Risk and Protective Factors Associated with Childhood Obesity in a Sample of Low-Income,Single Female,Parent/Guardian Households: Implications for Family Therapists

The United States is in the midst of a childhood obesity epidemic that disproportionately impacts underserved and diverse populations. In this study, in-depth qualitative interviews were conducted with 16 low-income, single, female, parent/guardians of an overweight or obese 3- to 8-year-old from socioeconomically disadvantaged backgrounds. Following the tenets of the thematic analysis approach, interviews focused on identifying risk and protective factors influencing parental and child health behaviors associated with child weight status. Results from the interviews are organized according to the Socioecological Framework to help identify risk and protective factors at various system levels. Findings from this investigation have relevance for family therapists as they can inform clinical and advocacy-focused interventions with disadvantaged families affected by childhood obesity.     

What Can We Learn from the Study of Mexican‐Origin Families in the United States?

Mexican‐origin families are a large and rapidly increasing subgroup of the U.S. population, but they remain underrepresented in family scholarship. This paper introduces a special section of four papers on Mexican‐origin families designed to contribute to the advancement of research on how cultural, family, and gender socialization processes unfold across key developmental periods and life transitions in this cultural context. Two longitudinal studies of Mexican‐origin families provided the data for these four papers: (a) The Juntos Project, an 8‐year longitudinal study of mothers, fathers, and adolescent sibling pairs in 246 Mexican‐origin families; and (b) The Supporting MAMI Project, a study following 204 adolescent mothers and their mother figures from the third trimester of pregnancy through their young children's 5th birthdays. In this introductory paper, we highlight four themes, including (a) differential acculturation and reciprocal socialization, (b) interdependence in families, (c) the intersection of culture and gender, and (d) methodological issues. We end with suggestions for future research.     

Narrative Approaches to Organizational Development: A Case Study of Implementation of Collaborative Helping

Across North America, community agencies and state/provincial jurisdictions are embracing family‐centered approaches to service delivery that are grounded in strength‐based, culturally responsive, accountable partnerships with families. This article details a collaborative consultation process to initiate and sustain organizational change toward this effort. It draws on innovative ideas from narrative theory, organizational development, and implementation science to highlight a three component approach. This approach includes the use of appreciative inquiry focus groups to elicit existing best practices, the provision of clinical training, and ongoing coaching with practice leaders to build on those better moments and develop concrete practice frameworks, and leadership coaching and organizational consultation to develop organizational structures that institutionalize family‐centered practice. While the article uses a principle‐based practice framework, Collaborative Helping, to illustrate this process, the approach is applicable with a variety of clinical frameworks grounded in family‐centered values and principles.     

Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems

The stepfamily literature is replete with between‐group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well‐being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent–child, parent–child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent–child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent–child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice.     

Taking Racism to Heart: Race-Related Stressors and Cardiovascular Reactivity for Multiracial People

Multiracial people experience an accumulation of racial stress for both their minority and their multiracial identities, yet no research has examined the physiological impact of this stress. This within-groups experimental study examined whether two race-related stressors—identity invalidation and discrimination from family—affect cardiovascular reactivity for Black/White multiracial adults (N = 60). The authors found a Condition × Phase interaction effect indicating that discrimination from family affected blood pressure. Invalidation had no effect on blood pressure. Las personas multirraciales experimentan una acumulación de estrés racial tanto a causa de su identidad multirracial como de su identidad como minoría, pero no hay investigaciones que hayan examinado el impacto psicológico de este estrés. Este estudio experimental dentro de grupos examinó si dos factores causantes de estrés relacionados con la raza (la invalidación de la identidad y la discriminación por parte de la familia) afectan a la reactividad cardiovascular de personas adultas multirraciales blancas/negras (N = 60). Los autores hallaron un efecto de interacción Condición × Fase que indica que la discriminación por parte de la familia tuvo un efecto sobre la presión sanguínea. La invalidación no tuvo efecto sobre la presión sanguínea.     

Pathways of Risk and Resilience: Impact of a Family Resilience Program on Active‐Duty Military Parents

Over the past decade, studies into the impact of wartime deployment and related adversities on service members and their families have offered empirical support for systemic models of family functioning and a more nuanced understanding of the mechanisms by which stress and trauma reverberate across family and partner relationships. They have also advanced our understanding of the ways in which families may contribute to the resilience of children and parents contending with the stressors of serial deployments and parental physical and psychological injuries. This study is the latest in a series designed to further clarify the systemic functioning of military families and to explicate the role of resilient family processes in reducing symptoms of distress and poor adaptation among family members. Drawing upon the implementation of the Families Overcoming Under Stress (FOCUS) Family Resilience Program at 14 active‐duty military installations across the United States, structural equation modeling was conducted with data from 434 marine and navy active‐duty families who participated in the FOCUS program. The goal was to better understand the ways in which parental distress reverberates across military family systems and, through longitudinal path analytic modeling, determine the pathways of program impact on parental distress. The findings indicated significant cross‐influence of distress between the military and civilian parents within families, families with more distressed military parents were more likely to sustain participation in the program, and reductions in distress among both military and civilian parents were significantly mediated by improvements in resilient family processes. These results are consistent with family systemic and resilient models that support preventive interventions designed to enhance family resilient processes as an important part of comprehensive services for distressed military families.     

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.     

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.     

Collaborative helping maps: a tool to guide thinking and action in family-centered services

This article highlights "disciplined improvisation" as a metaphor for community-based work with multi-stressed families. It introduces Collaborative Helping maps as a tool that both helps workers think their way through complex situations with families and provides a structure to support constructive conversations between workers and families about challenging situations. The article illustrates this map through a clinical vignette and uses interviews with workers to highlight ways in which the map can both enhance worker thinking and support constructive conversations between workers and families about problems that could easily divide them and lead to polarization and escalating tension.