An attachment perspective on couple interaction: Helping couples signal needs clearly and respond appropriately.

Attachment theory provides some important insights into couple relationships, including highlighting the importance of communicating one's needs clearly while also having a partner who is properly attuned and appropriately responsive to those needs. The purpose of this study was to provide an initial empirical examination of the signal-response dynamic. More specifically, we used data from 63 couples to examine the efficacy (in terms of psychophysiological arousal and feelings toward their partner) of a micro-intervention designed to help couples improve their signaling and responding when compared to a seminatural condition where the discussion more closely resembled how couples interact at home. We also explored the emotional experience of participants in various signaling and responding roles. Overall, we found preliminary evidence for addressing signaling and responding dynamics. We also found evidence that emotional experience varied according to signaling or responding roles. These findings have important potential clinical implications, which we discuss in depth.

The Profession of Couple, Marital, and Family Therapy (CMFT): Defining Ourselves and Moving Forward.

The field of Couple, Marital, and Family Therapy (CMFT) has evolved and strengthened, but we still have work to do when it comes to identity, comprehensive scholarly resources, empirical support, and name brand recognition. We explore the reasons for these challenges and propose ways to address them: embracing the interdisciplinary nature of the field, consistently organizing treatment effectiveness by problem rather than by intervention model, continuing innovation in theory development, and utilizing more diverse and meaningful research methods. This approach provides a more accurate representation of the scope of practice of CMFTs, the range of mental and physical health problems we address, and the depth and extent of the existing research on the effectiveness of relational therapies.

Collecting and Pooling Assessment and Outcome Data in Couple and Family Therapy Training Clinics: Reasons to Do It, Common Problems, and Some Suggestions for Avoiding Them.

The article by Johnson et al. (2015) is an excellent example of many of the advantages and challenges of collecting data in clinics associated with Couple and Family Therapy training programs. In the hopes of encouraging more use of clinic datasets for research, we suggest some ways to improve the feasibility, quality, and value of routinely collecting such data.

An attachment primer for couple therapists: research and clinical implications.

According to attachment theory, humans are relational beings and even a child's earliest experiences with caregivers have a profound effect on emotional development and an overall approach to relationships. With increasing regularity, couple therapy has utilized attachment language as a conceptual tool, but more work is needed to understand the full clinical implications of attachment theory. These include understanding the intergenerational nature of attachment and adapting the delivery, timing, and pace of interventions to client attachment strategies. In this article, we summarize the origins of attachment theory, its measurement, the role of attachment in couple relationships, attachment stability and change, and ways that attachment informs therapy process and intervention. We hope that this article will provide an impetus for couple therapists to expand their conceptualization and use of attachment in their clinical work and for couple researchers to conduct more clinically relevant, attachment-oriented process research.

Emotional congruence within couple interaction: the role of attachment avoidance.

Attachment strategies refer to the conscious representations individuals make of their relationships, including the level of perceived comfort and safety that relationships offer during distressing times. From early in life, some individuals learn the coping strategy of attachment avoidance. When distressed, these individuals shut down emotionally and seek to mask what they are feeling. This represents incongruence between emotional experience and expression. Yet congruence is an important part of interpersonal relationships. In addition, incongruence has been identified as a core aspect of repressive coping, about which research has identified several potential long-term health risks. In this study, we examined the relationship between attachment avoidance and congruence between what individuals experience physiologically and what they report. A total of 63 couples completed the Experiences in Close Relationships Scale (ECR; Brennan, Clark, & Shaver, 1998) and participated in a seminatural couple interaction and an interaction with a therapist/coach. Using dyadic data analysis and multilevel modeling, we found that, while avoidance was not associated with elevated skin conductance, it was indeed associated with greater incongruence between skin conductance and reports of feelings toward one's partner. Whereas individuals lower in attachment avoidance were likely to report more negative feelings toward their partners in the context of psychophysiological distress, those higher in attachment avoidance were more likely to report positive feelings toward their partners. We discuss implications of this incongruence and its potential to adversely influence individual and relationship health. We also discuss some important clinical considerations when working to increase emotional congruence.

Challenge and urgency in defining doctoral education in marriage and family therapy: valuing complementary models.

In this overview, I comment on the strong theme of the need to define and improve the quality of doctoral education in marriage and family therapy that pervades the three essays. Deficits in research training are the central concern, although the essayists take different perspectives on the nature of the research training needed. The different perspectives can be understood in terms of three different models of doctoral education. The institutional model focuses on professional training with little financial support for students and lower expectations for faculty research. The community of scholars model emphasizes a balance of research and practice with students required to attend full-time and financial support provided. Research is a mix of faculty- and student-driven and is often focused on professional issues. The star researcher model often held out as the ideal, although not yet represented in marital and family therapy (MFT), emphasizes faculty externally funded programmatic research with students working on and supported by faculty grant funding. The value and role of all three models in MFT doctoral education are described and discussed.

Moving up the continuum of hope: developing a theory of hope and understanding its influence in couples therapy.

For years therapists have suggested that hope is an important catalyst in the process of change. This study takes a grounded theory approach to address the need for a clearer conceptualization of hope, and to place interventions that increase hope within a therapeutic context so that therapists know how and when to use those interventions. Fifteen active and experienced marriage and family therapists from across the United States participated in hour-long phone interviews about hope in couples therapy. Moving Up the Continuum of Hope emerged as the core category from the grounded theory analysis of the data. This category represents a process, with general and specific conditions and consequences that increase a couple's level of hope. This study serves as a foundation for future process research on couples therapy, as well as research on hope in other contexts (e.g., individual and family therapy) and with other perspectives (e.g., clients).

Changing emotion: the use of therapeutic storytelling.

Even though using metaphors in a therapeutic context is common, there are very few studies that address their effects. This study examines the effects of storytelling in therapy. After discussing a problem in a current relationship, 42 female participants were randomly assigned to receive either a story or psychoeducational information. Results indicated that both treatments were equally successful in reducing amounts of negative affect and negative feelings toward the relationship. In addition, each story was able to facilitate a change in emotional valence. Finally, participants saw no difference between the depth and smoothness of each session. Examples on using storytelling within different models of marriage and family therapy are provided.

Observing attachment behavior in couples: the Adult Attachment Behavior Q-Set (AABQ).

Knowledge as to how attachment behavior is observable in couple interaction can be very useful to clinicians who use attachment theory or related theories to guide their work with couples. The development of the Adult Attachment Behavior Q-Set (AABQ), a 100-item Q-sort designed to be consistent with Main's Adult Attachment Interview (AAI) coding system, is described. Videotaped discussions were coded for a sample of 28 couples. The majority of the couples were married and had sought therapy for couple problems. Reliability of coding was adequate. Evidence for validity was promising, with a match of 84% between the AAI and AABQ for secure versus insecure, and 70% for the three categories of secure, dismissing, and preoccupied. Even though additional reliability and validity information are needed for the AABQ, it holds promise for providing insights into couple dynamics that could be useful in guiding interventions and in evaluating the outcome of couple therapy.

The Adult Attachment Interview and observed couple interaction: implications for an intergenerational perspective on couple therapy.

One of the assumptions of intergenerational family therapy is that how a person thinks and talks about family-of-origin experiences has important implications for current family relationships. The Adult Attachment Interview (AAI) is a measure of attachment security based on how coherently the person can discuss attachment experiences in childhood. This study examined the relationship between attachment security, as measured by the AAI, and couple interaction, as measured by the Georgia Marriage Q-Sort (GMQ), in a sample of 28 couples in therapy for relationship problems. During a conflict resolution discussion, those individuals who were less coherent in discussing their family of origin expressed more negative affect, less respect, less openness, more avoidance, and less willingness to negotiate when interacting with their partner. No evidence of intra-couple effects or "buffering" was found. The findings support a key assumption of intergenerational approaches to family therapy and suggest that applying attachment theory is a promising direction for refining and developing new interventions for couples.

The scientist-practitioner model in marriage and family therapy doctoral programs: current status.

We discuss the status of the scientist-practitioner model in marriage and family therapy (MFT) doctoral programs. Issues discussed include a lack of faculty research role models in doctoral programs, "farming out" the majority of research courses to other disciplines, problems with curriculum, and how the culture of MFT does not support research. We also present suggestions for improving doctoral research training. The goal is to improve the quality of research training in doctoral programs. We hope that this will help change the culture of MFT to include research as one of its primary goals and greatest assets.

Further understanding the systemic effects of childhood sexual abuse: a comparison of two groups of clinical couples.

This study addressed the impact of traumatic experiences on dyadic relationships by comparing general stress and trauma symptoms and relationship impairment measures between two clinical groups: female childhood sexual abuse (CSA) survivors (n=15) and their male partners, and a control group of couples who reported no CSA (n=17). Both female CSA survivors and their partners reported higher symptoms of stress, suggesting support for the theory of secondary traumatic stress. Relationship impairment results did not support the hypothesis that CSA would negatively impact the dyadic functioning of couples. Clinical implications and recommendations for future research are provided.