Changes in negative attributions during couple therapy for abusive behavior: relations to changes in satisfaction and behavior

This study examined effects of cognitive-behavioral couple therapy (n = 25 couples) and a variety of systems-oriented couple therapy models (n = 30 couples) in reducing negative attributions and degrees to which decreases in negative attributions were associated with improvements in other aspects of relationship functioning. Couples seeking treatment at a university clinic and experiencing psychological and/or mild-to-moderate physical abuse completed 10 weekly sessions. Attributions, relationship satisfaction, psychological abuse, communication, and negotiation were assessed before and after treatment. Women and men in both treatments exhibited decreased negative attributions, which moderated increases in satisfaction and decreases in negative communication, as well as increases in positive communication for men. The findings reinforce the importance of modifying negative attributions when intervening to reduce abuse.     

The feminist/emotionally focused therapy practice model: an integrated approach for couple therapy

Emotionally focused therapy (EFT) is a well-developed, empirically tested practice model for couple therapy that integrates systems, experiential, and attachment theories. Feminist family therapy theory has provided a critique of biased assumptions about gender at play in traditional family therapy practice and the historical absence of discussions of power in family therapy theory. This article presents an integrated feminist/EFT practice model for use in couple therapy, using a case from practice to illustrate key concepts. Broadly, the integrated model addresses gender roles and individual emotional experience using a systemic framework for understanding couple interaction. The model provides practitioners with a sophisticated, comprehensive, and relevant practice approach for working with the issues and challenges emerging for contemporary heterosexual couples.     

Network position and sexual dysfunction: implications of partner betweenness for men

This article combines relational perspectives on gender identity with social network structural perspectives on health to understand men's sexual functioning. The authors argue that network positions that afford independence and control over social resources are consistent with traditional masculine roles and may therefore affect men's sexual performance. For example, when a heterosexual man's female partner has more frequent contact with his confidants than he does--which the authors refer to as partner betweenness--his relational autonomy, privacy, and control are constrained. Analyses of data from the National Social Life, Health, and Aging Project (NSHAP) show that about a quarter of men experience partner betweennessa and that these men are 92% more likely to report erectile dysfunction. Partner betweenness is strongest among the youngest men in the sample, which may reflect changing conceptions of masculinity in later life. The authors consider several explanations for these findings and urge additional research on the links between health, gender, and network structure.     

A qualitative study of intimate partner violence universal screening by family therapy interns: implications for practice, research, training, and supervision

Although a few family therapy researchers and clinicians have urged universal screening for intimate partner violence (IPV), how screening is implemented-and, in particular, client and therapist response to screening-is vaguely defined and largely untested. This qualitative study examined the dilemmas experienced by couples and family therapy interns when implementing universal screening for IPV in an outpatient clinic setting. Twenty-two graduate students in a COAMFTE-accredited program were interviewed using qualitative research methods grounded in phenomenology. Three domains, 7 main themes, and 26 subthemes were identified. The three domains that emerged in this study include (a) therapist practice of universal screening, (b) client response to universal screening, and (c) therapist response to universal screening. Implications for practice, research, training, and supervision are discussed.     

Intervention research in couple and family therapy: a methodological and substantive review and an introduction to the special issue

This article serves as an introduction to this third version of research reviews of couple and family therapy (CFT) that have appeared in this journal beginning in 1995. It also presents a methodological and substantive overview of research in couple and family therapy from about 2001/2002 to 2010/2011 (the period covered in this issue), while also making connections with previous research. The article introduces quantitative research reviews of family-based intervention research that appear in this issue on 10 substantive areas including conduct disorder/delinquency, drug abuse, childhood and adolescent disorders (not including the aforementioned), family psycho-education for major mental illness, alcoholism, couple distress, relationship education, affective disorders, interpersonal violence, and chronic illness. The paper also introduces the first qualitative research paper in this series, as well as a paper that highlights current methodologies in meta-analysis. The first part of this article rates the 10 content areas on 12 dimensions of methodological strength for quantitative research and makes generalizations about the state of quantitative methodology in CFT. The latter part of the papers summarizes and makes comments on the substantive findings in the 12 papers in this issue, as well as on the field as a whole.     

HIV/AIDS and work: The implications for occupational therapy

Improvements in preventive and rehabilitative care have transformed many cases of Human Immunodeficiency Virus (HIV) from being an absolute fatal disease to a chronic, expensive illness. As survival rates and life expectancy increase for people with HIV/AIDS, work plays a more central role in improving their quality of life [5]. Persons with HIV/AIDS face numerous physical challenges in maintaining employment. Signs and symptoms of HIV infection and related opportunistic infections include fatigue, muscle weakness, neuropathy and decreased sensation, bowel and bladder incontinence, persistent cough, weight loss, decreased range of motion and coordination, limited endurance, cardiac problems and vision loss. Occupational therapy practitioners must identify the unique impact they can make on a client's quality of life by addressing work-related issues faced by the HIV/AIDS population.     

The prevailing cultures and staff dynamics in children's homes: implications for training

This paper is about training, and the learning needs of residential child care staff that training should address. It takes as its starting point research that focused on what happens in children's homes, as described by residential staff themselves. It depicts the tasks which staff carry out in relation to their overall goal of benefiting the children and young people in their care, and considers the ways in which staff work to develop and maintain viable and effective teams. Distinctive cultures emerge when working in staff teams, and the paper shows how these are related to the kinds of practice that can be achieved in residential settings. The knowledge base, practice skills, and personal qualities required to work within residential child care are detailed. The paper closes by addressing the implications which this research has for training residential staff to work effectively in group settings. It argues that fundamental to training competent residential staff is a commitment to developing an ongoing culture of learning in workplace settings.     

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.     

What clients of couple therapy model developers and their former students say about change, part II: model-independent common factors and an integrative framework

Proponents of the common factors movement in marriage and family therapy (MFT) suggest that, rather than specific models of therapy, elements common across models of therapy and common to the process of therapy itself are responsible for therapeutic change. This article-the second of two companion articles-reports on a study designed to further investigate common factors in couple therapy. We used grounded theory techniques to analyze data from interviews with MFT model developers Dr. Susan M. Johnson, Dr. Frank M. Dattilio, Dr. Richard C. Schwartz, former students of Dr. Johnson and Dr. Schwartz, and each of their clients who had been successful in couple therapy. This article reports model-independent variables, that is, general aspects of therapy that are not directly related to the therapist's model. Model-independent categories include client variables, therapist variables, the therapeutic alliance, therapeutic process, and expectancy and motivational factors, each with several subcategories. We also present a conceptual framework that outlines how model-dependent and model-independent common factors may interact to produce change. We discuss our findings and proposed framework in relation to the current common factors literature in psychology and MFT. We also discuss clinical, training, and research implications.     

Randomized controlled trial of emotionally focused couple therapy compared to treatment as usual for depression: Outcomes and mechanisms of change

This randomized controlled trial examined the effectiveness of Emotionally Focused Therapy (EFT) for depression and relationship satisfaction versus usual care (i.e., couple therapy other than EFT), and explored mechanisms of change. Mixed model trajectory analyses of 16 couples indicated EFT was associated with greater improvement in relationship satisfaction among men and women. Men receiving EFT reported greater improvements in depressive symptoms compared to usual care. Unified structural equation modeling revealed changes in relationship satisfaction preceded changes in depressive symptoms in one cluster of partners, while changes in depression preceded changes in relationship satisfaction in a second cluster. Two other clusters reported simultaneous changes in satisfaction and depression. This study provides encouraging results on the effectiveness of EFT for depression, and insight into mechanisms of change.     

Capital has an Internationale and it is going fascist: time for an international of the global popular classes

ABSTRACT

Global capitalism is approaching a general crisis of capitalist rule. It is urgent to renovate a popular revolutionary project and refound the state if we are to combat the onslaught of the neo-fascist right. Amin’s call for a new Internationale is a timely move in that direction, notwithstanding the many challenges of organizing such an Internationale. Developing an umbrella program must engage political and theoretical debate on the nature of the new global capitalism, learn from the failures of Syriza in Greece and the Pink Tide in Latin America, and reconceive the three-way relationship between states, parties, and social movements. The downward mobility and destabilization of working classes in the former First World and the destruction of the old labor aristocracies provides the recruiting grounds for 21st century fascism but also new opportunities for transnational North-South solidarities. A new Internationale must identify and prioritize the class antagonisms within and across countries and regions over core-periphery or Global North-South contradictions.     

Exposure to abuse, neglect, and household dysfunction among adults who witnessed intimate partner violence as children: implications for health and social services

Intimate partner violence (IPV) damages a woman's physical and mental well-being, and indicates that her children are likely to experience abuse, neglect and other traumatic experiences. Adult HMO members completed a questionnaire about adverse childhood experiences (ACEs) including childhood abuse, neglect, and household dysfunction. We used their responses to retrospectively assess the relationship between witnessing intimate partner violence and experiencing any of the 9 ACEs and multiple ACEs (ACE score). Compared to persons who grew up with no domestic violence, the adjusted odds ratio for any individual ACE was approximately two to six times higher if IPV occurred (p < 0.05). There was a powerful graded increase in the prevalence of every category of ACE as the frequency of witnessing IPV increased. In addition, the total number of ACEs was increased dramatically for persons who had witnessed IPV during childhood. There was a positive graded risk for self-reported alcoholism, illicit drug use, i.v. drug use and depressed affect as the frequency of witnessing IPV increased. Identification of victims of IPV must include screening of their children for abuse, neglect and other types of adverse exposures, as well as recognition that substance abuse and depressed affect are likely consequences of witnessing IPV. Finally, this data strongly suggest that future studies, which focus on the effect of witnessing IPV on long-term health outcomes, may need to take into consideration the co-occurrence of multiple ACEs, which can also affect these outcomes.     

Elderly migration and its implications for service provision in rural communities: an Ontario perspective

Following a discussion of the role of migration in the aging of rural populations and of consequent implications for service provision in rural communities, a case study featuring demographic and service use data for Grey County, Ontario, is presented. Cohort Survival Analysis of census data for the period 1971–1986 indicates a consistent net in-migration of elderly into the county and a complex but predictable pattern of elderly relocation from townships to villages and towns within Grey. The demographic analysis is complemented and extended by the examination of survey data on the residential history and service use of a sample of elderly residents drawn from two communities in Grey County. The survey results provide valuable clues for the interpretation of the demographic analysis and reveal residential history to be a potentially important pre-condition of dependence on formal services intended for the maintenance of elderly persons in the community. The paper concludes with a discussion of the need for local analysis of migration impacts and of the relationship between such impacts and longstanding problems of rural service provision.     

Exploring the experiences and dynamics of an unconditional cash transfer for low-income mothers: A mixed-methods study

ABSTRACT

Little is understood about how an unconditional cash transfer might operate and affect behavior among low-income parents of infants in the United States. We investigate these questions using data from a random-assignment pilot study (N?=?30) in which unconditional cash transfers were distributed monthly on debit cards to two groups of low-income parents in New York City during the first 12 months of their newborns’ lives. Mothers were randomized to receive either $100 per month or $20 per month. Mothers distinguished spending the cash transfer on essentials vs. extras, such as going out to dinner with family. The monthly cash transfer “tided them over,” even at the lower amount of $20, especially when income from other sources ran short at the end of the month. Some mothers reported saving money for unexpected expenses.     

Narrative and interactional process for preventing harmful struggle in therapy: an integrative empirical model

Resistance or struggle in therapy looms large as a predictor of treatment outcomes. This study organizes the significant empirical data on struggle into a coherent, operational framework for use by therapists in preventing and/or ameliorating harmful struggle in therapy. First, we review the prevalence and significance of struggle. Second, we offer a historical and conceptual overview, with emphasis on a contemporary interactional/systemic perspective on struggle. Third, we provide a synthesis of peer-reviewed research, profiling struggle at speech-act and episode levels of interaction process and across assessment/joining, intervention, and integration-consolidation phases of therapy. Fourth, based upon this review, we propose a three-factor model--consisting of eliciting dialogue, enactments, and accommodation--for successful therapy process relative to the occurrence of struggle.