Multi-Family Group Therapy for Sexually Abusive Youth

SUMMARY

Although Multi-Family Group Therapy (MFGT) has been a researched intervention for nearly 40 years, clinicians working with sexually abusive youth and their families have only more recently begun to utilize the intervention. We believe MFGT for a sexual offense-specific treatment population is a sophisticated and powerful clinical intervention with unique advantages including economical use of clinician resources, family-to-family transfer of knowledge and mentoring, community-based resourcefulness, and accelerated catalyzing of emotions. This article will provide direction on establishing the MFGT format as well as discuss its goals, curriculum, facilitation priorities, and strategies.     

Delivery Pain and the Development of Mother—Infant Interaction

This study examined delivery pain as a possible risk factor for the development of mother‐infant interaction. Eighty‐one mothers completed the Pain Catastrophizing Scale, the State‐Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale. A retrospective evaluation of labor pain was performed using the Visual Analog Scale at 2 days postpartum. Six weeks after birth the mothers were visited at home, completed measures of anxiety and depression, and were observed during a free play session with the infant. The mother's tendency to catastrophize pain predicted lower levels of mother‐infant reciprocity at 6 weeks, controlling for maternal age, education, parity, epidural analgesia, pain perception, anxiety, and depression. Trait anxiety was related to lower maternal sensitivity. The mother's tendency to catastrophize pain was discussed in relation to the personality trait of exaggerated emotional perception of pain and its potential interference with the formation of the mother‐infant relationship.     

Motivating Action and Maintaining Change: The Time‐Varying Role of Homework Following a Brief Couples' Intervention

Studies regarding the effectiveness of homework assignments in cognitive‐behavioral treatments have demonstrated mixed results. This study investigated predictors of compliance with homework recommendations and the time‐varying relationship of recommendation completion with treatment response in a brief couples' intervention (N = 108). More satisfied couples and couples with more motivation to change completed more recommendations, whereas couples with children completed fewer. The association between recommendation completion and treatment response varied with the passage of time, with the strongest effect observed 6 months after the intervention, but no discernible differences at 1 year postintervention. Couples that completed more recommendations experienced more rapid treatment gains, but even those couples doing substantially fewer recommendations ultimately realized equivalent treatment effects, although they progressed more slowly. Implications are discussed.     

Predicting Change in Marital Satisfaction Throughout Emotionally Focused Couple Therapy

Emotionally focused couple therapy (EFT) is an empirically validated approach to couple therapy that uses attachment theory to understand the needs and emotions of romantic partners. EFT is recognized as one of the most effective approaches to couple therapy, but to guide therapists in their use of EFT, a theoretically based model to predict change is needed. This study tested such a model by recruiting 32 couples, and 14 therapists who provided approximately 21 sessions of EFT. Couples completed self‐report measures of marital satisfaction, attachment security, relationship trust, and emotional control at pre‐ and posttherapy and after each therapy session. Results of hierarchical linear modeling suggested that individuals higher on self‐report attachment anxiety and higher levels of emotional control had greater change in marital satisfaction across EFT sessions. Assessing attachment security at the start of therapy will inform therapists of the emotion regulating strategies used by couples and may help couples achieve positive outcomes from EFT.     

The Multisystemic and Multilevel Investigation of the Expanded Therapeutic Alliance‐Psychological Functioning Relationship in Individual Therapy

The expanded therapeutic alliance, consisting of multiple interpersonal alliance relationships, is a common factor inherent to the practice of all systemic therapies. The following study has three specific aims: (a) Bring an expanded, multisystemic emphasis to the study of the therapeutic alliance in individual therapy; (b) Understand better the session‐by‐session relationship between alliance and psychological functioning, including distinguishing within‐person from between‐person variability by using multilevel modeling techniques; and (c) Explore the role of early attachment relationships and family‐of‐origin experiences in moderating the alliance‐psychological functioning relationship. Instead of taking only one or two alliance measurements throughout treatment like in the majority of previous research, we measured both alliance and psychological functioning continuously at each session for 296 subjects.     

Temporal Relationships Among Depressive Symptoms,Risky Behavior Engagement,Perceived Control,and Gender in a Sample of Adolescents

The goals of the study were to examine whether (a) risky behaviors precede depressive symptoms or, conversely, depressive symptoms predict risky behavior engagement; (b) gender moderates the relationship between risky behavior engagement and depressive symptoms; and (c) perceived control strengthens the association between risky behavior engagement and depressive symptoms. At Time 1, 118 adolescents completed self‐report measures assessing perceived control, risky behavior engagement, and depressive symptoms. Follow‐up assessments occurred every 6 weeks (Times 2–5), and participants completed measures assessing risky behavior engagement and depressive symptoms. Results indicated that neither risky behavior engagement nor depressive symptoms emerged as main effects for the sample as a whole. When examining the relationship between depressive symptoms and risky behavior engagement as a function of gender, boys', but not girls', risky behavior engagement predicted higher levels of depressive symptoms. Irrespective of whether we examined boys or girls, depressive symptoms did not predict risky behavior engagement. With regards to the role of cognitive vulnerability, adolescents with lower levels of perceived control reported higher levels of depressive symptoms following risky behavior engagement. These findings suggest that both gender and cognitive vulnerability factors may potentiate the relationship between risky behavior engagement and subsequent depressive symptoms.     

Parent‐Adolescent Language Use and Relationships Among Immigrant Families With East Asian,Filipino, and Latin American Backgrounds

This study examined differences in the quality of relationships between immigrant parents and their adolescent children as a function of the languages with which they speak to one another. Over 620 adolescents with East Asian, Filipino, and Latin American backgrounds completed measures on parent‐adolescent language use and relationships. Adolescents who spoke in different languages with their parents reported less cohesion and discussion with their mothers and fathers than did their peers who spoke the same language with their parents. Adolescents who mutually communicated in the native language with their parents reported the highest levels of cohesion and discussion. Longitudinal analyses indicated that whereas language use did not predict differential changes in parent‐adolescent relationships over a 2‐year period, the quality of relationships did predict changes in language use. The associations between language use and relationships generally existed regardless of the families' ethnic and demographic backgrounds, and these associations did not vary across families of different backgrounds.     

Religiosity,sexual behaviors,and sexual attitudes during emerging adulthood

The current study examined associations between religiosity and sexual behaviors and attitudes during emerging adulthood. Two hundred and five emerging adults completed surveys about five aspects of their religiosity (group affiliation, attendance at religious services, attitudes, perceptions of negative sanctions, and adherence to sanctions) and their sexual behaviors (abstinence, age of onset, lifetime partners, condom use) and attitudes (conservative attitudes, perceived vulnerability to HIV, and condom‐related beliefs). Associations were found between the measures of religiosity and sexuality, although the patterns differed by measures used. Religious behavior was the strongest predictor of sexual behavior. Many aspects of religiosity were associated with general sexual attitudes, which was not the case for perceived vulnerability to HIV and condom‐related beliefs. The findings support reference group theory and highlight the importance of considering the specific constructs of religiosity and sexuality assessed in studies of these topics.     

Systemic Consultation in Intellectual Disability Case Management

Systemic consultation is a form of tertiary case supervision derived from the principles of systemic family therapy. The present study defines the process and outcomes of systemic consultation through the experiences of case managers (CMs) working with people who have an intellectual disability. CMs were invited to present and discuss one of their complex cases with a team of consultants and attend a follow up session 4 to 6 weeks later. Measures of levels of stress, perception of workplace functioning, and workflow information were completed pre and post‐intervention and compared to measures completed by a second group of CMs receiving regular supervision only. After participation in systemic consultation, the networks of people CMs consulted about the case were significantly smaller and they scored significantly higher on a network measure of efficiency of information flow. The CMs experienced lower levels of stress and higher perception of workplace functioning, these differences approached significance. After attending the consultation outcome, themes included a reduced sense of being stuck and stressed, becoming an agent of change and taking perspective. The approach allows CMs space for reflection on practice and new perspectives to be heard. Case management has been under‐represented in documented research and evidence‐based training and supervision models, and is an area in which professional theory appears to be lacking.     

Family Cohesion And Control: A Multitrait-Multimethod Study*

This study assessed the convergent and discriminant validity of widely used various measures of family cohension and control using a multitrait, multi-method approach. Forty-two families, who had at least one adolescent and who were currently receiving family therapy, completed self-report measures of cohesion and control and engaged in Reiss' Card Sort Procedure. Ratings of the families' cohesiveness were also obtained from the families and their therapists. We were only partially successful in demonstrating convergent validity and discriminant validity for the family trait of cohesiveness across measures and methods, and even less so for family control. There was a general lack of relationship between self-report measures and either the therapist rating of family cohesion or the family's performance on the Card Sort Procedure. Our results cast doubt on the construct validity of some of the best measures of family functioning currently available. Implications of this are discussed.     

Family Therapy Retention: An Observation of First‐Session Communication

This study examined the relationship between communication patterns and retention among families (n = 18) receiving family therapy. Those that attended 12 sessions were labeled completers (n = 6), 4–8 sessions were middle dropouts (n = 6), and 1–3 sessions were early dropouts (n = 6). Audiotape recordings of the first therapy session were transcribed. The content (positive or negative) and total percentage of communications by the parent, adolescent, and therapist were coded. Completer and middle dropout parents (but not adolescents) showed higher talk time proportions than parents in the early dropout group. Completer families had higher percentages of therapist‐to‐parent communications, while early dropout families had higher percentages of therapist‐to‐adolescent communications. There were no significant differences between middle dropouts and completers in either content or total communications. These findings demonstrate the potential utility of examining within‐session communication patterns and suggest that within‐session processes may determine therapy retention.     

Academic Support Services and Career Decision‐Making Self‐Efficacy in Student Athletes

This study examined the relationship between evaluations of academic support services and student athletes’ career decision‐making self‐efficacy. One hundred and fifty‐eight NCAA athletes (68% male) from 11 Division I teams completed measures of satisfaction with their academic support services, career decision‐making self‐efficacy, general self‐efficacy, and locus of control. Results indicated that evaluations of academic support services were positively related to levels of career decision‐making self‐efficacy. In addition, this relationship was moderated such that student athletes with lower levels of general self‐efficacy and internal locus of control benefited more from positive experiences with academic support services. Limitations and implications are discussed.     

Cohesion and Enmeshment Revisited: Differentiation,Identity, and Well‐Being in Two European Cultures

We examined the nature and implications of family differentiation among adolescents facing a life transition in 2 European countries with differing family cultures. One hundred and twenty‐four Italian and 109 U.K. adolescents completed measures of family differentiation (cohesion and enmeshment), identity threat (perception of threat to the self associated with finishing school), life satisfaction, depressive symptoms, and anxiety. Confirmatory factor analyses showed that cohesion and enmeshment were distinguishable in both countries, orthogonal in the U.K. but positively correlated in Italy. Family cohesion was associated with better psychological well‐being in both countries; enmeshment was associated with poorer psychological well‐being in the U.K. but not in Italy. Structural equation models showed that effects on well‐being were fully mediated by identity threat in both cultures.     

Changes in Relationship‐Specific Attachment in Emotionally Focused Couple Therapy

Emotionally focused couple therapy (EFT; Johnson, The practice of emotionally focused couple therapy (1st/2nd edition). Brunner‐Routledge, New York, 2004) is an effective treatment of relationship distress (Johnson et al., Clinical Psychology: Science and Practice, 1999; 6, 67). However, less is known about EFT's impact on couples' relationship‐specific attachment bond. Using hierarchical linear modeling with a sample of 32 couples, we examined session‐by‐session changes in couples' relationship‐specific attachment anxiety and avoidance and pre‐ to posttherapy changes in their relationship‐specific attachment behaviors. Couples significantly decreased in relationship‐specific attachment avoidance, and those who completed a blamer softening significantly decreased in relationship‐specific attachment anxiety. Couples' attachment behavior significantly increased toward security. Finally, session‐by‐session decreases in relationship‐specific attachment anxiety and avoidance were significant associated with increases in relationship satisfaction across sessions. These results provide empirical support for the attachment‐based assumptions of EFT. Video abstract accessible by clicking here     

The Cohesiveness of Blocks In Social Networks: Node Connectivity and Conditional Density

This study shows several ways that formal graph theoretic statements map patterns of network ties into substantive hypotheses about social cohesion. If network cohesion is enhanced by multiple connections between members of a group, for example, then the higher the global minimum of the number of independent paths that connect every pair of nodes in the network, the higher the social cohesion. The cohesiveness of a group is also measured by the extent to which it is not disconnected by removal of 1, 2, 3,..., k actors. Menger's Theorem proves that these two measures are equivalent. Within this graph theoretic framework, we evaluate various concepts of cohesion and establish the validity of a pair of related measures: 1. Connectivity—the minimum number k of its actors whose removal would not allow the group to remain connected or would reduce the group to but a single member—measures the social cohesion of a group at a general level. 2. Conditional density measures cohesion on a finer scale as a proportion of ties beyond that required for connectivity k over the number of ties that would force it to k + 1.
Calibrated for successive values of k, these two measures combine into an aggregate measure of social cohesion, suitable for both small- and large-scale network studies. Using these measures to define the core of a new methodology of cohesive blocking, we offer hypotheses about the consequences of cohesive blocks for social groups and their members, and explore empirical examples that illustrate the significance, theoretical relevance, and predictiveness of cohesive blocking in a variety of substantively important applications in sociology.     

What Happens to Foster Kids: Educational Experiences of a Random Sample of Foster Care Youth and a Matched Group of Non-Foster Care Youth

Older youth often “age out” of foster care when they reach 18 or 21. Then what happens to them? How do their educational experiences during and after high school compare with children raised in intact families? This study used existing longitudinal data from 1980 through 1986 to investigate the high school and post high school experiences of a group of foster care youth and a matched group of youth living with at least one parent. The results were unequivocal: the foster youth dropped out of high school at a much higher rate and were significantly less likely to have completed a GED. The foster care high school graduates received significantly less financial assistance for education from their parents or guardians. Foster youth reported more discipline problems in school and experienced more educational disruption due to changing schools. They were significantly less likely to be in a college preparatory high school track. The adults in the lives of the foster care youth were less likely to monitor homework. These findings have important implications for child welfare policy and practice.     

Implementation of Behavioral Marital Therapy

Implementing behavioral marital therapy is discussed with emphasis on the techniques of problem-solving, communications training, behavioral contracting, and homework assignments. The therapist's intervention style and the aspects of treatment which aid in generalization and maintenance of therapeutic gains are also described, and a typical treatment session is outlined.     

Pathways from neighborhood to neglect: The mediating effects of social support and parenting stress

Neighborhood social cohesion relates to common bonds and feelings of trust between neighbors. The everyday demands of caregiving can take a toll on parents and increase their levels of stress and in some cases can lead to maltreatment. The current study seeks to understand how the support networks of parents relate to child maltreatment. Specifically, using structural equation modeling path analysis and a sample of 1045 families from Franklin County, Ohio, we examine the direct relationship between neighborhood social cohesion and child neglect as well as the indirect relationship between the two, mediated by social support and parenting stress. We find no significant direct association between neighborhood social cohesion and neglect. However, we find important indirect effects. Specifically, parents who reported higher levels of neighborhood social cohesion had higher levels of social support, lower levels of parenting stress, and consequently, lower levels of neglect.     

Family‐of‐Origin Influence on Career Thoughts

The family can exert an important influence on career decision making. This study investigated the impact of adaptability and cohesion in family‐of‐origin relationships on dysfunctional career thoughts in 269 college students (221 women, 48 men). The Career Thoughts Inventory and the Family Adaptability and Cohesion Scales–IV were used to assess family dynamics and dysfunctional career thoughts. The study addressed the following research question: What is the impact of family cohesion and adaptability in the participant's family of origin on dysfunctional career thoughts, specifically decision‐making confusion, commitment anxiety, and external conflict? Results revealed that higher levels of family cohesion were associated with lower levels of decision‐making confusion, commitment anxiety, and external conflict and that higher levels of family adaptability were associated with lower levels of external conflict.