Marital Interactions,Family Intervention,and Disagreements: A Daily Diary Study in a Low‐income Sample

Little research has examined associations between low‐income married couples’ daily interactions and severity of disagreements. Similarly, few researchers have considered how family‐strengthening interventions for low‐income couples may affect the quality of daily interactions and associations between interactions and conflict experiences. This study aims to fill these gaps in the literature by leveraging daily diary data from a random assignment study of a family‐strengthening intervention with low‐income husbands and wives 30 months postenrollment. Married couples randomly assigned to the intervention participated in 10 weeks of relationship education services. Control group couples received no services. Thirty months postrandom assignment, participants reported on the severity of daily marital disagreements over a 15‐day period, as well as their positive and negative emotions during inter‐spousal interactions. Multi‐level models demonstrated associations between reports of emotions in interactions and severity of disagreements. In addition, wives assigned to the family strengthening program reported fewer negative emotions during interactions at follow‐up than wives in the control condition. Finally, negative associations between positive emotions in interactions and severity of disagreements were stronger for wives assigned to the intervention, while positive associations between negative emotions in interactions and severity of disagreements were weaker for wives assigned to the intervention. Implications for future research and intervention development are discussed.     

International Family Therapy: A View from Kyoto, Japan

"International family therapy" is an emergent field within (or overarching) the field of family therapy. At this stage, it can be described as the collecting and sharing of experiences by family therapists from different countries. Recent publications (7) gather information principally from Western cultures in which systemic family therapy has grown over the past thirty years. Japan is of particular interest to Western practitioners because it is a highly successful, post-industrial culture that differs markedly from the West. Familiar family therapy interventions often work for unfamiliar reasons, and different goals are often needed in order to respond to apparently similar family problems. An expanded sense of choice around strategies for family life and family therapy that such diversity implies is the primary contribution that this maturing, international family therapy movement can make to family therapy.     

Disability and Family Intervention: A Perspective for Counselors

Thomas H. Hohenshil and Rodney K. Goodyear , Special Assignment Editors Disability and Family Intervention: A Perspective for Counselors Hilda P. Versluys, Physical Rehabilitation and Family Dynamics. Rehabilitation Literature, March-April, 1980, 41 (3–4), 58–65.     

Problem Definition in Marital and Family Therapy: A Qualitative Study

This paper describes findings from a grounded theory study on the process of constructing problem definitions by marital and family therapists. Coding of the observations and interviews resulted in two meta-problem definition processes. In the first meta-process clinicians kept their definitions internal to themselves during the therapy session. In contrast, the second meta-definition process involved clinicians bringing forth their internal problem definitions and incorporating them into the therapeutic conversation. Implications for existing conceptualizations and marital and family therapy practice and supervision are discussed, as well as suggestions for further consideration.     

Memory and Narrative Healing Processes in HIV Counseling: A View from Africa

The AIDS pandemic in Africa has wreaked pain on millions of people, particularly the youth. Beyond physical symptoms, the disease destroys the emotional and psychological well-being of its victims and their families. Although psychotherapists are desperately needed, most of those in Africa have not been given sufficient training in HIV counseling. In addition, access to specific models of healing for those traumatized by the news of infection with HIV disease is hardly available. Memory healing processes, which are essential in grief work in Africa, can be combined with ritual theory within a narrative framework to provide a model for bringing healing to clients traumatized by the news of HIV infection. Augustine Nwoye, Ph.D., is presently Associate Professor, and formerly Chairman, Department of Psychology, Kenyatta University, Nairobi, Kenya. A first version of the paper was presented as a Keynote Address at the International Conference in Durban, South Africa, organized by the South African Association of Marital and Family Therapy, May 2004. I thank Dr. Frida Rundell, the then President of the Association, for her invitation and hospitality.     

A Framework and Themes for Social Network Intervention

This paper is concerned with the development and application of social network concepts in clinical practice. A framework of network levels and sets for ordering data and observations is proposed; the phenomenon of truncated networks is considered and two emphases in network intervention (gathering and connecting forms) are proposed to conceptualize network characteristics and practice that follows from such characteristics. A number of current examples of network practice are placed within the framework, and several advantages of utilizing a network perspective as a complement to existing models of family therapy are noted.     

A Single Intervention: A Visit to the Family

The following letter is reported unchanged except for disguised names. Concern with repairing disrupted relationships of adult members of a family with their own parents has been a matter of growing interest to a number of family therapists; Bowen (1), Boszormenyi-Nagy (2), and Framo (3), among others have stressed the importance of sending family members back to their families of origin. This report makes no effort to formulate the process in any particular theoretical framework (i.e., as reestablishing connectedness after an “emotional cut-off” or rebalancing a ledger of fairness, or whatever) but is intended only to illustrate the kind of outcome one may hope for in prescribing such a maneuver. It is offered simply as a clinical note. The letter needs little prefatory explication. Mr. Jack Newburgher had been a patient in psychoanalytic treatment for four years, with a quite successful outcome. On two occasions in the course of his therapy a joint session had been held with Mr. Newburgher and his wife, Muriel, when changes in his behavior had precipitated crises in the marital relationship. His therapy had terminated about two years before the visit referred to in the letter. Mr. Newburgher had called and asked for a joint consultation with Muriel about an acute family problem they were experiencing. Some — not all — of the background material was described, not nearly as coherently as it is reported in Muriel's letter, but in sufficient detail to make it plain that she was in distress about having to withdraw completely from her parents and that their family was in disarray as a consequence of her distress. The acuteness of the emotional disturbance, against a background of a lifelong adversary relationship between Muriel and her father and a history of ten years of illness on her fathers' part, suggested that the distress was the product of Muriel's anxiety and guilt over a decision to cut herself off completely from her parents. As a consequence, Muriel was urged to visit her family of origin, with the caveat that she might indeed discover them to be malignantly self-centered people indifferent to their effect on her and her family, but that she would at least have the gratification of having tried. The reference to “speaking French” was to the therapist having suggested that, on the other hand, she might find that her parents expressed their feelings in a different modality from her definitions of how feelings should be expressed, much as though their native tongue were French and she were insisting that they must speak to her in English.     

The Reconciliation Pyramid—A Narrative-Based Framework for Analyzing Identity Conflicts

The Reconciliation Pyramid is suggested in this article as a heuristic tool for exploring accomplished or burgeoning reconciliation processes, as well as cases such as the Middle East, where only tentative and mostly failed steps have been taken towards reconciliation. The first part proposes a terminological framework indicating the relationship between metanarratives, national metanarratives, and national narratives . This terminology is used to analyze national narratives and their role in conflict evolvement and termination. The second part elaborates the seven stages of the Reconciliation Pyramid: Narrative acquaintance; narrative acknowledgement; expressing empathy; assumption of responsibility; readiness for restitution; asking and granting forgiveness and narrative integration. The article concludes with a short case study of the Camp David negotiations and reflects upon the suitability and contribution of the Reconciliation Pyramid to theoretical and empirical reconciliation research.     

Understanding Forgiveness as Discovery: Implications for Marital and Family Therapy

This article explores the concept of forgiveness in relationship systems and examines various conceptualizations and definitions found in the literature. Forgiveness is described as a complex psychological and relational process that is more a discovery than an act of will. A rationale for viewing forgiveness in a contextual, historical, and relational attachment paradigm is presented, and the association of forgiveness with empathy and emotional intelligence is discussed. Marital and family therapists are encouraged to attend to contextual family of origin issues and to facilitate an empathic relational environment where ambivalence is expected and tolerated for enhancing the process of forgiveness. Relevant clinical cases are shared to illustrate the process of forgiveness as discovery.     

Aging and Family Personality: A Developmental View

The dramatic numerical and proportional increase in the elderly population has important implications for family dynamics and the family life cycle. This paper considers some of the issues of aging, death, loss, and separation, as they relate to individual and family development and to shifting roles and responsibilities of family members.     

Medical Family Therapy in a Primary Care Setting: A Framework for Integration

As the profession of marriage and family therapy (MFT), as well as the emerging sub-specialty of medical family therapy (MedFT), continue to grow and evolve within the current healthcare system, the arena of integrated primary care (IPC) presents an ideal environment for professionals who are relationally and systemically inclined. Although there has been a inundation of literature detailing collaborative systems of healthcare, several gaps still exist: (a) a lack of horizontally integrated models (i.e., models that do not target specific diseases or demographic populations), (b) a lack of model utilization regardless of disease trajectory (i.e., decline, stabilization, improvement), and (c) a lack of IPC models explicitly utilizing MedFT/MFTs as the mental health providers within the system. In lieu of these gaps, the authors present a framework for IPC, utilizing MedFTs/MFTs, that is neither population nor disease specific, as well as a model geared towards implementation regardless of disease trajectory. The framework, which was obtained using ethnography of communication, details MedFTs?? interactions with front line medical providers and patients from initial contact through coordination of a shared treatment plan. Recommendations for future research studies incorporating the use of MedFTs in integrated primary care settings are extended in the context of a three world view framework (Peek in Collaborative medicine case studies: Evidence in practice. Springer, New York, pp 25?C38, 2008; Peek and Heinrich in Family Syst Med 13:327?C342, 1995, Integrated primary care: the future of medical and mental health collaboration. Norton, New York, pp 167?C202, 1998).     

Combined Individual/Marital Therapy: A Conflict Resolution Framework and Ethical Considerations

This paper illustrates how couple and individual treatment formats can be intertwined. A conflict resolution theoretical framework structures treatment around three goals: (1) relieving symptoms (anger, depression, and marital distress), (2) facilitating resolution of the couple's conflicts, and (3) building communication and conflict resolution skills. The literature review focuses on why combining individual and couple therapy is often important for married clients. Two Bicycles, an illustrative case incorporating both conjoint and individual interventions, is presented and analyzed with regard to when each format seems beneficial. Ethical and practical issues raised by dual format treatment include potential harm, informed consent, dual roles, confidentiality, and time and financial costs.     

The Risk-Based View of Trust: A Conceptual Framework

Trust and risk have often been linked in the literature, but their relationship is far from clear. Trust has been used in three different ways — namely, as a perception (subjective trust), as various personal and situational factors that lead to subjective trust (trust antecedents), and as the actions resulting from subjective trust (behavioral trust). We explain how risk is related to these three conceptions of trust. First, we argue that subjective trust and perceived risk are in fact mirror images of each other. Second, we show how behavioral trust can be viewed as risk taking, so that the causal relationship between subjective trust and behavioral trust is similar to that of perceived risk and risk taking. And third, we discuss the role of personal characteristics (such as risk propensity and trust propensity) in the risk–trust relationship. We also develop a number of propositions based on our risk-based view of trust.     

Brief Intervention of Alcohol Problems in Sub-Saharan Africa: A Review

The purpose of this review was to identify and assess studies that have described and quantified brief interventions of alcohol problems in sub-Saharan Africa. PubMed, Google scholar, CAB Abstracts and article references were searched to identify studies published in English between 1980 and 2009. Twenty-one eligible studies were described in detail and information on study characteristics extracted. All of the identified studies were conducted either in east or southern Africa and varied substantially in terms of study design, population and alcohol use definitions. Overall, brief intervention of alcohol problems in health care settings showed positive results but were difficult to integrate into routine practice. Brief interventions (ranging from a few to 12 sessions) in school settings showed mixed results. In individual or group format in community settings, brief interventions combined with HIV risk reduction counselling showed promising short term results. The findings of this review of sub-Saharan African research strongly support the possible impact of brief interventions of alcohol problems in various settings.