Feedback in Couple and Family Therapy: A Randomized Clinical Trial

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC (“treatment as usual” or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed.     

The Italian Version of SCORE-15: Validation and Potential Use

SCORE-15 (Systemic Clinical Outcome and Routine Evaluation) is a 15-item questionnaire for completion by family members aged 12 years and older to assess outcomes in systemic therapy. This study aimed to investigate (a) the psychometric properties and the internal consistency reliability of the Italian version of SCORE-15, (b) clinical responsiveness, and (c) normative (Italian) criteria. Furthermore, (d) the study sought to evaluate the participants’ representation of both their family and their problems, analyzing open-ended questions included in the SCORE-15. Data were collected from two clinical centers for 208 families (n = 507). Results confirmed the three-factor structure (i.e., strengths, difficulties, and communication), a good internal consistency reliability, and indicated a cutoff threshold for the Italian version. Furthermore, results showed that SCORE-15 is a good instrument for clinical responsiveness and that it can be used to explore the way in which family members describe their families and problems. Overall, SCORE-15 is a brief, psychometrically robust family assessment instrument that may be used for both researchers and practitioners in several domains of clinical and social psychology.     

Interventions to Empower Adults with Eating Disorders and Their Partners around the Transition to Parenthood

The transition to parenthood is perceived as a stressful life event, when parents experience an immense change of their psychological focus and a reorientation of roles and responsibilities in the family system. This process may be even more challenging in the presence of a parental eating disorder history. This paper reviews the impact of parental eating disorders on the parents, the couple relationship, and their child during the perinatal period. A parental eating disorder is associated with more negative expectations of parental efficacy as well as specific difficulties in couple communication over the child’s feeding, shape, and weight. Providers who better understand the effects of an eating disorder on parental functioning can more effectively intervene early on. We also present couple- or parent-based, empirically supported interventions for adults with eating disorders and their partners in the prenatal and postnatal periods: Uniting Couples in the treatment of Anorexia Nervosa (UCAN) and Uniting couples In the Treatment of Eating disorders (UNITE) both enhance recovery from the eating disorder through a couple-based intervention; the Maudsley Model of Treatment for Adults with Anorexia Nervosa (MANTRA) incorporates the support of partners, when appropriate; Parent-Based Prevention (PBP) focuses on improving parental functioning and reducing risk of negative parental and child outcomes. Finally, we discuss the clinical implications of addressing parental eating disorders and encourage more research on these families.     

Resilience Factors and Suicide Risk for a Sample of Transgender Clients

This study explored how individual- and community-based resilience factors operated together in order to reduce risk of suicide for a sample of transgender therapy clients. We collected cross-sectional survey data from 106 transgender therapy clients at a local community center, including demographic information, experiences of relational support, participants' emotional stability, and risk for suicide. Results from our mediation analysis indicated that high levels of perceived relational support are related to reduced risk for suicide and that this happens by way of a person's emotional stability. Clinical implications for family therapists are discussed based on the significant indirect effect found in this study.     

Lessons from the Transition to Relational Teletherapy During COVID-19

When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship-based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years, we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context’s constraints and exploiting its strengths is key to providing high-quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add-on to a face-to-face practice.     

Le dégoût dans le trouble obsessionnel compulsif,mécanismes, évaluation,implications pour des pistes thérapeutiques

IntroductionAlthough considered a basic emotion, disgust has received little attention from research from the psychology of emotions compared to other emotions such as fear or sadness.Literature findingsMany empirical and experimental data suggest, however, that disgust plays a determining role not only in our ability to adapt to our environment but also in the maintenance and development of certain psychopathological states such as obsessive-compulsive disorders. The purpose of this article is to review the literature on the construct of disgust, including its two basic dimensions of disgust and disgust. A first part will be dedicated to the acquisition of disgust in the framework of evaluative and Pavlovian learning, we will then describe in detail the assessment tools available in the literature allowing to evaluate the different dimensions, then we will address the continuum. Experience of disgust, from normal disgust to pathological disgust, and will particularly target its role in dysfunctional obsessions of contamination and emotional distress.DiscussionIf, from a theoretical point of view, the understanding of the underlying mechanisms of pathological disgust reactions improves, the proposals for treatment to mitigate these reactions are rare. New approaches to care will be described to allow the development of empirically based psychological interventions.ConclusionThe recognition of emotional influences beyond anxiety in obsessive-compulsive disorder (OCD) stems from the fundamental importance of a dimensional approach to psychopathology and support. The accumulated data suggest that the inclusion of disgust in the theoretical models of OCD, in particular those with contamination concern, will thus improve our understanding and treatment of this disorder.     

Heteronormative Relationship Education for Same‐Gender Couples

In recent years, same‐gender group‐based relationship education has emerged as a viable intervention to prevent relationship distress among same‐gender couples. However, many of these programs are conducted in metropolitan areas and lack the ability to reach rural populations. The current study sought to investigate whether two wide‐reaching web‐based heteronormative relationship education programs could positively impact same‐gender relationships. In a sample of 49 same‐gender couples, heteronormative relationship education had small (Cohen's d = 0.16–0.39) but reliably positive effects on key areas of relationship functioning and perceived stress relative to a waitlist control group. Additionally, when same‐gender couples were matched with different‐gender individuals with similar baseline characteristics, no reliable differences between the two groups emerged even though the program effects were sometimes half as large for same‐gender couples. Finally, same‐gender participants were as satisfied with the program as the matched different‐gender individuals. Though the results of the present study indicate that heteronormative relationship education can be helpful for same‐gender couples, additional tailoring should be undertaken to ensure that same‐gender couples experience as much benefit as possible. Estimates from the current study could be used in future studies to detect what might be small‐sized differences.     

Escalation and Regulation of Emotional Arousal in Couples Predicts Relationship Satisfaction Concurrently and 25 Years Later

Relationship distress and divorce are major risk factors for the development or exacerbation of psychopathology and psychosocial impairments. Given that heightened negative emotions within couples’ interactions may portend negative relationship outcomes, it is critical to understand how emotions unfold across a conversation and how partners may influence each other’s immediate emotional experiences. This study examined whether these regulatory dynamics within one interaction predicted relationship satisfaction concurrently and 25 years later. Vocally‐encoded emotional arousal (f₀) was measured during couples’ (N = 25 couples) conversations about a relationship issue. Across different analytical strategies, results demonstrate that one partner’s f₀ dynamics had immediate and long‐term associations with the other partner’s satisfaction. Partners were less satisfied if the other partner (a) expressed higher f₀ overall and (b) escalated more in f₀ across the conversation. Yet, partners were more satisfied when their f₀ escalated across the conversation. Also, women specifically were more satisfied if their f₀ remained elevated longer before regulating back to their emotional baseline. Thus, higher f₀ was associated with higher satisfaction in the same partner, but associated with less satisfaction in the other partner—particularly when these emotions come from women. It may be that partners have to decide whether to prioritize expressing their emotions fully or limit expression in the service of their partner’s happiness. These findings challenge us to think of ways to address this “win–lose” scenario so that couples can balance both partners’ emotional needs and preserve relationship quality across the life span.     

Evaluation of an integrated fluency and Acceptance and Commitment Therapy intervention for adolescents and adults who stutter: Participant perspectives

PurposeChildhood-onset stuttering is a neurodevelopmental disorder that may cause pervasive negative consequences for adults who stutter. In addition to significant challenges in personal, social, and emotional domains, stuttering has been shown to impose an economic burden on adults who stutter. Intervention for adults who stutter has historically addressed speech fluency more so than the covert psychosocial aspects of the disorder. There is an identified clinical need for holistic, efficacious, and cost-effective stuttering interventions that meet consumer needs. The purpose of the present study is to evaluate a novel, integrated intervention that combined traditional fluency techniques with Acceptance and Commitment Therapy, from the perspective of the adults who stutter who participated in the intervention.MethodTwenty-eight adults who stutter completed the intervention program. Participants were invited to complete an online post-program written survey (including qualitative comments) and a semi-structured interview to explore their evaluations of the program with respect to its authenticity, acceptability, and social validity.ResultsParticipants perceived positive psychosocial changes as a result of the program, and were satisfied with the program overall. Qualitative thematic analyses of the written survey comments and the semi-structured interviews identified two major themes: factors specific to the intervention and factors specific to the therapeutic process. Several important sub-themes were also identified.ConclusionFindings support the authenticity, acceptability, and social validity of an integrated fluency and psychosocial intervention for stuttering. Findings also highlight the need for consideration of the consumer voice in the management of stuttering disorders, in keeping with person-centred care.     

Testing a Military Family Stress Model

The current study examines a military family stress model, evaluating associations between deployment‐related stressors (i.e., deployment length/number, posttraumatic stress disorder [PTSD] symptoms) and parent, child, parenting, and dyadic adjustment among families in which a parent had previously deployed to Iraq or Afghanistan in the recent conflicts. Married families (N = 293) with at least one child between the ages of 4 and 12 were recruited from a Midwestern state. Service members were from the Reserve Component (National Guard or Reserves); fathers (N = 253) and/or mothers had deployed (N = 45) to the recent conflicts in the Middle East. Multiple‐method (observations of parenting and couple interactions; questionnaires) and multiple informant measures were gathered online and in the homes of participants, from parents, children, and teachers. Findings demonstrated associations between mothers’ and fathers’ PTSD symptoms and a latent variable of child adjustment comprising teacher, parent, and child report. Mothers’ but not fathers’ PTSD symptoms were also associated with dyadic adjustment and parenting practices; parenting practices were in turn associated with child adjustment. The results are discussed in terms of their implications for military family stress research and interventions to support and strengthen parents and families after deployment.