The efficacy of systemic therapy with adult patients: a meta-content analysis of 38 randomized controlled trials

Systemic therapy is a widely used psychotherapy approach. Yet there exist few systematic reviews on its efficacy. A meta-content analysis was performed to analyze the efficacy of systemic therapy for the treatment of mental disorders in adulthood. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems oriented therapy in various settings (family, couple, individual, group, multifamily group therapy) with adult index patients suffering from mental disorders were identified by database searches and cross-references in other reviews. Inclusion criteria were: index patient diagnosed with a DSM or ICD listed mental disorder, trial published in any language up to the end of 2008. The RCTs were content analyzed according to their research methodology, interventions applied, and results. Thirty-eight trials published in English, German, Spanish, and Chinese were identified, 34 of them showing systemic therapy to be efficacious for the treatment of mood disorders, eating disorders, substance use disorders, mental and social factors related to medical conditions and physical disorders, and schizophrenia. Systemic therapy may also be efficacious for anxiety disorders. Results were stable across follow-up periods of up to 5 years. There is a sound evidence-base for the efficacy of systemic therapy for adult index patients with mental disorders in at least five diagnostic groups.     

Age discrimination in the workplace: Validation of the Nordic Age Discrimination Scale (NADS)

Furunes, T. & Mykletun, R. J. (2010). Age discrimination in the workplace: Validation of the Nordic Age Discrimination Scale (NADS). Scandinavian Journal of Psychology, 51 , 23–30.
Due to population ageing, older workers will make up a larger proportion of the workforce. However, recent reports show an increase in perceived age discrimination among older employees. Previous research found that age discrimination may result in negative feelings, such as uselessness, powerlessness and lower self-esteem. This study develops and validates a scale for monitoring age discrimination in the workplace. The validation study draws on three datasets, from Norway, Sweden and Finland respectively. The study provides a psychometric contribution to the study of the behavioral component of ageism.     

Love in Action: An Integrative Approach to Last Chance Couple Therapy

This article presents an integrative approach to the special challenges of therapy with couples on the brink of dissolution or divorce—who often describe this therapy as their “last chance.” In some, one partner is considering ending the relationship, and in others, both partners are considering ending it. Often, these couples have had prior dissatisfying experiences in couple therapy. Four types of last chance couples are described: high‐conflict couples; couples in which partners have differing goals for their lives or different timelines for reaching shared goals; couples in which one or both partners have acted in a manner that violates the values, expectations, emotional comfort, or safety of the other; and couples in which there has been a gradual loss of intimacy. The Therapeutic Palette, a multiperspectival, theoretically eclectic integrative approach, is enlisted as a general framework for selecting and sequencing use of particular theories and their associated practices, based on the three “primary colors” of couple therapy: time frame/focus, level of directiveness, and change entry point. An additional complementary framework, the creative relational movement approach, is proposed to provide an integrative frame encompassing both language‐based and action‐based practices, suggesting that meaning is held and expressed as much through interaction or “relational motion” as it is through language. Principles of change are described. Due to the couple's level of crisis and desire for immediate evidence of possible improvement, priority is given to action‐based interventions in early stages of therapy, by engaging couples in “experiments in possibility.” Typical action approaches are described. An extended vignette follows.     

Principle‐Based Integrative Therapy with Couples: Theory and a Case Example

The Principle‐Based Integrative Therapy (PBIT) framework harnesses the principles of change underlying each theoretical model within integrative couple therapy treatments. PBIT has commonalities with other integrative approaches, and additional advantages stemming from its four tenets that guide therapists in combining strengths across models and overcoming each of their deficiencies. Tenet 1 advises that each model adds a core principle or mechanism of action that other models do not automatically address. Tenet 2 focuses on how techniques of one model may actualize the principles of other models. Tenet 3 ensures complementarity and a lack of conflict across principles. A case study and common case considerations are presented to illustrate how Tenets 1–3 can work in integrating Cognitive‐Behavioral, Multicultural, and Emotionally Focused Therapy models in working with a couple. Finally, Tenet 4 advocates for the use of models and empirically supported principles that also have received empirical support with diverse populations. Prerequisites and training implications for PBIT, and future clinical and research directions to further the utility of PBIT are discussed.     

What Does it Mean to be a Common Factors Informed Family Therapist?

The common factors paradigm in couple and family therapy has gained popularity over the past several decades, leading many therapists to refer to themselves as common factors family therapists. Despite this, no consensus exists on what it means to be a common factors family therapist, or if such a designation even makes sense given that the common factors paradigm is not a model. Synthesizing the existing common factors literature, a case is made for the designation “common factors informed family therapist,” and the following six core principles are outlined that characterize this designation: (1) sees overlap among theories; (2) passionate about theory, not a theory; (3) client centered; (4) monitors hope and the therapeutic alliance; (5) views clients as people rather than objects; and (6) prioritizes healing over therapy. Each of the concepts is discussed in depth, and clinical implications are provided.     

Evaluating Supervision Models in Functional Family Therapy: Does Adding Observation Enhance Outcomes?

This study examined the effects of observation‐based supervision Building Outcomes with Observation‐Based Supervision of Therapy (BOOST therapists = 26, families = 105), versus supervision as usual (SAU therapists = 21, families = 59) on (a) youth externalizing behavior problems and (b) the moderating effects of changes in family functioning on youth externalizing behaviors for adolescents receiving Functional Family Therapy (FFT). Exploratory analyses examined the impact of supervision conditions on youth internalizing problems. In 8 community agencies, experienced FFT therapists (M = 1.4 years) received either BOOST or SAU supervision in a quasi‐experimental design. Male (59%) or female (41%) adolescents were referred for the treatment of behavior problems (e.g., delinquency, substance use). Clients were Hispanic (62%), African American (19%), Non‐Hispanic White (12%), or Other (7%) ethnic/racial origins. Therapists (female, 77%) were Hispanic 45%, African American (19%), White Non‐Hispanic (30%), or other (4%) ethnic/racial backgrounds. Analyses controlled for the presence or absence of clinically elevated symptoms on outcome variables. Clinical outcomes were measured at baseline, 5 months, and 12 months after treatment initiation. Clients with externalizing behavior above clinical thresholds had significantly greater reductions in problem behaviors in the BOOST versus the SAU conditions. Clients below thresholds did not respond differentially to conditions. Supervisors in BOOST had more experience with the FFT model; as such, the observed results may be a result of supervisor experience. The BOOST supervision was associated with improved outcomes on problem behaviors that were above clinical thresholds. The findings demonstrate the importance of addressing client case mix in implementation studies in natural environments.     

An exploratory factor analysis of action responses to stuttering anticipation

PurposeWe previously introduced theStuttering Anticipation Scale (SAS; Jackson, E. S., Gerlach, H., Rodgers, N. H., & Zebrowski, P. M. (2018). My Client Knows That He’s About to Stutter: How Can We Address Stuttering Anticipation during Therapy with Young People Who Stutter? Seminars in Speech and Language, 39, 356–370) – a non-standardized self-report measure for children, teens, and adults who stutter (CWS, TWS, AWS) that quantifies how often they engage in 25 commonly reported action responses to anticipation. The purpose of this study was to leverage the SAS to explore the factor structure of action responses to stuttering anticipation.MethodsA total of 121 people who stutter completed the SAS online (27 CWS, 40 TWS, 54 AWS). We used exploratory factor analysis (EFA) to determine the underlying latent variables within the 25 SAS items that characterize how people who stutter respond to anticipation.ResultsA three-factor model was most appropriate for the data with regard to factor loadings and other model fit indices. The three factors were named: avoidance (17 items), physical change (4 items), and approach (4 items).ConclusionUnderstanding these three types of action responses to anticipation can help guide clinical decision-making by providing a novel framework for clinicians and their clients who stutter to discuss how the client tends to respond to anticipation, and explore ways to facilitate productive responses to anticipation.     

Do Parents’ Adverse Childhood Experiences Influence Treatment Responses to Parent-Child Interaction Therapy? An exploratory Study with a Child Welfare Sample

This exploratory study of 23 parent–child dyads receiving child welfare services examined the association between the number of adverse childhood experiences (ACEs) parents reported and their children’s externalizing behaviors. We also assessed whether the effects of Parent-Child Interaction Therapy (PCIT) on externalizing behaviors varied by parents’ ACE histories. Results indicated that parents’ ACE scores were associated with child externalizing symptoms at baseline, but not at a second postbaseline assessment. Although all parents reported reductions in child externalizing behavior from baseline to postbaseline, only reductions reported by parents with four or more ACEs were statistically significant. Implications for implementing PCIT with trauma-exposed families are discussed.     

大学生互联网使用动机模式研究

基于“互联网态度调查表 (IAS)” ,采用两组大学生被试 ,分别进行探索性因素分析和验证性因素分析 ,探讨了大学生互联网使用动机的模式 ,编制了“大学生互联网使用动机量表”(IUMS CS)。结果发现 :(1 )大学生互联网使用动机由“信息获取性动机”和“人际情感性动机”构成。基于IAS形成的大学生互联网使用动机量表具有较理想的项目区分度、内部一致性信度、构想效度和效标效度。 (2 )大学生互联网使用动机与上网次数的关系不密切 ,但与上网时间有一定关联。 (3 )“人际情感性动机”可作为病理性互联网使用行为模式的有效预测指标