"Don't you care about the well-being of your race?": African American couples discuss racial differences involving criticisms of other Black people.

African American couples have unique racial stress and high relationship instability, although few studies have examined the role of racial stressors in their relationships. This qualitative study used grounded theory to examine 10 African American couples' disagreements about criticisms of other Black people. Each couple completed a standard couple problem-solving task modified to focus solely on racial differences between the partners. Two models of couple relationships framed the approach; the general vulnerability-stress-adaptation model (Karney & Bradbury, Psychol. Bull., 118, 1995, 3) was combined with a comprehensive race-focused model (Bryant et al., J. Fam. Theory Rev., 2, 2010, 157). The goal was to understand racial stress faced by African Americans, including its context, how and why it is stressful, how they cope, and its consequences in their relationship. A tentative model emerged, suggesting that some African Americans have early race-related experiences that make them vulnerable to concerns about how Black people are seen by others. This may result in a unique minority status stressor that appears indicative of internalized stereotypes and may often include gendered criticisms of their partners. Partners seem to adapt by looking to other African Americans to take personal responsibility for their behavior and defending their racial group. Black male-female gender role issues appear to emerge as a consequence of racial stress that also seems salient across all aspects of the model. Future studies can further examine culturally specific models involving African Americans' criticisms of other Black people and identify successful couple-level strategies to overcome internalized oppression.

Las parejas afroestadounidenses tienen un estrés racial único y una gran inestabilidad en la relación, pero pocos estudios han analizado el papel que desempeñan los factores desencadenantes de estrés racial en sus relaciones. En este estudio cualitativo se utilizó la teoría fundamentada para analizar los desacuerdos de 10 parejas afroestadounidenses acerca de las críticas de otras personas de color. Cada pareja realizó una tarea estándar de resolución de problemas en la pareja modificada para centrarse únicamente en las diferencias raciales entre los integrantes de la pareja. El enfoque se enmarcó en dos modelos de relaciones de pareja. El modelo general de vulnerabilidad-estrés-adaptación (Karney & Bradbury, 1995) se combinó con un modelo integral centrado en la raza (Bryant et al., 2010). El objetivo fue comprender el estrés racial que enfrentan los afroestadounidenses, incluidos su contexto, cómo y por qué es estresante, cómo lo afrontan y sus consecuencias en su relación. Surgió un modelo tentativo, el cual indicó que algunos afroestadounidenses tienen experiencias tempranas relacionadas con la raza que los hacen vulnerables a las preocupaciones acerca de cómo otras personas ven a las personas de color. Esto puede generar un factor desencadenante de estrés único de las minorías que parece indicar estereotipos internalizados y con frecuencia puede incluir críticas marcadas por el género de sus parejas. Los integrantes de la pareja parecen adaptarse recurriendo a otros afroestadounidenses para que se responsabilicen personalmente de su conducta y defendiendo a su grupo racial. Aparentemente, los problemas de roles de género de los hombres y las mujeres de color surgen como consecuencia del estrés racial que también parece destacarse entre todos los aspectos del modelo. En futuros estudios se pueden analizar más profundamente modelos culturalmente específicos relacionados con las críticas de los afroestadounidenses a otras personas de color y reconocer estrategias satisfactorias a nivel de la pareja para superar la opresión internalizada.

The Black Lives Matter Movement: A Call to Action for Couple and Family Therapists.

The frequent police killings during the COVID-19 pandemic forced a reckoning among Americans from all backgrounds and propelled the Black Lives Matter movement into a global force. This manuscript addresses major issues to aid practitioners in the effective treatment of African Americans via the lens of Critical Race Theory and the Bioecological Model. We place the impacts of racism on Black families in historical context and outline the sources of Black family resilience. We critique structural racism embedded in all aspects of psychology and allied fields. We provide an overview of racial socialization and related issues affecting the parenting decisions in Black families, as well as a detailed overview of impacts of structural racism on couple dynamics. Recommendations are made for engaging racial issues in therapy, providing emotional support and validation to couples and families experiencing discrimination and racial trauma, and using Black cultural strengths as therapeutic resources.

Las frecuentes muertes a manos de la policía durante la pandemia de la COVID-19 obligaron a los estadounidenses de todos los orígenes a hacer una evaluación e impulsaron el movimiento Black Lives Matter hasta convertirlo en una fuerza mundial. Este manuscrito aborda las cuestiones principales con el fin de ayudar a los profesionales en el tratamiento eficaz de los afroestadounidenses desde la perspectiva de la teoría crítica de la raza y el modelo bioecológico. Ubicamos los efectos del racismo en las familias negras en un contexto histórico y describimos las fuentes de resiliencia de estas familias. Analizamos el racismo estructural incorporado en todos los aspectos de la psicología y en áreas afines. Ofrecemos un resumen de la socialización racial y de cuestiones relacionadas que afectan las decisiones de crianza en las familias negras, así como un panorama detallado de los efectos del racismo estructural en la dinámica de pareja. Se dan recomendaciones para integrar las cuestiones raciales en la terapia, brindar apoyo emocional y validación a parejas y familias que sufren discriminación y trauma racial, y usar las ventajas culturales de las personas de color como recursos terapéuticos.

Principle-Based Integrative Therapy with Couples: Theory and a Case Example.

The Principle-Based Integrative Therapy (PBIT) framework harnesses the principles of change underlying each theoretical model within integrative couple therapy treatments. PBIT has commonalities with other integrative approaches, and additional advantages stemming from its four tenets that guide therapists in combining strengths across models and overcoming each of their deficiencies. Tenet 1 advises that each model adds a core principle or mechanism of action that other models do not automatically address. Tenet 2 focuses on how techniques of one model may actualize the principles of other models. Tenet 3 ensures complementarity and a lack of conflict across principles. A case study and common case considerations are presented to illustrate how Tenets 1-3 can work in integrating Cognitive-Behavioral, Multicultural, and Emotionally Focused Therapy models in working with a couple. Finally, Tenet 4 advocates for the use of models and empirically supported principles that also have received empirical support with diverse populations. Prerequisites and training implications for PBIT, and future clinical and research directions to further the utility of PBIT are discussed.

El marco de la Terapia Integrativa Basada en Principios (PBIT) aprovecha los principios de cambio que subyacen a cada modelo teórico dentro de los tratamientos de la terapia integrativa de pareja. La PBIT tiene similitudes con otros enfoques integrativos y otras ventajas que surgen de sus cuatro principios que guían a los terapeutas en la combinación de los puntos fuertes de los distintos modelos y en la superación de cada una de sus deficiencias. El primer principio recomienda que cada modelo agregue un principio o mecanismo fundamental de acción que otros modelos no aborden automáticamente. El segundo principio se centra en cómo las técnicas de un modelo pueden actualizar los principios de otros modelos. El tercer principio garantiza la complementariedad y la falta de conflictos entre los principios. Se presentan las consideraciones de un caso práctico y de casos comunes para ilustrar cómo estos tres principios pueden funcionar en la integración de los modelos de terapia congnitivo-conductual (CB), multicultural (MC) y centrada en las emociones (EFT) a la hora de trabajar con una pareja. Finalmente, el cuarto principio propone el uso de modelos y principios factuales que también hayan recibido apoyo empírico con diversas poblaciones. Se debaten los prerrequisitos y las consecuencias de la capacitación para la PBIT, así como las futuras direcciones clínicas y de investigación para impulsar la utilidad de la PBIT.

Treatment outcomes of a combined cognitive behavior therapy and pharmacotherapy for a sample of women with and without substance abuse histories on an acute psychiatric unit: do therapeutic alliance and motivation matter?

BACKGROUND AND OBJECTIVES: Women with comorbid psychiatric and substance abuse problems (PwSA) experience more consequences from their use and typically have the poorest prognosis and outcome, compared to those with psychiatric problems but without substance abuse problems (PwoSA). The present study examined outcomes of a combined intensive inpatient cognitive behavior therapy (CBT) and pharmacotherapy program for women with PwSA and PwoSA. METHODS: Sample consisted of 117 women on a women-only acute inpatient unit (PwSA = 50, PwoSA = 67). RESULTS: Women in both groups made significant improvements in psychological functioning. High motivation at admission and therapeutic alliance at discharge were associated with improved psychological functioning at discharge for both groups. SCIENTIFIC SIGNIFICANCE: Findings provide preliminary support for the efficacy of a combined CBT and pharmacotherapy program for women with psychiatric diagnoses on a women-only acute inpatient unit, and for pre-treatment motivation and therapeutic alliance as important correlates of better treatment outcomes.

Engagement and retention in outpatient alcoholism treatment for women.

Reviews of the dropout literature note significant attrition from addiction treatment. However, consistent predictors have not been identified and few studies have examined factors related to retention and engagement for women in gender-specific treatment. The current study consisted of 102 women and their partners randomized to individual or couples outpatient alcoholism treatment. Women attended more treatment sessions if they were assigned to individual treatment, older, had fewer symptoms of alcohol dependence, had more satisfying marital relationships, had spouses who drank, and had matched preference for treatment condition. Women were more engaged in treatment (ie, completed more assigned homework) if they had fewer children at home, fewer alcohol dependence symptoms, later age of onset of alcohol diagnosis, more satisfying marital relationships, and spouses who accepted or encouraged their drinking. Results highlight important associations of treatment and relationship variables with treatment retention and engagement.

Impact of racial perspectives and contextual variables on marital trust and adjustment for African American couples.

This study examined the associations of racial perspectives that represent pro-African American, anti-African American, or a mixture of these beliefs with marital trust and adjustment for African American couples (N = 93). Religious well-being and socioeconomic status (SES) were examined as contextual moderators. For husbands only, the anti-African American perspective was inversely associated with couple functioning, the mixed perspective was inversely associated with marital trust, and the pro-African American perspective predicted marital trust only for husbands having relatively low religious well-being and relatively high SES. The limited effects of pro-African American attitudes suggest the need to evaluate a wider range of these attitudes in future research. Also, findings corroborate suggestions for therapists to routinely assess and address both cultural pride and shame issues relevant to African American couple relationships.

Exploratory factor analysis of African Self-Consciousness Scale scores.

This study replicates and extends prior studies of the dimensionality, convergent, and external validity of African Self-Consciousness Scale scores with appropriate exploratory factor analysis methods and a large gender balanced sample (N = 348). Viable one- and two-factor solutions were cross-validated. Both first factors overlapped significantly and were labeled "Embracing African Heritage." The second subscale of the two-factor solution was labeled "Refusal to Deny African Heritage." Only the structural validity of the first factor of the two-factor solution was fully consistent with prior findings. Partial evidence of convergent validity was found for all factors, and only the second factor of the two-factor solution received external validity support. Implications for usage of the African Self-Consciousness Scale and recommendations for further investigation are discussed.

School violence, adjustment, and the influence of hope on low-income, African American youth.

The current study investigated the prevalence and impact of exposure to school violence using a cross-sectional design with a sample of 132 low-income, African American fifth graders (mean age = 10.20). Additionally, hope was examined in relation to adjustment and as a potential resilience factor in the context of school violence. Students completed self-report measures for exposure to school violence frequencies, self-concept, and hope. Teachers completed a teacher-rated survey assessing levels of problem behaviors, social skills, and academic competence. Results indicated that the majority of youth had been personally victimized or witnessed violence during a 3-month period. Exposure to school violence was positively associated with problem behaviors, and negatively associated with social skills, self-concept, and academic competence; hope was inversely related to externalizing behaviors and positively related to self-concept. Hope buffered the effects of personal victimization and witnessing violence on self-concept. Gender differences were observed for a number of the analyses. The implications of both the prevalence and impact of exposure to school violence, as well as the moderating effects of hope, are discussed.

Pretreatment attrition from couple therapy for male drug abusers.

This study tracked pretreatment attrition of 120 callers, 84 of whom were potentially eligible for outpatient couple treatment for male drug abuse. Demographic, significant other, substance use, and access related variables were examined as predictors of intake and treatment entry. Results were similar to other findings regarding variables associated with initiation of individual substance use treatment, and 29% of eligible callers entered treatment. Men whose partners did not use substances or who used in moderation were more likely to attend the intake session, and couples who received referrals were more likely to enter treatment than those who responded to a newspaper advertisement.