Chronic pain and “effective” family functioning: A re-examination of the McMaster Model of Family Functioning

This paper attempts to explore the relevance and applicability of the McMaster Model of Family Functioning. It is suggested that what is construed as effective family functioning by the McMaster Model may not be feasible and different standards are needed to determine optimal level of functioning in families with a chronically sick member.     

Toward a Stress Process Model of Children’s Exposure to Physical Family and Community Violence

Theoretically informed models are required to further the comprehensive understanding of children’s ETV. We draw on the stress process paradigm to forward an overall conceptual model of ETV (ETV) in childhood and adolescence. Around this conceptual model, we synthesize research in four dominant areas of the literature which are detailed but often disconnected including: (1) exposure to three forms of physical violence (e.g., child physical maltreatment, interparental violence, and community ETV); (2) the multilevel correlates and causes of ETV (e.g., neighborhood characteristics including concentrated disadvantage; family characteristics including socio-economic status and family stressors); (3) a range of consequences of ETV (e.g., internalizing and externalizing mental health problems, role transitions, and academic outcomes); and (4) multilevel and cross domain mediators and moderators of ETV influences (e.g., school and community factors, family social support, and individual coping resources). We highlight the range of interconnected processes through which violence exposures may influence children and suggest opportunities for prevention and intervention. We further identify needed future research on children’s ETV including coping resources as well as research on cumulative contributions of violence exposure, violence exposure modifications, curvilinearity, and timing of exposure.

60 Years of Practice,Research, and Teaching in Family Psychology and Family Therapy

Recent theoretical and empirical evidence as well as experimental and practical highlights from 60 years of clinical practice, research, and teaching in family therapy are summarized. This summary contains recent highlights that remain in my memory more vividly than others. I shall start with selected models of Relational Competence Theory (RCT), including variations on the theme of the Deadly Drama Triangle and their workbook applications.     

The Family FIRO Model: Exploring Relationship Needs of “At-Risk” Families

This research investigates the conceptualization and application of the family fundamental interpersonal relations orientation(FIRO) model to an at-risk family population. The relationships between the family FIRO domains of inclusion, control, and intimacy and family functioning indices, as measured by the Family Assessment Device (FAD) subscales, were explored. An at-risk family population ( N = 43 primary caretakers) was assessed at four time intervals, using an ex post facto design with multiple linear regression model testing. The results indicated significant relationships between FIRO model domains and FAD subscales. A case example further explored the application of the family FIRO model with at-risk families.     

Family-Friendly Policies,Supervisor Support,Work–Family Conflict,Family–Work Conflict,and Satisfaction: A Test of a Conceptual Model

The present study tests a model of antecedents (i.e., the use of family-friendly policies, supervisor support, number of hours worked, having childcare responsibility) and consequences (i.e., job and family satisfaction) of work–family conflict and family–work conflict. As hypothesized, we found that the use of family-friendly policies, hours worked per week, and supervisor support were predictive of work–family conflict. In addition, as predicted, childcare responsibility and supervisor support were found to be related to family–work conflict. Work–family conflict was found to be related to both job and family satisfaction. Our research extends previous research in a number of ways. We believe that a particular strength of our study is it incorporated data gathered at different points in time and from more than one source.     

A Developmental Perspective of Marriage and Family Therapist's Ethical Principles: Support for the Practitioner–Ethics Relationship Model

This study explored therapists' professional ethics by assessing therapist at-risk behaviors as they relate to ethical proficiency in the field of Marriage and Family Therapy. A survey assessing practice behaviors was distributed among marriage and family therapists (MFTs) of varying levels of experience. Data gathered were analyzed using factor analysis, structural equation modeling, and multiple regression. Results indicate a positive relationship between the latent variables of risk and justification, as well as a significant relationship between these variables and years of clinical experience. Findings provide evidence to support the practitioner–ethics relationship model proposed by the authors. Implications of these findings, as well as future directions for research and policy are suggested.     

Mothers’ and Adolescents’ Perceptions of Family Environment and Adolescent Social-Emotional Functioning

Research has emphasized the importance of the relationship between family functioning and adolescent behavioral development. The present study examines family environment and social-emotional functioning of primarily minority adolescents, viewed from both adolescents’ and mothers’ perspectives. Participants were a school-based sample of adolescents with and without risk for emotional and behavioral disabilities and their mothers (N = 86 dyads). Results suggested an association between the mothers’ views of their adolescent children’s problem behaviors and the adolescents’ self-ratings of risk-taking behaviors across 5 years. Overall, mothers of the at risk youth receiving special education services reported higher ratings of youth problem behaviors, but results also indicated that mothers of the at risk adolescent boys not receiving special education services perceived greater depressive symptoms in their children and more family conflict in their homes. Mothers of youth at risk but not receiving special education services experienced higher levels of stress associated with being a parent than mothers of the not-at-risk adolescents. The parent measures of adolescent behavior and depressive symptoms, family conflict, and parental stress were not predictive of the social-emotional functioning of these adolescents in the multilevel models. Implications of these findings for early identification and family focused intervention programs are discussed.     

Evaluation of a Train-The-Trainers Model for Family Peer Advocates in Children’s Mental Health

Standardized training and credentialing is increasingly important to states and healthcare systems. Workforce shortages in children's mental health can be addressed through training and credentialing of professional peer parents (called family peer advocates or FPAs), who deliver a range of services to caregivers. A theory-based training program for FPAs targeting skills and knowledge about childhood mental health services (Parent Empowerment Program, or PEP) was developed through a partnership among a statewide family-run organization, state policy leaders, and academic researchers. Prior studies by this team using highly-experienced family peer advocates (who were also co-developers of the training program) as trainers found improvements in knowledge about mental health services and self-efficacy. In 2010, to meet demands and scale the model, a training of trainers (TOT) model was developed to build a cohort of locally-trained FPAs to deliver PEP training. A pre/post design was used to evaluate the impact of TOT model on knowledge and self-efficacy among 318 FPAs across the state. Participants showed significant pre-post (6 month) changes in knowledge about mental health services and self-efficacy. There were no significant associations between any FPA demographic characteristics and their knowledge or self-efficacy scores. A theory-based training model for professional peer parents working in the children's mental health system can be taught to local FPAs, and it improves knowledge about the mental health system and self-efficacy. Studies that evaluate the effectiveness of different training modalities are critical to ensure that high-quality trainings are maintained.     

Gender Differences in the Importance of Work and Family Roles: Implications for Work–Family Conflict

In this study we explored between- and within-gender differences in the importance of life roles and their implications for work–family conflict. In earlier research (Cinamon & Rich, 2002) we found 3 profiles of workers who differ in attributions of importance to work and family roles: persons who assigned high importance to both the work role and the family role (“Dual” profile); participants who ascribed high importance to the work role and low importance to the family role (“Work” profile); and participants who attributed high importance to the family role and low importance to the work role (“Family” profile). We used these profiles to clarify the relationship between gender and work–family conflict. Participants were 126 married men and 87 married women who were employed in computer or law firms. Significant between- and within-gender differences were found in the distribution of participants to profiles. Men were equally distributed throughout the profiles, whereas women were underrepresented in the Work category. More women than men fit the Family profile, and more men than women fit the Work profile. No gender differences were found for the Dual profile. Women reported higher parenting and work values than men did. Between-gender differences in work–family conflict were apparent, as were within-gender differences across profiles. Results demonstrate the value of examining both between- and within-gender variation in studies of gender and work–family conflict.     

The Science and Art of Integrating Psychodrama and Bernard’s Discrimination Model

This article presents the useful technique of Jacob L. Moreno’s psychodrama in counselor education supervision training. This article addresses how psychodrama can be used with student supervisors who are not sure which of Bernard’s discrimination model roles they are using in supervision. Bernard’s model uses three roles that help supervisors function successfully in their relationships with supervisees. Psychodrama may help student supervisors decide what action would be the most appropriate in a given supervision session. Student supervisors may also benefit from psychodrama in processing internal conflict they may experience in their supervisory role. Faculty members training new supervisors may use these techniques to help their student supervisors gain more awareness on how they view their relationships with supervisees.     

Young Women’s Experience of Anorexia,Family Dynamics and Triangulation

The study explored the experience of triadic family relationships of six young women with a diagnosis of Anorexia Nervosa alongside a consideration of their attachment strategies. The research methods employed semi-structured individual interviews, a family sculpt and use of an adapted version of the Adolescent Separation Anxiety Test (SAT). This adaptation featured a unique development for this study of photographs depicting triadic family separation and conflict situations. These attempted to offer an integrated view of their experience of anorexia and of family relationships alongside a consideration of the attachment strategies evoked. Interpretative Phenomenological Analysis was used to generate themes that captured the young women’s experience, and a modified version of the SAT protocol coding was used to explore attachment strategies. The main themes to emerge from the data were found to be: Relational distance to attachment figures, Barriers to emotional connection, and Perception of parents’ relationship. Attachment strategies were shown to influence perceptions of family relationships and of triadic processes and conflicts. Clinical implications of the findings are discussed alongside limitations of the study and indications for future research.     

Family Cohesion and Adaptation in Pediatric Chronic Conditions: The Missing Link of the Family’s Condition Management

The quality of family functioning has been considered an important predictor of adaptation in children with chronic conditions and their parents. Previous research suggests that beyond general family functioning, the specific experience of the family’s condition management is paramount for understanding family members’ adaptation. This study’s first goal was to compare family functioning and parents’ and children’s adaptation outcomes across four chronic conditions: asthma, diabetes, epilepsy, and obesity. Secondly, we explored the mediating role of family life difficulties and parental mutuality, as two potential paths through which family cohesion is linked to family members’ adaptation. A total of 263 parents of children (3–19 years old) with asthma (n = 77), obesity (n = 79), epilepsy (n = 52) and diabetes (n = 55) completed self-report measures of family cohesion, family life difficulty, parental mutuality, anxiety and depressive symptoms, and their children’s health-related quality of life (HrQoL). The results showed that families of children with diabetes, obesity, and epilepsy were at higher risk of experiencing family difficulties and children’s deteriorated HrQoL when compared to families of children with asthma. With regard to the links among study variables, although family cohesion had both a direct and indirect relationship with parental depressive symptoms, its links with parental anxiety symptoms and children’s HrQoL were only indirect, through family life difficulty. These associations were consistent across the four clinical groups. These findings emphasize the relevance of family-centered interventions aimed at promoting family cohesion, parents’ mutuality, and effective coping with the demands of pediatric chronic conditions.     

How Do Experienced Family Therapists View Their Practice? An Exploratory Assessment of Clinical Skills and Their Relation to Theories of Family Therapy

This study examines the fit between theory based therapeutic skills and the perceptions of experienced therapists about their own skills. Participants responded to a measure of family therapy skills. Of the generic skills, two factors were identified which cut across many areas of practice. For the theory specific skills, two factors were identified which cut across four theories of family therapy. One was consistent with an expert style of therapy and the other reflected a collaborative approach to practice. These findings suggest that clinical training in family therapy should develop ways to train clinicians to match their clinical practice with client needs over theory based models.     

Family Poverty and Trajectories of Children’s Emotional and Behavioural Problems: The Moderating Roles of Self-Regulation and Verbal Cognitive Ability

Socio-economic disadvantage is strongly associated with children’s emotional (internalising) and behavioural (externalising) problems. Self-regulation and verbal cognitive ability have been related to children’s emotional and behavioural resilience to socio-economic disadvantage. Despite being inter-related, self-regulation and verbal cognitive ability have not been examined jointly as promoting resilience in young children. This study investigated the roles of self-regulation and verbal cognitive ability in children’s emotional and behavioural resilience to family socio-economic disadvantage from early to middle childhood (ages 3, 5, and 7 years; N?=?16,916; 49 % girls). Using multivariate response growth curve modelling, we found that the relationship between socio-economic disadvantage and internalising problems was stronger for children with lower verbal cognitive ability. Also, poor children with high and low levels of self-regulation showed a widening gap in both emotional and behavioural problems over time. Poor and non-poor children alike benefited from self-regulation, but poor children appeared to be more vulnerable to low self-regulation. Self-regulation and verbal cognitive ability seem to be important protective factors for young children growing up in poor families.     

Adolescents’ Perceptions of Family Connectedness,Intrinsic Religiosity,and Depressed Mood

Using a sample of 248 ninth and tenth grade students at public high schools, we examined adolescents’ perceptions of family connectedness, intrinsic religiosity, and adolescents’ gender in relation to depressed mood and whether intrinsic religiosity and gender moderated the association of aspects of family connectedness to adolescent depressed mood. Using hierarchical multiple regression analyses we tested models separately for three forms of family connectedness (overall family cohesion, mothers’ support, and fathers’ support), intrinsic religiosity, and depressed mood. In each model, family connectedness was negatively associated with depressed mood. Intrinsic religiosity was not significantly associated with depressed mood. However, in the mothers’ support model, both a two-way interaction (mothers’ support × intrinsic religiosity) and a three-way interaction (adolescents’ gender × mothers’ support × intrinsic religiosity) were significantly related to depressed mood. In the two-way interaction, higher intrinsic religiosity was a moderator, strengthening the association between mothers’ support and depressed mood. In the three-way interaction, gender differences were found. For boys, high intrinsic religiosity strengthened the association between mothers’ support and depressed mood. Among girls, when mothers’ support was low, intrinsic religiosity provided an additional source of connectedness in protecting against depressed mood. Our findings show that connectedness in overall family systems, mother–adolescent subsystems, and father–adolescent subsystems are all important to emotional resilience in adolescents by protecting against depressed mood. Future studies of adolescent religiosity may benefit from including diverse forms of family connectedness in understanding the protective processes provided by aspects of religiosity in promoting adolescents’ emotional resilience.     

Parental Depression and Divorce and Adult Children’s Well-Being: The Role of Family Unpredictability

We examined how parental depression and divorce are associated with anxiety and depression among college students (N = 126; 83% female; 89% Caucasian). Participants provided retrospective recollections of their parents’ depression, and they completed The Center for Epidemiologic Studies-Depression Scale and portions of the Trait Anxiety Scale. In addition, they filled out the brief Marlow-Crowe Social Desirability Scale and the Retrospective Family Unpredictability Scale. Parental depression related to students’ depression, and aspects of family unpredictability (unpredictable money, maternal discipline, and paternal nurturance) mediated this relationship. Parental depression also related to students’ anxiety, however family unpredictability was not a strong mediator of this relationship. Finally, students reporting parental divorce did not report elevated depression or anxiety scores, although parental divorce did relate to perceptions of parental depression. We discuss implications and ideas for treatment and future research.