both survivors and perpetrators to break the cycle of violence. Collaborative action among practitioners, policymakers, and researchers is essential to create safer and more supportive communities for all individuals affected by IPV in the region. PubDate: 2025-03-20
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Abstract: Relationship improvement and the treatment of mental health problems in a relational context focuses on what we can observe or is self-reported. This leads to a focus on interaction patterns between couples or partners’ perceptions in relationships. Advances in assessing neurological and physiological processes have expanded observable relationship processes, but most MFT models have not yet integrated this knowledge. We propose an intervention model based on the idea that relationship interactions are influenced by pre-conscious physiologic processes around the perceived threat of situations. When a situation is perceived as threatening, partners’ innate response is based on survival and self-protection, which inhibits the physiologically based social engagement system. This model describes interventions to: (1) improve navigation of pre-conscious, and conscious processes through increasing positive emotional regulation, (2) reduce the influence of negative past events on current relationships, and (3) work toward having more connecting interactions and fewer protecting interactions in relationships. PubDate: 2025-03-18
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Abstract: Video gaming (also called gaming) is a contemporary activity affecting individuals and romantic partnerships. Researchers have found that gaming has a detrimental effect on romantic partnerships, with most of the focus being on the negative impact of gaming within heterosexual couples composed of male gamers. The focus on the detrimental influence of gaming has not allowed researchers to fully explore the experiences of romantic partners in which gaming has a positive influence. This study sought to explore the role of video gaming in relationships, specifically seeking to address limitations in the existing literature by exploring experiences with gaming as a shared hobby among a majority polyamorous and LGBTQIA + sample. We recruited partners in which all individuals in the partnerships identified as gamers. We analyzed interview data using transcendental phenomenology and identified three themes. These three themes addressed the influence of gaming on partnerships. We then discuss clinical implications, such as questions to ask gamer partners in therapy, and future directions. PubDate: 2025-03-14
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Abstract: The United States incarcerates the highest proportion of adolescents in the world. As efforts have been made to reduce recidivism for justice-involved youth, researchers have found that family therapy for youth in prison settings reduces recidivism rates and improves community reintegration. Marriage and family therapists (MFTs) are uniquely trained to deliver therapeutic services which include entire family systems and can support adolescents and their families. The present study examined the lived experience of 14 MFTs as a means of ascertaining the present state of family therapy being delivered to incarcerated youth by MFTs in juvenile detention facilities. Semi-structured interviews were conducted and analyzed using a phenomenological approach. Several major themes emerged from participant interviews: (a) inadequate training, (b) influence of correctional staff, (c) importance of family involvement, (d) influence of employee retention, and (e) development of a growth mindset. Additionally, seven subthemes emerged. Possible implications for future research, policy, practice, and clinical training are discussed. PubDate: 2025-03-13
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Abstract: This study explored the key components of effective apologies in couple relationships and their role in repair and communication. Seven experienced family and couples’ therapists were interviewed, sharing insights from their clinical practice. Thematic analysis revealed five main areas: (a) apology content—including the themes of experiencing genuine remorse and understanding, honest acceptance of responsibility for causing hurt, and making amends and mending the heart; (b) timing and delivery—emphasizing the themes of neither too late nor too soon, and words and gestures in harmony; (c) motivations for apology—which include striving for beneficial results, and avoiding negative consequences; (d) typology of apology—featuring the theme of the continuum of apologies: from superficial to sincere; and (e) contextual factors—highlighting the theme of the cultural and educational mosaics shaping apology. Findings emphasize that empathy, genuine remorse, and reparative actions are essential for rebuilding trust. Cultural and gender differences, shaped by societal norms, were discussed, particularly in how men and women approach apologies in romantic relationships. This study provides valuable insights for both therapists and couples, emphasizing the apology’s crucial role in fostering reconciliation and healthy relationships. PubDate: 2025-03-04
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Abstract: Emotional connections with significant caregivers greatly influence how individuals perceive themselves and others in intimate relationships. Grounded in the differentiation of self theory, this study examined factors that contribute to the quality of couple relationships. It investigated the association between parental attachment bonds and the quality of romantic attachments, as well as whether differentiation of self processes mediate these relationships. The study involved 480 participants in couple relationships, with an average age of 35.4 years, who completed assessments on parental attachment bonds (using the Parental Bonding Instrument), differentiation of self (using the Differentiation of Self Inventory Revised), and couple functioning (using the Dyadic Adjustment Scale). Structural Equation Modeling analyses revealed that the quality of parental attachment predicted distinct patterns of differentiation of self, which subsequently accounted for significant variability in dyadic adjustment levels. The implications of our findings are discussed. PubDate: 2025-02-27
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Abstract: Those who enter the medical field are required to work extensive hours, invest significant money on their education, and can experience multiple relocations through different levels of training. The demands of a career in medicine may create work-to-family conflict that could lead to physicians and their partners seeking services for mental health concerns and/or relationship dissatisfaction. Systemically trained therapists are well suited to understand how the high career demands of the medical field influence the support systems of physicians, as well as advocate for third order change in educational and/or training systems that physicians are in to support the next generations of physicians. The purpose of this study was to highlight the unique experiences of those in physician relationships to understand how the work demands of a career in medicine impact their relationships. Data were collected from survey responses of individual participants (n = 35) who are in a physician relationship lasting at least 6 months and included both medical and non-medical partners. Results revealed five themes and 17 subthemes which highlight the unique experiences of those in physician relationships. Results identify aspects of physician relationships that mental health clinicians can use to guide therapeutic work with these clients in couple’s therapy. Future research and clinical implications are discussed. PubDate: 2025-02-04
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Abstract: There has been a surge of interest in interventions based on Buddhist traditions in the domain of relational therapy research. Our scoping review aimed to present a comprehensive overview of the current research landscape on this topic. Through systematic selection criteria, we identified 16 studies. We discovered that these interventions predominantly focused on mindfulness or compassion—two pillars taken from the Buddhist tradition. Although the findings are varied, the collated evidence indicates that Buddhism-based interventions are promising in improving physical, mental, and relational health for individuals and dyads. However, the sustainability of these benefits needs to be examined. A point of concern is the possible dilution of the practices’ effectiveness when stripped of their comprehensive, traditional Buddhist context. We conclude from this review that while interventions such as mindfulness- and compassion-based programs can positively affect well-being, their efficacy might be constrained when these practices are detached from their broader, original Buddhist context. Therefore, future research should expand the field to develop intervention programs that maintain the integrity of holistic Buddhist wisdom to enhance relationship health and well-being. PubDate: 2025-01-21
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Abstract: Parental Reflective Functioning is considered a critical variable, both for the exercise of parenthood and for child development. For some years now, there has been a need for sufficiently sensitive and effective instruments to explore and evaluate Parental Reflective Functioning. This preliminary study presents the construction and validation of a short version of the Parent Development Interview-Revised, which we call Parent Development Interview-Brief. The main objective of this abbreviation is to maintain the semi-structured nature of the interview while decreasing the time needed to administer it. A multicenter and cross-sectional study with a normative sample of 60 mothers of children under five years of age with normotypical development is presented. To analyze the criterion validity of the Parent Development Interview-Brief, participants completed the Cuestionario de Apego Adulto [Adult Attachment Questionnaire] and the Parenting Stress Index-Short Form. The psychometric qualities of the new instrument are discussed, as well as the need for sufficiently sensitive, reliable, and effective tools to tap Parental Reflective Functioning for use in clinical contexts and research. PubDate: 2025-01-08
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Abstract: This article describes the findings of a study that explored potential factors that influence the pass rate for those taking marriage and family therapy (MFT) licensing exams, both the national and California exams. An online, national survey was conducted to determine factors associated with passing the MFT licensing exams. The survey included measures of test anxiety, coping strategies, perceived stress, and experience of discrimination. The demographic results included patterns of racial and age disparities similar to those reported by the Association of Social Work Boards (2022), especially for Black respondents. Specific and readily implemented recommendations for making the current exams more equitable include (a) changing the phrasing of questions, (b) clarifying and reducing the scope of the content, (c) reducing the number of questions during the 4-hour period, and (d) ensuring adequate accommodations for disabilities. PubDate: 2025-01-06
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Abstract: The purpose of this exploratory study was to first examine the dyadic trajectory of attachment change over a longer period (i.e., 5 years) than has been examined in previous research; second, to identify a mean trajectory of attachment security for couples with no history of contact with therapy as well as the effect of therapy utilization; and third, to examine couples’ attachment trajectories for gender differences. This study included 294 heterosexual married couples (78.6% European American). One-hundred and nine (37.07%) female partners and 121 (46.60%) male partners indicated that they had never utilized therapy prior to the study or during the study (had never utilized therapy at all). Research questions were explored using dyadic longitudinal multilevel modeling with pre-existing data. Results indicate overall that couples in this sample were low on attachment insecurity at the start of data collection and became slightly more insecure over a five-year span at a statistically significant, but likely unnoticeable rate. Couples with no therapy use-ever began the study with low attachment insecurity and remained relatively secure throughout the study. Couples who consistently received therapy before and during the study reported the highest levels of insecure attachment and increased in insecurity at a faster rate in comparison to those who had never attended therapy. Males who received consistent therapy before and during the study also demonstrated significantly greater attachment insecurity than their female partners. Therapy that does not specifically focus on attachment related issues is not likely to alter attachment styles. Clinicians may wish to investigate partners’ attachment histories, including complications from trauma or abuse, and tailor treatment to attachment related issues if attachment style change is a treatment goal. Future research could examine attachment change over time for couples of lower income, more diverse racial stratification, and experiencing greater relationship distress. PubDate: 2025-01-03
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Abstract: The integration of digital technologies into family therapy practices presents both significant opportunities and notable challenges. This editorial examines recent trends impacting the field, including the adoption of cloud-based storage solutions, the involvement of entities outside the scope of standard privacy regulations in data management, the rise of patient-generated health data, and the increasing use of tracking technologies. While cloud-based storage offers enhanced scalability and accessibility, it also introduces concerns about data security and confidentiality. The participation of non-regulated entities in managing family health data creates risks associated with insufficient privacy protections. Patient-generated health data provides valuable insights but raises privacy and data management issues. Additionally, tracking technologies can compromise sensitive health information by potentially disclosing it without explicit consent. This editorial emphasizes the need for marriage and family therapists to actively engage in the development and regulation of digital health tools to ensure that privacy and data security are prioritized, thereby safeguarding family confidentiality and maintaining trust in a digital age. PubDate: 2025-01-03
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Abstract: The willingness to apologize and forgive is robustly associated with relational and personal wellbeing, and thus, it may be worthwhile for children to be taught about the importance of apologies and forgiveness through apology prompting from their parents. However, there is limited research on parental apology prompting, as well as on parental attitudes on the developmental importance of child apologies. Guided by Family System Theory, we investigated whether the proclivity to apologize to and forgive a romantic partner is associated with positive parental attitudes on apologies and parental apology prompting. We also examined the role of childhood experiences with apologies, and moderators of these associations. We recruited a sample of parents of 3–10-year-olds. Parents’ proclivity to apologize to their romantic partner and their childhood experiences with apologies were positively associated with positive parental attitudes on apologies and parental apology prompting. The association between the proclivity to apologize to the romantic partner and parental apology prompting was mediated by positive parental attitudes on the developmental importance of child apologies. The proclivity to retaliate against the romantic partner was negatively associated with positive parental attitudes on apologies and parental apology prompting. Political conservatism and romantic relationship satisfaction moderated the association between the proclivity to apologize to the romantic partner and parental apology prompting. Further, we share measures of childhood experiences with apologies and parental attitudes on apologies that may be useful for future research. Results suggest that it may be advantageous for parent couples to prompt apologies from their children. PubDate: 2024-12-21
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Abstract: The term “preferred future” refers to the outcomes a client hopes to achieve through psychotherapy. Collaborative goal setting is a crucial component of many psychotherapy approaches. This article describes the six ways to focus on a preferred future in solution-focused brief therapy: (1) common project, (2) Vision of a preferred future, (3) goal(s), (4) skill(s), (5) values, and (6) small signs of progress. All variants are briefly expounded upon with accompanied case examples. The second part of the article focuses on the transitions from problem descriptions to various forms of work related to a preferred future, and on the transitions among different methods of preferred future conversations. The primary purpose of this article is to broaden therapists’ strategies when working with preferred futures, enhancing their adaptability in managing these types of conversations with their clients. PubDate: 2024-12-20
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Abstract: The training programs in marriage and family therapy have received criticism for providing multicultural counseling to diverse populations from White and Western perspectives. Training programs provide less focus on the training needs around cultural competency and cultural humility for students of color. This research study is a phenomenological approach to understand the experiences of students of color in their MFT training programs and during their early clinical experiences, as they developed their multicultural counseling competencies. After interviewing eight participants about their lived experience, data was analyzed via a thematic analysis and resulted in identifying three themes. (1) There are specific multicultural counseling skills that participants frequently use (2) Learning in a White environment means learning without adequate representation, without diverse content and research, and without discussions focusing on diversity. (3) MFT programs need to incorporate a more diverse training approach including increased diversity in its faculty, literature, and general content. PubDate: 2024-11-22
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Abstract: The term ‘parentification’ describes role-reversed family processes when children provide care to their parents and family. Given the fact that race and ethnicity are among the least considered factors in the past research on parentification, the purpose of this phenomenological study was to understand the lived experiences of parentification of young Asian American adults within their sociocultural context using the contextual therapy theory. Eight individuals (five identified as Hmong, two as lu Mien, and one as Filipino), seven females and one male, ages ranging from 24 to 29, participated in semi-structured interviews. Data were analyzed using reflexive thematic analysis from which the predominant themes of early and extensive parentification experiences as children of immigrant parents, strong influences of cultural expectations, and lost childhood and identity emerged. Furthermore, the study participants complied with gender-based cultural role expectations to help their families survive. Clinical implications and study limitations are discussed. PubDate: 2024-11-02
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Abstract: Although Systemic Family Therapy (SFT) is an evidence-based approach for adolescent behavior problems, manualized SFT models have not been widely adopted in usual care due to the training and implementation resources required. This article presents a core competencies framework for offering SFT to adolescents and their families. It begins by discussing challenges to implementing SFT in routine care and presents the core elements strategy. It then describes the rationale and procedures for developing competency guidelines for SFT. It then describes a paradigm shift that undergirds SFT and articulates two categories of competencies: Systemic Stance and Systemic Skills. The Systemic Stance competencies described are Collaborative and Empowering, Nonjudgmental Curiosity, Respect for Complexity, Maintain a Relational Focus, Focus on Process, Conscious of Similarities and Differences, and Critical Consciousness. The Systemic Skills competencies described are Systemic Assessment, Construct a Relational Cycle, Problem Formulation, Broaden the Map, Goal Formulation, Maintain Balance among Family Members, and Putting Forth and Drawing Forth. The article concludes with a discussion of implications for implementation, practice, and future research. PubDate: 2024-10-17
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