The Challenges of COVID-19 for Divorcing and Post-divorce Families

COVID-19 and the accompanying procedures of shelter-in-place have had a powerful effect on all families but have additional special meanings in the context of families contemplating divorce, divorcing, or carrying out postdivorce arrangements. This paper explores those special meanings for these families. It also offers suggestions for couple and family therapists involved in helping these families during the time of COVID-19.     

The Epidemiology of Homicide followed by Suicide: A Systematic and Quantitative Review

This systematic review of population based studies of homicide followed by suicide was conducted to examine the associations between rates of homicide‐suicide, rates of other homicides and rates of suicide. The review analysed 64 samples, including the case of an outlier (Greenland) that were reported in 49 studies. There was a significant association between the rates of homicide‐suicide and those of other homicides in studies from the U.S.A. Outside the U.S.A. there was no clear association between homicide‐suicide and other homicide but there was modest but significant association between rates of suicide and homicide‐suicide. Homicide‐suicide appears to be closer in epidemiological terms to homicide than suicide in regions with high rates of homicide and measures to reduce homicide in these regions may also reduce homicide‐suicide.     

Guidelines for classifying evidence-based treatments in couple and family therapy

Guidelines for Evidence-Based Treatments in Family Therapy are intended to help guide clinicians, researchers, and policy makers in identifying specific clinical interventions and treatment programs for couples and families that have scientifically based evidence to support their efficacy. In contrast to criteria, which simply identify treatments that "work" and have been employed in the evaluation of other psychotherapies, these guidelines propose a three-tiered levels-of-evidence-based model that moves from "evidence-informed," to "evidence-based," to "evidence-based and ready for dissemination and transportation within diverse community settings." Each level reflects an interaction between the specificity of the intervention, the strength and readth of the outcomes, and the quality of the studies that form the evidence. These guidelines uniquely promote a clinically based "matrix" approach in which the empirical support is evaluated according to various dimensions including strength of the outcomes, the applicability across cultural contexts, and demonstration of specific change mechanisms. The guidelines are offered not only as a basis for understanding the evidence for diverse clinical approaches in couple and family therapy within the systemic tradition of the field, but also as an alternative aspirational model for evaluating all psychotherapies.     

Additive,Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder

This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components—including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading—were introduced sequentially as the focus of treatment shifted to address refusal topographies along the chain of behaviors associated with consumption. The assessment process, treatment planning and sequencing, and generalization of treatment gains to caregivers are presented in detail. In doing so, the study illustrates the core features involved in applying a flexible, evidenced-based approach to treat severe feeding difficulties.     

Confirming,Validating, and Norming the Factor Structure of Systemic Therapy Inventory of Change Initial and Intersession

Progress or feedback research tracks and feeds back client progress data throughout the course of psychotherapy. In the effort to empirically ground psychotherapeutic practice, feedback research is both a complement and alternative to empirically supported manualized treatments. Evidence suggests that tracking and feeding back progress data with individual or nonsystemic feedback systems improves outcomes in individual and couple therapy. The research reported in this article pertains to the STIC^® (Systemic Therapy Inventory of Change)—the first client‐report feedback system designed to empirically assess and track change within client systems from multisystemic and multidimensional perspectives in individual, couple, and family therapy. Clients complete the STIC Initial before the first session and the shorter STIC Intersession before every subsequent session. This study tested and its results supported the hypothesized factor structure of the six scales that comprise both STIC forms in a clinical outpatient sample and in a normal, random representative sample of the U.S. population. This study also tested the STIC's concurrent validity and found that its 6 scales and 40 of its 41 subscales differentiated the clinical and normal samples. Lastly, the study derived clinical cut‐offs for each scale and subscale to determine whether and how much a client's score falls in the normal or clinical range. Beyond supporting the factorial and concurrent validity of both STIC forms, this research supported the reliabilities of the six scales (Omega_hierarchical) as well as the reliabilities of most subscales (alpha and rate–rerate). This article delineates clinical implications and directions for future research.     

Integrative problem-centered metaframeworks therapy II: planning, conversing, and reading feedback

This is the second of 2 articles presenting Integrative Problem Centered Metaframeworks (IPCM) Therapy, a multisystemic, integrative, empirically informed, and common factor perspective for family, couple, and individual psychotherapy. The first article presented IPCM's foundation concepts and Blueprint for therapy, focusing on the first Blueprint component—Hypothesizing or assessment. This article, focusing on intervention, presents the other 3 Blueprint components—Planning, Conversing, and Feedback. Articulated through the Blueprint, intervention is a clinical experimental process in which therapists formulate hypotheses about the set of constraints (the Web) within a client system that prevents problem resolution, develop a therapeutic Plan based on those hypotheses, implement the Plan through a coconstructed dialogue with the clients, and then evaluate the results. If the intervention is not successful, the results become feedback to modify the Web, revise the Plan, and intervene again. Guided by the therapeutic alliance, this process repeats until the presenting problems resolve. IPCM Planning sequentially integrates the major empirically and yet‐to‐be empirically validated therapies and organizes their key strategies and techniques as common factors. Conversing and Feedback employ empirical STIC^® (Systemic Therapy Inventory of Change) data collaboratively with clients to formulate hypotheses and evaluate interventions. This article emphasizes the art and science of IPCM practice.