CONTEMPORARY FAMILY THERAPY最新文献

The multiple benefits of family-based treatment (FBT) used in substance use disorder (SUD) treatment include increased treatment engagement, better treatment outcomes, and cost-effectiveness compared to other behavioral health treatment modalities. However, the prevalence and types of FBTs offered among SUD treatment facilities are largely unknown. The present study used data collected during 2009–2010 from 325 treatment centers in the United States to (1) explore the prevalence in the utilization of FBT in SUD treatment, and (2) identify differences between treatment facilities that do and do not offer FBT. Results indicated that the adoption of FBT was negatively associated with the percentage of clients who were unemployed or involved in the criminal justice system at time of intake, and positively related to the number of hours of individual therapy and treatment center emphasis on utilizing the 12 Steps. Additionally, the majority of treatment centers that followed the American Society of Addiction Medicine (ASAM) clinical guidelines offered FBT. Lastly, the percentage of families involvement was negatively associated with centers’ proportion of revenues from Medicaid (i.e., health insurance for those with limited income) and positively associated with treatment center revenues from private insurance. The impact of having FBT in SUD treatment centers is discussed.

This study examined the development of the therapy alliance over the first six sessions of couple therapy using a dyadic latent growth curve. The role of relationship adjustment, symptom distress, and attachment to alliance development were also examined. Participants were 165 couples in a treatment-as-usual setting. The alliance increased over the first six therapy sessions for males and females with males following a curvilinear pattern of growth. Additionally, female relationship adjustment was related to initial alliance levels for females while symptom distress was related to female alliance development. Male attachment avoidance and female attachment anxiety were related to male initial alliance. Couple therapists need to pay attention to intake level of female adjustment, symptom distress, and attachment—along with male attachment, as these are related to alliance development. Therapists should also be mindful that female and male alliance follow a different developmental trajectory.

Finding effective interventions and best practices for families during the divorce or separation process has been prevalent for many years due to the continuous impact that divorce has on families and the greater society. To meet the needs of the community, two mental health professionals developed and facilitated a parent education course targeting the reduction of coparental conflict. Due to the unique attributes of the course, researchers began a quantitative study of the program by having participants complete pre- and post-surveys. The final sample for this study consisted of 212 parent participants. Findings from the data are reported along with implications for facilitators, program developers, mental health providers, and future researchers.

Anxiety is very pertinent to systemic family therapy (SFT), however, there is little research that seeks to understand people’s experiences with anxiety symptoms and how they impact people’s lives and relationships. The aim of this study was to examine the trending hashtag #ThisIsWhatAnxietyFeelsLike—a commonly used hashtag related to anxiety—to look more closely at how users talk about their anxiety symptoms on Twitter and how these symptoms influence people’s interactions and relationships with others. We used a qualitative thematic analysis to analyze 1318 relational tweets posted with this hashtag that occurred between February 2017 and February 2018 and uncover themes related to experiences with anxiety. The analysis revealed six core themes: (a) deflated self in relation to others and their perceptions; (b) fear, worry and avoidance behaviors that influence relationships; (c) negative emotional responses leading to feeling misunderstood, lonely, and like a failure; (d) social triggers; (e) anxiety management strategies; and (f) things for others to avoid.

Although structural strategic family therapy (FT) is an evidence-based approach for adolescent behavior problems, manualized family therapy models have not been widely adopted in usual care due to the training and implementation resources required. This article presents a competency framework for utilizing family collaboration with adolescent cases. It begins by discussing challenges to implementing FT in routine care and presents the core elements strategy, then introduces three “branches” that together constitute a continuum of family involvement—family collaboration, family skills training, and systemic family therapy—and describes the rationale and procedures for focusing on competency guidelines for family collaboration specifically. It then describes the basic techniques and competency guidelines for six core elements of family collaboration: family systems outreach, adolescent ecosystem, location of self, goal setting, family participation, caregiver consultation, family session management. It concludes by discussing future directions for this framework and the development of additional competencies for the other branches. While further research is necessary to test the efficacy of the treatment branches and accompanying competency standards, this article presents an innovative approach to involving family members in care that includes accessible competency guidelines.

Few digital divorce interventions have undergone rigorous randomized control trial study (RCT) testing of their physical and psychological health effects. This paper describes the Cooperation after Divorce (CAD) intervention including background, target group, design and engagement strategies, intervention development, content, and theoretical cornerstones. The 17-module digital psychoeducational intervention addresses three main content areas: (1) the divorcee themselves, (2) the children, and (3) co-parenting. The content of the modules provided psychoeducation and therapeutic activities focused on the maladaptive interactional patterns between former partners and how to develop new interactional schemas, including a focus on when and how to communicate with the former partner in a way that does not escalate conflict. A randomized controlled trial (N = 778) assessed the effect of CAD in terms of number of sick days. Participants were assessed at 3-, 6- and 12-month post-divorce. Independent samples t test revealed that participants in the intervention group on average reported 5.82 fewer sick days one year post-divorce than did participants in the control condition. The results suggest that digital post-divorce interventions decrease sick days for newly divorce individuals, thereby offering long-term human, family, and public health benefits.

Across studies, intuitive eating is associated with many health indicators. The Intuitive Eating Scale-2 (IES-2), the instrument for measuring intuitive eating, had not previously been explored with a sample of sexual minority [Sexual minority refers to individuals who experience consensual sexual identity, attraction, or behavior that is non normative (typically sexual minority individuals are lesbian, gay, bisexual, queer, or non-heterosexual)] individuals despite the disparities in eating behaviors and stress that persist among this population. Further, past work suggests the context of being partnered can be both protective and harmful for eating behaviors, highlighting an important avenue for investigating intuitive eating at the dyad level. This study sought to investigate the factor structure of the IES-2 and to explore the associations between both partner’s mental health, relational quality, and interpersonal eating interactions within a dyadic sample of 228 married male sexual minority couples (88% white, 8.8% Latino or Hispanic, 5.3% African American or Black, and 5.9% in other racial or ethnic groups). The original four-factor solution did not fit the current sample; instead, a new, fifth factor emerged, which was labeled as Eating Not as Coping. Intuitive eating behaviors were dyadically associated with mental and relational health and partners’ health-related interactions with one another. Future use of the IES-2 is informed by present results which may also inform recommendations for practice with and study of health and relationships.

With increasing numbers of stepfamilies, there is a growing need for evidence-based, informed therapeutic treatment. Stepfamilies experience unique challenges, such as grief, depression, adjustment difficulties, and increased family/parental conflict (Jensen et al. Family Process 57:477–495, 2018). Adolescents in stepfamilies have the greatest difficulty adjusting, resulting in attachment-related consequences which can be detrimental to their academic performance, mental health, and overall well-being, such as depression, loyalty conflicts and low academic performance (Jensen et al. Family Process 57:477–495, 2018; Papernow Family Process 57:25–51, 2018). Family therapy can provide an avenue for processing and adapting to the changes that arise in the process of transitioning into stepfamilies for all members of the family, especially adolescents. This article reviews current research on stepfamilies and recommends Attachment Based Family Therapy (ABFT) as a model from which family therapists may draw as they approach treatment of stepfamilies. With a focus on the attachment between family members, especially between adolescents and their parents, ABFT addresses the underlying damages that occur during the many changes in family dynamics and provides a clear avenue to repairing parent-child attachment.

Abstract

Systemic models of couple and family therapy (CFT) are often categorized into two transtheoretical paradigms: modernism and postmodernism. Traditionally, these paradigms have been positioned in opposition to one another and are critiqued for their respective epistemologies and stances on the definitions of truth and reality. The binarizing of systemic models has created theoretical divisions in the field of CFT that restricts many clinicians from addressing the limitations and harnessing the benefits of each transtheoretical paradigm. Metamodernism, a philosophical paradigm that emphasizes theoretical pluralism, reflexivity, and dialectical processes, has arisen as a potential solution for addressing the philosophical tensions between modernism and postmodernism; however, there currently exists no approach to systemic therapy that aligns with the tenets of this paradigm. This article delineates the application of metamodernism in the field of systemic therapy through the presentation of Dynamic Narrative Therapy, an innovative approach to systemic therapy drawn from the integration of two foundational theoretical models (i.e., strategic family therapy and narrative family therapy). This integration synergizes the strategic concepts of circular causality and feedback loops as well as the narrative use of deconstruction, externalization, and narrative metaphor to illustrate a more comprehensive approach to the therapeutic change.

In Gottman Couple Therapy (GCT), the intervention of Dreams-within-Conflict (DWC) helps break down a gridlocked issue between couples through deeper emotional expression and experiencing (in-counseling exploration of emotions). The current study examined experiencing in a single session of DWC for N = 30 individuals (15 couples) using multiple methods such as self-assessment questionnaires, observation rating and coding of the video recording, and feedback interviews. The before and during DWC best experiencing video segments were selected and rated by two raters independently on the experiencing scale (ES) for partners. The changes in experiencing mode and peak scores (ESM and ESP) during DWC were investigated in the presence of individual characteristics of attachment (anxiety and avoidance) and relationship mindfulness traits. A paired-samples t-test showed a significant increase in experiencing for both partners. Hierarchical linear modeling analysis indicated that gender (women) significantly and positively predicted ESM. ESP was predicted positively by gender (women) and negatively by avoidance, though the results were not conclusive. Thematic analysis was used to look at the Indian couples' experiencing as shared by them in order to better grasp the therapeutic implications. The qualitative findings confirm the quantitative results that couples outside of intervention utilized experiencing levels 1–3 predominantly and moved to 3–4 levels during best experiencing segments of intervention. Couples reviewed positively to the emotional experiencing techniques used during the DWC intervention.