Common Factors Come Alive: Practical Strategies for Implementing Common Factors in MFT Training

Presently, MFT training programs teach MFT models in a way that emphasizes differences over similarities (Karam et al. in J Marital Fam Ther, 2015. doi: 10.1111/jmft.12096; Sprenkle and Blow in J Marital Fam Ther 30:113–129, 2004a. doi: 10.1111/j.1752-0606.2004.tb01228.x, in J Marital Fam Ther 30:151–157, b. doi: 10.1111/j.1752-0606.2004.tb01230.x; Sprenkle et al. in Common factors in couple and family therapy: the overlooked foundation for effective practice. Guilford Press, New York, 2009). Although teaching a variety of models and their distinctiveness is vital, doing so may create a competitive rather than integrative relationship between models (Karam et al. 2015). While Karam et al. 2015 encourage the inclusion of common factors in MFT training, we expand their justification for the importance of doing so We also explain conceptual and practical ways to include common factors in MFT training. Common factors instruction can fulfill multiple purposes: (a) create a sense of cohesiveness for programs which need to teach breadth of topics that can seem unrelated, (b) help prepare practitioners who need to learn many models well but will likely adopt an integrative approach, (c) align with basic skills training, (d) align with process research, and (e) enhance the richness of individual models. For each of these purposes, we provide an example of a classroom activity. We conclude with a unifying example of how one student may learn the common-factors perspective and weave it into her reflective practices as an MFT student.     

Developing Dyadic Evaluation for Supervision: An Exploratory Factor Analysis

This study addresses the need for empirically validated tools to support the training, supervision, and the discovery of best practices in Marital and Family Therapy (MFT). This project represents a first step in developing the Dyadic Supervision Evaluation (DSE), an assessment tool that is grounded in developmental and systemic theory and is psychometrically strong. An Exploratory Factor Analysis (EFA) approach was applied to data from 88 trainee-supervisor dyads across four time periods during the first year of clinical training, resulting in 20 factors, including 9 factors for trainees and 11 factors for supervisors with internal reliabilities ranging from α’s = .82–.98. Discussion addresses the utility of the DSE in documenting the developmental and dyadic progression of supervision during the first year of MFT training.     

Expectations About Couple Therapy Over Time

One common factor of therapy, expectations, has been demonstrated to be a significant contributor to outcome in individual therapy. Despite this, little is known about expectations about couple therapy. This paper presents the qualitative results of a study exploring clients’ expectations before beginning couple therapy and after six sessions. Results indicate that clients form pre-therapy expectations about their therapist, the process of therapy, and their partner. Results also showed that after six sessions, clients’ expectations about therapy were often met or modified in ways that were positive. Implications for therapists and researchers are included.     

Managing Emotional Responses in Therapy: An Adapted EFT Supervision Approach

Therapists often encounter experiences in therapy that elicit emotionality, this could be in the form of self-of-the-therapist issues, compassion fatigue, or professional burnout. Whereas approaches to supervision for self-of-the-therapist issues recognize the need for accessing the supervisee’s emotionality, approaches have not focused on how the clinical and professional system could also be part of the cycle. We propose an adapted emotionally focused supervision approach that employs steps one through six of the EFT model. To display how this approach would work, we provide the example of work with longer-term clients. Working with longer-term clients can be a challenge for many therapists, and both the professional and client system come with factors increasing emotional risk to the therapist. Engaging the therapist’s emotionality through supervision has the potential to improve therapeutic outcomes, as well as reduce loss of good therapists in the field to professional burnout.     

Safety Behaviors and Social Anxiety: An Examination of the Social Phobia Safety Behaviours Scale

The Social Phobia Safety Behaviours Scale (SPSBS) is a measure designed to identify and assess safety behavior use. The current study is the first to evaluate the psychometric properties of the English SPSBS. Using four samples (N?=?725), the component structure, validity, and ability of the SPSBS to function as a state measure were examined. The results of the principal component analyses suggest that the SPSBS is a two-component measure, consisting of an inhibitory behavior component and a management of physical symptoms component, and the scale has good internal consistency. The SPSBS also showed good concurrent validity in both clinical and nonclinical samples. Moreover, there was evidence to suggest that the SPSBS is an accurate measure of situational use of safety behaviors as compared to observers’ ratings. The results of this investigation show that the SPSBS is a useful tool for the identification and measurement of safety behaviors.     

The Co-Development of Parenting Stress and Childhood Internalizing and Externalizing Problems

Although the detrimental influence of parenting stress on child problem behavior is well established, it remains unknown how these constructs affect each other over time. In accordance with a transactional model, this study investigates how the development of internalizing and externalizing problems is related to the development of parenting stress in children aged 4–9. Mothers of 1582 children participated in three one-year interval data waves. Internalizing and externalizing problems as well as parenting stress were assessed by maternal self-report. Interrelated development of parenting with internalizing and externalizing problems was examined using Latent Growth Modeling. Directionality of effects was further investigated by using cross-lagged models. Parenting stress and externalizing problems showed a decrease over time, whereas internalizing problems remained stable. Initial levels of parenting stress were related to initial levels of both internalizing and externalizing problems. Decreases in parenting stress were related to larger decreases in externalizing problems and to the (stable) course of internalizing problems. Some evidence for reciprocity was found such that externalizing problems were associated with parenting stress and vice versa over time, specifically for boys. Our findings support the transactional model in explaining psychopathology.     

Clarity of Personal Values and Committed Action: Development of a Shorter Engaged Living Scale

The Engaged Living Scale (ELS) is a measure of the process of engaged living, defined by Acceptance and Commitment Therapy as the evaluation and performance of valued life activities. This 16-item measure was recently created and has been validated in middle-aged and chronic pain samples. The aim of the present study was to validate the ELS-16 in a young-adult sample and additionally to develop a shorter ELS. This study was conducted using different samples of Portuguese young-adult college students. The dimensionality of the ELS-16 (which was translated to Portuguese from the original Dutch) was tested through a CFA. The adequacy of the shorter ELS (ELS-9) was also tested through a CFA. The scales’ internal reliability and other psychometric qualities were additionally analysed. Results from the CFA suggested that the model benefits from the establishment of correlations between pairs of error terms of items with similar contents. These results led to the decision to shorten the measure by excluding the item of each pair with the lowest communalities. The ELS-9 was then created and its CFA results revealed good to excellent adjustment values and goodness-of-fit indices. Results also showed that the ELS-16 and the ELS-9 present adequate to good psychometric properties. The present study thus shows that these instruments seem to be reliable measures of engaged living and to perform adequately in young-adult college students, with the ELS-9 being a new contribution to health research and allowing faster administrations.     

A Further Evaluation of the Triarchic Conceptualization of Psychopathy in College Students

The current study provides additional information about the nomological networks of the personality dimensions associated with the triarchic conceptualization of psychopathy – boldness, meanness, and disinhibition (Patrick et al. 2009). All analyses were based on a sample of college students (N = 633 to 637; 50 % women). We evaluated correlations between measures of the triarchic constructs and measures of the facets and domains of the Five-Factor Model (FFM). We also evaluated associations between triarchic constructs and measures of self-esteem, narcissism, aggression and antisocial behavior and tested whether the triarchic measures increment measures of the FFM for predicting these variables. We replicated and extended previous studies concerning the correlates of boldness, meanness, and disinhibition. We also found evidence that measures of the triarchic dimensions incremented measures of the FFM, especially when considering self-reported antisocial behavior.     

Internal and External Validity of Sluggish Cognitive Tempo and ADHD Inattention Dimensions with Teacher Ratings of Nepali Children

The objective was to evaluate the validity of sluggish cognitive tempo (SCT) and ADHD-inattention (IN) symptoms in children from Nepal. Teachers rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), anxiety, depression, academic impairment, social impairment, and peer rejection dimensions in 366 children (50 % girls) in first through sixth grades (M _age?=?9.35, SD _age?=?1.96) on two separate occasions separated by 4-weeks. Seven of the eight SCT symptoms and all nine ADHD-IN symptoms showed convergent validity (substantial loadings on their respective factors) and discriminant validity (higher loadings on their respective factor than the alternative factor) at both time-points. Across all three separate analyses (assessment 1, assessment 2, and from assessment 1 to assessment 2), higher SCT scores were associated with lower ADHD-HI scores and higher depression, academic impairment, and social impairment scores after controlling for ADHD-IN while higher ADHD-IN scores were associated with higher ADHD-HI, ODD, academic impairment, and peer rejection scores after controlling for SCT. Also, as hypothesized, SCT scores were not related to ODD scores after controlling for ADHD-IN. The study provides the first evidence for the internal and external validity of the SCT dimension relative to the ADHD-IN dimension with teacher ratings of children from Nepal, thereby increasing the validity of the SCT construct beyond North America, Western Europe, South America, and South Korea.     

Photographic Assessment of Change in Trichotillomania: Psychometric Properties and Variables Influencing Interpretation

Although photographic assessment has been found to be reliable in assessing hair loss in Trichotillomania, the validity of this method is unclear, particularly for gauging progress in treatment. The current study evaluated the psychometric properties of photographic assessment of change in Trichotillomania. Photographs showing hair loss of adults with Trichotillomania were taken before and after participating in a clinical trial for the condition. Undergraduate college students (N?=?211) rated treatment response according to the photos, and additional archival data on hair pulling severity and psychosocial health were retrieved from the clinical trial. Photographic assessment of change was found to possess fair reliability (ICC?=?0.53), acceptable criterion validity (r?=?0.51), good concurrent validity (r?=?0.30–0.36), and excellent incremental validity (ΔR ²?=?8.67, p?<?0.01). In addition, photographic measures were significantly correlated with change in quality of life (r?=?0.42), and thus could be considered an index of the social validity of Trichotillomania treatment. Gender of the photo rater and pulling topography affected the criterion validity of photographic assessment (partial η ²?=?0.05–0.11). Recommendations for improving photographic assessment and future directions for hair pulling research are discussed.