Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

Couple‐based Intervention for Depression: An Effectiveness Study in the National Health Service in England

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple‐based treatment for depression (BCT‐D) provided in London services that are part of the “Improving Access to Psychological Therapies” (IAPT) program in England. Twenty‐three therapists in community clinics were trained in BCT‐D during a 5‐day workshop, followed by monthly group supervision for 1 year. The BCT‐D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT‐D. Eighty‐five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT‐D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT‐D, although they were not the focus of treatment. BCT‐D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT‐D in routine clinical settings.     

Human values: Genetic and environmental effects on five lexically derived domains and their facets

Whereas a substantial genetic component of Conservatism and Religiosity is well documented, there is little evidence with respect to the behavior genetics of other aspects of human values. A sample of 157 monozygotic and 74 dizygotic twins reared together received the Austrian Value Questionnaire (AVQ), which measures a broad variety of value domains and their facets, found by the lexical approach in the German language. Family resemblance of Intellectualism, Harmony, Materialism, and Conservatism was best explained by additive or dominance genetic and non-shared environmental effects, whereas the influence of the environment shared by twins was negligible. In contrast, Religiosity was transmitted by additive genetic, shared and non-shared environmental influences. At the level of facets, the Intellectualism and Harmony showed a homogenous etiology while Religiosity, Materialism, and Conservatism were etiologically heterogeneous.     

A factor analytic investigation of the BASC-2 Behavioral and Emotional Screening System Parent Form: psychometric properties, practical implications, and future directions

The Behavior Assessment System for Children, Second Edition (BASC-2) Behavioral and Emotional Screening System Parent Form (BESS Parent; Kamphaus & Reynolds, 2007) is a recently developed instrument designed to identify behavioral and emotional risk in students. To describe the underlying factor structure for this instrument, exploratory (EFA) and confirmatory factor analyses (CFA) were conducted utilizing two subsets of a large, nationally-representative sample. The results of the EFA suggested that the BESS Parent contained a four-factor latent structure (i.e., Externalizing, Internalizing, Adaptive Skills, and Inattention), which was supported by CFA. Results support further investigation into utilizing four subscales in addition to an overall risk score; distributional and reliability information for the BESS Parent subscales is provided. Practical implications for school psychologists interested in early identification and directions for future research are discussed.     

Testing orofacial abilities of children who stutter: the Movement, Articulation, Mandibular and Sensory awareness (MAMS) assessment procedure

Objective

The purpose of this article is to introduce a new assessment designed to measure the orofacial abilities of children who stutter (CWS), the Movement, Articulation, Mandibular and Sensory Awareness (MAMS) Orofacial Assessment. The new instrument was developed and validated to measure orofacial abilities in a comprehensive manner.

Design

A group of 43 CWS (mean age 13.10 years, S.D. 2.10 years) and a control group of 32 fluent children (mean age 13.4 years, S.D. 2.6 years) were tested with the new tool. It was hypothesized, that (a) the MAMS is a reliable and valid instrument to measure orofacial abilities in CWS, (b) fluent children have better orofacial abilities than CWS and (c) that the therapy outcome of CWS depend on their orofacial abilities.

Results

The MAMS Orofacial Assessment proved to be a valid and reliable instrument to assess orofacial abilities. Compared with their fluent peers, CWS had significantly worse orofacial abilities. CWS with better orofacial abilities had a better prognosis for therapy outcome.

Conclusions

The new instrument is a reliable and valid tool to measure orofacial abilities and MAMS distinguishes CWS and controls. Orofacial abilities are one set of factors that influence therapy outcome for CWS.Educational objectives: The reader will get an overview over of the literature on orofacial abilities in people who stutter and will learn about and be able to (1) describe different characteristics of orofacial abilities, (2) use the MAMS Orofacial Assessment in the diagnostic process for CWS and for research purposes, and (3) interpret the results of the MAMS to use them for therapy planning.     

Behavior model and guidance strategies of the crossing behavior at unsignalized intersections in the connected vehicle environment

The connected vehicle environment is considered to be a disruptive technology that reconstructs the way people travel and road transport, and more importantly, ensures traffic safety. This study aims on investigating drivers’ interactive behavior at an unsignalized intersection in the connected vehicle environment. Specifically, a simplified iterative behavior model was established to predict the potential conflicting vehicles’ behavior. Furthermore, based on principles of safety, efficiency, and comfort, the guidance strategies were proposed to help the subject vehicles cross intersections. A multi-user driving simulator experiment was carried out and 48 participants were divided into 24 pairs to complete the test. The simplified iterative behavior model was constructed based on the dynamic interaction of each participant pair as they approached the intersection from straight-crossing directions. The comparison results showed the behavior model was an effective microscopic simulation tool for vehicles at unsignalized intersections with high accuracy and good applicability. Then, the guidance strategies under different compliance rates (baseline, 50 % compliance, 100% compliance) were evaluated based on three indexes i.e. standard deviation of speed (SDS), duration of crossing the intersection (DCI), and time exposed post-encroachment-time (TEP). The numerical simulation results showed that the guidance strategies could effectively improve the safety and efficiency of drivers crossing the intersection under both 50% and 100% compliance rates. Besides, with the increase of compliance rate, the comfort level also increased evidently. This study can provide theoretical and algorithmic references for microscopic simulation and guidance strategy at unsignalized intersections in the connected vehicle environment.     

Personal choice: A blessing or a burden,or both? A cross‐cultural investigation on need for closure effects in two Western and two East‐Asian societies

The present study investigates the role of dispositional need for closure (NFC) in how individuals within a particular culture perceive and appreciate choice. Data sets from the US (283 adults), Europe (263 adults and 427 students), China (218 adults and 309 students) and Singapore (258 students) were collected. The results showed that in Western cultures, people perceived choice in a linear way as either a burden or a blessing, whereas in Chinese culture, such opposition between perspectives did not appear, and individuals generally saw choice as both burden and blessing simultaneously. In Western cultures, high dispositional NFC was strongly associated with viewing choice‐as‐a‐burden, whereas Chinese respondents with a high NFC perceived choice as a blessing and a burden simultaneously. The Singaporean results were similar to the Western pattern. These findings are discussed in terms of the NFC literature and cultural differences in dialectic versus differentiation thinking styles.     

Assessment of Parenting Practices Related to Conduct Problems: Development and Validation of the Management of Children's Behavior Scale

We report on the development and initial validation of the parent-report scale, Management of Children's Behavior Scale (MCBS), designed to evaluate parenting practices related to conduct problems in children. Children (N=396, ages 2-14) referred for outpatient treatment and their parents served as participants. We evaluated the composition and consistency of the scale and provided evidence pertaining to concurrent, predictive, and incremental validity. Evidence for each type of validity was consistent with the conceptualization of the scale and the pertinence to child conduct problems. The measure also was sensitive to therapeutic changes. Parenting practices targeted in treatment (parent management training) improved as predicted over time. The results suggest the measure may be useful in evaluating parenting practices known to relate to conduct problems and often targeted for intervention in parent- and family-based treatment.     

Quantifying the psychopathic stare: Automated assessment of head motion is related to antisocial traits in forensic interviews

Clinicians have long noted that individuals with high psychopathic traits exhibit unique interpersonal style often observable during forensic interviews. Here we develop an automated approach for quantifying head dynamics during video-recorded naturalistic clinical interviews. We expected head dynamics would be related to psychopathic traits. As predicted, dwell times indicate that those with higher levels of psychopathic traits are characterized by more stationary head positions, focused directly towards the camera/interviewer, than were individuals low in psychopathic traits. These associations were primarily driven by developmental/antisocial features of psychopathy, indicating that those with severe and life-course persistent antisocial behavior exhibit more rigid and focused orienting of their head during interpersonal communication. These results encourage more research into the automated quantification of behavioral manifestations of personality to support clinical observations that psychopaths exhibit unique qualities in non-verbal interpersonal communication.