NEIGHBORHOOD FAMILY-FRIENDLINESS AND ITS EFFECT ON FAMILY RELATIONS: EVIDENCE FROM UTAH

This article explores the effect of neighborhood family-friendliness on three measures of family relations: marital burnout, marital satisfaction, and parent-child relations. Regression analyses of survey data from northern Utah provide some support that neighborhood family-friendliness, measured here as neighborhood cohesion and neighborhood assessment, positively affects family functioning. For men, neighborhood cohesion was negatively associated with marital burnout and positively associated with marital satisfaction. For both men and women, neighborhood assessment was positively associated with marital satisfaction. These relationships were stronger for men than for women.     

EFFECTS OF THE PARENTAL COALITION ON ADOLESCENT EMANCIPATION FROM THE FAMILY

This study examined the relationship between late adolescents' perception of their parents' marital coalition and academic success as a college freshman. The hypothesis was tested that late adolescents from families with a primary cross-generational bond (e.g., mother-son) have more difficulty emancipating from the family than offspring from families in which mother and father are the primary dyadic alliance in the family. Academic success as a college freshman was utilized as one measure of the late adolescents' success in separating from the family. The subjects were 36 18–year-old freshman males placed on academic probation and 36 passing males matched on ethnicity and SAT scores. The principal results were that subjects reporting a primary marital alliance were more likely to succeed academically and were more internal on the Rotter I-E scale than subjects who reported a nonmarital alliance as primary. The findings provide support for the theory of structural family relations, and clarify familial processes that affect late adolescent emancipation from the family.     

THE REPRODUCTION OF FAMILIES: THE SOCIAL ROLE OF FAMILY THERAPY?

Family therapy, while highlighting the significance of family functioning for individual experience and behavior, has in general failed to respond to the critical analyses of the family that have recently been developed, and particularly that offered by the women's movement. Consequently, it cannot investigate the possibility that "dysfunction" in families is actually socially created and maintained. Family therapy's failure to consider the broader contexts of family functioning, a failure that is facilitated by the use of systems theory as its major theoretical underpinning, results in an uncritical acceptance of the contemporary family form.     

THE EFFECTIVENESS OF FAMILY INTERVENTIONS IN THE TREATMENT OF PHYSICAL ILLNESS

Although a large body of research demonstrates that the family has a powerful influence on physical health, the evidence for the effectiveness of family interventions in physical illness is less conclusive. Family therapy and other family interventions appear to be most effective in chronic childhood illnesses such as asthma and diabetes. Family interventions have also been shown to be effective in the management of some cardiovascular and neurologic disorders and for the treatment of obesity. Family therapy appears to be more effective than individual therapy for some groups of patients with anorexia nervosa. This research supports the increasingly important role of medical family therapy in the new health care system. Recommendations for future research are discussed.     

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.     

Affection and conflict in marital and parent-child relationships

In this study, we examined affection and conflict in marital and parent-child relationships, as reported by mothers, fathers, and 9- and 10-year-old children in a community sample of 87 families. Affection and conflict were inversely related within relationships, with mixed findings across relationships. Most reports showed an association between marital and parent-child conflict as well as between marital and parent-child affection. According to fathers, however, the association between marital affection and father-child affection is moderated by marital conflict. Clinical implications of the associations between positive and negative dimensions of family interaction and of the links between marital and parent-child relations are discussed.     

THE EFFICACY AND EFFECTIVENESS OF MARITAL AND FAMILY THERAPY: A PERSPECTIVE FROM META-ANALYSIS

This article reviews the major findings from a multiproject meta-analysis of the effects of marital and family therapy (MFT). Across 163 randomized trials, MFT demonstrates moderate, statistically significant, and often clinically significant effects. No orientation is yet demonstrably superior to any other, nor is MFT superior to individual therapy. Cost effectiveness information is scant in these 163 studies, but supportive. Randomized experiments yield very different answers from nonrandomized experimental studies of the effects of MFT, calling into question whether we should mix the two in reviews. We have also found several new differences in the ways that marital therapy (MT) and family therapy (FT) studies are conducted, making them harder to compare. Finally, important questions still exist about whether any psychotherapy, including MFT, yet has sufficient information about how well research generalizes to everyday clinical practice.     

THE McMASTER FAMILY ASSESSMENT DEVICE: RELIABILITY AND VALIDITY*

This paper reports a series of studies investigating the reliability and validity of the McMaster Family Assessment Device (FAD). The results indicated that the FAD has: (a) adequate test-retest reliability, (b) low correlations with social desirability, (c) moderate correlations with other self-report measures of family functioning, and (d) differentiates significantly between clinician-rated healthy and unhealthy families. Cut-off scores for identifying healthy and unhealthy families also were developed which have adequate sensitivity and specificity. Additionally, the relationships between the FAD, Family Unit Inventory, and FACES-II suggests that the cohension and adaptability scales from the FACES-II have a linear relationship with health/pathology.     

THE EVALUATION PHASE OF SYSTEMIC FAMILY THERAPY*

The initial, evaluation phase of family therapy is of decisive importance within the systemic perspective. Contacting a therapist is always a complex action for a family. The therapist's evaluation must include the possibility that continued contact may influence the family negatively and limit their potential for change. If there appears to be a logical context in which continued therapy can be justified, it will be necessary to use the first three or four sessions to collect essential data and to organize them meaningfully. It is essential to clarify the circular interaction that is maintaining the symptom, as well as the presence of specific family structures and traditions, and the kind of relationships the family attempts to establish with the therapist. On the basis of this information, the therapist can build models of the family's functioning. These models, according to general system theory, make possible logical intervention in complicated, living systems, without distorting them by artificially splitting them into their component parts. Two models that are important to our treatment perspective—the phenomenological and the mythical—are presented.     

THE MARGINALIZATION OF FAMILY THERAPY: A HISTORICAL AND CONTINUING PROBLEM

Family therapy, and marital and family problems, are mariginalized in the larger fields of mental and physical health care, which is a misfortune both for family therapy and for other mental health professions. The early family therapists, who had multidisciplinary backgrounds, attempted toestablish a new, nondisciplinary paradigm and also tried to expand the perspectives of the more traditional mental health disciplines. More recently, family therapists have exerted greater effortsto establish marriage and family therapy as a differentiated, autonomous profession. These alternatives each involve dilemmas for the family therapy field. The positive side of becoming a distinctive profession is greater internal strength and clear professional identy; the downside is the threat of increased marginalization in rlation to the other professions, a tendency toward intellectual isolation, and hence restricted opportunities for invigorating new challenges. Family therapy now needs to develop new modes of interchange, collaboration, and selective integration with otherhealth care professions. Such interchange will be beneficial both to family therapy and to other professions.     

FAMILY ASSESSMENT IN CHILD CUSTODY DISPUTES*

This paper has operationalized family systems theory to explicate the interfacing dynamics between family dissolution and child custody disputes. The authors suggest that clinical assessment and intervention in these matters which focus solely on individual and marital, or child dimensions, fail to recognize the powerful influences of systemic family process. A family assessment model, evolved from clinical work with over 200 court-referred custody cases, is described. The model involves a cross-sex therapy team with each member responsible for a specific family subsystem. The role of each therapist and the functioning of the team is outlined. Specific criteria for determining custody recommendations are identified based on patterns of family process and dissolution.     

Role of Marital Quality in Explaining Depressive Symptoms After Marital Termination Among Older Adults

This study assesses whether prior marital quality moderates the impact of divorce or widowhood on subsequent depression. Poor marital quality may buffer depression associated with divorce/widowhood; conversely, the effect of divorce/widowhood on depression could be exacerbated by previous marital quality. Three waves from the National Survey of Families and Households based on respondents, ages 50 and older, (N?=?2,570) included eight marital quality measures. We find limited evidence suggesting higher marital quality elevates, while lower marital quality decreases, depression after divorce. No moderating effects were found for widowhood. Additionally, health condition is more important than current marital status for elders’ well-being after divorce or widowhood. Heterogeneity in the context of the marriage before divorce should be considered when examining marital termination effects on elders’ depression.     

A COMPARISON OF THE McMASTER AND CIRCUMPLEX FAMILY ASSESSMENT INSTRUMENTS*

This study compared clinical rating scales and self-report scales from the McMaster and Circumplex models of family functioning. Forty-one families were given self-report measures, while clinicians assessed the families using clinical rating scales. There are three main findings: (a) The McMaster instruments have superior sensitivity (i.e., ability to correctly identify clinical families based on instrument scores); (b) there is greater correspondence between clinical rating scales and family member self-report inventories on the McMaster instruments; (c) there is lack of support for the curvilinear model of pathology suggested by the Circumplex model, as evidenced by unequal and linear distribution of scores on the Circumplex dimensions.     

The Intergenerational Transmission of Financial Stress and Relationship Outcomes

Numerous studies have focused on the intergenerational transmission of poverty, financial stress, and family functioning. Other research has shown how financial stressors can predict various family processes, including parent–child interactions, family conflict, and couple communication, and relationship outcomes, including marital stability and satisfaction. This study shows continued evidence that financial stress from the male and female partner's family of origin may predict marital dissatisfaction using dyadic data techniques. Also, an exploration of indirect paths also found that the presence of current financial stress partially mediates these associations.     

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.     

THE EFFICACY OF MARITAL AND FAMILY THERAPY: AN EMPIRICAL OVERVIEW, CONCLUSIONS, AND RECOMMENDATIONS

Based primarily on the contributions to this Special Issue of JMFT, this article provides an overview of the empirical research on the efficacy of marital and family therapy for the following disorders and problems: schizophrenia; affective (mood) disorders; slected externalizing, internalizing, and pervasive developmental disorders of childhood; adolescent conduct disorder; marital distress and the prevention of divorce; alcoholism; adult and adolescent drug abuse; and various chronic adult, adolescent, and childhood physical disorders. Convincing scientific evidence supports the efficacy of broadly defined marital and family therapy for the treatment of many disorders, as well as its superiority to standard and individual treatments for certain disorders and populations. We conclude with recommendations for future research as well as for collaborative initiatives between marital/family therapists and other professionals working in the marriage and family field.     

Parenting challenges and parents’ intimate relationships

ABSTRACT

Parenthood is a rewarding as well as a potentially stressful event for many couples as it brings many changes to their lives. Having young children at home can result in decreased relationship satisfaction and a low-quality sexual relationship. Same-sex couples may, however, report different parenting experiences, and their parenthood may not significantly affect their level of relationship satisfaction. The quality of marital relationship is an important determinant of the parenting stress and the quality of the parent-child relationship. Mothers and fathers who report dissatisfaction with their marriage and relationship experience more parenting difficulties and stress than those who are satisfied with their relationships. Although research into transition to parenthood is very significant, the association between parenting challenges and parents’ intimate relationships remains an understudied topic. Research needs not only to highlight the importance of parents and family well-being and its direct impacts on the child’s well-being, but also to emphasize the bidirectional association between parent-child interactions and couples’ intimate relationship satisfaction.     

QUANTIFYING THE CLINICAL ASSESSMENT OF FAMILY HEALTH

The Family Health Scale is an instrument designed to quantify the quality of family functioning from the perspective of an external clinical observer. Rating may be based on whatever information is available on the family but, ideally, should be derived from a valid standardized method of direct observation like the Family Task Interview (Kinston and Loader, 1986). Clinical judgement must be exercised in rating, and new methods to enhance its quality have been devised. The scale may be used with nonlabelled, as well as psychiatrically labelled, families. The FHS has demonstrated consistently high inter-rater agreement, and test-retest reliability. Evidence is also offered for its validity and specificity.     

FAMILY INTERVENTION IN A CASE OF MULTIPLE PERSONALITY

The authors report a case of multiple personality in which therapy was directed at the marital couple, rather than focusing on the multiple personality per se. The symptoms of the individual are seen as a disturbance in the family homeostasis and were treated from that standpoint. The functions of the symptom in the areas of impulse discharge, superego operation, boundaries of closeness-distance, and self-object representations for the couple and family are discussed.