An Auto‐Ethnographic Study of “Open Dialogue”: The Illumination of Snow

This auto‐ethnographic study describes the changes in the author's thinking and clinical work connected to her first‐hand experience of Open Dialogue, which is an innovative, psychosocial approach to severe psychiatric crises developed in Tornio, Finland. In charting this trajectory, there is an emphasis on three interrelated themes: the micropolitics of U.S. managed mental health care; the practice of “dialogicality” in Open Dialogue; and the historical, cultural, and scientific shifts that are encouraging the adaptation of Open Dialogue in the United States. The work of Gregory Bateson provides a conceptual framework that makes sense of the author's experience and the larger trends. The study portrays and underscores how family and network practices are essential to responding to psychiatric crises and should not be abandoned in favor of a reductionist, biomedical model.     

“We Hardly Ever Talk about It”: Emotional Responsive Attunement in Couples after a Child's Death

Within Western cultural traditions, the idea that parents should talk about the death of their child with each other is deeply rooted. However, across bereaved parent couples there are wide variations in communication about their grief with each other. In this study, we explored the experiences of bereaved couples related to the process of talking and not talking. We used a thematic coding approach to analyze 20 interviews with 26 bereaved parents (11 interviewed as couples, four as individuals). Four main meanings emerged out of our analysis: not talking because of the inadequacy and pointlessness of words in grief, not talking as a way to regulate emotions in daily life, not talking as an expression of a personal, intimate process, and not talking because the partner has the same loss but a different grief process. In addition, we found that the process of talking and not talking can partly be understood as an emotional responsive process on an intrapersonal and interpersonal level. In this process partners search for a bearable distance from their own grief and their partner's, and attune with their relational context. A better understanding of this process is sought in a dialectical approach, emphasizing the value of both talking and not talking in a tense relationship with each other. Implications for clinical work are described.     

Unequally into “Us”: Characteristics of Individuals in Asymmetrically Committed Relationships

This study examined characteristics of individuals that are associated with being in asymmetrically committed relationships (ACRs), defined as romantic relationships in which there was a substantial difference in the commitment levels of the partners. These ACRs were studied in a national sample of unmarried, opposite‐sex romantic relationships (N = 315 couples). Perceiving oneself as having more potential alternative partners was associated with increased odds of being the less committed partner in an ACR compared to not being in an ACR, as was being more attachment avoidant, having more prior relationship partners, and having a history of extradyadic sex during the present relationship. Additionally, having parents who never married was associated with being the less committed partner in an ACR but parental divorce was not. Although fewer characteristics were associated with being the more committed partner within an ACR, more attachment anxiety was associated with increased odds of being in such a position compared to not being in an ACR. We also address how some findings change when controlling for commitment levels. Overall, the findings advance understanding of commitment in romantic relationships, particularly when there are substantial asymmetries involved. Implications for both research on asymmetrical commitment as well as practice (e.g., therapy or relationship education) are discussed.     

When the “U” is not Inverted: Trajectories of Expressed Emotional Arousal Predict Relationship Satisfaction

Maladaptive emotional reactivity and dysfunctional communication during couple conflict are both destructive to couple functioning, and observational research has elucidated how conflict escalates. However, much of the evidence is based on measures that combine content (i.e., what was said) and the emotion with which it was said, which are then examined using sequential analyses. Despite the general presumptions about underlying emotional reactivity and escalation in negative emotions as part of relationship distress and deterioration, little empirical data are available that directly examine these continuous shifts in emotions. The current study examined concurrent and longitudinal associations between relationship satisfaction and trajectories of change in vocally expressed emotional arousal during couple conflict in 62 couples who participated in a relationship education program. Contrary to expectations and patterns found in distressed couples, trajectories followed a U‐shape rather than an inverted U‐shape curve, with steeper and more persistent decreases in emotional arousal predicting more stable relationship satisfaction over time. In addition, there were within‐couple effects. These results suggest that early signs for relationship deterioration may be less in the form of overt escalation as would be seen in distressed couples. Instead, couples who subsequently deteriorate more are less effective in calming emotional arousal. They also are less able to remain at lower emotional arousal. It is possible that the more pronounced escalation toward the end of the conversation in more at‐risk couples is a precursor of the greater escalation patterns seen in distressed couples; this should be examined empirically. Limitations and implications are discussed.     

While We Wait: The Foolishness of Scarcity,the “Devalued Other,” and Pedagogies of “Becoming”

This article considers how Christian women leaders might, in the absence of global economic equality for women, reframe theological dialogue that affirms the work and worth of the “devalued other” – 21st‐century women living in economic insecurity – and to declare that Jesus' eschatological hope is in the feminization of abundance. The article engages the parable of the wise and foolish virgins as a messianic requirement to deconstruct the barriers that keep the devalued other from seeing her full potential and to challenge the foolishness of scarcity that has taken hold of the daughters of privilege. It seeks to engage an African feminist hermeneutic as the primary methodology and to craft an emerging pedagogy of “becoming” that speaks to the cosmic shift to strengthen the agency of women as we await the coming Parousia.     

Beyond “Lots of Hugs and Kisses”: Expressions of Parental Love From Parents and Their Young Children in Two‐Parent,Financially Stable Families

Given that parental love is essential for children's optimal development, the current study gathered examples of how parental love was demonstrated within parent–child relationships. Fifty‐eight two‐parent, financially stable families consisting of a mother, father, and young child (3–7 years old) from the Midwest were interviewed regarding how they demonstrated or perceived parental love. Results from an inductive thematic analysis revealed considerable variability in how parental love was demonstrated, with five themes emerging that overlapped between parents and their children: playing or doing activities together, demonstrating affection, creating structure, helping or supporting, and giving gifts or treats. Some gendered patterns among these themes were found with mothers emphasizing physical and verbal affection and fathers highlighting their more prominent role as playmates. The lay examples provided by parents and children in this exploratory study extend previous conceptualizations of parental love and underscore the importance of parents being attuned and responsive to the specific needs of their children.     

Latina/o Children Living With an Immigrant Mother With Depression: Developmental and Cultural Nuances in Recognition and Coping

The psychological experience of maternal depression and its impact on immigrant Latina/o families often goes unrecognized and unaddressed. Children may feel especially helpless and confused about the changes they observe in their mothers’ mood and behavior, and about the deterioration of family relationships. Given the interdependence of family structures of immigrant Latina/o households, maternal depression can be detrimental to Latina/o youth attributions and coping strategies, and to their relationship with their mothers. The quantitative focus of most research on maternal depression in Latina/o samples limits our understanding of family processes in maternal depression. The current qualitative study explores the perceived impact of maternal depression on Latina/o youths’ attributions and coping strategies. This inquiry involved focus groups with 12 participants aged 9–16 years to explore their perspectives on maternal depression. All youth had participated in a 12‐week multifamily group intervention focused on building family and cultural strengths to address maternal depression on immigrant Latina/o families. Findings of the focus groups illuminated the essential experience of youth living with maternal depression, and indicated that there are developmental considerations for how youth recognize and make meaning of maternal depression, and cope with disrupted family life. Additionally, youth reported engaging in these culture‐specific ways of coping: using close sibling relationships and family structure as support, having fathers and extended family members engage in additional and restorative parenting practices, and participating in religious practices to seek refuge from family stress. We propose considerations for intervention and further areas of research.     

Mentalizing Family Violence Part 1: Conceptual Framework

This is the first of two companion papers describing concepts and techniques of a mentalization‐based approach to understanding and managing family violence. We review evidence that attachment difficulties, sudden high levels of arousal, and poor affect control contribute to a loss of mentalizing capacity, which, in turn, undermines social learning and can favor the transgenerational transmission of violent interaction patterns. It is suggested that physically violent acts are only possible if mentalizing is temporarily inhibited or decoupled. However, being mentalized in the context of attachment relationships in the family generates epistemic trust within the family unit and reduces the likelihood of family violence. The implications of this framework for therapeutic work with families are discussed.     

The Association between Attachment Styles and Physical Intimate Partner Violence Perpetration and Victimization: A Meta‐Analysis

In this meta‐analysis, we examine attachment styles—something commonly incorporated into couples therapy—and their association with physical intimate partner violence (IPV) perpetration and victimization among men and women. This meta‐analysis incorporated 33 studies that looked at the association between four different attachment styles and IPV. This study examined the strength of the correlation among different attachment styles and IPV perpetration and victimization, examined gender differences in the strength of the association among attachment styles and IPV, and compared the strength of the association with IPV among different attachment styles. We found that anxious attachment, avoidant attachment, and disorganized attachment styles were all significantly associated with physical IPV perpetration and victimization. Secure attachment was significantly negatively related to IPV perpetration and victimization. There was a significantly stronger association between avoidant attachment and IPV victimization for women compared to men. Clinical implications related to the importance of fostering secure attachments when working with couples or individuals who have experienced IPV are addressed.     

‘Just black sometimes’, part 2: reflections on an adolescent's journey

In this second article about work at a refugee centre for unaccompanied minors in Berlin, the author discusses his encounter with Syrian and Afghani adolescents who were enrolled in the program. Issues around adaptation to a new culture are explored with attention to the dynamics of conformity and marginalization. The questions of what happens to adolescent refugees separated from their families, and how their identity formation is shaped by this burden is explored in relation to the author's meeting with a Syrian adolescent living in Berlin. To illustrate the long reach of a missing father who has been left behind, characters from Virgil's Aeneid are discussed to amplify heroic and spiritual aspects within father‐son relationships. The interplay between needing help and allowing for resilience is explored as an important aspect of refugees’ transitions, while also considering variables such as dependence and independence, foreign and familiar, being with or without family, and adjusting to the present and/whilst relating to the past; tensions between these alternatives can create various psychosocial challenges for adolescent refugees.     

Mentalizing Family Violence Part 2: Techniques and Interventions

This is the second of two companion papers that provide an overview of mentalization‐based concepts and techniques when working with the seeming “mindlessness” of intra‐family violence. The focus of this paper is on general mentalization‐oriented approaches and specific interventions that aim to (1) disrupt the non‐mentalizing cycles that can generate intra‐family violence and (2) encourage the emergence of patterns of family interactions that provide the foundation for non‐violent alternatives. Various playful exercises and activities are described, including the taking of “mental state snapshots” and “selfies” in sessions and staging inverted role‐plays, as well as using theatrical masks and creating body–mind maps and scans. These can make “chronic” relationship issues come alive in session and permit “here and now” experiences that generate a safe context for mentalizing to take place. At the core of the work is the continuous focus on integrating experience and reflection. Without acute awareness of the thoughts and feelings occurring in the sessions, mere reflection is not likely to enable change. By increasing mentalizing in the family system, family members’ trusting attitudes grow, both within and outside the family.     

Family‐Based HIV and Sexually Transmitted Infection Risk Reduction for Drug‐Involved Young Offenders: 42‐Month Outcomes

This study tested a family‐based human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention approach integrated within an empirically supported treatment for drug‐involved young offenders, Multidimensional Family Therapy (MDFT). A randomized, controlled, two‐site community‐based trial was conducted with 154 youth and their parents. Drug‐involved adolescents were recruited in detention, randomly assigned to either MDFT or Enhanced Services as Usual (ESAU), and assessed at intake, 3, 6, 9, 18, 24, 36, and 42‐month follow‐ups. Youth in both conditions received structured HIV/STI prevention in detention and those in MDFT also received family‐based HIV/STI prevention as part of ongoing treatment following detention release. Youth in both conditions and sites significantly reduced rates of unprotected sex acts and STI incidence from intake to 9 months. They remained below baseline levels of STI incidence (10%) over the 42‐month follow‐up period. At Site A, adolescents who were sexually active at intake and received MDFT showed greater reduction in overall frequency of sexual acts and number of unprotected sexual acts than youth in ESAU between intake and 9‐month follow‐ups. These intervention differences were evident through the 42‐month follow‐up. Intervention effects were not found for STI incidence or unprotected sex acts at Site B. Intensive group‐based and family intervention in detention and following release may reduce sexual risk among substance‐involved young offenders, and a family‐based approach may enhance effects among those at highest risk. Site differences in intervention effects, study limitations, clinical implications, and future research directions are discussed.     

Longitudinal Associations among Parental Acceptance,Familism Values,and Sibling Intimacy in Mexican‐Origin Families

Prospective associations among parent – adolescent acceptance and familism values in early and middle adolescence and sibling intimacy in late adolescence and young adulthood were assessed in 246 Mexican‐origin families. Older sibling gender and sibling gender constellation were investigated as moderators of these associations. Sibling intimacy was stable over time and younger siblings with older sisters reported higher levels of sibling intimacy than those with older brothers. As predicted, stronger familism values were associated with greater sibling intimacy, but this link was evident only for older sisters and for girl‐girl dyads. The links from mother‐ and father‐acceptance to sibling intimacy also depended on the gender constellation of the sibling dyad: Higher levels of maternal warmth were associated with greater sibling intimacy for older sisters and girl‐girl sibling pairs but higher levels of paternal warmth were linked to greater sibling intimacy only for older siblings in mixed‐gender sibling dyads. Findings are consistent with prior research on the role of gender in family relationships but extend this work to encompass the effects of both parents' and siblings' gender, as well as the role of sociocultural values in parents' socialization influences.     

Couples with Intimate Partner Violence Seeking Relationship Help: Associations and Implications for Self‐Help and Online Interventions

In‐person conjoint treatments for relationship distress are effective at increasing relationship satisfaction, and newly developed online programs are showing promising results. However, couples reporting even low levels intimate partner violence (IPV) are traditionally excluded from these interventions. To improve the availability of couple‐based treatment for couples with IPV, the present study sought to determine whether associations with IPV found in community samples generalized to couples seeking help for their relationship and whether web‐based interventions for relationship distressed worked equally well for couples with IPV. In the first aim, in a sample of 2,797 individuals who were seeking online help for their relationship, the levels and correlates of both low‐intensity and clinically significant IPV largely matched what is found in community samples. In the second aim, in a sample of 300 couples who were randomly assigned to a web‐based intervention or a waitlist control group, low‐impact IPV did not moderate the effects of the intervention for relationship distress. Therefore, web‐based interventions may be an effective (and easily accessible) intervention for relationship distress for couples with low‐intensity IPV.     

Helping Parents Cope with Suicide Threats: An Approach Based on Nonviolent Resistance

Parent training in nonviolent resistance was adapted to deal with situations of suicide threat by children, adolescents, and young adults. The approach aims at reducing the risk potential and the mutual distress surrounding the threat‐interaction. Parent training in nonviolent resistance has been shown to help parents move from helplessness to presence, from isolation to connectedness, from submission to resistance, from escalation to self‐control, and from mutual distancing and hostility to care and support. Those emphases can be crucial for the diminution of suicide risk. Parents show good ability to implement the approach and report gains on various areas over and beyond the reduction in suicide threat. A particular advantage is that the method can be used also in cases where the young person threatening suicide is not willing to cooperate.     

Father Knows Best: Paternal Presence and Sexual Debut in African‐American Adolescents Living in Poverty

Adolescents found within single‐parent families without a residential father have reported higher levels of sexual debut and higher levels of reported pregnancy. Using data from the Mobile Youth Survey, the purpose of this study is to determine the impact of the presence of a father figure on the sexual debut of African‐American adolescents living in poverty and to determine if gender moderates the relationship between the presence of a father figure and sexual debut. Additionally, this study will examine the family processes in which the presence of a father figure can affect the sexual debut of African‐American adolescents who live within economically and socially disadvantaged communities. The results revealed that African‐American adolescents reporting a father figure had lower rates of sexual debut than those youth reporting no father figure. Gender was not found to be a significant moderator in the relationship between father figure presence and sexual debut. However, existing curfews and family rules did account for some of the effects of presence of a father figure and sexual debut. The results suggest that when adolescents have a father figure in their lives, it may reduce the possibility of early sexual debut.