Qualitative research in family therapy: a substantive and methodological review

Over the last decade, marriage and family therapy (MFT) researchers have developed a growing interest in qualitative research. In this article, we review substantive and methodological trends in the published qualitative studies within the MFT field. The research is compared and contrasted in the following areas: General topic, epistemological theory, methodological theory, sampling and sample, data collection, data analysis procedure, and approach to reliability and validity. We also provide recommendations for future research.     

A Systematic Review of Gay,Lesbian, and Bisexual Research Samples in Couple and Family Therapy Journals

The purpose of this study is to review samples from research on gay, lesbian, and bisexual (GLB) issues and to evaluate the suitability of this body of research to support affirmative and evidence‐based practice with GLB clients. The authors systematically reviewed the sampling methodology and sample composition of GLB‐related research. All original, quantitative articles focusing on GLB issues published in couple and family therapy (CFT)‐related journals since 1975 were coded (n = 153). Results suggest that within the GLB literature base there is some evidence of heterocentrism as well as neglect of issues of class, race, and gender. Suggestions to improve the diversity and representativeness of samples—and, thus, clinical implications—of GLB‐related research in CFT literature are provided.     

THE INTEGRATIVE PSYCHOTHERAPY ALLIANCE: FAMILY,COUPLE AND INDIVIDUAL THERAPY SCALES*

The therapeutic alliance concept has been confined primarily to the literature on individual psychotherapy. This paper formally introduces the concept into the family and marital therapy domain and presents various clinical hypotheses about the nature of the alliance and its role in familyand marital therapy. A systemic perspective is brought to bear on the concept within individual psychotherapy. A new, integrative definition of the alliance is presented that conceptualizes individual, couple and family therapy as occurring within the same systemic framework. The implications of this integrative-alliance concept for family, couple and individual therapy research are examined. Three new system-ically oriented scales to measure the alliance in individual, couple and family therapy are presented along with some preliminary data on their methodological characteristics.     

In the Mix,Yet on the Margins: The Place of Families in Urban Neighborhood and Child Development Research

In the 1990s, the most popular theoretical and empirical research issue concerning the local ecologies of families focused on the impact of family structures (e.g., household composition) and processes (e.g., child management strategies) on the relationship between urban neighborhoods and child and adolescent development. In this article, we synthesize and critically examine the decade's prevailing literature on the topic, organizing this review into three areas: (a) the research designs of quantitative and ethnographic studies of urban neighborhoods, families, and child outcomes; (b) the conceptual approaches used in these studies; and (c) the role of structural and behavioral features of family and parenting as factors that influence the relationship between urban neighborhoods and child development in ethnically and racially diverse populations. Results suggest that although family has been center stage in the neighborhood effects research question of the decade, it has remained on the margins in terms of theoretical and methodological specificity. Recommendations for future research are also offered.     

Group work in the mental health field: researching outcome

This paper reviews outcome studies from groups facilitated for persons living with serious mental illness. Although the research base is limited (groups posing considerable methodological challenges), available studies show that, in general, group work is as effective as individual work, if not more so. This paper describes findings from studies of short-term, long-term and self-help groups dealing with mood disorders, schizophrenia, eating disorders and borderline personality disorders over the last 10 years. The concept of ‘time-effective’ group work is discussed as are the potentially harmful effects of group participation. The paper concludes by arguing that group work is an effective and less expensive treatment option that would benefit from further research to establish an evidence base, both for current practice and for the expansion of group work practice in the future.     

Toward an effective treatment system for adolescents with substance use disorders: The role of the states

A 2002 national expert panel found that the treatment system for adolescents with substance use disorders was inadequate and underdeveloped. The panel recommended immediate improvement in five areas: youth-serving agency collaboration, treatment system financing, workforce development, the implementation of evidence-based practices, and family involvement in all aspects of treatment. In 2004, the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA), designed the State Adolescent Substance Abuse Treatment Coordination Grant program (SAC) and implemented it in 2005 to address the critical need in the field. This paper reviews the adolescent substance use disorders treatment system, discusses selected drivers for change and the design of the SAC grant program, and summarizes some of the program's results. Both quantitative and qualitative data analysis document that substantive systems development occurred within each of the sixteen grantees and that federal–state partnerships are useful in creating systemic change.     

Listening to Children in Care: A Review of Methodological and Theoretical Approaches to Understanding Looked after Children’s Perspectives

This article reviews 44 refereed journal articles published between 2003 and 2008. All of the articles attempt to directly uncover the experiences or perspectives of young people cared for by the state in foster, residential or kinship care homes. The review reveals that this field is developing a rich body of evidence derived from a broad range of methodological and theoretical frameworks. In this sample, research designs appeared to be influenced by placement settings, as well as theoretical orientations, but comparative and longitudinal designs were used in both quantitative and qualitative studies. Participative research designs were only present in qualitative designs within a broadly interpretive theoretical orientation. It is suggested in this article that researchers should critically reflect on the use of constructs that may negatively label young people in care. It is also suggested that there could be fuller reporting of ethical issues. Despite some identified gaps, such as the participation of young people in quantitative research designs and research with younger age groups, the article concludes that there appears to be an encouraging emergence of theoretical and methodological diversity in this research area.     

THE EFFECTIVENESS OF FAMILY THERAPIES FOR SELECTED BEHAVIORAL DISORDERS OF CHILDHOOD

This article reviews the scientific evidence for the effectiveness of family-based aproaches in the treatment of selected childhood behavioral disorders. Although limitations certainly exist, family interventions have consitently improved child and, in some cases, parent functioning in families with children presenting with conduct disorder (CD) and autism. Parents and other family members also directly benefit from child-focused interventions, gaining in knowledge, child management skills, and attitudinal improvements. Longh-term follow-ups indicate that CD and autistic children achieved lasting gains. Similarly, the research on attention-deficit/hyperactivity disorder (ADHD) indicates that parent training improves child noncompliance and aggression yet does not consistently affect core symptoms of ADHD. There is no evidence that adding short-term family interventions improves ADHD child functioning beyond improvements from the use of psychostimulant medications. Some tentative support for family involvement in the treatment of childhood anxieties and fears is reviewed, but clear conclusions await future investigations. Finally, several methodological limitations and needed areas of research are discussed.     

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     

Research on the treatment of couple distress

This article reviews the research on couple therapy over the last decade. The research shows that couple therapy positively impacts 70% of couples receiving treatment. The effectiveness rates of couple therapy are comparable to the effectiveness rates of individual therapies and vastly superior to control groups not receiving treatment. The relationship between couple distress and individual disorders such as depression and anxiety has become well established over the past decade. Research also indicates that couple therapy clearly has an important role in the treatment of many disorders. Findings over the decade have been especially promising for integrative behavioral couples therapy and emotion-focused therapy, which are two evidence-based treatments for couples. Research has also begun to identify moderators and mediators of change in couple therapy. Finally, a new and exciting line of research has focused on delineating the principles of change in couple therapy that transcends approach.     

The effectiveness of family interventions for physical disorders

This article reviews the evidence for the effectiveness of family interventions in the prevention and treatment of physical disorders. Pathways by which families influence physical health and a typology of family interventions are described. Family intervention studies, particularly randomized clinical trials, are reviewed in four clinical areas: family caregiving of elders, childhood chronic illness, spouse involvement in chronic adult illnesses, and health promotion/disease prevention. Implications for family clinicians and recommendations for future research are presented.     

How Many Bytes Does It Take? A Content Analysis of Cyber Issues in Couple and Family Therapy Journals

In the fifteen years since the explosion of the Internet, using cyber technology for work and social functions has exponentially increased. Yet, questions around how to manage such changes remain elusive in family therapy literature. In this investigation, we conducted a content analysis to determine to what extent marriage/couple and family therapy (M/CFT) journals have responded to the integration of the Internet in couple and family life. We found 79 of 13,274 articles across seventeen journals focused on the Internet in some capacity. Implications for clinical practice, training, and future research are discussed. Video Abstract     

Thirty Years of Lottery Public Health Research: Methodological Strategies and Trends

Cognitive measurement techniques, such as self-reports of behavior and reaction time measures, largely dominate the field of psychological research. It is uncommon for researchers to examine a phenomenon of interest by observing actual behavior within natural settings. To illustrate the existence of this methodological trend for gambling research, this article reviews systematically selected samples of the peer-reviewed literature related to lottery gambling in general and the literature related to pathological gambling and lottery more specifically. The results indicate that self-report surveys dominate the extant lottery literature, and experimental investigations of video lottery terminal gambling supplement those papers. This landscape encourages researchers to expand their methodological approaches to the study of lottery gambling. Currently, we know more about what research participants tell us they do with respect to lottery gambling than we do about their real-life lottery gambling behavior.     

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.     

Coming out of the dark: content analysis of articles pertaining to gay, lesbian, and bisexual issues in couple and family therapy journals

The present study seeks to extend previous research regarding literature related to gay, lesbian, and bisexual (GLB) issues published in couple and family therapy (CFT)-related journals by presenting the results from a content analysis of GLB studies in CFT-related journals from 1996 to 2010. Results of the analysis revealed a 238.8% increase in total GLB content published since the original review. Articles pertaining to therapy with GLB clients continue to represent the largest area of publication. With one exception, all surveyed journals showed an increase in the percentage of GLB content since the first study. Emerging areas of research include studies related to supervision and training, GLB mental health and substance use, and sexual minority adolescents. A movement away from deficit-based perspectives could open a new lens on family life.     

Race,class, and educational opportunity: Trends in the sociology of education

This essay examines some of the trends in educational, sociological, and social psychological research on inequality of educational opportunity for African Americans in the United States. A review of theoretical approaches and methodological developments is followed by an overview of research and theory in selected substantive areas; social allocation processes in schools (ability grouping, tracking, etc.), the relationship of poverty to academic achievement, and educational attainment. The article concludes with recommendations for future research.     

Social focus on health and children’s well-being

This special section on children’s health and well-being is an outgrowth of the 2010 International Sociological Association’s (ISA) World Congress in Gothenburg, Sweden. Within the Congress, the Research Committee 53, Sociology of Childhood, organized a panel focused on the health and well-being of children. Together, this collection makes two distinct contributions: first in terms of considering children’s health disparities as an area of concern within sociology, and second by considering children’s health as a factor that shapes other areas of children’s well-being. In addition, these papers offer novel empirical research on children’s health and varied methodological and theoretical orientations. Each paper also makes contributions to social policy, first in the area of infant health affecting later educational outcomes, second in the area of family structure and children’s health, and additionally in understanding type 2 diabetes for children at the individual and structural levels. Finally, these studies highlight the interplay—between the individuals’ health on the one hand and structure and culture on the other—as children’s life chances are shaped.     

Assessing child welfare outcomes: the American perspective

This paper examines US research on child welfare outcomes, focusing on family preservation, out-of-home care, and family reunification services. The review highlights the range of mixed findings in each of these areas, along with methodological issues and constraints. In light of the complexity of child welfare services, future outcome research should complement the rigorous use of quantitative methods with the careful application of qualitative methods.     

A Primer for the Use of Multilevel Models in Couple and Family Therapy Research

This article serves as a primer for understanding how to use multilevel modeling (MLM) techniques in couple and family therapy outcome and process research. It outlines the use of HLM and Mplus—two of many software programs that can perform multilevel modeling—and provides an applied example of using MLM to investigate the use of postsession feedback on couple satisfaction and change, as well as the influence of trauma on the use of postsession feedback. Two graduate students in COAMFTE accredited PhD programs read the primer and provided questions to the first author that arose. Answers to these questions have been incorporated throughout the explanation of this methodological approach in hopes of addressing common stuck points for those using MLM.     

Racial Profiling and Traffic Stops: An Examination of Research Approaches and Findings in the War on Drugs

This article is a review of some of the main research approaches to understanding racial profiling as it manifests in the traffic stop. It orients the emergence of racial profiling as a product of the war on drugs philosophy guiding law enforcement in the late 20th century and discusses how the contemporary nature of racial profiling has origins in a long history of racialized policing in the United States. Theoretical and methodological approaches to the issue, particularly from mainstream criminologists, focus on quantitative assessment of exposure to law enforcement agents and rational choice-based arguments that it makes sense to target certain groups based on the hue of the criminal justice system. More critical approaches examined within complicate this notion by contextualizing racial profiling in contemporary times as a mere manifestation of historical efforts by the state to marginalize communities of color.