Parents Taking Action: A Psycho‐Educational Intervention for Latino Parents of Children With Autism Spectrum Disorder

The increased prevalence of autism spectrum disorder (ASD) among Latino children, later diagnosis, limited access to bicultural specialist support, and worsened health outcomes when compared to non‐Latinos points to the need for a culturally relevant parent education intervention. This pilot study examined the feasibility, acceptability, and preliminary outcomes of a culturally derived intervention, Parents Taking Action, for 19 Spanish‐speaking mothers of children with ASD. This study introduces the Promotora de Salud Model of intervention delivery to the autism field. A mixed‐methods design including one group pre‐ and posttest design and focus groups was used to evaluate the outcomes of PTA. We found that the intervention was both feasible to implement and acceptable to participants. We also found significant increases in empowerment oriented outcomes for parents between pre‐ and posttest suggesting that the intervention is promising. Suggestions for future research and practice are offered.     

A Balancing Act: Integrating Evidence‐Based Knowledge and Cultural Relevance in a Program of Prevention Parenting Research with Latino/a Immigrants

Family therapists have a unique opportunity to contribute toward the reduction of widespread mental health disparities impacting diverse populations by developing applied lines of research focused on cultural adaptation. For example, although evidence‐based prevention parent training (PT) interventions have been found to be efficacious with various Euro‐American populations, there is a pressing need to understand which specific components of PT interventions are perceived by ethnic minority parents as having the highest impact on their parenting practices. Equally important is to examine the perceived cultural relevance of adapted PT interventions. This qualitative investigation had the primary objective of comparing and contrasting the perceived relevance of two culturally adapted versions of the efficacious parenting intervention known as Parent Management Training, the Oregon Model (PMTO). According to feasibility indicators provided by 112 Latino/a immigrant parents, as well as findings from a qualitative thematic analysis, the core parenting components across both adapted interventions were identified by the majority of research participants as relevant to their parenting practices. Participants exposed to the culturally enhanced intervention, which included culture‐specific sessions, also reported high satisfaction with components exclusively focused on cultural issues that directly impact their parenting practices (e.g., immigration challenges, biculturalism). This investigation illustrates the relevant contributions that family therapy scholars can offer toward addressing mental health disparities, particularly as it refers to developing community‐based prevention interventions that achieve a balance between evidence‐based knowledge and cultural relevance.     

Depth in Cultural Socialization in Families with Children Adopted from China

Parents raising children adopted from a different racial/ethnic group usually engage in cultural socialization—providing activities in adoptees’ birth culture—hoping to instill pride and help adoptees develop a positive identity. Adoptive parents engage in a wide variety of socialization activities, yet adult adoptees have reported not having deep enough exposure from their parents. The present study explored the depth of cultural socialization in transracial adoptive families. Informed by Pinderhughes' Ethnic‐Racial Socialization model, this study developed a continuum examining the depth in cultural socialization with three indicators: (1) the depth of cultural activities, (2) parents’ motivation for cultural socialization, and (3) parental cultural attitudes. Qualitative analyses of 41 White parents raising children adopted from China found that parents’ motivation and acknowledgement of cultural differences reflected deep appreciation of adoptees’ birth culture, however, activities they provided were not as deep. Activities that facilitated close relationships with people who shared adoptees’ background in a natural context appeared to provide the deepest cultural connection. Despite limitations, the study demonstrated that the depth continuum was able to capture variations and nuances in cultural socialization. Suggestions for future research and recommendation for practice were also included.     

A Community‐Responsive Adaptation to Reach and Engage Latino Families Affected by Maternal Depression

As family researchers and practitioners seek to improve the quality and accessibility of mental health services for immigrant families, they have turned to culturally adapted interventions. Although many advancements have been made in adapting interventions for such families, we have yet to understand how the adaptation can ensure that the intervention is reaching families identified to be in greatest need within a local system of care and community. We argue that reaching, engaging, and understanding the needs of families entails a collaborative approach with multiple community partners to ensure that adaptations to intervention content and delivery are responsive to the sociocultural trajectory of families within a community. We describe a cultural adaptation framework that is responsive to the unique opportunities and challenges of identifying and recruiting vulnerable families through community partnerships, and of addressing the needs of families by incorporating multiple community perspectives. Specifically, we apply these principles to the cultural adaptation of an intervention originally developed for low‐income African American and White families facing maternal depression. The new intervention, Fortalezas Familiares (Family Strengths), was targeted to Latino immigrant families whose mothers were in treatment for depression in mental health and primary care clinics. We conclude with key recommendations and directions for how family researchers and practitioners can design the cultural adaptation of interventions to be responsive to the practices, preferences, and needs of underserved communities, including families and service providers.     

Adapting the Unique Minds Program: Exploring the Feasibility of a Multiple Family Intervention for Children with Learning Disabilities in the Context of Spain

The Unique Minds Program (Stern, Unique Minds Program, 1999) addresses the socio‐emotional needs of children with learning disabilities (LD) and their families. Children and their parents work together in a multiple family group to learn more about LD and themselves as people with the capacity to solve problems in a collaborative way, including problems in family school relationships. This article reports the cultural adaptation of the program for use in Spain and findings from a feasibility study involving three multiple family groups and a total of 15 children and 15 mothers, using a pre‐post design. This Spanish adaptation of the program is called “Mentes Únicas”. Standardized outcome measures indicated an overall statistically significant decrease in children's self‐rated maladjustment and relationship difficulties by the end of the program. Improvements were endorsed by most mothers, although they were not always recognized by the children's teachers. The program had a high level of acceptability: Mothers and children felt safe, understood, and helped throughout the sessions. The efficacy of the adapted intervention for the context of Spain remains to be tested in a more rigorous study.     

Systematic Review and Meta‐analysis of Stepping Stones Triple P for Parents of Children with Disabilities

The aim of this systematic review and meta‐analysis was to examine the effectiveness of Stepping Stones Triple P (SSTP) parent training programs on child behavior problems and parenting outcomes in families of children with developmental disabilities. Sixteen suitable studies including data from over 900 families were identified in a search for English language published and unpublished controlled outcome studies. SSTP has five levels on a graded continuum of increasing intensity targeting families with differing degrees of treatment need from low intensity media‐based parenting information campaigns at level 1, through brief interventions at levels 2 and 3, to more intensive parent training and family therapy interventions at levels 4 and 5. Analyses were conducted on the combination of all levels of SSTP and separately for each level. For combined levels, significant overall effect sizes were found for parent‐reported child problems (d = 0.46), researcher observed child behavior (d = 0.51), parenting style (d = 0.70), parenting satisfaction/self‐efficacy (d = 0.44), parental adjustment (d = 0.27), and coparental relationship (d = 0.26), but not researcher‐observed parent behavior. Strong support was found for level 4 SSTP as an effective intervention for improving child and parent outcomes in families of children with disabilities who have clinically significant problems. Less intensive SSTP interventions for cases with circumscribed difficulties yielded fewer significant treatment effects, and there were relatively few studies of such interventions.     

The Cultural Adaptation of a Community‐Based Child Maltreatment Prevention Initiative

A unique primary prevention effort, Strong Communities for Children (Strong Communities), focuses on changing attitudes and expectations regarding communities' collective responsibilities for the safety of children. Findings from a 6‐year pilot of the initiative in South Carolina have shown promise in reducing child maltreatment, but efforts to adapt the initiative to different cultural contexts have been lacking. No models exist for adapting an initiative that takes a community‐level approach to ensuring children's safety. Thus, this article addresses the gap by providing an overview of the original initiative, how the initiative was adapted to the Israeli context, and lessons learned from the experience. Building on conceptualizations of cultural adaptation by Castro et al. (Prevention Science, 5, 2004, 41) and Resnicow et al. (Ethnicity and Disease, 9, 1999, 11), sources of nonfit (i.e., sociodemographic traits, political conflict, government services, and the presence and role of community organizations) were identified and deep and surface structure modifications were made to the content and delivery. Ultimately, this article describes the adaption and dissemination of a community‐based child maltreatment prevention initiative in Tel Aviv, Israel, and addresses researchers' calls for more publications describing the adaptation of interventions and the procedures that need to be implemented to achieve cultural relevance.     

Parentification,Stress, and Problem Behavior of Adolescents who have a Parent with Mental Health Problems

When adolescents live with a parent with mental illness, they often partly take over the parental role. Little is known about the consequences of this so‐called parentification on the adolescents' internalizing and externalizing problems. This survey study examined this effect cross‐sectionally and longitudinally in a sample of 118 adolescents living with a parent suffering from mental health problems. In addition, the study examined a possible indirect effect via perceived stress. Path analyses were used to examine the direct associations between parentification and problem behavior as well as the indirect relations via perceived stress. The results showed that parentification was associated with both internalizing and externalizing problems cross‐sectionally, but it predicted only internalizing problems 1 year later. An indirect effect of parentification on adolescent internalizing and externalizing problems via perceived stress was found, albeit only cross‐sectionally. These findings imply that parentification can be stressful for adolescents who live with a parent with mental health problems, and that a greater awareness of parentification is needed to prevent adolescents from developing internalizing problems.     

Mothers’ Dreams,Children Realities: The Case of Uprooted Families from South Lebanon

In this exploratory qualitative study, 15 mothers and 18 adolescents who, as family members of the South Lebanon Army, were uprooted from that country and now living in Israel, were interviewed separately. The mothers described their image of the adaptive adult, which stressed the positive values of loyalty to the family, orientation toward the group, respect, and acceptance of hierarchy and guided their child‐rearing goals and socialization. The children shared similar attitudes about the importance of family loyalty and orientation toward the group, but differed from their mothers with regard to the issues of respect and obedience. We discussed the notion of “liminality,” to further our understanding of the families in transition and suggest how it applies to the uprooted members of South Lebanon army. We suggest that different time orientations and contextual factors influence the participating mothers’ image of the adaptive adult and the degree to which their children accept it. Implications for research and interventions are also explored.     

Coparental Affect,Children's Emotion Dysregulation,and Parent and Child Depressive Symptoms

Children's emotion dysregulation and depressive symptoms are known to be affected by a range of individual (parent, child) and systemic (parent–child, marital, and family) characteristics. The current study builds on this literature by examining the unique role of coparental affect in children's emotion dysregulation, and whether this association mediates the link between parent and child depressive symptoms. Participants were 51 mother–father–child triads with children aged 7 to 12 (M age = 9.24 years). Triads discussed a time when the child felt sad and a time when the child felt happy. Maternal and paternal displays of positive affect were coded, and sequential analyses examined the extent to which parents were congruent in their displays of positive affect during the emotion discussions. Results indicated that interparental positive affect congruity (IPAC) during the sadness discussion, but not the happiness discussion, uniquely predicted parent‐reported child emotion dysregulation, above and beyond the contributions of child negative affect and parental punitive reactions. The degree of IPAC during the sadness discussion and child emotion dysregulation mediated the association between maternal, but not paternal, depressive symptoms and child depressive symptoms. Findings highlight the unique role of coparental affect in the socialization of sadness in youth and offer initial support for low levels of IPAC as a risk factor for the transmission of depressive symptoms in youth.     

Parent Education for Migrant Mothers of Left‐Behind Children in China: A Pilot Randomized Controlled Trial

Although numerous studies have indicated the significance of parental support and parent–child communication in alleviating the adverse effects of parental departure on left‐behind children, researchers have rarely addressed the impact of parent education on migrant parents. On the basis of the results of a pilot randomized controlled trial, the study reported here involved examining the possible outcomes and feasibility of a parent education program for rural‐to‐urban migrant mothers of left‐behind children in China. Informed by an existential–narrative approach to parent education, the program was composed of six 2.5‐hour sessions. The sample included 56 migrant mothers recruited from a social service center in Shenzhen, China, who were randomly assigned to either the immediate group (n = 28, M = 34.82 years, SD = 4.12, aged 23–43) or the waitlist control group (n = 28, M = 34.68 years, SD = 4.53, aged 28–43). The hypotheses of the trial were twofold: that the program would positively affect participants’ parental identity and that it would improve mother–child relationships and parenting practices. The results revealed no significant difference in parental identity between the intervention group and the waitlist control group at the post‐test assessment after ruling out the effects of pretest survey scores. However, significant differences did emerge in parent–child relationships and parenting practices. Overall, the results corroborate the feasibility of examining the current program for migrant mothers in China in a full trial. The findings also offer insights into developing empirically supported parent education programs for migrant parents.     

Dyadic Coping in Couple Therapy Process: An Exploratory Study

This study aimed at moving beyond previous research on couple therapy efficacy by examining moment‐by‐moment proximal couple and therapist interactions as well as final treatment outcomes and their reciprocal association. Seven hundred four episodes of dyadic coping within 56 early therapy sessions, taken from 28 married couples in treatment, were intensively analyzed and processed using a mixed‐methods software (T‐LAB). Results showed that negative dyadic coping was self‐perpetuating, and therapists tended to passively observe the negative couple interaction; on the contrary, positive dyadic coping appeared to require a therapist's intervention to be maintained, and successful interventions mainly included information gathering as well as interpreting. Couples who dropped out of treatment were not actively engaged from the outset of therapy, and they used more negative dyadic coping, whereas couples who successfully completed treatment showed more positive dyadic coping very early in therapy. Results highlight the role of therapist action and control as critical to establishing rapport and credibility in couple therapy and suggest that dyadic coping patterns early in therapy may contribute to variable treatment response.     

Predictors of Engagement in Family Mediation and Outcomes for Families that Fail to Engage

An important limitation to the effectiveness of family mediation in assisting separated parents is parents failing to engage in the mediation process. In 524 parents who presented to a telephone‐based mediation service, 113 (22%) initiating parents withdrew from mediation before the other parent was invited to participate, 241 (46%) initiating parents had respondent parents who declined to participate in mediation, and 170 cases (33%) completed mediation. We tested whether socio‐demographic variables, psychological distress, coparental acrimony, parenting problems, or children's behavioral difficulties predicted mediation engagement. High interparental acrimony predicted failure to engage in mediation, but none of the other variables predicted mediation engagement. We followed a sample of 131 families that did not mediate and found they showed elevated psychological distress, acrimony, parenting problems and child adjustment difficulties, which remained unchanged 6 months later. Further research is needed to explore strategies to enhance respondent parent engagement with mediation, and to address the negative outcomes for those separated families not proceeding with mediation.     

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.     

Parents' Differential Treatment of Adolescent Siblings in African American Families

Research on European and European American families suggests that parents' differential treatment of siblings has negative implications for youths' adjustment, but few studies have explored these dynamics in minority samples. This study examined parents' differential acceptance and conflict in a sample of mothers, fathers, and two adolescent siblings in 179 African American families who were interviewed on three annual occasions. In an effort to replicate findings from European and European American samples, we assessed the longitudinal associations between differential treatment and adolescent adjustment and tested three sibling characteristics (birth order, gender, and dyad gender composition) as potential moderators of these linkages. To illuminate the sociocultural context of differential treatment and its implications, we also explored parents' cultural socialization practices and experiences of financial stress as potential moderators of these links. Multilevel models revealed that, controlling for average parent–child relationship qualities, decreases in parental acceptance and increases in parent–youth conflict over time—relative to the sibling—were associated with increases in youths' risky behavior and depressive symptoms. Links between differential treatment and adjustment were not evident, however, when mothers engaged in high levels of cultural socialization and in families under high financial stress. The discussion highlights the significance of sociocultural factors in family dynamics.     

Beyond Acculturation: An Investigation of the Relationship of Familism and Parenting to Behavior Problems in Hispanic Youth

In the adolescent research literature, acculturation processes have been linked to the development of serious behavior problems in Hispanic adolescents, but not enough is known about how that process takes place. This article reports an investigation that sought to shed light on empirically plausible mechanisms by which family processes (i.e., familism and parenting practices) may operate as mediators of acculturation‐related factors on adolescent problem behaviors among 167 Hispanic sixth‐ or seventh‐grade early adolescents. SEM analyses identified an empirically plausible mediated pathway through which parenting practices may operate as a mediator of the effects of acculturation‐related variables on adolescent problem behaviors. Second, although the role of familism as a mediator was not supported, the results did provide support for familism having indirect effects on behavior problems also through parenting practices. The findings are discussed in the context of existing research and clinical developments in the treatment of Hispanic adolescents and families.     

The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility

Infertility is a challenging experience, affecting individual and couples’ adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross‐sectional study, a total of 134 participants (67 couples with infertility) completed self‐report questionnaires assessing infertility‐related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes.     

The Partners for Life Program: A Couples Approach to Cardiac Risk Reduction

Morbidity and mortality are reliably lower for the married compared with the unmarried across a variety of illnesses. What is less well understood is how a couple uses their relationship for recommended lifestyle changes associated with decreased risk for illness. Partners for Life compared a patient and partner approach to behavior change with a patient only approach on such factors as exercise, nutrition, and medication adherence. Ninety‐three patients and their spouses/partners consented to participate (26% of those eligible) and were randomized into either the individual or couples condition. However, only 80 couples, distributed across conditions, contributed data to the analyses, due to missing data and missing data points. For exercise, there was a significant effect of couples treatment on the increase in activity and a significant effect of couples treatment on the acceleration of treatment over time. In addition, there was an interaction between marital satisfaction and treatment condition such that patients who reported higher levels of marital distress in the individuals condition did not maintain their physical activity gains by the end of treatment, while both distressed and nondistressed patients in the couples treatment exhibited accelerating gains throughout treatment. In terms of medication adherence, patients in the couples treatment exhibited virtually no change in medication adherence over time, while patients in the individuals treatment showed a 9% relative decrease across time. There were no condition or time effects for nutritional outcomes. Finally, there was an interaction between baseline marital satisfaction and treatment condition such that patients in the individuals condition who reported lower levels of initial marital satisfaction showed deterioration in marital satisfaction, while non satisfied patients in the couples treatment showed improvement over time.