Strengthening the systemic ties that bind: integrating common factors into marriage and family therapy curricula.

Specific models guide the training of marriage and family therapists (MFTs) as they offer both structure and organization for both therapists and clients. Learning models may also benefit therapists-in-training by instilling confidence and preventing atheoretical eclecticism. The moderate common factors perspective argues that models are essential, but should not be taught as "the absolute truth," given there is no evidence for relative efficacy of one empirically validated model versus another, and no single model works in all instances. The following article provides a blueprint for infusing a common factors perspective into MFT programmes by reviewing innovations in course design, outlining specific teaching strategies, and highlighting potential implementation challenges.

Targeting Threats to the Therapeutic Alliance: A Primer for Marriage and Family Therapy Training.

Although theory and research highlight the importance of the client-therapist relationship, marriage and family therapy (MFT) training has historically centered on specific models, consisting of proprietary language and techniques, instead of common factors like the therapeutic alliance. In this article, we begin by making an argument for explicitly focusing on the therapeutic alliance in MFT training programs. Next, we highlight common alliance threats experienced by both faculty members and student therapists. We then integrate research-informed principles with clinical wisdom to outline specific recommendations and concrete skill-building exercises for MFT educators and supervisors to use with their students to address these threats and advance training on the therapeutic alliance.

Therapist-worldview matching: not as important as matching to clients.

In this essay, we respond to Simon's article (2012). We discuss our view that therapy works best when therapists can match therapeutic interventions to the worldview of clients. We see this matching to client worldview as rooted in research evidence, and we suggest that therapists can practice authentically and effectively using more than one divergent therapy approach. We conclude the paper by pointing out points of disagreement we have with Simon's use of Davis and Piercy's (Journal of Marital and Family Therapy, 2007a; 33, 298; Journal of Marital and Family Therapy, 2007b, 32, 515) study, a study Simon uses to ground his arguments.

Common factors of change in couple therapy.

Though it is clear from meta-analytic research that couple therapy works well, it is less clear how couple therapy works. Efforts to attribute change to the unique ingredients of a particular model have consistently turned up short, leading many researchers to suggest that change is due to common factors that run through different treatment approaches and settings. The purpose of this article is to provide an empirically based case for several common factors in couple therapy, and discuss clinical, training, and research implications for a common factors couple therapy paradigm. Critical distinctions between model-driven and common factors paradigms are also discussed, and a moderate common factors approach is proposed as a more useful alternative to an extreme common factors approach.

Intervention research in couple and family therapy: a methodological and substantive review and an introduction to the special issue.

This article serves as an introduction to this third version of research reviews of couple and family therapy (CFT) that have appeared in this journal beginning in 1995. It also presents a methodological and substantive overview of research in couple and family therapy from about 2001/2002 to 2010/2011 (the period covered in this issue), while also making connections with previous research. The article introduces quantitative research reviews of family-based intervention research that appear in this issue on 10 substantive areas including conduct disorder/delinquency, drug abuse, childhood and adolescent disorders (not including the aforementioned), family psycho-education for major mental illness, alcoholism, couple distress, relationship education, affective disorders, interpersonal violence, and chronic illness. The paper also introduces the first qualitative research paper in this series, as well as a paper that highlights current methodologies in meta-analysis. The first part of this article rates the 10 content areas on 12 dimensions of methodological strength for quantitative research and makes generalizations about the state of quantitative methodology in CFT. The latter part of the papers summarizes and makes comments on the substantive findings in the 12 papers in this issue, as well as on the field as a whole.

Behavioral couples therapy for the treatment of substance abuse: a substantive and methodological review of O'Farrell, Fals-Stewart, and colleagues' program of research.

Behavioral couples therapy (BCT) is an evidence-based couple therapy intervention for married or cohabitating substance abusers and their partners. This paper provides readers with a substantive and methodological review of Fals-Stewart, O'Farrell, and colleagues' program of research on BCT. The 23 studies included in this review provide support for the efficacy of BCT for improving substance use behavior, dyadic adjustment, child psychosocial outcomes, and reducing partner violence. This review includes a description of BCT, summaries of primary and secondary outcomes, highlights methodological strengths and weaknesses, notes barriers to dissemination, suggests future research directions, and provides clinical implications for couple and family therapists. Although there are several versions of BCT developed for the treatment of substance abuse this paper focuses on the version developed by O'Farrell, Fals-Stewart, and colleagues.

The present and future of MFT doctoral education in research-focused universities.

Doctoral education is greatly impacted by context, and the large majority of marital and family therapy (MFT) doctoral programs are PhD programs in research-focused universities. I believe their primary mission is to equip students to become scientist-practitioners and do original research that will advance the science of the discipline, whereas the mission of the typical master's program is to produce strong practitioners who are research informed. It is the emphasis on the scientific method, not the content specialty area, that should be the hallmark of PhD programs in research-focused contexts. I describe metrics for success that include not only research productivity but also the development of a supportive, open, flexible, and generous program culture. The research mission of these programs has been only modestly helped by the Commission on Accreditation for Marriage and Family Therapy Education process and the programs are largely not doing the programmatic intervention research that the field needs. As the universities that house these programs are also "raising the bar," the long-term viability of the programs themselves will likely hinge on success in this arena.

The research-informed clinician: a guide to training the next-generation MFT.

The gap between clinical research and practice is a major challenge facing marriage and family therapy (MFT) training programs. Until now, the answer to bridge this gap has primarily been the Boulder Scientist-Practitioner Model. Although realistic for doctoral students, it may not be a good fit for MFT master's students who have primarily clinical career ambitions-which we believe is a legitimate and positive career choice. The following article articulates a "research informed" perspective as opposed to the scientist-practitioner framework as a research-training model for clinically oriented MFT master's programs. After articulating the similarities and differences between these two approaches, the authors outline 10 practical ideas to integrate research into programs that desire to remain clinical in focus, but also research informed.

Conceptualizing and treating problem gambling as a family issue.

Few family therapists have training in the identification, assessment, and treatment of problem gambling and its impact on couple and family relationships. The authors conceptualize problem gambling (PG) as a family issue and encourage clinicians and researchers to pay attention to the systemic antecedents and consequences of PG on family relationships. A review of the literature and clinicians' experiences regarding the impact of PG on couple and family relationships are presented and discussed. In light of the limited systemic-based treatments for PG, marriage and family therapists are urged to begin paying attention to this emerging issue that has significant couple and family ramifications.

Is who delivers the treatment more important than the treatment itself? The role of the therapist in common factors.

In this article, we discuss the role of the therapist in change in couple and family therapy. We argue that the therapist is a key change ingredient in most successful therapy. We situate our discussion in the common factors debate and show how both broad and narrow common factor views involve the therapist as a central force. We review the research findings on the role of the therapist, highlight the strengths and weaknesses of this literature, and provide directions for future research. We then use this review as a foundation for our recommendations for theory integration, training, and practice.

Toward a common-factors approach to supervision.

Despite the proliferation of supervision models, there is no evidence to suggest that any one model of supervision is in any way superior to any other. Many in the field have called for models that can bridge the various theoretical approaches to clinical supervision, and identify the essential elements of supervision. This article briefly explores the range of existing supervision models, and suggests a rationale for seeking factors common across the various models. The authors highlight the development of a new supervision model that synthesizes current thinking about supervision into three dimensions. The three dimensions are defined, and resulting supervisory roles explored. Implications for supervision practice, research, and training are discussed.

Training family therapists to work with children and families: a modified Delphi study.

This study examined child inclusion issues and training marriage and family therapists (MFTs) to treat children. This modified Delphi study utilized a panel of experts, and gathered data through questionnaires and qualitative interviews. Panelists believe children should participate in family therapy sessions for both child and adult problems, except when parents are discussing sex or sensitive issues. Child-focused courses should emphasize developmental issues, engaging techniques, theoretical issues, play therapy theory, MFT treatment for child disorders, and specific child/family problems. Panelists suggest numerous child-focused references, but reached consensus for only one. Key therapist attributes and skills were identified. Deductive and inductive training methods and the role of supervision were highlighted. Although therapist playfulness and creativity were emphasized, few play techniques were included in the final profile.

Common factors and our sacred models.

In this article we argue that much of what makes one treatment effective is common to other forms of effective treatment--both in psychotherapy generally and in marital and family therapy (MFT) specifically. Yet MFT has largely ignored the research on common factors. In this article we present a moderate view of common factors that, while repudiating the extreme position that there is no difference among treatment models, stresses that there are common factors and mechanisms of change that undergird most forms of successful treatment. These common mechanisms of change should be given more attention in our field, which has tended to emphasize the uniqueness of our sacred models. We delineate some of the major common factors, review the empirical evidence for them, and discuss implications of adapting a common factors informed approach to family therapy.

Common factors are not islands--they work through models: a response to Sexton, Ridley, and Kleiner.

In this article, we respond to Sexton, Ridley, and Kleiner (this issue) from three different perspectives. First, we discuss their criticisms as rooted in a portrait of common factors to which we do not subscribe. Second, we discuss points of agreement and partial agreement between our two articles. Finally, we discuss our areas of clear disagreement with their points of view. In these areas of disagreement we put forth the common factors approach as an empirically supported lens; we discuss the influence of investigator allegiance on the specificity conclusion; and we challenge the idea that the common factors lens is simple. In conclusion, we illustrate how common factors work through a credible therapy model using functional family therapy as an example.

Effectiveness research in marriage and family therapy: introduction.

The papers in this volume offer compelling evidence that MFT is making significant progress toward becoming an evidenced based discipline. Nonetheless, a large gap persists between research and practice, which perpetuates a false dichotomy between the art and science of treatment and has other deleterious consequences for the field. The methodological strengths of the investigations reported, which focus on clinical trials, are discussed along with concerns raised about this type of research. Several important challenges facing MFT research in the decades ahead are described. Finally, MFT education must be changed substantially to give more emphasis to the science of the discipline.

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.