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.     

Qualitative research in family therapy: publication trends from 1980 to 1999

In the early 1990s, scholars from a variety of disciplines encouraged greater inclusion of qualitative research methodology in the mental health field. Moon, Dillon, and Sprenkle (1990) hoped their paper “Family therapy and qualitative research” would serve as a stimulus for further development of qualitative research in the field of family therapy. Ten years later, entering the new millennium, has the field been influenced by recommendations for an increase in use of qualitative methodology in family therapy? A content analysis was conducted on articles published in the marriage and family therapy literature from 1980 to 1999. Of the numerous articles examined in four journals, 131 articles were published using qualitative research methodology. Findings support the contention that qualitative research is increasing, but still accounts for a small number of research articles published in marriage and family therapy journals.     

Qualitative evaluation of family therapy programs: a participatory approach

In this article, we provide examples of participatory qualitative evaluation methods that can be used within family therapy training programs. These methods can elicit useful feedback to improve programs and, at the same time, empower trainees to become partners in the evaluation process.     

Infidelity in committed relationships II: a substantive review

This article, a follow-up on our methodological review of infidelity studies, provides a substantive review of the research findings on infidelity in committed relationships. The aim of this article is to present the most conclusive findings available to both researcher and practitioner on the subject of infidelity. We highlight attitudes toward infidelity; prevalence data; types of infidelity; gender dynamics and infidelity; issues in the primary relationship and their relationship to infidelity; race, culture, and infidelity; education, income, employment, and infidelity; justifications for infidelity; individual issues and their relationship to infidelity; same-sex couples and infidelity; attachment and infidelity; opportunity and infidelity; the aftermath and recovery process from infidelity; and clinical practices.     

The use of theory in family therapy research: a content analysis of family therapy journals

Ninety-five studies from Family Process and Journal of Marital and Family Therapy were evaluated with regard to their use of theory. While a majority of the articles were judged to use theory in either an explicit or an implicit manner, 42% did not appear to draw on theory in either the introductory or discussion sections. Studies that used qualitative methods appeared to use theory more frequently and explicitly than those using quantitative methods alone. Systems theory was found to be the most common conceptual framework, followed by feminism. We conclude that the link between theory and research in family therapy needs strengthening and suggest that the role of theory in family therapy be reexamined.     

Sexual double standards: a review and methodological critique of two decades of research

A review of 30 studies published since 1980 found evidence for the continued existence of sexual double standards: different standards of sexual permissiveness for women and men. Experimental studies have included predominantly White North American college students; ethnographies, focus group and interview studies, and linguistic analyses have included more diverse samples. Studies show that sexual double standards are influenced by situational and interpersonal factors (e.g., the target's age, level of relationship commitment, and number of partners), and that double standards are local constructions, differing across ethnic and cultural groups. This review discusses methodological issues, including the strengths and limitations of quantitative and qualitative approaches. It also discusses implications for women s high-risk sexual behavior and sexual identity, and suggests directions for future research.     

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.     

Infidelity in committed relationships I: a methodological review

Infidelity is perhaps the most complex issue encountered by couple therapists. Although clinical literature, opinion, and speculation on this topic are abundant, research literature is sparse. What little available research exists is, in most cases, neither robust nor helpful to the practicing therapist. This article provides, in both narrative and table format, a comprehensive methodological review of the available research literature on infidelity from 1980 to present. Topics addressed in the narrative include the lack of a consensus on the definition of infidelity; design challenges, such as retrospective research, confidentiality, measures, and variables, and sampling issues, such as diversity and randomization. Throughout the article, we offer suggestions for future research.     

Spiritual assessment in marital and family therapy: a methodological framework for selecting from among six qualitative assessment tools

Emerging professional and cultural developments underscore the importance of spiritual assessment. Most marriage and family therapists, however, appear to have received little training on the topic. Consequently, this article overviews a complementary family of six recently developed qualitative assessment approaches or tools, an initial brief assessment tool and five comprehensive assessment tools, and presents a methodological framework for using the six tools. To help decide whether or not a comprehensive assessment is warranted after conducting an initial brief assessment, two general guidelines are offered. Suggestions for selecting the appropriate comprehensive assessment tool are also presented, and summarized graphically in the form of a decision tree. The overall methodological framework is designed to be congruent with the recent spiritual assessments recommendations issued by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the largest healthcare accrediting organization in the United States.     

What about the family in family therapy research?*

Family therapists are frequently criticised for not publishing any substantiation of the effectiveness of their therapeutic interventions. This paper discusses why clinicians do not evaluate their work through examining current recommendations for family therapy evaluation, and the effects of these recommendations on the family under study. We provide some criteria specific to the family which will assist clinicians in selecting measurement instruments to evaluate family therapy. These relate to ethics, parsimony and design features of the study. The complexity of family therapy evaluation must be addressed if more clinicians are to do evaluation.     

Toward a developmental family therapy: the clinical utility of research on adolescence

Tremendous advances have been made in our understanding of the intrapersonal, interpersonal, familial, and contextual characteristics and processes that contribute to adaptive as well as maladaptive developmental outcomes with high-risk and clinically referred adolescents. This empirical knowledge base offers clinically rich opportunities for systematic treatment development. An important step in this process is distinguishing which research findings in basic science areas such as developmental psychology and developmental psychopathology might have clinical relevance. Toward this goal, we review relevant but selective research in areas that are central to clinical work with adolescents (parent-adolescent relationship, biological aspects, and affect and cognition), and we offer examples of how basic research in these areas can inform treatment.     

A content analysis of research in family therapy journals

In order to assess trends in family therapy research, empirical articles (N = 195) from three family therapy journals over a 5-year period were coded for several variables: authorship, external funding, methodology, sample, purpose, cost effectiveness, use of therapeutic model, and topic. Results indicated that a large pecentage of research in these journals focused on nonclinical issues and used nonclinical samples. Authors were affiliated with a wide variety of disciplines and reported low levels of external funding for their research. While a majority of the studies used quantitative methods, there appeared to be a growing number of studies using qualitative methods. Implications of these findings are discussed in light of research reviews over the past two decades.     

Protecting persons in family therapy research: an overview of ethical and regulatory standards

Family therapists are expected to engage in ethical and responsible research, while maintaining rigorous ethical standards and adhering to federal regulations that require protection for research participants. We present a short historical overview of the significant events and ethical controversies leading to the formulation of current regulations in human subject research and review. Federal regulations and guidelines, including issues of informed consent, special populations, and conflict of interest are reviewed. A short list of recommendations to assist family therapists in staying abreast of contemporary research protocol is provided.     

Integrating research and clinical training in marriage and family therapy training programs

The future of the profession and practice of marriage and family therapy (MFT) rests with those who promote the integration of research and clinical practice. The Boulder scientist-practitioner model is useful in conceptualizing MFT training, but it is not the perfect solution. Four MFT programs (two master's and two doctoral) are featured in this article for their work in integrating research and practice. Helpful strategies presented include: Encouraging students to question the therapy process; integrating research in the curriculum and supervision; discussing the positives and negatives of empirically supported treatments; focusing on change; and developing creative classroom experiences to use within the scientist-practitioner model.     

Spiritual issues in family therapy: a graduate-level course

With the advent of the biopsychosocial approach in family therapy, the domain of spiritual issues is increasingly being recognized as important to families. This article will describe a graduate-level seminar on Spiritual Issues in Family Therapy at the University of San Diego that offers family therapy students the opportunity to examine issues of spirituality, religion, and meaning and their place in therapy. One premise of the course is that research has demonstrated that most clients consider their spiritual life to be relevant to personal problems and would prefer a therapist who is comfortable with such topics. The goals of the course include (1) training in opening a dialogue with individuals and families about spiritual issues and discerning when referral may be appropriate; (2) expanding an awareness of wisdom traditions through use of comparative religions material; and (3) identifying from current practice many of the spiritual issues that may arise in the clinical setting.     

Aesthetic forms of data representation in qualitative family therapy research

In this article we provide a rationale for using alternative, aesthetic methods of qualitative representation (e.g., creative writing, art, music, performance, poetry) in qualitative family therapy research. We also provide illustrative examples of methods that bring findings to life, and involve the audience in reflecting on their meaning. One problem with such forms of data representation has been that, until recently, there have not been standards with which to evaluate them. We summarize evolving standards and explain when the forms are appropriate and when they are not. We also address issues of legitimacy and conflicting standards held by others.     

The theory,structure, and techniques for the inclusion of children in family therapy: a literature review

Many barriers prevent therapists from including young children in family therapy, despite the theoretical belief that every family member should be present. Although there is a wealth of literature describing how to include children, the information has not been compiled in a way that is easily accessible to therapists. In this article, we report the findings of an exhaustive and systematic literature review of 64 publications, published between 1972 and 1999, related to including children in family therapy. The purpose of this article is to offer therapists a succinct compilation of theoretical, structural, and practical aspects as well as a comprehensive listing of specific techniques for including children in family therapy.