Validation of the intersession alliance measure: Individual, couple, and family versions.

Monitoring the therapeutic alliance throughout treatment can improve client outcomes and lead to improved care. The individual, couple, and family versions of the intersession alliance measure (IAM) were developed to facilitate routine monitoring of the expanded therapeutic alliance. Psychometric properties of the three versions of the IAM were examined using a clinical sample. Participants were drawn from clinics in the United States participating in the Marriage and Family Therapy Practice Research Network. Using this sample, results indicate that items on each version of the IAM load on one factor, are invariant across sex, and that each version has good internal consistency, test-retest reliability, and concurrent validity. The IAM-C and IAM-F also have good predictive validity, while the IAM-I has more limited evidence for its predictive validity. These results suggest that the IAMs are valid and reliable measures that can facilitate the routine monitoring of the expanded therapeutic alliance in psychotherapy.

Lost in translation: Therapeutic Alliance as a mediator in the relationship between teletherapy and marital satisfaction.

The global impact of the SARS-COV-2 pandemic necessitated a rapid shift to online/teletherapy psychotherapy services. While research suggests the feasibility and efficacy of teletherapy, there is limited investigation into couple teletherapy's impact on satisfaction and therapeutic alliance. This study aimed to address this gap by examining changes in couple satisfaction during tele- and in-person therapy sessions over 12 sessions and exploring whether therapeutic alliance development mediates these changes. Using growth curve modeling in a sample of 416 couples, it found that teletherapy participants initially reported higher couple satisfaction, but improvement in this domain was slower than in-person therapy recipients. The development of the therapeutic alliance mediated this effect via two indirect paths. Implications include the need for focused attention on alliance development in teletherapy and more empirically-informed approaches in couple teletherapy.

Call me maybe? In-person vs. teletherapy outcomes among married couples.

ABSTRACTObjective: The objective of this study was to investigate the effectiveness of teletherapy compared to in-person couple therapy in outcomes such as couple satisfaction, sexual satisfaction, and the therapeutic alliance.Method: Data from 1157 married clients seeking couple therapy were examined. Individual growth curve models were used to analyze changes in the aforementioned outcomes, with teletherapy as a predictor. The study also examined client age and clinic type as moderators.Results: The results indicated that overall, teletherapy is as effective as in-person therapy in improving outcomes. However, there were notable differences in the development of the therapeutic alliance. The alliance improved at twice the rate in in-person therapy as in teletherapy. Clinic type was also found to be a moderator of changes in sexual satisfaction. Clients in group and private practices reported improvements in sexual satisfaction; whereas clients seen in training clinics reported decreases in sexual satisfaction.Conclusion: The study concludes that although teletherapy may be a viable alternative to in-person couple therapy, there are nevertheless differences in the development of the therapeutic alliance that warrant care and further investigation. The setting of the therapy also plays a role in the effectiveness of therapy, although not specific to therapy modality.

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.

Evaluating Scholarship Productivity in COAMFTE-Accredited Doctoral Programs: An Update.

Scholarly productivity continues to be used as a significant factor when universities make decisions about granting tenure to faculty, allocating resources, and supporting program goals. In 2009, DuPree, White, Meredith, Ruddick, and Anderson reviewed research productivity in faculty from COAMFTE-accredited PhD programs. As an update, the purpose of this article is to re-examine scholarly productivity trends among COAMFTE-accredited doctoral programs through the use of several evaluation methods. Specifically, productivity was examined in the following areas: (a) family therapy journal publications; (b) publications in any type of peer-reviewed journal; (c) h-factor index scores; and (d) historic and recent journal publication trends.

Exploring Similarity and Stability of Differentiation in Relationships: A Dyadic Study of Bowen's Theory.

Bowen family systems theory (BFST) identifies differentiation of self as a crucial characteristic that relates to one's individual and relational maturity. Bowen theorizes that an individual's level of differentiation typically remains static over time and that individuals select and pair in relationships with others who have similar levels of differentiation. This study aimed to test the hypotheses of BFST by using components of differentiation of self, emotional reactivity, and emotional cutoff, in dyadic structural equation modeling. Specifically, a longitudinal dyadic confirmatory factor analysis and structural equation longitudinal panel model were two analyses utilized to statistically test the dyadic nonindependence and stability of emotional reactivity and emotional cutoff across time. Results indicated mixed support for Bowen's assumptions regarding similarity (nonindependence) and stability. That is, small levels of nonindependence and significant stability paths across time were found. Theoretical implications and considerations for future research are discussed.

Families and childhood cancer: an exploration of the observations of a pediatric oncology treatment team.

The authors propose that families facing childhood cancer inadvertently become part of a distinct cultural group. To better train clinicians working with these families, this study was conducted as a phenomenological exploration of the common experiences of those who work with, and participate in, this "culture of cancer" (i.e., members of a pediatric oncology treatment team that includes medical family therapists). Two primary themes emerged from the data: culture of change and relationships. A qualitative description of medical family therapists as part of the treatment team was also developed. Insight into this culture and recommendations for family therapists working in this area of practice are provided.

Negative and positive peer influence: Relations to positive and negative behaviors for African American, European American, and Hispanic adolescents.

The purpose of the current study was to examine adolescents' perceptions of negative and positive peer influence (i.e., indirect peer association and direct peer pressure) as they related to adolescent behavior. Regression analyses were conducted using a sample of African American, European American, and Hispanic adolescents (N=1659, M age=16.06, SD=1.10). The study found differences and similarities in relation to respondents' ethnicity vis-à-vis indirect peer association and adolescent behavior. Although few ethnic-based differences occurred as a function of indirect negative peer association, indirect positive peer association was not as consistently or as strongly related to behaviors for minority youth as it was for European American youth.

Do general treatment guidelines for Asian American families have applications to specific ethnic groups? The case of culturally-competent therapy with Korean Americans.

To serve Korean American families effectively, marriage and family therapists need to develop a level of cultural competence. This content analysis of the relevant treatment literature was conducted to discover the most common expert recommendations for family therapy with Asian Americans and to examine their application to Korean Americans. Eleven specific guidelines were generated: Assess support systems, assess immigration history establish professional credibility, provide role induction, facilitate "saving face," accept somatic complaints, be present/problem focused, be directive, respect family structure, be nonconfrontational, and provide positive reframes. Empirical support (clinical and nonclinical research) and conceptual support for each guideline are discussed, and conclusions are reached regarding culturally competent therapy with Korean American families.

Developing culturally competent marriage and family therapists: treatment guidelines for non-African-American therapists working with African-American families.

To serve African-American families effectively, marriage and family therapists need to develop a level of cultural competence. This content analysis of the relevant treatment literature was conducted to examine the most common expert recommendations for family therapy with African Americans. Fifteen specific guidelines were generated, including orient the family to therapy, do not assume familiarity, address issue of racism, intervene multi-systemically, do home visits, use problem-solving focus, involve religious leader, incorporate the father, and acknowledge strengths. Conceptual and empirical support for each guideline is discussed, and conclusions are made regarding culturally competent therapy with African-American families.