Toward a culturally sensitive application of emotionally focused couples therapy: A qualitative study of therapists' experience using EFT in Spanish-speaking countries/cultures.

The purpose of the current study was to identify specific ways Emotionally Focused Couples Therapy (EFT; S. Johnson) could be adapted to better meet the needs of clients in Spanish-speaking countries throughout Europe and the Americas. The results were drawn from responses to a qualitative questionnaire regarding the experiences of learning and applying EFT; 103 therapists in 12 different countries where Spanish is spoken responded to the survey. Overall, the results suggest that the therapists surveyed consider EFT to be a "good fit" for many Spanish-speaking clients because of its focus on emotion, attachment theory, close interpersonal relationships, and model-specific interventions that match cultural values. Participants suggested a few culture-specific modifications regarding how to access and process emotion with men in therapy, translation of key EFT concepts and phrases into Spanish, and navigating the intersection of two cultural values (respeto and personalismo). Fewer modifications were suggested by therapists as they discussed application of the model than while learning it.

Relación entre diferenciación del self y agresión entre pares en estudiantes universitarios argentinos / Relationship between Differentiation of Self and Peer Aggression among Argentine University Students

Resumen La agresión entre pares, sea un caso aislado o recurrente, se ha convertido en un problema cada vez más frecuente que socava el desarrollo psicoafectivo saludable en adolescentes y universitarios. Como en el caso de otras conductas de riesgo, la investigación sugiere que los aspectos emocionales son relevantes para su prevención. El objetivo de este trabajo fue explorar la posible relación entre la agresión entre pares, la agresión frecuente como potencial conducta de bullying, y la diferenciación del self, un constructo procedente de la perspectiva sistémica, vinculado con la autorregulación emocional y la madurez afectiva. Universitarios de entre 17 y 20 años (. = 365), completaron sendos cuestionarios autoadministrados sobre estilos de vida (Carlos et al., 2016) y diferenciación del self (Duch-Ceballos et al., 2022). En esta muestra, los análisis realizados indican que menores niveles de diferenciación del self en los varones se asocian con mayor probabilidad de agresión entre pares, tanto sufrida como ejercida. Además, uno de los componentes de la diferenciación del self, la reactividad emocional, predijo también las probabilidades de agresión (sufrida y ejercida) entre las mujeres. La diferenciación del self está recibiendo una creciente atención como variable relevante para explicar la conducta de los adolescentes y jóvenes emergentes, especialmente en lo que refiere a conductas de riesgo. Este sería el primer estudio sobre la relación entre diferenciación del self, agresión entre pares y agresión frecuente como potencial conducta de buylling. Finalmente, a partir de los resultados encontrados, se plantean futuras líneas de investigación y aplicaciones prácticas.

Abstract The socio-emotional well-being of children and adolescents is a subject of interest, both for academics and researchers, as well as for parents, teachers, and educators. Initiatives on this subject promoted from the scientific and social fields are constantly increasing, and tend to have multiple objectives, among which one is to understand the dynamics of violence and aggression (which can lead to harassment situations), in order to design more effective prevention and intervention programs. Research suggests that emotional aspects are relevant to the prevention of aggression. Within this realm, we have focused on Differentiation of self (DoS). The Differentiation of Self is the central construct of Bowen's (1978) systemic family theory, considered from the systemic perspective as one of the most comprehensive theories of human behavior. With multiple applications in various fields, DoS is a multidimensional construct, defined as the ability to balance emotional and intellectual functioning -intrapsychic dimension-, and intimacy and autonomy in personal relationships -interpersonal dimension-. Based on previous studies in which associations between bullying and socio-emotional competencies were found, the objective of this study was to find relationships between differentiation of self and peer aggression. The sample of this study was comprised of university students between 17 and 20 years old (. = 365; . = 18.3, SD = .7), who were studying the first or second year of different careers at a private university in Argentina. Participants completed self-administered questionnaires on lifestyles (Carlos et al., 2016) and the Spanish version of the Differentiation of Self Inventory-Revised (S-DSI; Rodríguez-González et al., 2015). Considering that peer aggression does not represent bullying in all cases, the association between self-differentiation and peer aggression was first analyzed and, second, this same association was analyzed, but considering frequent aggression. Peer aggression was perpetrated by 54 % of women and 63 % of men (. = .043) and suffered by 72 % of women and 61 % of men (. = .124). Frequent peer aggression was perpetrated by 15 % of women and 21 % of men (. = .001) and suffered by 41 % of women and 24 % of men (. = .146). Both measures of DoS (Emotional reactivity and Emotional cutoff) were associated with a lower prevalence of both aggression and frequent aggression. This work offers two main findings. First, given the high incidence of peer aggression, the results of this study confirm the relevance of the research on peer aggression and, specifically, on frequent aggression associated with bullying. Second, present data suggests the existence of a relationship between differentiation of self and aggression. Since the idea and perceptions about aggression could be changing, new research is suggested, based around the cultural context and social changes that identify how the concept of bullying evolves should be promoted. Moreover, it would be positive to develop new research that can delve into the role played by the differentiation of self, since it is a factor that impacts the development and health of adolescents. The significant relationship between peer aggression and DoS found in this study contributes to the empirical corpus that affirms the relevance of the emotional factor in aggressive and bullying behaviors. In this sense, this study joins others that support the idea of intervening in aggression and buylling through the development of school intervention programs aimed at developing emotional competencies, involving students and also parents and educators.

Differentiation of self and relationship attachment, quality, and stability: A path analysis of dyadic and longitudinal data from Spanish and U.S. couples.

OBJECTIVES: In the current study, we examined the relationship between differentiation of self (DoS) and key relationship functioning variables among couples. This is the first study to test such relationships using a cross-cultural longitudinal approach (i.e., samples from Spain and the U.S.) while controlling for stressful life events-a key theoretical construct in Bowen Family Systems Theory. METHODS: A sample of 958 individuals (n = 137 couples from Spain, and n = 342 couples from U.S.) was used in cross sectional and longitudinal models to analyze the effects of a shared reality construct of DoS on anxious attachment, avoidant attachment, relationship stability, and relationship quality while considering gender and culture. RESULTS: Our cross-sectional results indicated that men and women from both cultures experienced an increase in DoS over time. DoS predicted increased relationship quality and stability and decreased anxious and avoidant attachment in U.S. participants. Longitudinally, DoS predicted increased relationship quality and decreased anxious attachment for Spanish women and men, while it predicted greater relationship quality and stability and decreased anxious and avoidant attachment of U.S. couples. Implications of these mixed findings are discussed. CONCLUSIONS: Higher levels of DoS are linked with a better couple relationship across time, despite varying levels of stressful life events. Although some cultural differences regarding the links between relationship stability and avoidant attachment exist, this positive link between differentiation and the couple relationship is mostly consistent across the U.S. and Spain. The implications and relevance for integration into research and practice are discussed.

Efficacy of Emotionally Focused Therapy among Spanish-speaking couples: study protocol of a randomized clinical trial in Argentina, Costa Rica, Guatemala, Mexico, and Spain.

BACKGROUND: Couple relationship distress is common and associated with poor physical, psychological, and relational outcomes for both partners. Emotionally Focused Therapy for couples (EFT) is a short-term structured approach based on attachment theory that integrates a humanistic, experiential approach to restructuring emotional experience and a systemic structural approach to restructuring interactions. This model has been shown to be an effective treatment for couple distress. The supporting research, however, has only been conducted with English-speaking couples. Despite Spanish being the second-most spoken language and meaningful cultural differences between English- and Spanish-speaking countries, the efficacy of EFT has not been examined in this cultural context. This study will examine the efficacy of EFT in this particular context and advance the understanding of potential mechanisms of change. METHODS: We will use a multicenter randomized wait-list controlled design to examine the efficacy of EFT in a Spanish-speaking sample of moderately distressed couples. One hundred forty individuals in 70 couples in Argentina, Costa Rica, Guatemala, Mexico, and Spain will be randomly assigned to receive 19-21 sessions of EFT or be placed on a waitlist. Outcomes on a range of relational and individual mental health variables will be assessed prior to random assignment, throughout treatment, and at the conclusion of treatment. Primary outcomes will include dyadic adjustment, couple satisfaction, and attachment. Secondary variables, such as loneliness, parenting, affective communication, and sexual satisfaction, will be included as potential mediators of the treatment effect. Couples in the treatment group will also be assessed at 3-, 6-, 12-, 18-, and 24-month follow-ups. Process variables such as the therapeutic alliance will also be assessed routinely in couples assigned to the treatment group. Couples in the waitlist will receive a psycho-educational program based on EFT after completing the study. DISCUSSION: This study will be the first RCT of Emotionally Focused Therapy in a Spanish-speaking context. The results of the study will inform researchers interested in whether treatments developed and tested in the USA and Canada can be effective in differing cultural contexts. It may also point researchers and clinicians to areas where cultural adaptation is needed to improve efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT04277325. Registered on February 20, 2020.

Religiosity and Sexual Initiation Among Hispanic Adolescents: The Role of Sexual Attitudes.

Introduction: Religiosity and sexuality present numerous interconnections. Little is known regarding the specific causal pathways between each religiosity dimension and sexual behavior. The objectives of this study were (1) to explore the relationship between religiosity (measured through attendance at religious services, salience, and prayer) and sexual initiation in adolescents and (2) to establish the role of sexual permissiveness as mediator of the impact produced by religiosity in sexual initiation. Methods: This study analyzes data from an ongoing school-based international study examining what young people feel and think about relationships, love, and sexuality. An anonymous, self-administered online questionnaire was developed in Spanish. A total of 4,366 students, aged 14-18, completed the questionnaire. A final sample of 2,919 questionnaires was analyzed. Two unconditional logistic regression models were fit with religiosity variables and possible confounders as independent variables (with and without permissiveness, respectively). The dependent variable was sexual initiation. A final path analysis was performed to further understand the results. Results: Our study highlights that, in predominantly Catholic and Spanish-speaking countries, the fact of attending church and praying may greatly contribute to postponing sexual relations during adolescence, even independently of their attitudes on sexual permissiveness. Conversely, the effect of salience on sexual initiation seems to be fostered only through the mediation of sexual permissiveness. Our findings point to an indirect effect of the three religiosity dimensions (and in particular, religious salience) through permissive attitudes. Conclusion: Religiosity could be a relevant factor to explain sexual initiation during adolescence.

Couple Adjustment and Differentiation of Self in the United States, Italy, and Spain: A Cross-Cultural Study.

This study comprises a first attempt to explore a cross-cultural application of Bowen family systems theory and examines the relationship between differentiation of self and couple adjustment using measurement invariance. A sample of 2,141 individuals (n = 915 from the United States; n = 635 from Italy; n = 591 from Spain) completed measures of differentiation of self (DSI-R; Skowron & Schmitt, J Marital Fam Ther, 29, 2003, 209) and couple adjustment (DAS; Spanier, J Marriage Fam, 38, 1976, 15). Results showed evidence of partial measurement equivalence for the DSI-R across the three samples. Additionally, results from latent regression showed that less emotional cutoff predicted greater couple adjustment in the United States, Spain, and Italy, whereas greater emotional reactivity predicted poorer couple adjustment only in the more collectivistic cultures, Spain and Italy. Our findings are consistent with prior empirical studies, which suggest that emotional cutoff is a strong predictor of relationship adjustment. The use of measurement invariance provides a foundation for future studies to continue employing rigorous statistical methods when examining constructs across different cultures. The findings highlight culture-specific similarities and differences in differentiation that may benefit practitioners by informing psychotherapy with individuals, couples, or families from diverse populations.

Este estudio constituye un primer intento de explorar la aplicabilidad intercultural de la teoría de sistemas familiares de Bowen y de analizar la relación entre la diferenciación del self y el ajuste de la pareja utilizando un análisis de invariancia. Una muestra de 2.141 personas (n = 915 de Estados Unidos; n = 635 de Italia; n = 591 de España), completaron medidas de diferenciación del self (DSI-R; Skowron & Schmitt, 2003) y de ajuste diádico (DAS; Spanier, 1976). Los resultados aportan pruebas de equivalencia parcial de las medidas del DSI-R entre las tres muestras. Además, los resultados de la regresión latente indicaron que un menor corte emocional predijo mayor ajuste de la pareja en Estados Unidos, España e Italia, mientras que una mayor reactividad emocional predijo un menor ajuste de la pareja solo en las culturas más colectivistas: España e Italia. Nuestros resultados concuerdan con estudios empíricos anteriores, que sugieren que el corte emocional es un fuerte predictor del ajuste relacional. El uso del análisis de invariancia ofrece una base para que futuros estudios sigan utilizando métodos estadísticos rigurosos cuando se examinan constructos entre culturas diferentes. Los resultados ponen de manifiesto diferencias y similitudes específicas en la diferenciación entre las culturas estudiadas, que pueden ayudar a los profesionales orientando la psicoterapia de personas, parejas o familias de poblaciones diversas.

The Experience of Learning EFT in Spanish-speaking Countries: A Multi-National Replication Study.

This study is a multi-national follow-up to the original (Sandberg and Knestel (2011) Journal of Marital and Family Therapy, 37, 393-410) article on the process of learning Emotionally Focused Couples Therapy (EFT). A total of 102 clinicians from nine Spanish-speaking countries (Mexico, Costa Rica, Guatemala, Spain, Colombia, Argentina, Chile, Ecuador, and El Salvador) participated in the study. A comparison of results across the two studies revealed more similarities than differences. However, a few notable differences emerged from responses to qualitative questions, namely a heightened sense of appreciation for and resonance with the focus on core emotion in EFT and less frequent reports of difficulty learning and adapting to the model among Spanish-speaking therapists. These differences were consistent with common cultural values and forms of expression in Latin America and Spain. Results are discussed in terms of training, supervision, and future research as well.

Short-Term and Long-Term Effects of Training in EFT: A Multinational Study in Spanish-speaking Countries.

This study seeks to validate the cross-cultural effectiveness of emotionally focused couple therapy (EFT) training in a sample of Spanish-speaking clinicians. The 28-hr formalized training for EFT was offered in six different Spanish-speaking countries, covering Europe, North America, Central America, and South America. Two hundred and seven therapists of 14 different Spanish-speaking nationalities completed pre-training assessments, 153 of them completed post-training assessments, and 92 therapists also completed the follow-up assessment. Using multilevel growth modeling (MLM), results indicated that therapists experienced significant and positive changes in terms of EFT competence (knowledge and skill acquisition), mature empathy, self-compassion, and attachment over time. Implications for transnational EFT training, specifically in Spanish-speaking countries, are discussed.

Stressful Life Events and Physical and Psychological Health: Mediating Effects of Differentiation of Self in a Spanish Sample.

The pathways between differentiation of self and health remain only partly elucidated. This cross-cultural study sought to test Bowen's hypothesis about the associations between differentiation, stressful life events, and physical and psychological health, in a sample of 466 Spanish adults. Results show that people with higher levels of differentiation were less prone to physical ailments (e.g., heart disease, cancer, or blood disorders) and psychological symptoms (e.g., depression or anxiety). Further, differentiation mediated the association between stress (i.e., perceived negativity of stress in the past year and number of stressful events across the lifetime) and physical and psychological health. The current research provides cross-cultural empirical evidence for the links between differentiation and mind and body health in a Mediterranean culture.

Spanish adaptation of the Differentiation Of Self Inventory-Revised (DSI-R) / Adaptación al español del Differentiation of Self Inventory-Revised (DSI-R)

This study introduces the Spanish Differentiation of Self Inventory(S-DSI) version, a 26 item measure, consisting of 2 subscales-Emotional Reactivity and Emotional Cutoff-focusing on adults (ages 25+) and their significant relationships, including current relations with family of origin. Translation of DSI into Spanish was conducted using a back translation method, with two independent teams for translation into Spanish and back-translation into English. A sample of 1047 adult men and women (living in Spain, native Spanish speakers) completed the Spanish-DSI scale and a socio-demographic questionnaire. Exploratory factor analysis was conducted on a randomly selected half of the sample, and results yielded a two subscale-solution that closely conformed with the original DSI's Emotional Reactivity and Emotional Cutoff scales. Results of a confirmatory factor analysis cross-validated the measure's factor structure in the remaining sample. Implications for cross-cultural research and culturally-informed study of Bowen theory in Spanish populations are further discussed.

Este trabajo presenta la versión española del Differentiation of Self Inventory (S-DSI), un instrumento de 26 ítems, con dos subescalas -Reactividad Emocional y Corte Emocional-, orientado a población adulta (mayores de 25 años) y al estudio de sus relaciones significativas, lo que incluye las relaciones con la familia de origen y las actuales. La traducción del DSI-R al español se realizó a través del método de traducción inversa, con dos equipos de traducción independientes para la traducción al español y la traducción inversa al inglés. Una muestra de 1047 mujeres y hombres adultos (residentes en España y con el español como lengua nativa) cumplimentaron la traducción española del DSI-R y un cuestionario sociodemográfico. Se llevó a cabo un análisis factorial exploratorio con la mitad de la muestra seleccionada al azar. Sus resultados conducen a un modelo de dos subescalas que corresponden en gran medida con las subescalas originales Emotional Reactivity y Emotional Cutoff del DSI-R. Los resultados del análisis factorial confirmatorio realizado con la otra mitad de la muestra corroboran esta estructura factorial. Se discuten finalmente las implicaciones para la investigación transcultural y para el estudio culturalmente fundamentado de la Teoría de Bowen en poblaciones de habla española.