A 20-Year Review of Common Factors Research in Marriage and Family Therapy: A Mixed Methods Content Analysis

Introduced by Sprenkle, Blow & Dickey (1999), common factors in marriage and family therapy (MFT) have been discussed over the past two decades. Although the MFT common factors literature has grown, there are misconceptions and disagreements about their role in theory, practice, research, and training. This content analysis examined the contributions of the common factors paradigm to MFT theory, practice, research, and training over the past 20 years. We identified 37 scholarly works including peer-reviewed journal articles, books, and chapters. Using mixed methods content analysis, we analyze and synthesize the contributions of this literature in terms of theoretical development about therapeutic effectiveness in MFT, MFT training, research, and practice. We provide commentary on the substantive contributions that the common factors paradigm has made to these areas, and we discuss the implications and limitations of the common factors literature, and provide recommendations for moving common factors research forward.     

Dyadic Research in Marriage and Family Therapy: Methodological Considerations

With training that emphasizes relationship systems, marriage and family therapists are uniquely attuned to interpersonal dynamics, interdependence, and the influence of relationships on individuals’ perceptions, beliefs, and attitudes. While recent statistical advances have contributed to a proliferation of resources designed to introduce researchers to dyadic data analysis, guidelines related to the methodological aspects of dyadic research design have received less attention. Given the potential advantages of dyadic designs for examining couple and family relational and therapeutic processes, the purpose of this article is to introduce marriage and family therapy researchers to dyadic research methodology. Using examples from our own research, we discuss methodological considerations and lessons learned related to sampling, measurement, data collection, and ethics. Recommendations for future dyadic research are provided. Video Abstract     

The use of Theory in Family Therapy Research: Content Analysis and Update

In this study, we evaluated 275 empirical studies from Journal of Marital and Family Therapy and Family Process from 2010 to 2015 on their use of theory, and compared our findings to those of a similar previous analysis (Hawley & Geske, 2000). Overall, theory seems to have become much better incorporated in empirical family therapy research, with only 16.4% of the articles not using theory in either their introductory or discussion sections. Theory appeared better incorporated in the introductory sections than in the discussion sections. Systems theory remained the most commonly used conceptual framework, followed by attachment theory. We discuss areas for improving theory incorporation in family therapy research, and offer suggestions for both family therapy researchers and educators.     

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.     

Assessment in Marriage and Family Therapy: A Review of Clinical Updates for Family Therapists

This article presents information from an integrative literature review that examined assessment processes presented to marriage and family therapists in Clinical Updates for Family Therapists, Volumes 1 (2005), 2 (2006), and 3 (2007). The study was based on the concern that marriage and family therapy is losing its systemic relational focus as practitioners must comply with diagnosis models using the Diagnostic and Statistical Manual of Mental Disorders. Using integrative literature review methods, similar to qualitative research, 54 articles were deconstructed to identify assessment tools and diagnostic processes being presented as best practice. Of the 54 articles, 96% identified the importance of having a family or couple relational perspective for working with individuals with mental disorders; however, only 54% provided any explanation to how this could be accomplished. These findings suggest a need to increase the identification of unique, relational assessment practices in articles that offer best practice techniques in marriage and family therapy.     

Integrity of the Marriage and Family Therapy Research Literature: Perceptions and Recommendations

Reports of falsification, fabrication, plagiarism, and other violations of research integrity across the sciences are on the increase. Joining with other disciplines to actively protect the integrity of the marriage and family therapy (MFT) research literature is of utmost importance to both the discipline and the future of the profession. To inform the issues raised, results are presented of an informal survey among MFT clinical members on their perceptions about the literature together with their preferences for how best to protect its integrity. This article initiates an important discussion about the honesty of MFT research.     

A Curriculum for Graduate-Level Marriage and Family Therapy Education*

The Delphi technique of refining group opinion was used to develop a graduate level marriage and family therapy curriculum. Opinions were synthesized from a national panel of 20 AAMFT Approved Supervisors and 25 training directors of graduate-level marriage and family therapy programs. Three rounds of questionnaires were employed and 101 content areas met the criteria for inclusion into the final curriculum. Discussed are the similarities and differences of this curriculum and the current “model” AAMFT curriculum. It is hoped that the curriculum devised from this study will lead to the continued rethinking, refinement, and evolution of marriage and family therapy education.     

A Content Analysis of Quantitative Research in Journal of Marital and Family Therapy: A 10‐Year Review

We examined the trends of quantitative research over the past 10 years in the Journal of Marital and Family Therapy (JMFT). Specifically, within the JMFT, we investigated the types and trends of research design and statistical analysis within the quantitative research that was published in JMFT from 2005 to 2014. We found that while the amount of peer‐reviewed articles have increased over time, the percentage of quantitative research has remained constant. We discussed the types and trends of statistical analysis and the implications for clinical work and training programs in the field of marriage and family therapy.     

Dissemination and Implementation Research in Marriage and Family Therapy: An Introduction and Call to the Field

Despite the considerable resources allocated to research to promote public health, interventions capable of benefiting individuals and families are not finding their way into regular practice. An important avenue for addressing this problem is through dissemination and implementation (D&I) science, a burgeoning research area focusing on translating empirical knowledge into everyday practice. This article begins by suggesting ways in which MFTs are uniquely equipped to contribute to and benefit from D&I research. We will then provide an overview of D&I research, outlines key D&I models, and highlight examples of family intervention research relevant to MFTs using the key models. Finally, we conclude by providing the field with important next steps to advance the presence of MFT research within D&I scholarship.     

The Regulation of Marriage and Family Therapy1: An Update

Regulations concerning the practice of marriage and family therapy are reviewed. The current status of efforts to license and certify are presented, based on data from AAMFT state and multi-state division Presidents. Materials should be of significance to individuals and organizations attempting to modify current or promote new legislation.     

Reflecting on the Past: A Content Analysis of Family Therapy Research from 2000‐2015

In this content analysis, researchers examine articles published from 2000 to 2015 in three family therapy journals, yielding a total of 948 empirical articles. The purpose is to provide an overview of the research being published, assess who is publishing, and investigate the current state of clinical effectiveness research in marriage and family therapy (MFT). Most first authors were affiliated with MFT programs and primarily included diversity and couples in their research. There was a significant increase of research on clinical process—though the number of clinical outcome studies held steady. There were no significant changes with regard to research funding. Implications support the use of innovative research methods to provide evidence of clinical effectiveness.     

Human Sexuality Education in Marriage and Family Therapy Graduate Programs

Given the likelihood that marriage and family therapists will encounter clients with sexual concerns, it is important to know how graduate training programs are preparing future clinicians to work with this domain of life. Sixty‐nine marriage and family therapy (MFT) program directors completed an online survey to examine how sexual health education is integrated into graduate training programs. Findings indicate that while the majority of program directors value sexuality curriculum, and most programs require at least one course in this area, there are barriers to privileging sex topics in MFT graduate programs. Barriers include few MFT faculties with expertise in human sexuality and marginalized sexual health topics. Implications for training MFT graduate students and their work with future clients are discussed.     

Live Supervision and Instant Feedback in Marriage and Family Therapy*

In the context of the increasing attention paid to, and increasing demand for training in marital and family therapy, this paper briefly describes several models of supervision and treatment appropriate for use in this field. Advantages and disadvantages of four basic supervision and treatment models are discussed: traditional, co-therapy, direct observation with delayed feedback, and direct observation with instant feedback. The increased options in adopting the latter model are emphasized and a verbatim sample of a case illustrating its use is presented.     

Targeting Threats to the Therapeutic Alliance: A Primer for Marriage and Family Therapy Training

Although theory and research highlight the importance of the client–therapist relationship, marriage and family therapy (MFT) training has historically centered on specific models, consisting of proprietary language and techniques, instead of common factors like the therapeutic alliance. In this article, we begin by making an argument for explicitly focusing on the therapeutic alliance in MFT training programs. Next, we highlight common alliance threats experienced by both faculty members and student therapists. We then integrate research‐informed principles with clinical wisdom to outline specific recommendations and concrete skill‐building exercises for MFT educators and supervisors to use with their students to address these threats and advance training on the therapeutic alliance.     

Methods of Self-Confrontation in Family Therapy

The research, clinical applications, and effects of audiotape and videotape self-confrontation techniques to family therapy are reviewed. A variety of new applications, such as cross-confrontation and interpersonal process recall, are integrated into the practice of family therapy. Thirteen specific audiovisual self-confrontation methods are reviewed along with reported positive and negative effects of their use. As most novel additions to a therapists "bag of tricks", self-confrontation methods are being abused, applied randomly and unsystematically. There is an urgent need for well-designed and relevant research in the area.     

Marriage and Family Therapy Trainees' Reports of Explicit Weight Bias

Discrimination based on an individual's weight has been observed in health care, education, retail, and other public sectors (Puhl & Huer, Obesity, 17, 941, 2007). Such inequity, known as “weight bias,” generates negative short‐term and long‐term consequences for the individuals that experience it (Puhl & Brownell, Weight bias in health care settings, 2007). Past research has shown that healthcare trainees exhibit weight bias (Phelan et al., Obesity, 22, 1201, 2014; Wigton & McGaghie, Journal of General Internal Medicine, 16, 262, 2001), yet little focus is given to weight bias in marriage and family therapy (MFT) education. The purpose of this study was to survey MFT students (N = 162) to explore weight bias and how contextual factors associate with weight bias. Participants in MFT programs reported explicit weight bias, with specific contextual factors associating with more bias. Female participants reported more fear of gaining weight, and individuals who identified as overweight had higher rates of explicit weight bias. Contextual differences and implications for training programs are discussed.     

Most and Least Meaningful Learning Experiences in Marriage and Family Therapy Education

Marriage and family therapy educators increasingly emphasize training competencies. What we know less about is what makes family therapy education meaningful to marriage and family therapy (MFT) graduate students and what does not. In this study, through an Internet survey, we explored the most and least meaningful learning experiences of 68 MFT graduate students and recent graduates of Commission on Accreditation for Marriage and Family Therapy Education—accredited programs. We used thematic analysis to identify and illustrate resulting themes, which included the importance of experiential and personal components to learning, the professor‐student alliance, tying theory to practice, and the experiences of students with their clients, among others. We discuss the implications of these findings to support family therapy education and offer tentative suggestions for formative discussions both within and across programs. Video Abstract is found in the online version of the article .     

A Mixed Methods Exploration of Single Session Family Therapy in a Child and Adolescent Mental Health Service in Tasmania,Australia

Single session therapy (SST) is grounded in the belief that clients and families can effect change after one therapeutic encounter, using their own resources, with brief support and assistance from therapists. SST has been found to be an effective intervention for children, young people, and their families presenting with a wide range of difficulties. Research in child and adolescent mental health has shown that over 50% of families find one SST encounter is enough with no need for further specialist input. This study aims to explore family member experiences of SST (undertaken as single session family therapy and termed hereafter SSFT) as an initial intervention in a regional child and adolescent mental health service (CAMHS), specifically in terms of worry, confidence, and satisfaction outcomes. An exploratory, mixed methods convergent design was utilised using a combination of open questions and Thurstone scales. All eligible family members were invited to complete questionnaires before and after the SSFT, asking about level of worry, confidence, and overall satisfaction with SSFT. Quantitative and qualitative findings indicated most family members had a positive experience of SSFT, although differences were found between young people, parents, and siblings. Overall, family members’ level of worry decreased, while only parental confidence in managing the presenting issue(s) increased. Over half of the families did not require further contact with CAMHS following the SSFT. Our findings support previous research that SSFT is an effective, family-inclusive, and well received intervention for a variety of mental health issues facing children and young people. SSFT could be considered a beneficial and well received first response for the majority of CAMHS clients, which prioritises a family-inclusive approach. Future research could focus on attaining a more in-depth understanding of individual family member experiences with a view to improving SST delivery.     

Challenge and Urgency in Defining Doctoral Education in Marriage and Family Therapy: Valuing Complementary Models

In this overview, I comment on the strong theme of the need to define and improve the quality of doctoral education in marriage and family therapy that pervades the three essays. Deficits in research training are the central concern, although the essayists take different perspectives on the nature of the research training needed. The different perspectives can be understood in terms of three different models of doctoral education. The institutional model focuses on professional training with little financial support for students and lower expectations for faculty research. The community of scholars model emphasizes a balance of research and practice with students required to attend full-time and financial support provided. Research is a mix of faculty- and student-driven and is often focused on professional issues. The star researcher model often held out as the ideal, although not yet represented in marital and family therapy (MFT), emphasizes faculty externally funded programmatic research with students working on and supported by faculty grant funding. The value and role of all three models in MFT doctoral education are described and discussed.     

Licensing Marriage and Family Counselors: A Model Act

The author presents a model bill for the licensing of marriage and family counselors and describes some of the historical context in which it developed within the Conciliation Court movement. The model bill is similar to the one proposed by the American Association of Marriage and Family Counselors. Editor.