Relationship-undermining statements by psychotherapists with clients who present with marital or couple problems.

This study examined the prevalence of relationship undermining statements by psychotherapists as reported by clients in individual therapy who presented with relationship problems, and whether these statements were associated with worse outcomes for client relationships. Participants (n = 101) reported on recollections of whether their therapist had suggested that their partner would never change, had a diagnosable personality/mental health disorder, had negative motives, that the relationship was doomed from the start or beyond repair now, or that divorce/breakup was their best option. Findings showed high prevalence of these undermining statements and associations with poorer relationship outcomes and shorter duration of therapy. We discuss potential explanations for this phenomenon and offer implications for the training of therapists who treat individual clients with relationship problems.

The Effectiveness of Couple and Individual Relationship Education: Distress as a Moderator.

Current literature yields mixed results about the effectiveness of relationship education (RE) with low-income participants and those who experience a high level of individual or relational distress. Scholars have called for research that examines whether initial levels of distress act as a moderator of RE outcomes. To test whether initial levels of relationship and/or individual distress moderate the effectiveness of RE, this study used two samples, one of couples who received couple-oriented relationship education with their partner (n = 192 couples) and one of individuals in a relationship who received individual-oriented RE by themselves (n = 60 individuals). We delivered RE in a community-based setting serving primarily low-income participants. For those attending with a partner, there was a significant interaction between gender, initial distress, and time. Findings indicate that women who were relationally distressed before RE reported the largest pre-postgains. Those who attended an individual-oriented RE program reported significant decreases in individual distress from pre to post, but no significant relationship gains. Findings also suggest that initial levels of distress did not moderate the effectiveness of individual-oriented RE.

What Are They Thinking? A National Study of Stability and Change in Divorce Ideation.

This study reports on a nationally representative sample of married individuals ages 25-50 (N = 3,000) surveyed twice (1 year apart) to investigate the phenomenon of divorce ideation, or what people are thinking when they are thinking about divorce. Twenty-eight percent of respondents had thought their marriage was in serious trouble in the past but not recently. Another 25% had thoughts about divorce in the last 6 months. Latent Class Analysis revealed three distinct groups among those thinking about divorce at Time 1: soft thinkers (49%), long-term-serious thinkers (45%), and conflicted thinkers (6%). Yet, divorce ideation was not static; 31% of Time 1 thinkers were not thinking about it 1 year later (and 36% of nonthinkers at Time 1 were thinking about it 1 year later). Also, Latent Transition Analysis revealed 49% of Time 1 long-term-serious thinkers, 56% of soft thinkers, and 51% of conflicted thinkers had shifted groups at Time 2, mostly in the direction of less and softer thinking about divorce. Overall, divorce ideation is common but dynamic, and it is not necessarily an indication of imminent marital dissolution.

It got me thinking: The impact of participating in a divorce decision-making interview.

Although there is literature documenting the reasons for and outcomes of divorce, there is limited research about the divorce decision-making process. Researchers with the National Divorce Decision-Making Project interviewed (n = 30) people in the process of making a divorce decision. One year later they conducted a second interview (n = 22) with the same sample to track any changes in participants' divorce ideation. The current study reports on the results of a thematic analysis of participants' responses to the final question, "How did the initial interview impact your thinking about the future of your marriage?" Three salient themes emerged from the data: (1) talking got me thinking, (2) thinking got me acting, and (3) the conversation was (surprisingly) therapeutic. The authors highlight possible clinical implications and directions for future research.

State of research in MFT: Thoughts from the Editor's Chair: This article is a modified transcript of the keynote address given by Dr. Steven M. Harris, Editor of the Journal of Marital and Family Therapy, at the inaugural annual meeting of the Intervention Research Topical Interest Network of the American Association for Marriage and Family Therapy. The meeting was held on October 5, 2022 at the Kellogg Center on the campus of Michigan State University.

The Editor of JMFT discusses the state of research in systemic family therapy.

What are they doing? A national survey of help-seeking and relationship-repair behavior of individuals who are thinking about divorce.

Guided by the Stages of Change (SOC) model, we explored relationship-repair behaviors among those thinking about divorce, employing a recent national longitudinal survey of married individuals (N = 745). Person-centered analyses explored whether there were distinct typologies of relationship-repair behaviors. We found four distinct classes: Intense Seekers (6%), who engaged at high levels of all kinds of repair behaviors, including professional services; Moderate-fading Seekers (14%), who engaged in moderate levels of various repair behaviors, including professional services, but did not sustain that behavior over a year; and Minimal-private Seekers (42%) and Private-sustained Seekers (38%), who eschewed professional services and engaged in low-to-moderate personal and private repair behaviors. We discuss possible applications of the SOC model to the divorce decision-making process and conclude with implications for practice, including the need to allocate greater attention to personal and self-help interventions that match the way most people try to repair their relationships.

A caregiver perspective of how Alzheimer's disease and related disorders affect couple intimacy.

OBJECTIVES: Alzheimer's disease and related disorders (ADRD) pose a potential threat to the interpersonal and intimate relationships in couples. The objective of this study was to understand the lived experiences of individuals with a spouse suffering from ADRD and how this diagnosis affects intimacy within these marital relationships. METHOD: This qualitative study used a phenomenological approach to capture the lived experiences of caregivers of ADRD individuals. A total of 10 interviews were conducted, with six participants recruited from a neurology clinic and four participants drawn from support groups. Structured interviews with open-ended questions were conducted, with thematic units derived from the interview analysis. RESULTS: All participants reported some strain in the ADRD relationship, with different aspects of the disease affecting closeness and connection within the couple. The quality of the marital relationship prior to diagnosis impacted every participant in some fashion as well as having to adjust to ADRD related behaviors. Outside effects on the relationship, coping with the disease and degree of intimacy were additional themes reported from the interviews, with positive and negative attributes given to these themes. CONCLUSION: Although the caregiving role can be difficult for a spouse, it does not mean that the ADRD has to always negatively impact the marital relationship. Understanding the role that intimacy can play for these couples and how it might contribute to coping strategies for couples affected by ADRD can be a powerful adjunct to other treatments available.

The impact of discernment counseling on individuals who decide to divorce: experiences of post-divorce communication and coparenting.

Discernment counseling is designed to help couples considering divorce arrive at a greater sense of clarity and confidence in their decision making about the future of their marriage. Possible outcomes include making no change to the marriage, divorcing, or attempting reconciliation through couples therapy. To date, no research has been done on whether or not discernment counseling helps couples who decide to divorce with their post-divorce family life (i.e., coparenting). We surveyed 11 people (from male-female couples) and conducted in-depth interviews with eight who had undergone discernment counseling and subsequently divorced to see what impact discernment counseling had on their post-divorce coparenting relationship. We analyzed the data from a phenomenological perspective. Respondents described their discernment counseling experience as helpful for achieving clarity and honesty in the divorce decision-making process, they shared their appreciation for the structure of the intervention, and indicated that it led to a greater coparental cooperation post-divorce.

How long do people wait before seeking couples therapy? A research note.

A widely cited but poorly supported idea in the couples therapy field is that the average couple waits six years before starting therapy for serious relationship problems. This figure is often accompanied by the notion that many couples come "too late" and have poor prospects for recovery. This is the first large-sample study on the delay between the onset of serious marital problems and entry into couples therapy (N = 270) and individual therapy (N = 101) for relationship problems. We found an average interval of 2.68 years from onset of problems and entering couples therapy, with the great majority of couples entering therapy within two years. Findings were similar for seeking individual therapy for relationship problems. The main clinical implication is that therapists have little reason to be pessimistic about the majority of couples waiting so long before starting therapy that their problems are not resolvable.

The Lived Experience of Ambiguous Marital Separation: A Phenomenological Study.

Researchers have long treated marital separation as a linear transition that inevitably leads to divorce. Popular sources suggest that some couples separate without clarity about how the separation will end, often to assess whether to divorce or stay married. However, to date, we could not locate any empirical research on this kind of ambiguous separation. With a sample of 20 currently separated persons from around the United States, this study employed a hermeneutic phenomenological design to inquire about the experience of separating from one's spouse when the separation was initiated without clarity about how it would end. Six essential themes emerged: (a) our relationship feels ambiguous, (b) separation is a private experience, (c) separation is a lonely experience, (d) benefits to separating, (e) separation is not sustainable, and (f) the outcome is unclear. The article concludes with a discussion of and implications for the study findings.

Family therapist comfort with and willingness to discuss client sexuality.

Limited empirical information exists on whether or not marriage and family therapists are having sexuality-related discussions with their clients. When helping professionals ignore client sexuality, the potential for unintended negative outcomes increases. The researchers surveyed 175 clinical members of the American Association for Marriage and Family Therapy to assess how their clinical training and education, their perceived sexual knowledge, and their comfort with sexual material influenced their willingness to engage in sexuality-related discussions with their clients. The results indicate that sexuality education and supervision experiences are the cornerstone for a therapist's base level of comfort. It is through sexuality education and supervision that sex knowledge is acquired and comfort levels are increased. Once comfort with sexual discussions increases, then therapists are more likely to engage in sexuality discussions with their clients.

Mother-father-adolescent triadic concordance and discordance on home environment factors and adolescent disordered eating behaviors.

INTRODUCTION: This study utilizes triadic data to examine the association between mother-father-adolescent concordance (agreement) and discordance (disagreement) on home environment factors (i.e., parental encouragement of dieting, family functioning) and adolescent unhealthy weight control behaviors and binge eating. METHOD: A subsample of adolescent-mother-father triads (n = 833; adolescents ages 10-22) from two coordinated population-based studies (EAT 2010 and F-EAT) were used. Poisson regression analysis was used to estimate the relative risks of each eating disordered behavior. RESULTS: Triads were more concordant (range 9-42%) than discordant (range 4-24%). Triadic agreement that parents did not encourage dieting was associated with a lower risk of adolescent eating disordered behaviors in some triadic combinations. Additionally, triadic concordance on high family functioning was also associated with a lower risk of adolescent eating disordered behaviors among some triadic combinations. DISCUSSION: Results suggest that triadic concordance on healthy home environment factors is associated with fewer adolescent disordered eating behaviors in some triads. Family based interventions may want to consider focusing on strategies to help move mother-father-adolescent triads closer on seeing the home environment more similarly. Future research is needed on triadic concordance/discordance and disordered eating behaviors to confirm study results and to inform the development of family based interventions. (PsycINFO Database Record

Clinical Training and Practice Patterns of Medical Family Therapists: A National Survey.

Medical family therapy (MedFT) has gained momentum as a framework in healthcare for individuals and families. However, little is known about what background training and clinical experiences Medical Family Therapists (MedFTs) have in everyday practice. This study investigated the clinical training of MedFTs and their practices in a variety of care settings. A survey was completed by 80 participants who use a MedFT framework in practice, with descriptive data on curriculum, clinical training, and treatment characteristics. Results reflect that many MedFTs lack formal coursework in key content areas of their graduate training and work primarily with psychological and relational concerns. Future research is needed to explore how MedFTs practice around specific mental health and chronic health conditions.

Confiding About Problems in Marriage and Long-Term Committed Relationships: A National Study.

This study examined confiding patterns in a national sample of 1000 U.S. adults aged 25-70 to inform the development of an educational program for confidants, called Marital First Responders. Results showed that 73% of U.S. adults have been a confidant to someone with a problem in a marriage or long-term committed relationship. The most common confiding relationship was between friends, followed by siblings. Confidants reported a wide range of problems brought to them, ranging from everyday complaints to serious issues such as infidelity and divorce. Confiders identified the most and least helpful responses. Findings suggest that naturally occurring confiding relationships have considerable potential to be the first level of help for troubled couple relationships.

Discernment Counseling for "Mixed-Agenda" Couples.

This article describes discernment counseling, an approach to working with couples where one partner is leaning toward divorce and the other wants to preserve the relationship and work on it in couples therapy. These "mixed-agenda" couples are common in clinical practice but have been neglected in the literature. The goal of discernment counseling is clarity and confidence regarding the next steps for the relationship, based on a deeper understanding of each partner's contributions. Sessions emphasize individual conversations with each partner. An analysis of 100 consecutive cases found that about half of the couples chose to start couples therapy in order to reconcile, with most of the rest choosing the divorce path. Longer term follow-up information is also presented.