Family Process最新文献

Managing the Therapeutic Alliance is often complex when it comes to the treatment of borderline personality disorder (BPD), but the alliance is crucial for the success of the therapy. Combined individual and family interventions have been shown to be very useful in treating of these cases. This study has two objectives. First, to describe how the family therapeutic alliance facilitates therapeutic change through family psychotherapy for families with a member diagnosed with BPD. Second, to analyze how the therapeutic change achieved through combined individual and family systemic relational psychotherapy affects the individual functioning of the patient with BPD. This single case study used the System of Observation of Family Therapy Alliances (SOFTA-o) to analyze the therapeutic alliance, along with two semi-structured clinical interviews, one at the beginning and one at the end of therapy. Results show a dynamic and positive evolution of the therapeutic alliance throughout the therapeutic process and how this alliance facilitated therapeutic change, both reducing the symptomatology of the patient with BPD and improving family communication and functioning. Results contribute to highlighting the importance of including family therapy as an intervention unit in protocols for patients with BPD.

Research has long emphasized the adverse effects of poverty on children; however, within-family processes of how safety nets offset the effects of poverty differ by race and ethnicity are unclear. Guided by the context-sensitive family stress model, the current study investigated within-family processes among safety nets, maternal parenting stress, and child behavioral problems among low-income families and revealed differences in these processes among Hispanic, Black, and White mothers. Using The Future of Families and Child Wellbeing Study (FFCWS), participants included 2251 low-income mothers and their children, repeatedly surveyed when children were 1, 3, 5, and 9 years old. Mothers reported their public and private safety nets, their parenting stress levels, and children's behavioral problems at each time point. Multilevel models revealed within-family mediation pathways from mothers' perceived private safety net supports, maternal parenting stress, and child externalizing and internalizing problems, but only for Black, not for White or Hispanic mothers. Prospective within-family associations were found between receiving a high number of public safety net programs and higher child externalizing problems, as well as between receiving private safety nets and higher maternal parenting stress and higher child behavioral problems. Findings were discussed in light of the context-sensitive family stress model, with implications for theory and intervention practices.

Relationship education has shown promising effects for low-income couples on outcomes such as promoting positive communication, improving global relationship satisfaction, parenting, and individual psychological distress. Studies also indicate that couples' baseline distress (e.g., relational and individual) moderates outcomes. Yet, few studies implemented a person-centered approach to analyzing data for those who participate in relationship education. In a sample of 488 low-income opposite-gendered couples, we identified latent profile groups for men and women based on self-reported relationship satisfaction and behavioral self-regulation scores, thus incorporating both relational and individual factors. Results yielded a three-class solution for men and a four-class solution for women. We then examined group profile differences in individual psychological distress and relationship satisfaction change scores after completing the relationship education intervention (12 h of PREP's Within Our Reach). Results indicated significant differences, suggesting that group membership can predict overall improvements in both psychological and relationship distress. Thus, RE programmers and policymakers may consider flexible delivery (e.g., more or less content; more or less intense coaching) that considers overall baseline relational and/or individual functioning as opposed to a one-size-fits-all method.

Family members and loved ones of individuals with Borderline Personality Disorder (BPD) can experience high levels of distress. Types of distress reported by family members include burden, grief, depression, guilt, and powerlessness. Hopelessness is a construct that has received little attention despite its potential relevance for this group. This study sought to examine, and assess potential change in, hopelessness among individuals attending a 12-week Family Connections (FC) program. Participants were 75 family members, 29 men and 46 women. Most participants were parents (n = 43; 57%). Data were collected at four time-points and outcomes included hopelessness, burden, and grief. The majority of participants (82%) reported scores within the ‘minimal’ or ‘mild’ ranges of hopelessness before the FC program. A greater proportion of participants in the 60–70 year age group reported scores in the ‘moderate/severe’ category when compared with younger age groups. The mean hopelessness score for all participants before FC was 4.61 which is considered mild. There was no significant difference in hopelessness scores after program completion. Although mean scores increased at both 3-month and 12-month follow-ups, they continued to remain in the ‘mild’ category. Hopelessness scores in the current study are similar to those reported in previous studies, although no significant change was found after FC completion. Concepts of personal vs. situational hopelessness should be considered, as well as the relevance of assessing personal hopelessness for this participant group. Further research is needed to determine the relationship between family member hopelessness and index client wellbeing.

Caregivers play an integral role in supporting children's development, not only through their individual parenting practices but also how they work together as coparents. The literature on coparenting is extensive; however, most of the research has relied on global measures to assess the quality and functioning of the coparenting relationship. Examining the coparenting relationship with domain-specific measures enables a deeper understanding of this complex family process. One domain of particular interest is emotion socialization given the vast and long-term consequences emotion socialization has on children's emotional, social, behavioral, and psychological functioning. Emotion socialization literature would benefit from a domain-specific coparenting measure, as researchers have rarely explored how coparents work together when responding to their children's emotions (i.e., coparenting children's emotions). As such, an emotion-focused coparenting measure could address gaps in both coparenting and emotion socialization literature. This study outlines the development and psychometric evaluation of a domain-specific measure of coparenting, the Coparenting Children's Emotion Scale (CCES), which assesses how parents work together when responding to their children's emotions. In the current study, the factor structure, reliability, and validity of the CCES were examined in an Australian sample. Findings from exploratory and confirmatory factor analyses showed that the CCES comprises two subscales that capture coparents' levels of support/cooperation and undermining. In the current sample, both CCES subscales demonstrated good to excellent internal consistency, and good convergent and concurrent validity. The CCES will provide researchers and practitioners with a domain-specific measure to use in exploratory and intervention research.

The psychotherapy field has a long history of integration to improve treatment effectiveness. One type, assimilative integration, offers innovative opportunities to family therapy to incorporate the clinical and research contributions of different approaches. This paper contributes to the literature on integration by exploring how Eye Movement Desensitization and Reprocessing (EMDR) can be assimilated into Attachment-Based Family Therapy (ABFT) for youth in residential psychiatric treatment. ABFT seeks to improve attachment security to parental figures by asking adolescents and young adults to discuss attachment ruptures. This process, specially designed for patients with internalizing disorders, can provoke anxiety, particularly for a patient population that commonly has a history of trauma and adverse life experiences. EMDR is a first-line therapy for post-traumatic stress disorder and has the potential to be effective in treating various other mental health conditions. When patient emotional withdrawal or dysregulation due to breaches in trust between child and parent emerges in ABFT, EMDR may help desensitize associated memories and bolster the family therapy process. The authors provide an overview of both models, and a detailed case study as an example. The paper concludes with a discussion on implications, integration efforts, and limitations.

The shared loss of a child can present challenges to couple relationships as both partners attempt to cope with their own grief and their partner's grief. In this longitudinal qualitative study, five bereaved parent couples participated in 13 total interviews, revealing coregulatory interactions surrounding their shared loss. Using thematic coding and grounded theory analysis, their reflections were organized into three interrelated process themes: regulating self, regulating other, and forming our grief rhythm. This article explores the complexity of the last theme “forming our grief rhythm” in-depth, and a new theoretical orientation, the relational window of tolerance, is introduced to examine how couples coregulate both fragile and stable states within their shared grief. The reflections of bereaved parents indicated that prolonged “dual fragile states” and prolonged “imbalanced states” may hinder relationship quality. In order to regain relationship stability, couples learned to trade off supporting one another and/or to resonate with one another in their shared pain. Implications for future research and clinical practice are discussed, focusing especially on how to integrate individual and relational needs into grief therapy frameworks.

Family reactions to coming out can affect the mental health of individuals who disclose their sexual orientation or gender identity. Therefore, it is important to have an appropriate tool to assess them. The Perceived Parental Reactions Scale (PPRS) assessed perceived parental reactions to the disclosure of gay, lesbian, or bisexual sexual orientation by their children. We adapted the PPRS so that it can be answered by any individual belonging to a sexual or gender minority, and can be answered regarding any member of the family, not just parents. A total of 2627 individuals from Spain participated in this study, with a mean age of 31.59 (SD = 11.26). Participants completed the adapted PPRS questionnaire, now named the Family Reaction to Coming Out (FRCO). The FRCO assessed family reactions when disclosing their sexual orientation or gender identity. The majority of participants identified as cisgender men (47.5%) or cisgender women (44.9%), and as gay/lesbian (51.9%). A one-factor model emerged through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The FRCO displayed excellent internal consistency and demonstrated good levels of invariance for participants' gender (male vs female vs nonbinary gender), family member's gender (male vs female), and type of family member (parents vs other family member). Supporting convergent validity, the FRCO has shown a positive correlation with fear of family reaction to coming out. These findings support the validity and reliability of the FRCO tool in assessing the reactions of any family member within the Spanish context.