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.     

Internship training in marriage and family therapy: a survey of doctoral program objectives and implementation

This article presents the results of a survey that examined the implementation of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) internship requirement by accredited doctoral Marriage and Family Therapy (MFT) programs. Representatives from each of 10 doctoral MFT programs provided responses to questions regarding program objectives for internship training. Respondents also provided subjective impressions regarding the effectiveness with which established internship goals are accomplished, associated benefits and difficulties, and adequacy of the standards. Results suggest that although most programs perceive the internship requirement as beneficial, many express concern regarding the effects of the internship requirement on other aspects of training and in relationship to the overall goals for doctoral MFT education. Conclusions and recommendations are offered based on the mixed findings.     

Use of simulated clients in marriage and family therapy education

Knowledge of how one should manage suicidal, homicidal, child maltreatment, and domestic violence situations is paramount in the training of marriage and family therapists (MFTs). Simulated patient modules were created to help clinical faculty address these crisis situations in a protected learning environment. The modules were implemented by the MFT faculty in collaboration with the Office of Clinical Skills Assessment and Education at East Carolina University's Brody School of Medicine. Qualitative data over the course of 2 years revealed six thematic domains regarding therapists' performance, therapists' emotions, the simulation experiences, and lessons learned. Educational, clinical, and research recommendations include tools to implement simulation exercises into marriage and family therapy programs as well as suggestions to assess for teaching effectiveness.     

The Cultural Genogram: experiences from within a marriage and family therapy training program

The purpose of this article is to illustrate and demonstrate the use of the Cultural Genogram (CG) in a graduate-level course in gender and culture for family therapists-in-training at a large Midwestern university's accredited program in family therapy. Although the importance of the CG as a training tool is delineated by Hardy and Laszloffy, very little information exists about the actual implementation and usefulness of this tool within a training program for family therapists. In this article, we present a qualitative research study of the lived experiences of a class of women from diverse cultures as they constructed and presented their CGs. We discuss the basic curriculum and structure of the course in which the CG was used, the process the class members developed to create and present their CGs, the effects of presenting the CGs, and a set of recommendations and ideas for further exploration.     

Compassion fatigue in marriage and family therapy: implications for therapists and clients

Given that marriage and family therapists are exposed to a wide range of circumstances that leave them uniquely vulnerable to experiencing compassion fatigue, it is important to examine the stresses and hazards they face and what those consequences mean for both themselves and clients. It is essential that they identify how compassion fatigue negatively affects the therapeutic relationship and overall treatment outcome as well as that of the personal life of the family therapist. The marriage and family therapist is responsible and ethically obligated to identify and implement ways in which he or she can prevent and remedy compassion fatigue.     

Postmodernism in marriage and family therapy training: doctoral students' understanding and experiences

The purpose of this study is to advance our understanding of how doctoral students perceive postmodernism's influence in the field of Marriage and Family Therapy (MFT). According to the literature, postmodernism has had a profound impact on many fields, including MFT. However, tracking of how postmodernism is actually being rendered in theory, research, practice, and training warrants investigation. This study utilized focus group interviews to investigate the perceptions of MFT doctoral students. Findings suggest that while participants are attracted to postmodern tenets, they also report feeling a mixture of liberation and excitement with confusion and fear regarding how postmodernism is influencing MFT models of therapy.     

Making space for racial dialogue: our experience in a marriage and family therapy training program

Marriage and family therapy (MFT) training programs need to create opportunities for all students to develop cultural competency by raising their racial awareness and sensitivity. Likewise, therapists of color need to be offered space in MFT programs to voice their experiences and venues for their voices to be heard. This article reports on the efforts within a master's level, accredited MFT training program to create space, through participatory action research, for the unique experiences of therapists of color and White therapists who are deeply committed to racial sensitivity.     

Understanding the experience of Black clients in marriage and family therapy

Past research on Black clients' utilization of therapy focused on the barriers that prevent Black clients from attending therapy and the reasons for these barriers. However, few studies have been conducted that focus on how Black clients attending therapy actually experience these barriers. This study utilized both Likert and open-ended questions to examine the obstacles 16 Black clients face in their attempts to attend family therapy. The most frequently identified obstacles were related to concerns over family member response and cultural barriers to therapy. Participants also reported concerns about racial and/or cultural differences and a lack of understanding by non-Black therapists. The implications of this study addressed how to effectively meet the therapeutic needs of Black clients.     

Training experiences of international doctoral students in marriage and family therapy

Recognizing mental health needs of diverse populations, emphasizing cultural diversity, and recruiting ethnic minority students are important foci of current of marriage and family therapy training programs. However, the profession has made little progress in identifying the needs and experiences of its international students and practitioners. This research examines the experiences of doctoral-level international students across the areas of theory, clinical training, supervision, practice, and research. A qualitative methodological approach was used to explore the research questions. Thirteen in-depth interviews were conducted. Findings revealed that most respondents experienced some adjustment problems, want more academic and career support, and need increased recognition for their cultural differences. Recommendations for training international students are included.     

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.     

Restarting a family: having children in second marriage

The impact of divorce and remarriage on fertility is examined. The author reviews the literature and questions the approach used in most studies, which focus on the fertility experience of remarried women. He argues instead that the remarried couple should be the focus of inquiry. Original data from interviews with 25 remarried couples in Aberdeen, Scotland, are used to illustrate childbearing patterns in second marriages.     

Beyond common factors: multilevel-process models of therapeutic change in marriage and family therapy

A number of scholars have proposed the common factors perspective as the future direction of marriage and family therapy (MFT). Although intuitively appealing, the case for the common factors perspective is not as clear-cut as proponents portray. In its current form, the common factors perspective overlooks the multilevel nature of practice, the diversity of clients and settings, and the complexity of therapeutic change. In contrast, comprehensive process-based change models are an alternative to the limitations of common factors. In this article, we consider the limitations of the common factors perspective and propose the necessary and sufficient components and processes that might comprise comprehensive, multilevel, process-based therapeutic change models in MFT.     

Sexual addiction and marriage and family therapy: facilitating individual and relationship healing through couple therapy

In recent decades there has been an increase in literature regarding sexual addiction as well as a growing number of clients presenting in therapy with problems related to their sexual behaviors (including internet sexual addiction). This article (a) presents a synthesis of the research on the impact of sexual addiction on the addict, the partner, and the couple; (b) outlines the process of healing for each based on the research synthesis; and (c) discusses the role of marriage and family therapy in facilitating both individual and relationship healing from sexual addiction. Implications for future research in sexual addiction, generally, and in marriage and family therapy, specifically, are presented.     

Approaches to the study of gender in marriage and family therapy curricula

This study compares two accredited marriage and family therapy programs: One includes a separate course on gender, and the other integrates gender throughout the curriculum. Students from the two programs rated their own and their peers' experience of how gender education effects therapy, program culture, and personal life. Results indicate that students from the integrated program view their peers as incorporating gender ideas in therapy to a significantly greater extent (t = 2.83, p < .05) than do students in the gender course program. However, students from the program that has a gender course leaned more toward agreement with feminist concepts than did students from the integrated program. Overall, students appear to be learning about gender and integrating these concepts into their work as therapists. Discussion is included on how to choose a gender curriculum.     

The practice of clinical research in accredited marriage and family therapy programs

This study aims to explore the prevalence of clinic-based research among accredited marriage and family therapy (MFT) programs and reveal rationales explaining why academic settings may or may not be conducting clinical research. Findings of this project are the result of electronic-mail surveys completed by 26 accredited MFT programs. Approximately one-half of the respondents reported currently conducting clinic-based research. Open-ended responses reveal factors that lead to research success and failure, as well as reasons research was not being conducted at training programs.     

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.     

Factors influencing student selection of marriage and family therapy graduate programs

To understand which factors students consider most important in choosing a marriage and family therapy (MFT) graduate program and how programs met or did not meet these expectations of students over the course of graduate study, we conducted an online mixed-method investigation. One hundred twelve graduate students in Commission on Accreditation for Marriage and Family Therapy Education-accredited programs responded to an online survey assessing what factors led them to select a specific graduate program in MFT. In the quantitative portion, students ranked each factor (personal fit, faculty, funding, research, clinical work, and teaching) as well as characteristics of each factor in relation to its importance in their selection of an MFT program. Additionally, students indicated to what level their programs meet their expectations. In the qualitative portion, students described how they believed their chosen program was or was not meeting their expectations. Both doctoral and master's students ranked personal fit as the top factor affecting their choice of graduate program in MFT, but they differed on the characteristics of each of these factors and their importance in selecting an MFT program. Implications for this research include program evaluation and program advertising, and are consistent with the scientist-practitioner model.     

Integrating gender on multiple levels: a conceptual model for teaching gender issues in family therapy

As the field of family therapy has evolved, there has been growing recognition as to the importance of gender in family therapy. To prepare the next generation of family therapists adequately, it is important that they recognize the many and complex ways in which gender permeates their work. In this article we present an integrative model to help educators teach family therapists about gender issues. The model examines how gender influences clinical work on multiple levels, including contextual levels such as society and the marriage and family therapy field. The model also acknowledges how gender can influence individuals, including clients, therapists, and supervisors. Finally, the model attempts to capture the complexity of how gender can impact the relational dynamics between two or more individuals.