A REVIEW AND EVALUATION OF MARITAL AND FAMILY THERAPIES FOR AFFECTIVE DISORDERS

Although the efficacy of individual treatments of affective disorders has been well-documented, there are also significant limitations to existing treatments. In the last decade attention has focused increasingley on the interpersonal context of affective illness, and on marital and family relationships in particular. As a result, a number of approaches have been developed which directly involve family members in treatment. In this article we evaluate the current status of marital and family therapies for affective illness. We begin with a discussion of several lines of research bearing on the relationships between family processes and affective illness. The available treatment outcome data evaluating the efficacy of marital and family interventions are then reviewed, with particular attention paid to predictors of treatment success and cost efficacy issues. Finally, we suggest several priorities for future research.     

STRUCTURED MARITAL SEPARATION AS A MARITAL TREATMENT METHOD*

This article describes therapist-structured marital separation for distressed couples during their critical period of deciding whether to divorce or remain married. Characteristics of marital distress appropriate for structured marital separation are identified and discussed; potential benefits are explicated; and the design of the separation contract is specified. Issues addressed in the structure of the separation include the duration of the separation; the frequency of contact between partners; sexual contact between partners; dating; sexual contact with others; privacy; and contact with children.     

TREATMENT OF MARITAL CONFLICT AND PREVENTION OF DIVORCE

This paper provides a review of previous literature reviews on the effectiveness of marital therapy and evaluates the long-term efficacy of couples therapy in preventing marital separation and divorce. There is general agreement that marital therapy can be effective in reducing marital conflict and promoting marital satisfaction, at least in the short term. Research examining the long-term efficacy of couples therapy for the prevention of marital separation and divorce is sparse but promising with respect to its effectiveness in promoting marital stability. Predictors of successful marital therapy outcomes, the clinical significance of marital therapy outcomes, and the cost effectiveness of marital therapy are also discussed.     

MARITAL PARADIGMS: COMPATIBILITY, TREATMENT, AND OUTCOME IN MARITAL THERAPY

Marital paradigms comprise the guiding images that serve as reference models for a couple's relationship. Such individualized images can be understood as variations on a small set of basic themes. An understanding of clients' marital paradigms can help foeus treatment on the most appropriategoals usingapproaches and techniques that are most effective for a particular couple. An unselected group of 103 couples seen in systems-oriented marital therapy were reviewed, to identify outcome and treatment issues as a function of marital paradigm. Based on outcome criteria that took marital paradigm into account, 92% of 38 cases where both partners identified with the same basic paradigm were judged to be treatment successes, while only 60% of the cases where the partners identified with different paradigms could be considered successful outcomes. Clinical approaches based on experience with marital therapy conducted within a paradigmatic framework are presented.     

COMPUTER-BASED INTERPRETATION OF THE MARITAL SATISFACTION INVENTORY: USE IN TREATMENT PLANNING

This paper describes the computer-based interpretive system for the Marital Satisfaction Inventory (MSI) and its application in initial phases of clinical assessment and treatment planning. The automated MSI interpretive report contains sections regarding profile validity and global marital affect, spousal communication, specific areas of interaction, concerns regarding children, role orientation, and family history of distress. A case study and sample narrative demonstrate the manner in which the MSI computerized report can be incorporated into initial clinical assessment and treatment planning. Clinical findings at intake are compared with MSI profiles for this couple obtained at termination and follow-up. Both strengths and limitations of self-report measures and computer-based interpretive reports in marital therapy are considered.     

MARITAL THERAPY: QUALITIES OF COUPLES WHO FARE BETTER OR WORSE IN TREATMENT

To evaluate the effectiveness of couples therapy and determine the characteristics and qualities of couples who fare best in treatment, 139 couples presenting at a nonlaboratory sliding-fee clinic in Dallas, Texas, were evaluated. Observational and self-report measures of the Beavers Systems Model were taken at the first session and, for some subjects, at termination. Therapists also rated the couples on goal attainment and on dimensions of the therapeutic alliance. Not surprisingly, there was a direct association between number of sessions and goal attainment, with couples attending only one or two sessions having the lowest goal attainment. There were also significant family functioning qualities associated with success: more competent couples fared better in therapy. Another consistent finding was that couples with no children did better in treatment than those who were also parents. It is interesting that remarried couples without children did best in treatment, followed by first-married couples with no children, first-married couples with children, and, finally, remarried couples with children. Implications for screening and clinical work with couples are presented.     

COMPONENT ANALYSIS OF BEHAVIORAL MARITAL THERAPY: 2-YEAR FOLLOW-UP AND PREDICTION OF RELAPSE

The present study provides 2-year follow-up data for a comparison between a complete behavioral marital therapy treatment package (CO) and two of its major components, behavior exchange (BE) andcommunication/problem-solving training (CPT). Data are reported for 34 couples who were randomly assigned to one of these three treatments, completed the treatment to which they were assigned, and were available for the 2-year follow-up. The effects of therapy at the 2-year follow-up were evaluated using a global measure of marital satisfaction and a checklist of presenting marital problems. Statistically significant differences between the three treatments were not in evidence on any of the measures. However, couples in the CO treatment condition were most likely to be happily married and least likely to be separated or divorced. Attempts to identify variables which predicted long-term outcome were largely unsuccessful. Ananalysis based on standardized telephone interview indicated that, while neither therapist attributes nor maintenance of treatment-derived relationship skills were associated with long-term marital satisfaction, stressful life events subsequent to therapy termination were negatively related to marital satisfaction.     

A COMPARATIVE ANALYSIS OF THE NATIVITY WEALTH GAP*

We investigate the relative wealth position of immigrant households residing in Australia, Germany, and the United States. In Germany and the United States, wealth differentials stem from differences in the educational attainment and demographic characteristics of the native and immigrant populations, rather than income differentials. In contrast, the small nativity wealth gap in Australia exists because immigrants to Australia do not translate their relative educational and demographic advantage into a wealth advantage. Overall, we find substantial disparity in the economic well‐being of immigrant and native families which is largely consistent with domestic labor markets and immigration policies. (JEL F22, D31)     

LOCAL SPORTS TEAMS AND CELEBRATION OF COMMUNITY: A COMPARATIVE ANALYSIS OF THE HOME ADVANTAGE

In major sports events between representatives of different cities, the home team has been known to have a major advantage over the visiting team. Drawing on Durkheim, Schwartz and Barsky (1977) have demonstrated that the social support of the audience is the main determinant of this advantage. In their conclusion, Schwartz and Barsky characterize sports events as a "celebration of local community"(p. 658). This article tests the celebration of community thesis by comparing the relative home advantage among 23 professional basketball teams during the 1981–82 season. Three broad variables are hypothesized to affect a team's home court advantage: (1) provincialism and stability of the city; (2) uniqueness of the home arena; and (3) the tradition of the team. Support is found for all three variables. Not only is there a home advantage in organized sports, but the magnitude of the advantage is itself bound by the social context within which the team performs.     

THE MARITAL AND FAMILY THERAPY EXAMINATION PROGRAM: A SURVEY OF PARTICIPANTS

Participants in the Examination in Marital and Family Therapy between November 1994 and May 1996 were surveyed to ascertain who took the examination, how they prepared for it, whether they thought that it was fair, and how these variables related to scores. Two-thirds of the respondents were female. Most were taking the examination for the first time, were relatively young, were Caucasian, and spoke English as their primary language. They primarily practiced marital and family therapy and had completed master's level university programs in marital and family therapy, counseling, and psychology. Most were sitting for the examination relatively soon after completing their training in marital and family therapy. Individual study was the preparation method of choice for half of the sample. Demographic variables had a modest but ambiguous effect on test score. Educational background had none. However, a relatively short latency between graduation and examination was related to a higher score, as was the use of multiple preparation procedures. With regard to fairness, the participants largely agreed that the examination was moderately difficult, but that the problems were realistic and they had enough time to complete the test.     

DEVELOPMENTAL LESSONS OF SEASONED MARITAL AND FAMILY THERAPISTS: A QUALITATIVE INVESTIGATION

Little has been published regarding the development of therapists during their professional careers. This qualitative research study explored the development of seasoned marriage and family therapists (MFTs) in order to identify important events and themes in their personal and professional lives. The main developmental theme that emerged was the integration of their personal and professional selves. Information gained from this study might be useful in understanding the self of the therapist within training and supervision and might partially provide a map of the possible transitions facing MFTs along their developmental journey.     

MATERIALISTIC VALUES IN HONG KONG AND GUANGZHOU: A COMPARATIVE ANALYSIS OF TWO CHINESE SOCIETIES

This article integrates two competing perspectives on value orientation. Inglehart's postmaterialism thesis stresses the permanent effects of childhood experience in which economic deprivation leads to materialism in adult life. The human development perspective, in contrast, emphasizes the evolution of a person's value system as life-cycle development unfolds new circumstances and possibilities. We adopt a developmental framework to test claims from these two perspectives. On the basis of micro-level data, we compare the materialistic values of two historically and culturally different Chinese societies, Hong Kong and Guangzhou. Findings support Inglehart's assertions that childhood experience has lasting effects and that rapid social changes create birth cohort differences in materialistic concerns. But life-cycle developments, such as education, marriage, and current social status, are equally important in influencing a person's value orientation. Both perspectives see only part of the picture, and an integrated approach is needed to better understand how people construct and maintain their value system.     

ENRICHMENT OUTCOME RESEARCH:A META-ANALYSIS OF PREMARITAL, MARITAL AND FAMILY INTERVENTIONS

The findings from a meta-analysis of 85 studies of premarital, marital, and family enrichment, representing 3,886 couples or families are presented. Metaanalysis is a method for statistically aggregating and evaluating empirical findings. Findings from the study are discussed in terms of overall enrichment effectiveness as well as salient program, subject, design, measurement, and analysis characteristics. The enrichment studies yielded an average effect size of .44, which indicates that the average person who participates in enrichment is better off following intervention than 67% of those who do not. The most powerful factors related to outcome were measurement variables rather than those related to program content, structure, leadership, or participant characteristics. Implications of these findings are discussed.