Family Process最新文献

The prevalence of cardiometabolic morbidity (e.g., high blood pressure, heart attack, stroke, type 2 diabetes) and multimorbidity development (2 or more cardiometabolic morbidities) are rapidly growing in the US. Cardiometabolic morbidity and multimorbidity are linked to poor well-being outcomes, high healthcare costs, and mortality. There is little known about cardiometabolic multimorbidity health disparities, particularly regarding mutable factors that might be targeted in future health interventions. In the present study, using a biopsychosocial framework (Biobehavioral Family Model), we examine whether cardiometabolic morbidity and multimorbidity development are linked to premorbid family and marital relationships and if it differs depending on socioeconomic status (i.e., educational attainment) using three waves of Midlife in the US (N = 4951). We assessed cardiometabolic development with three conceptualizations: number of cardiometabolic morbidities (i.e., count variable), individual cardiometabolic morbidities (i.e., diabetes, high blood pressure, stroke, heart attack), and severity of cardiometabolic multimorbidity (e.g., 3+ vs. zero morbidities). Family strain increased the number of cardiometabolic morbidities (OR = 1.17) and the severity of multimorbidity (e.g., 3+ morbidities: OR = 1.38). People with a high school education experienced family support as a buffer to the negative health impact of education level. Generally, marital quality appeared less impactful on cardiometabolic morbidity and multimorbidity development compared to family strain. Positive and negative family characteristics appear to function differently across educational attainment. These findings indicate that adults' non-intimate family relationships predict important outcomes such as diabetes, heart attack, stroke, and cardiometabolic multimorbidity and should be considered targets for preventative health interventions.

Couples appear to frequently experience relationship problems, yet estimates of the prevalence and prediction of three distinct help-seeking steps, (1) recognition of serious relationship dissatisfaction, (2) considering help, and (3) receiving relationship help, are unknown for representative population samples. This is unfortunate as such knowledge may inform policy makers in the development of strategies to motivate couples to seek help. The prevalence of these steps along with reasons for not acquiring help was studied in a representative population sample of 1014 Dutch heterosexual couples. Multilevel Actor-Partner Interdependence Modeling (APIM) analyses estimated the extent to which static socio-demographic factors were predictive of help-seeking behaviors. Of all partners, 28.6% reported having ever been seriously dissatisfied with their relationship (step 1), of which 86.2% had told their partner they were dissatisfied, on average 1.5 years after onset of the dissatisfaction. Of the seriously dissatisfied partners 36.4% considered professional relationship help (step 2) and 19.5% eventually received help (step 3), on average 3.7 years after the onset of dissatisfaction. Of these, 88.5% consulted a (couple) therapist. Main reasons for not acquiring help were that “things got better” (48.8%) and “the partner did not want relationship help” (35.4%), whereas financial considerations and shame were rarely endorsed. Although serious relationship dissatisfaction was common (i.e., 40.1% of all couples consisted of at least one partner who was ever dissatified), few couples sought help and they did so rather late. Waxing and waning of dissatisfaction often guided the decision to not seek help. Women and younger partners were more proactive in help-seeking. Marital status, having children, and education were largely unrelated to help-seeking.

Depressive symptoms are one of the mental health problems among Korean American (KA) youth. Although several studies examined mental distress among KA youth, few have examined the associations between different familial factors, negative emotionality, and depressive symptoms among them, especially using longitudinal data. Drawing on the Triadic Model of Family Process (TMFP), this study examined the longitudinal associations between Korean-specific aspects of familial factors and depressive symptoms among KA youth and the mediation role of negative emotionality in the relationships. Using KA youth and parent data from the Midwest Longitudinal Study of Asian American Families (MLSAAF) project, path analyses revealed that family enmeshment and youth-reported intergenerational conflict were associated with youth depressive symptoms, with negative emotionality serving as a mediator. The findings suggest that interventions aimed at reducing negative emotionality and improving parent–youth relationship quality and family boundaries could be helpful in reducing youth depressive symptoms.

The cornerstone of the contextual family therapy model is predicated on the belief that all family members benefit from trustworthy relationships, which result from (a) acknowledging the contributions of deserving family members, (b) engaging in responsible interactions, and (c) ensuring a fair distribution of relational burdens and benefits. Nonetheless, conflicts may arise when one partner asserts a claim to relational resources based on need, while the other believes they are entitled to such resources based on merit. Based on relational ethics and the development of trust, this paper focuses on the therapist's role in facilitating the conflict-resolution process to assist couples in reestablishing individual responsibility and accountability within the systemic framework of couple therapy. It elucidates several clinical strategies, including (a) cultivating trust through fairness and focusing on the importance of reciprocity and equitable give-and-take, (b) detecting destructive entitlement, and (c) marital relationships and ethics of care. Several clinical examples are discussed, as well as common couple relational issues associated with horizontal and vertical relationships, partnership, and fusion, and the impact of gender and power dynamics and trustworthiness based on the feminist lens.

Contextual family therapy offers a unique explanatory and clinically valuable framework to address complex multigenerational processes in families of immigrants who experience cumulative migration-related traumas. In this paper, we offer a new extended, specific conceptualization of immigrant families' generational dynamics using existing literature within the five-dimensional contextual therapy framework illustrated with a clinical example. We highlight the importance of social and relational justice, loyalty, entitlement, and parentification in transgenerational processes in addressing manifestations of these traumas that are frequently overlooked in clinical practice with different generations of immigrant families. Clinical guiding principles include acknowledgment of the social nature of situational injustices and their consequences for relational justices, exploration of loyalty conflicts (familial, cultural, and national), active dialogue of mutual care, exoneration, and stimulating constructive entitlement through active giving. This paper contributes to further development of contextual therapy theory and provides practical guidance for clinicians working with international migrants including second and third generations.

This article aims to present the basic tenets of contextual therapy and its treatment goals, methodology, and theory of change. It provides an orientation for readers who are new to the approach and should serve as an updated frame of reference for readers already familiar with it. An important contribution of this article is that it clarifies the place of contextual therapy in the vast field of family therapy and dispels some common misunderstandings about the path of its founder, Ivan Boszormenyi-Nagy (1920–2007). Additionally, it demonstrates why contextual therapy should be counted among the postmodern, collaborative approaches to family therapy, which contradicts the usual view that it belongs to the earlier modern models of family therapy. Furthermore, it shows that contextual therapy is well-equipped to incorporate the current and future contributions of human sciences and offers unique therapeutic resources to address the individual and relational consequences of injustices that should remain relevant for the foreseeable future.

Although parents' parenting stress has been found to be related to coparenting, existing research has mostly focused only on one parent or examined the unidirectional effects between the two factors. The present study investigated the actor and partner effects as well as the bidirectional association between parents' parenting stress and coparenting in Chinese society. The study participants were 522 Chinese father−mother dyads with elementary school-aged children who followed for two measurement occasions (half a year apart). The cross-lagged actor-partner interdependence model (APIM) was used to examine the actor effects and partner effects in the bidirectional associations between both parents' parenting stress and coparenting. The findings revealed that both fathers' and mothers' parenting stress significantly negatively predicted their spouses' coparenting (partner effects), and mothers' coparenting significantly negatively predicted their spouses' parenting stress (partner effects). However, the actor effects between parents' parenting stress and coparenting were not significant. Furthermore, there were significant bidirectional associations between fathers' parenting stress and mothers' coparenting. Findings from the present study reveal the dynamic interaction between parenting stress and coparenting. The results point to the need for providing preventive interventions to parents with high levels of parenting stress and establishing a collaborative interaction framework between parents.

Emotionally focused therapy (EFT) is an evidence-based treatment for relational distress based on experiential, humanistic, and attachment theories. Despite the empirical support for EFT, there are no studies on EFT delivered via teletherapy. In this study, we aimed to understand therapists' experiences delivering EFT through teletherapy using open-ended questions on a web-based survey of certified EFT therapists (n = 69). Reflexive thematic analysis identified five themes: (1) Delivering EFT via teletherapy is similar to in-person therapy, (2) Delivering EFT via teletherapy is more challenging than in-person therapy, (3) Delivering EFT via teletherapy is more challenging with certain clients, (4) therapists adapted EFT for teletherapy, and (5) teletherapy and the COVID-19 pandemic changed therapy practice. The themes illustrated the mixed experiences of EFT therapists using teletherapy. Whereas some found it straightforward to use EFT via teletherapy with couples, others experienced exhaustion and barriers. Practice recommendations for delivering EFT via teletherapy are outlined, including modifying assessment strategies, implementing new safety protocols, and providing additional psychoeducation.

Despite the extensive body of evidence documenting how pandemic-related stressors (e.g., disruptions in daily routine) impact individuals' mental health, research examining family mechanisms through which stressors impact parental stress remains insufficient. The present study aims to address this gap by exploring a moderated mediation model that predicts parental stress resulting from the accumulation of pandemic-related stressors. Specifically, we hypothesized a second-stage moderated mediation model in which family resilience beliefs moderated the second-stage indirect paths through family relationships and marital satisfaction, resulting in conditional indirect effects. Study data were collected from American parents (n = 1386). There was no evidence that family relationships and marital satisfaction mediated the association between stressor pile-up and parent stress. In addition, family resilience beliefs did not significantly impact how marital satisfaction or family relationships affect parental stress. However, marital satisfaction mediated the relationship between stressor pile-up and parental stress across all levels of family resilience beliefs. The findings of this study carry significant implications for post-pandemic family interventions, suggesting the incorporation of resilience belief training and stress management strategies to improve intrafamilial communication.

Emotion regulation is central in many therapy models, including couple and family therapy models. This article draws on poststructuralist governmentality studies and processual affect theory to offer insight into how the therapeutic concept of emotion regulation may reflect and support neoliberal affective forms of self-governance. We suggest that couple and family therapy—through using professional discourses and affect-oriented techniques or interventions—may be another site wherein neoliberal governmentality is implemented and extended in contemporary westernized neoliberalized societies. In facilitating emotion regulation, we argue that there is a risk that therapists may implicitly promote a neoliberal worldview that encourages clients to mobilize neoliberal techniques to become self-improving, entrepreneurial subjects, responsible for their happiness and well-being. Conditions of precarity associated with individualist, neoliberal capitalist ideologies and policies (e.g., unemployment, job insecurity, forced migration, wealth inequalities, mass incarceration, social isolation) generate emotional burdens for people to manage that professional techniques or interventions may normalize as clients' self-management tasks. We theorize emotion regulation as an affective governmentality tactic of power and suggest that couple and family therapy can offer points of resistance to individualization and responsibilization and opportunities for creating or affirming alternative subjectivities and affectivities.