The transition to parenthood: II. Stability and change in marital structure

At 1 year postpartum, 22 of 38 couples demonstrated the same level of marital competence as they had prenatally, 14 couples demonstrated deterioration in their marital relationship, and 2 couples were improved. At each of four levels of marital competence, there was a trend for the couples to demonstrate the same relationship response to parenthood. Highly competent relationships remained at high levels of competence. Competent but pained relationships were most vulnerable to regressive change in structure. Dominant-submissive, complementary relationships tended to remain stable at that level. Dominant-submissive, conflicted or severely conflicted relationships were most unpredictable and stability, regression, and improvement were seen. These findings are explored for possible correlations and are discussed from the perspective of several current models of family development.     

The transition to parenthood: I. The rating of prenatal marital competence

This article is the first of three that will present data from the Timberlawn Psychiatric Research Foundation Young Family Project, a study of the development over time of competent family systems. The Project is briefly described and findings are presented from the initial data collection period. The operational definitions of marital competence and the Continuum of Marital Competence are presented, and the data are interpreted to suggest that the spouses' levels of individual psychological health, their agreement on values, and their socioeconomic status are related to the level of marital competence. The level of prenatal marital competence at Time 1 is used as an independent variable with which to predict both changes in marital structure and incorporation of the child into the family system at 3 months and 1 year postpartum. The results of these analyses will be presented in two subsequent articles.     

Family Therapy in Trouble: Psychoeducation as Solution and as Problem

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho-therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.