Communication of Information about Genetic Risks: Putting Families at the Center

Genetic information is a family affair. With the expansion of genomic technologies, many new causal genes and variants have been established and the potential for molecular diagnoses increased, with implications not only for patients but also their relatives. The need for genetic counseling and intrafamilial circulation of information on genetic risks grew accordingly. Also, the amount and, particularly, the complexity of the information to convey multiplied. Sharing information about genetic risks with family members, however, has never been an easy matter and often becomes a source of personal and familial conflicts and distress. Ethical requisites generally prevent healthcare professionals from directly contacting their consultands' relatives (affected or still at risk), who often feel unsupported throughout that process. We discuss here the communication of genetic risks to family members. We first consider genomic testing as a basis for family‐centered health care, as opposed to a predominant focus on the individual. We reviewed the literature on sharing genetic risk information with family members, and the associated ethical issues for professionals. Some clinical cases are presented and discussed, and key issues for meeting the needs of individuals and families are addressed. We argue that genetic information is inextricably linked to the family and that communicating about genetic risks is a process grounded within the broader milieu of family relationships and functioning. We conclude for the need for a more family‐centered approach and interventions that can promote sensitive attitudes to the provision of genetic information to and within the family, as well as its inclusion in educational and training programmes for genetic healthcare professionals.     

Effectiveness of the ‘Hold me Tight’ Relationship Enhancement Program in a Self‐referred and a Clinician‐referred Sample: An Emotionally Focused Couples Therapy‐Based Approach

While evidence‐based couple therapies are available, only a minority of troubled couples seek help and they often do this too late. To reach more couples earlier, the couple relationship education (CRE) group program “Hold me Tight” (HmT) based on Emotionally Focused Couples Therapy (EFCT) was developed. This study is the first to examine the effectiveness of HmT. Using a three‐wave (waiting period, treatment, and follow‐up) within‐subject design, HmT was delivered to 79 self‐referred couples and 50 clinician‐referred couples. We applied a comprehensive outcome measure battery. Our main findings were that (1) self‐referred couples significantly improved during HmT on all measures, that is relationship satisfaction, security of partner‐bond, forgiveness, daily coordination, maintenance behavior, and psychological complaints, with a moderate‐to‐large mean effect size (d = .63), which was maintained (d = .57) during the 3.5 month follow‐up; (2) in clinician‐referred couples, who were vulnerable in terms of insecure attachment status and psychopathology, the improvement during HmT was moderate (d = .42), but this was reduced during the 3.5‐month follow‐up to a small effect (d = .22); (3) emotional functioning (typical HmT target) as well as behavioral functioning (typical Behavioral Couples Therapy‐based CRE target) improved during HmT; and (4) individual psychological complaints, although not specifically targeted, were reduced during HmT. These findings suggest that HmT is a promising intervention for enhancement of relationship functioning. Clinical implications are discussed.     

Multiple Levels of Family Factors and Oppositional Defiant Disorder Symptoms Among Chinese Children

Family factors are closely associated with child developmental outcomes. This study examined the relationship of oppositional defiant disorder (ODD) symptoms and factors at whole family, dyadic, and individual levels in Chinese children. Participants, who were recruited from 14 primary schools in north, east, and south‐west China, included 80 father‐child dyads and 169 mother‐child dyads. Children in the participating dyads were previously diagnosed with ODD. Results revealed that family cohesion/adaptability was indirectly associated with ODD symptoms via parent–child relationship and child emotion regulation. Parent–child relationship affected ODD symptoms directly and indirectly through child emotion regulation. In addition, the effects of family cohesion/adaptability on parent emotion regulation and child emotion regulation were mediated by the parent–child relationship. The tested model provides a comprehensive framework of how family factors at multiple levels are related to child ODD symptoms and highlights the importance of understanding child emotional and behavioral problems within the family context, more specifically within the multiple levels of family relationships.     

French translation and validation of the Karitane Parenting Confidence Scale

IntroductionPerceived parental self-efficacy (PSE) is thought to play a crucial role in parental well-being, the parent-infant relationship, and other aspects of infant development, particularly in the early postnatal period. The Karitane Parenting Confidence Scale (KPCS) is a 15-item self-report questionnaire designed for parents with infants aged 0–12 months.ObjectiveTo explore the factor structure of a French translation of the KPCS and assess its psychometric qualities.MethodUsing a French-language translation of the KPCS (KPCS-F), 257 parents of children aged 0–12 months were recruited via childcare structures (e.g. nurseries, community centers, mother and child protection centers). Confirmatory factor analyses (CFA) were conducted to examine 2- and 3-factor solutions for the KPCS-F scale. Internal reliability and convergent validity were evaluated.ResultsThe best model was a two-factor solution (PSE “infant care” and PSE “parental role”) restricted to 12 items. Sound internal consistency was indicated, with a Cronbach's alpha coefficient of 0.80 and a McDonald's omega coefficient of 0.80. Test-retest reliability was good. KPCS-F score was correlated with social support and psychological well-being scores.ConclusionThe KPCS-F showed substantial validity and reliability for this sample. The translated scale should therefore improve assessment and intervention processes for professionals working with parents of young children.     

Coparenting and Children's School Readiness: A Mediational Model

We examined the long‐term direct and indirect links between coparenting (conflict, communication, and shared decision‐making) and preschoolers' school readiness (math, literacy, and social skills). The study sample consisted of 5,650 children and their biological mothers and fathers who participated in the Early Childhood Longitudinal Study‐Birth Cohort. Using structural equation modeling and controlling for background characteristics, we found that our conceptual model of the pathways from coparenting to child outcomes is structurally the same for cohabiting and married families. Controlling for a host of background characteristics, we found that coparenting conflict and shared decision‐making were negatively and positively, respectively, linked to children's academic and social skills and co‐parental communication was indirectly linked to academic and social skills through maternal supportiveness. Coparenting conflict was also indirectly linked to children's social skills through maternal depressive symptoms. The overall findings suggest that for both cohabiting and married families, the context of conflicted coparenting may interfere with the development of children's social competencies and academic skills, whereas collaborative coparenting promotes children's school readiness because mothers are more responsive to their children's needs. These findings have implications for programs aimed at promoting positive family processes in cohabiting and married families.     

Prenatal Representations of Coparenting Among Unmarried First‐Time African American Mothers

Results of semistructured interviews with 45 pregnant unmarried first‐time African American mothers indicated a wide range of expectancies concerning the coparenting relationship they would develop with others once their baby arrived. Most common coparenting systems projected by respondents involved maternal grandmothers and/or the babies' fathers, though other caregivers were explicitly anticipated in a smaller number of cases. Multiperson coparenting systems were the norm, and only 2 of 45 respondents anticipated that they would be entirely on their own with no coparental system whatsoever. Qualitative analyses of mothers' narratives about postbaby coparenting systems revealed five main constructions: having thought about and anticipating coparenting, positive in outlook; having thought about and anticipating coparenting, but with mild concerns (conflict, unreliability); having thought about coparenting and anticipating limited or no support; having thought about coparenting and anticipating significant conflict and nonsupport; and having not thought much about coparenting, being neither focused on nor worried about this issue. Illustrations of each of these types are provided, and directions for family science and practice are discussed.     

Coparenting Interventions for Fragile Families: What Do We Know and Where Do We Need To Go Next?

With a large and growing share of American families now forming outside of marriage, triangular infant–mother–father relationship systems in “fragile families” have begun to attract the interest of family scholars and clinicians. A relatively novel conceptualization has concerned the feasibility of intervening to support the development of a sustained and positive coparenting alliance between mothers and fathers who have not made an enduring relationship commitment to one another. At this point in time, there are very few published outcome studies of programs explicitly conceived to help build coparenting alliances in such families. This article reviews what we currently know from this evolving field of study, and from those related responsible fatherhood and marriage and relationship enhancement (MRE) initiatives that included any explicit targeting, strengthening, and assessment of fragile family coparenting in their designs. We summarize lessons learned thus far from Access and Visitation (AV) programs for non‐residential fathers, from MRE programs for low‐income, unmarried couples, and from newer programs for fragile families directly designed to target and support coparenting per se. We close with recommendations for charting this important new family process terrain.     

Understanding autism: how family therapists can support parents of children with autism spectrum disorders

The number of children diagnosed with an Autism Spectrum Disorder has increased dramatically in the last 20 years. Parents of children with autism experience a variety of chronic and acute stressors that can erode marital satisfaction and family functioning. Family therapists are well-suited to help parents stay connected to each other as they create a "new normal." However, family therapists need updated information about autism, and they need to understand how family therapy can help parents of children with autism. Because having a child with autism affects multiple domains of family life, this paper explores how family therapists can utilize an integrative approach with parents, enabling them to flexibly work with the domains of action, meaning, and emotion.     

Couple Relationship Education at the Transition to Parenthood: A Window of Opportunity to Reach High‐Risk Couples

This study evaluated if the transition to parenthood is a window of opportunity to provide couple relationship education (CRE) to new parents at high risk for future relationship problems. Fifty‐three percent of eligible couples approached agreed to participate in CRE and of these 80% had not previously accessed CRE. Couples were a broad representative of Australian couples having their first child, but minority couples were underrepresented. A third of couples had three or more risk factors for future relationship distress (e.g., cohabiting, interpartner violence, elevated psychological distress, unplanned pregnancy). Low education was the only risk factor that predicted drop out. The transition to parenthood is a window of opportunity to recruit certain types of high‐risk couples to CRE.     

L’accompagnement à la recherche d’un emploi : enjeux,modèles,et perspectives de recherche

What is at stake in the process of elaborating support to provide job seekers with personal advice, both theoretically and practically speaking? All through a review of papers, this article focuses on different theoretical schemes in the process of helping jobseekers to get back to work, but it also details the currently existing support devices and analyses their effects. Eventually it concentrates on the main psychological features taken into account in the process of counseling. As a conclusion, this article examines the perspectives and the consequences of molding and shaping personal counseling for jobseekers from a research angle.