Recruiting and training multilingual family therapists: A content analysis of COAMFTE-accredited marriage and family therapy program websites.

Among U. S. Limited English Proficiency (LEP) communities, language needs and preferences create significant barriers to accessing quality healthcare and contribute to growing physical and mental health disparities. To mitigate these barriers, it is critical to recruit and train a new generation of linguistically diverse providers, including marriage and family therapists (MFTs). This study examined how Marriage and Family Therapy (MFT) program website content promotes a commitment to recruiting and training multilingual MFTs. The study sample consisted of all currently accredited programs (N = 122) and included coding for the presence or absence of (a) an explicit commitment to multiculturally and linguistically informed training, (b) specialized multilingual training and supports, and (c) multilingual faculty involved in training multilingual students or engaged in related scholarship. Results indicate that a majority of MFT programs are communicating a commitment to multiculturally informed training, but the same is not true of linguistically responsive training.

Two-Year Follow-Up of the Efficacy of the PREP Training on Iranian Newlyweds.

The aim of the present study was to replicate the efficacy of the Prevention and Relationship Education Program (PREP) training on marital satisfaction and dyadic adjustment among a group of Iranian newlyweds. One hundred and sixty heterosexual couples (N = 320 participants) were randomly assigned to an experimental or a wait list control group. Data from one hundred and forty-eight couples were analyzed. Participants completed the ENRICH Marital Satisfaction Scale (The Family Journal, 1, 1993, 196-207) and Dyadic Adjustment Scale (The Journal of Sex Research, 39, 1976, 190-196) at pretest, posttest, 1-year follow-up, and 2-year follow-up. Results indicated that mean marital satisfaction and dyadic adjustment scores between the experimental and control groups were significantly different at posttest. Therefore, PREP training improved marital satisfaction and dyadic adjustment of couples at posttest. The data suggests that PREP training program can be introduced as an effective relationship education program for Iranian newlyweds.

Infidelity in the Time of COVID-19.

Infidelity occurs in approximately 25% of marriages and is associated with various negative consequences for individuals (e.g., depression, anxiety, and post-traumatic stress), the couple relationship (e.g., financial loss, increased conflict, and aggression), and the couple's children (e.g., internalizing and externalizing behaviors). Infidelity is also one of the most frequently cited reasons for divorce. The increased stress brought on by the pandemic may be putting couples at an increased risk for experiencing infidelity, and data collected during the pandemic have shown that people across the United States are engaging in behaviors that are associated with a high likelihood of experiencing infidelity. The negative consequences of infidelity are also likely to be exacerbated for couples during the pandemic due to the intersection with the social, emotional, and financial consequences of COVID-19. Furthermore, couples are likely to experience disruptions and delays to the affair recovery process during the pandemic, which can negatively impact their ability to heal. Therefore, recommendations for navigating affair recovery during the pandemic, including adaptations for therapy, are also discussed.

La infidelidad se da en aproximadamente el 25 % de los matrimonios y está asociada con varias consecuencias negativas en las personas (p. ej.: depresión, ansiedad, estrés postraumático), la relación de pareja (p. ej.: pérdida económica, aumento de conflictos y agresiones) y los hijos de la pareja (p. ej.: comportamientos de internalización y de externalización). La infidelidad también es uno de los motivos de divorcio más frecuentes. El aumento del estrés que genera la pandemia puede aumentar el riesgo de las parejas de ser infieles, y los datos recogidos durante la pandemia han demostrado que las personas de los Estados Unidos están teniendo conductas asociadas con una alta probabilidad de ser infieles. Además, durante la pandemia, las consecuencias negativas de la infidelidad tienden a exacerbarse en las parejas debido a la combinación con las consecuencias sociales, emocionales y económicas de la COVID-19. Asimismo, el proceso de recuperación de la aventura amorosa tiende a interrumpirse y retrasarse durante la pandemia, lo cual puede influir negativamente en la capacidad de sanar de las parejas. Por lo tanto, también se dan recomendaciones para orientarse en el proceso de recuperación de la aventura amorosa durante la pandemia, por ejemplo, adaptaciones relacionadas con la terapia.

Marital Hypnotherapy: A Session with Milton Erickson with Commentary.

Hypnosis has primarily been used to treat individual problems. Occasionally, it has been applied to couples' problems such as infertility. We present a transcript of a treatment session of Dr. Milton Erickson in which he works with a married couple and interpret his techniques. We emphasize the following principles. Dr. Erickson's assessment was brief, just long enough to determine a general target. He used hypnotic induction to build responsiveness. He used evocative communication. He seeded ideas that, when presented later, had a powerful impact. He moved in small, strategic steps. The main intervention was designed to elicit dormant resources and adaptive states. He followed through, providing suggestions on how to use these resources. In presenting this case and our analysis of it, we highlight some of Dr. Erickson's methods and conceptualization of several intervention techniques.

Marital communication skills training to promote marital satisfaction and psychological health during pregnancy: a couple focused approach.

BACKGROUND: Studies showed that decreased marital satisfaction and increased risk of depression and anxiety were mutually related. Therefore, this study was conducted to evaluate the effect of communication skills training with a couple focused approach on marital satisfaction and psychological symptoms among pregnant women. METHODS: This experimental study was performed on 60 pregnant women with low marital satisfaction who were divided into two groups of intervention and control. The women in the intervention group and their husbands participated in a communication training program based on the couple focused approach. The levels of anxiety, depression, and marital satisfaction were evaluated before and then one and three months after the intervention using valid questionnaires. RESULTS: The results indicated that after the intervention, compared to the pre-intervention period, the levels of marital satisfaction increased while the levels of depression and anxiety decreased significantly in the intervention group (p < 0.05). The comparison of the groups revealed significant differences in the scores of marital satisfaction, depression, and anxiety in the intervention and control groups at the intervals of one month and three months after the intervention (p < 0.05). CONCLUSIONS: The research findings indicated that communication skills training program based on the couple focused approach and an emphasis on the needs of pregnant women during the pregnancy can improve the marital satisfaction and psychological health of pregnant women. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT2017012932264N2, Date of registration: 2017-06-28 Retrospectively registered.

Randomized Controlled Trial of the Marriage Checkup: Depression Outcomes.

The association between relationship functioning and depressive symptoms is well established. This study examined the effects of the Marriage Checkup, a brief two-session Assessment and Feedback relationship intervention, on depressive symptoms. Two hundred and nine married couples participated in the Marriage Checkup and were randomized into Treatment (N = 108) and Waitlist-Control Conditions (N = 101). Compared to the control condition, intervention participants reported significant improvements in depressive symptoms (d = 0.55), with an even greater effect for those who were reporting more severe baseline depression symptoms (d = 0.67). These outcomes are comparable to those within long-term individual psychotherapy, couple therapy, and pharmacology trials, making this the briefest intervention to date to demonstrate significant improvements in depressive symptoms. Clinical implications are discussed.

The Profession of Couple, Marital, and Family Therapy (CMFT): Defining Ourselves and Moving Forward.

The field of Couple, Marital, and Family Therapy (CMFT) has evolved and strengthened, but we still have work to do when it comes to identity, comprehensive scholarly resources, empirical support, and name brand recognition. We explore the reasons for these challenges and propose ways to address them: embracing the interdisciplinary nature of the field, consistently organizing treatment effectiveness by problem rather than by intervention model, continuing innovation in theory development, and utilizing more diverse and meaningful research methods. This approach provides a more accurate representation of the scope of practice of CMFTs, the range of mental and physical health problems we address, and the depth and extent of the existing research on the effectiveness of relational therapies.

Strengthening Clinical Research in Marriage and Family Therapy: Challenges and Multilevel Solutions.

There is a critical need for high-quality and accessible treatments to improve mental health. Yet, there are indications that the research being conducted by contemporary marriage and family therapy (MFT) scholars focuses less on advancing and disseminating clinical interventions than in previous decades. In this article, we describe challenges to increasing rigorous clinical research in MFT. We use systems mapping and the intervention-level framework to identify strategic goals designed to drive innovation in clinical research in the field. It is our hope this article encourages dialog and action among MFT stakeholder groups to support clinical science that will improve the health and functioning of families.

Expanding Systems Thinking: Incorporating Tools from Medical Sociology into MFT Education and Research.

The field of marriage and family therapy has historically focused on dynamics within family systems, and at times the role of social and cultural factors external to the family. To date, however, little scholarship has examined how therapists themselves are embedded within a mental healthcare system. The purpose of this article is to demonstrate how structural components of the mental healthcare system shape the practice of therapy. We draw from the field of medical sociology to illustrate how three dominant structures-managed care, diagnosis, and evidence-based models-are intertwining and mutually reinforcing systems that have significant and long-term implications for systemic therapists and researchers. We recommend incorporating a sociological understanding of such structures into MFT education and research.

Issuing and Responding to Unusual Questions: A Conversation Analytic Account of Tom Andersen's Therapeutic Practice.

Tom Andersen is considered one of the key contributors to the development of postmodern practice. Little is known, however, about the ways in which his ideas and practices are routinely carried out in situ. We used Conversation Analysis (CA) to investigate a session of couple therapy facilitated by Andersen. We show how Andersen and client participants oriented to and addressed problems of understanding that occurred between them. The source of this trouble was Andersen's use of unusual question formulations. We offer preliminary evidence that such unusual formulations served particular interactional and institutional (i.e., therapeutic) functions in their local contexts of use. We conclude by considering some implications of this analysis-and of conversation analytic inquiry more generally-for the practice of family therapy.

Discursive Research and Clinical Realities, or the Eye of the Beholder.

The comparison of four discursive and conversational analysis studies performed on the same couple consultation session, held by Tom Andersen, show a diversity of results. It can be argued the results are so varied that they constitute different realities, often incompatible with each other. This, far from being a shortcoming of these studies, can be seen as the true richness they can offer to the practicing therapist, who can use research to investigate the different perspectives we can adopt in viewing our clinical activity. The comparison of the four studies raises questions about the role of the therapist in such process. Clinical implications of this are also discussed.

The EIS Model: A Pilot Investigation of a Multidisciplinary Sex Therapy Treatment.

Marital couples not experiencing a satisfying sexual relationship are less satisfied in their overall relationship. There is, however, a paucity of controlled outcome studies researching the effectiveness of sex therapy interventions. This study was a pilot investigation of a new manual-based sex therapy called the EIS (empathy, intimacy, and sexual satisfaction) model. Results showed significant improvement in sexual and marital satisfaction, marital intimacy, and verbal sexual intimacy for men and women, and sexual function for women. Effect sizes were large for these variables and posttreatment differences. Results provide initial support for the theory and interventions of the EIS model. Treatment should include addressing vulnerable communication, relational intimacy, conflict resolution, sexual functioning, sexual medicine care, and sensual and sexual skills.

The Development and Implementation of a Multi-Couple Therapy Model with Torture Survivors in the Democratic Republic of the Congo.

In this article, we present development and feasibility of implementation of a multi-couple group for use with torture-surviving couples. The model was developed in the Democratic Republic of the Congo in a community that experienced widespread torture during the wars from 1998 to 2004. The Torture-Surviving Couple Group model is a short-term intervention designed to use few human resources to address relational difficulties resulting from exposure to traumatic stressors. The model was guided by critical and feminist epistemologies and employed an ecological lens to incorporate neurobiology and attachment processes along with narrative therapy techniques. An existing multi-couple group model for addressing violence (Stith, Rosen, McCollum, & Thomsen, ), and a stage model for healing trauma (Herman, ) also informed the structural development of the Torture-Surviving Couple Group model. Couple groups were conducted using a 10-session program with 13 couples who met weekly. Session themes were incorporated into four phases emphasizing: (a) preparation; (b) safety and stabilization; (c) processing the relationship effects of trauma and grief; and (d) reintegration and rebuilding couple and family life. Couples reported and showed remarkable progress in their relationships after participating in the groups. Clinical and research implications and discussed along with the feasibility of developing and testing the model in a post-conflict low income setting.

The Effects of Briefly Interrupting Marital Conflict.

This study examined couples' (N = 94) behavior resulting from two proximal change interventions. One was a spousal "compliments intervention" to increase positivity, and the other was a "criticize intervention" to increase negativity. Participants were randomly assigned to one of the two intervention conditions or a control group. There was no main effect in affect from the pretest conflict discussion to the posttest conflict discussion between the interventions or control group. However, a manipulation check on how couples acted during either intervention produced a significant interaction effect. Pretest affect during conflict and marital satisfaction significantly predicted couples' construal of the intervention. Professionals may need to monitor how couples use specific interventions and direct the processes how the intervention is construed by the couple.

Group Couples' Intervention to Improve Sexual Health Among Married Women in a Low-Income Community in Mumbai, India.

This article describes the design and implementation of a group couples' intervention focused on improving women's sexual health as a component of a multilevel community, clinical, and counseling intervention project conducted in association with a gynecological service in a municipal urban health center in a low-income community in Mumbai, India. The group couples' intervention involved four single-gender and two mixed-gender sessions designed to address the dynamics of the marital relationship and establish a more equitable spousal relationship as a means to improve women's sexual and marital health. Involvement of men presented a major challenge to couple's participation. For those couples that did participate, qualitative findings revealed significant changes in couple and family relations, sexual health knowledge, and emotional well-being.

Dyadic Supervision Evaluation: An Actor-Partner Relational Model.

This article contributes to research practices in marital and family therapy, specifically the dyadic and development over time in clinical supervision, and describes and applies methodological strategies to develop measurements congruent with the systemic and developmental principles of the field. This project evaluates the psychometric properties of the dyadic supervision evaluation (DSE) in terms of measurement equivalence and causality. A structural equation analysis is conducted utilizing the actor-partner interdependent model resulting in a goodness of fit. This study presents a longitudinal model for evaluating the supervisory relationship and proposes a model of clinical supervision evaluation. The relationship among latent constructs in the DSE and its limitations related to inference and application are discussed.

Results of Gottman Method Couples Therapy with Gay and Lesbian Couples.

The results of an uncontrolled study of Gottman Method Couples Therapy in changing relationship satisfaction with 106 gay and lesbian couples is reported in this paper. Measurement of relationship satisfaction was conducted at five separate time points. The data show significant improvements in relationship satisfaction following eleven sessions of therapy for both gay male and lesbian couples. Effect sizes suggest that this therapy was highly effective, compared to the usual 0.5 standard deviation effect size in couples therapy. Initial co-morbidities did not affect the size of the changes; in fact, some changes were significantly larger for three initial co-morbidities.

Alternative or Nontraditional Sexualities and Therapy: A Case Report.

A traditionally marginalized subset of couples engage in consensual nonmonogamy (CNM: open marriage, polyamory, swinging, etc.) or alternative sexualities, such as kink or bondage/discipline, dominance/submission, and sadism/masochism. Nonmonogamous and sexually diverse individuals often experience discrimination or stigma in various domains of professional services, including mental healthcare. These cases require knowledge, skills, and awareness to provide culturally sensitive care, which is often called "kink aware therapy" or "poly-friendly therapy" within alternative sexuality communities. This article explores one application of a kink-focused and CNM-focused therapeutic framework for working with a couple who is exploring nontraditional sexualities. This case incorporates evidence-based clinical practice and identifies the limitations and significant gaps in the empirical research literature.

A infidelidade no relacionamento amoroso: possibilidades no trabalho clínico com casais / Infidelity in romantic relationships: opportunities in couples' clinical work

Embora o que se entenda como infidelidade varie de acordo com o contexto sociocultural e o contrato estabelecido por cada casal, seu impacto na relação costuma ser significativo e desafiador. Neste artigo, serão abordadas possibilidades de intervenção junto a casais que buscam terapia em virtude da infidelidade conjugal. É importante considerar a infidelidade como um fenômeno complexo, relacionado a questões intrapsíquicas, relacionais, situacionais e socioculturais. O terapeuta deve abordar (a) o impacto inicial da descoberta da infidelidade; (b) a história da relação, de forma a contextualizar o acontecido; e (c) o seu futuro. Nesse processo, mostram-se úteis tanto sessões individuais como conjugais. O entendimento da infidelidade requer um olhar sistêmico, que consiga abranger a história do casal e da família, suas crenças e seus padrões relacionais. O terapeuta precisa ser capaz de criar um ambiente de compreensão mútua que possibilite as mudanças desejadas pelos cônjuges.(AU)

Although its meaning may differ according to specific socio-cultural contexts and to the established contract, infidelity always causes stress on couples' relationships and is very challenging to deal with. This article addresses possibilities of intervention when dealing with couples who seek therapy due to infidelity. It must be considered as a complex phenomenon, associated to intrapsychic, relational, situational and socio-cultural issues. Therapists must address: (a) the initial impact of the of infidelity revelation; (b) the history of the relationship, in order to contextualize what happened; and (c) what can be expected for the relationship's future. In this process, both individual and couples sessions are useful. Understanding infidelity requires a systemic approach, which should consider the history of the couple and of their family; their beliefs and their relational patterns. Therapists should be able to create an environment of mutual understanding thus contributing to the changes desired by the spouses.(AU)

Emotionally Focused Couple Therapy for Parents Raising a Child with an Autism Spectrum Disorder: A Pilot Study.

Many couples raising children diagnosed with an Autism Spectrum Disorder (ASD) are often resilient in confronting unique parental demands, while others experience greater risk for relational distress. Research has shown that Emotionally Focused Couple Therapy (EFT) is efficacious with couples raising chronically ill children and relevant to the relational demands of parents of children diagnosed with an ASD. This pilot study tested the effectiveness of EFT with seven couples presenting with moderate to severe distress, who were also parents of a child diagnosed with an ASD. Results demonstrated significant decreases in marital distress at posttreatment and 6-month follow-up. The study also identified several unique themes associated with couple distress and the parenting experiences of this population.