Couple relationship education content: What we have and what we are missing.

Couple relationship education (CRE) has decades of research showing mixed results for participants. Various competing frameworks for CRE content have emerged in the development of the field, yet content has not been systematically investigated. Through an inductive content analysis of 15 different CRE programs, this study explored content themes and categories that are common across programs. Analysis found four themes throughout the programs: interactional skills, the self in the relationship, partner bonding, and relationship motivations. Categories for each theme were identified and are presented and discussed. Findings validate the primacy of teaching interactional skills within CRE including consistency in topics (e.g., communication training, conflict management). Other themes were also common (e.g., self in the relationship), though their categories were more diverse (e.g., self-care, expectations, personality). Several factors that have emerged as more significant in relationship theory and research were not well-represented in the content analysis (e.g., socioecological contexts, systemic patterns).

Integrative Systemic Supervision: Promoting Supervisees' Theoretical Integration in Systemic Therapy.

Integrative systemic therapy (IST) is a meta-theoretical perspective, grounded in systemic theory and integration, that transcends therapy models in individual, couple, and family therapy. To foster supervisees' theoretical integration and systemic thinking, two of IST's primary tools-the essence diagram and blueprint-are described and applied to inform an integrative, systemic meta-perspective for supervision. Recommendations, specific guiding questions, and examples are provided to operationalize these tools in the multi-level supervision system (i.e., supervisor-supervisee-client system). IST supervisors and other supervisors who are interested in integrative, systemic training can use these tools to guide the process of supervision and strengthen supervisees' ability to hypothesize, plan, converse, and read clients' feedback in relation to the various tasks of therapy. The essence diagram and blueprint are applied to facilitate case consultation and cultivate the development of supervisees' clinical competencies. Particularly, the problem-solving focus of IST has been adapted to include a competency-based and professional growth-oriented dimension for supervision to better promote supervisees' development. Lastly, the advantages and challenges of IST-influenced supervision are discussed.

La terapia sistémica integral (TSI) es una perspectiva metateórica basada en la teoría sistémica y la integración, que trasciende los modelos de terapia en la terapia individual, de pareja y familiar. Para fomentar la integración teórica de los supervisados y el pensamiento sistémico, se describen y se aplican dos de las herramientas principales de la TSI-el diagrama del eje y el diseño- a fin de respaldar una metaperspectiva integradora y sistémica de la supervisión. Se ofrecen recomendaciones, preguntas orientadoras específicas y ejemplos para poner en funcionamiento estas herramientas en el sistema de supervisión multinivel (p. ej.: sistema supervisor-supervisado-paciente). Los supervisores de la TSI y otros supervisores que estén interesados en la capacitación integradora y sistémica pueden usar estas herramientas para guiar el proceso de supervisión y fortalecer la capacidad de los supervisados para plantear hipótesis, planificar, conversar y leer los comentarios de los pacientes en relación con las diferentes tareas de la terapia. El diagrama del eje y el diseño se aplican para facilitar la consulta de casos y cultivar el desarrollo de las competencias clínicas de los supervisados. Particularmente, se ha adaptado el eje de resolución de problemas de la TSI para incluir una dimensión basada en competencias y orientada al crecimiento profesional a fin de que la supervisión promueva mejor el desarrollo de los supervisados. Por último, se comentan las ventajas y las dificultades de la supervisión influida por la TSI.

Parent and Peer Emotion Responsivity Styles: An Extension of Gottman's Emotion Socialization Parenting Typologies.

This theoretical paper introduces six emotion socialization typologies that can be used for designating emotion responsivity styles of parents and peers of children in middle childhood, referred to as Parent and Peer Emotion Responsivity Styles (PPERS). This typology draws on theoretical foundations of meta-emotion and emotion socialization. These typologies are compliment with and extend Gottman's emotion-based parenting styles, as they are organized generally by whether the response is more positive or more negative and whether the response is more emotionally constructive or destructive, but extend the four styles to include whether the parent or peer targets the emotion directly when responding to a child's emotions, or whether they target the emotion-related behavior. On the positive end, there is the Emotion Constructive style, which targets the child's emotions directly. The other two positive styles include Emotion Responsive and Emotion Acceptive, which target the child's emotional behaviors with higher or lower levels of activity. On the negative side, there is the Emotion Destructive style which is employed to target the emotion itself, while the Emotion Punitive and Emotion Dismissive styles target the child's emotion-related behavior with varying levels of activity. Implications for the development and study of these theoretical typologies are discussed.

Couple teletherapy in the era of COVID-19: Experiences and recommendations.

The unprecedented times of the novel Coronavirus quarantine and subsequent stay-at-home orders have changed the way many couple therapists provide clinical services. Understanding couple therapists' experiences with teletherapy is important for optimizing future telehealth delivery with couples. Thus, the purpose of this mixed methods survey study was to explore couple therapists' experiences of transitioning from in-person/traditional therapy to online/telehealth delivery. A total of 58 couple therapists completed an online survey for this study. Reported are both quantitative and qualitative findings. Overall, this study found that couple therapists experienced a positive shift from traditional/in-person therapy to online/telehealth therapy, with a majority of couple therapists (74%) reporting they would continue providing teletherapy after the novel Coronavirus pandemic and social distancing regulations had ended. Thematic analysis was used to identify themes from couple therapists' experiences related to advantages, challenges, and recommendations for practice. Implications for clinical training and future research are discussed.

The Systemic Therapy Inventory of Change (STIC) Initial Scales: Are they sensitive to change?

The Systemic Therapy Inventory of Change (STIC) is a multisystemic and multidimensional feedback system that provides therapists feedback about systemic domains of client change in individual, couple, and family therapy over time. The goal of the present study is to investigate the sensitivity to change of the scores of the STIC Initial Scales. In total, 583 clients who voluntarily sought individual, couple, or family therapy services and participated in a randomized controlled trial study were included in the study. Their pre- and posttherapy responses to the STIC Initial measures and corresponding validation measures for individual functioning, couple relationship, child adjustment, and family functioning were compared. The results support the sensitivity to change of the scores of the four STIC Initial Scales investigated: Individual Problems and Strengths (IPS), Relationship with Partner (RWP), Family/Household (FH), and Child Problems and Strengths (CPS). Of particular note, the IPS demonstrated even greater change over time than the BDI-II, BAI, and OQ-45. The discriminant validity of measuring change with the CPS was not supported. Thus, the STIC Initial IPS, RWP, and FH can be usefully employed to measure multisystemic changes in both research and clinical work. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Integrative Systemic Therapy: Lessons on Collaboration and Training for the 21st Century.

The field of couple, marital, and family therapy (CMFT) is at an important juncture of identity development and synthesis. Integrative Systemic Therapy (IST) is a problem-centered metaframeworks approach that meets the growing needs of family therapists working with diverse and complex family systems and restores the field to its original focus on collaboration. This paper describes the process by which IST developed featuring anecdotes from live interviews with the founders. We briefly outline IST's theoretical pillars and the essential way IST practitioners deliver treatment including a blueprint for therapy. Finally, we propose that IST is a comprehensive, systemic guide uniquely beneficial to CMFT training and discuss our approach to integrating IST into our training of students in a COAMFTE accredited program.

Temporality of couple conflict and relationship perceptions.

Using 5 waves of longitudinal survey data gathered from 3,405 couples, the present study investigates the temporal associations between self-reported couple conflict (frequency and each partner's constructive and withdrawing behaviors) and relationship perceptions (satisfaction and perceived instability). Autoregressive cross-lagged model results revealed couple conflict consistently predicted future relationship perceptions: More frequent conflict and withdrawing behaviors and fewer constructive behaviors foretold reduced satisfaction and conflict frequency and withdrawal heightened perceived instability. Relationship perceptions also shaped future conflict, but in surprising ways: Perceptions of instability were linked with less frequent conflict, and male partner instability predicted fewer withdrawing behaviors for female partners. Higher satisfaction from male partners also predicted more frequent and less constructive conflict behavior in the future. These findings illustrate complex bidirectional linkages between relationship perceptions and couple conflict behaviors in the development of couple relations. (PsycINFO Database Record

Attachment Versus Differentiation: The Contemporary Couple Therapy Debate.

This paper reviews the current debate between differentiation and attachment in treating couples through exploring the tenets of crucible therapy (Schnarch, 1991) and emotionally focused couple therapy (Johnson, 2004). We provide a review of the two theories-as well as the two "pure form" example models-and explore the debate in light of the integrative movement in couple and family therapy (Lebow, 2014). We also examine points of convergence of the two theories and models, and provide clinicians and researchers with an enhanced understanding of their divergent positions. Both differentiation and attachment are developmental theories that highlight the human experience of balancing individuality and connection in adulthood. The two models converge in terms of metaconcepts that pervade their respective theories and approach. Both models capitalize on the depth and importance of the therapeutic relationship, and provide rich case conceptualization and processes of therapy. However, they substantially differ in terms of how they view the fundamental aspects of adult development, have vastly divergent approaches to how a therapist intervenes in the room, and different ideas of how a healthy couple should function. In light of the deep polarization of the two models, points of integration-particularly between the broader theories of attachment and differentiation-are offered for therapists to consider.

Does Personality Matter in Diabetes Adherence? Exploring the Pathways between Neuroticism and Patient Adherence in Couples with Type 2 Diabetes.

BACKGROUND: Personality has received some attention in the Type 2 diabetes literature; however, research has not linked personality and diabetes adherence behaviors (diet and exercise), identified pathways through which they are associated, nor taken into consideration important contextual factors that influence behavior (the patient's partner). METHODS: Dyadic data from 117 married, heterosexual couples in which one member is diagnosed with Type 2 diabetes was used to explore associations between each partner's neuroticism and patient dietary and exercise adherence through the pathways of negative affect, depression symptoms, and couple-level diabetes efficacy (both patient and spouse report of confidence in the patient's ability to adhere to diabetes management regimens). RESULTS: Results revealed that higher levels of neuroticism were associated with lower patient dietary and exercise adherence through (1) higher levels of depression symptoms (for patients' neuroticism) and negative affect (for spouses' neuroticism), and (2) lower levels of couple-level diabetes efficacy. CONCLUSIONS: The results from this study provide evidence that both patient and spouse personality traits are associated with patient dietary and exercise adherence through increased emotional distress-albeit different emotional pathways for patients and spouses-and lower couple confidence in the patients' ability to manage their diabetes.

Associations Between Family of Origin Climate, Relationship Self-Regulation, and Marital Outcomes.

Using dyadic data from 961 married couples from the Relationship Evaluation Questionnaire project, the current study explored the direct association between family of origin climate and marital outcomes and the indirect association via relationship self-regulation (RSR). Results from the actor-partner interdependence model analysis indicated that family of origin climate was positively associated with marital stability directly and indirectly via the effects of RSR and marital satisfaction for both men and women. Results suggest that the experience one has in their family of origin is associated with their marital outcomes through their RSR. Actor-partner direct and indirect effects indicate that spouses' RSR may have important consequences for both partner's evaluation of the marriage. Implications for intervention and future research are discussed.