A Longitudinal View of the Association Between Therapist Warmth and Couples' In‐Session Process: An Observational Pilot Study of Emotionally Focused Couples Therapy

This longitudinal dyadic clinical process study used coded data from eleven couples to determine the influence of therapist warmth behaviors on couples' warmth behaviors over time in therapy. A mixed effects model was used to examine within‐ and between‐individual variability. Men and women were modeled separately. A series of two‐level multilevel models of change were examined, where Time is Level 1 and Individual is Level 2. Findings were mixed. There was no significant relationship between therapist warmth toward wife and wife warmth toward husband; however, there was a significant relationship between therapist warmth toward husband and husband warmth toward wife. Findings demonstrated that 62.9% of the variance in husband warmth toward wife was accounted for by therapist warmth to husband across time in therapy. Specifically, therapist warmth toward husband was significantly and positively related to husband warmth toward wife over time in therapy. Clinical implications and directions for future research are discussed.     

An Analytical Framework for Designing Community‐Based Care for Chronic Diseases

In this study, we propose a methodological framework to provide a road map to clinicians and system planners in developing chronic disease management strategies, and designing community‐based care. We extend the analytical epidemiologic model by utilizing a patient flow approach, in order to model the multiple care‐provider visit patterns of patients with a specific chronic illness. The patterns of care received by a group of patients are represented in compact form by means of a Markov model that is based on a disease‐specific state space. Our framework also reflects the case‐mix biases as well as the care‐provider level clustering of the patients. By using this approach, we identify the patterns of care, determine the care provider and patient characteristics associated with optimal management of care, and estimate the potential influence of various interventions. The framework is applied to the data of 4000+ stroke patients discharged from the acute care hospitals of Quebec to their homes. Our findings provide a basis for designing community‐based care initiatives for stroke survivors in the province.     

Generosity and the Maintenance of Marital Quality

This study examined whether generosity in marriage was associated with marital quality. The authors conceptualized generosity as a type of relationship maintenance behavior and used data from the new Survey of Marital Generosity (a national survey of married couples, N = 1,365 couples and 2,730 total participants). They found that generosity—defined here as small acts of kindness, displays of respect and affection, and a willingness to forgive one's spouse his or her faults and failings—was positively associated with marital satisfaction and negatively associated with marital conflict and perceived divorce likelihood.     

Relationship education among incarcerated populations

Abstract

Incarceration represents a significant shift in the life course trajectories of the nearly seven million inmates in the American criminal justice system and their families and can have far-reaching effects on intimate and family relationships. Prior research has highlighted the relationship difficulties that inmates face while incarcerated and upon their release. Using a life course perspective, we review the disruptive impact of incarceration on relationships. We examine how relationship education targeted to incarcerated individuals may be an opportunity to provide knowledge and skills that help improve and maintain healthy relationships both during incarceration and upon release. Relationship education courses have consistently been shown to be effective within a variety of settings, and preliminary studies indicate that they may be effective within incarcerated populations as well.     

“I'm still raring to go”: Successful aging among lesbian,gay, bisexual,and transgender older adults

While we know that minority status differentiates the experience of aging, little research has been done to examine the ways in which patterns of successful aging may differ in diverse subgroups of older adults. In this exploratory study, we investigated and described experiences of successful aging in a sample of lesbian, gay, bisexual and transgender (LGBT) older adults. Directed by a community-based participatory research process, we conducted semi-structured in-depth interviews with 22 LGBT adults, age 60 and older. We took an inductive, grounded theory approach to analyze the taped and transcribed interviews. We coded respondent experiences in four domains: physical health, mental health, emotional state and social engagement. Four gradations of successful aging emerged. Very few in our sample met the bar for “traditional success” characterized by the absence of problems in all four domains of health. Most of the sample was coping to a degree with problems and was categorized in one of two gradations on a continuum of successful aging: “surviving and thriving” and “working at it.” A small number was “ailing”: not coping well with problems. Some of the experiences that respondents described were related to LGBT status; others were related to more general processes of aging. The research suggests that a successful aging framework that is modified to include coping can better describe the experiences of LGBT older adults. The modified conceptual model outlined here may be useful in future research on this population, as well as more broadly for diverse populations of adults, and may be adapted for use in practice to assess and improve health and well-being.     

The Therapeutic Pyramid: A Common Factors Synthesis of Techniques,Alliance, and Way of Being

Common factors in therapy such as the therapeutic alliance and client motivation have been found to account for more change than therapy models. But common factors have been critiqued as only lists of variables that provide little practical guidance. Some researchers have demonstrated that certain common elements (e.g., the therapeutic alliance) account for more variance than others (e.g., techniques), suggesting that some factors should be emphasized over others. Such findings suggest the need for alternatives to model‐based therapy, with one alternative being meta‐models, or “models of models,” that focus on how therapeutic factors interact with each other to produce change. The purpose of this article is to propose a meta‐model describing the relationship between two specific common factors—the therapeutic alliance and interventions. We also propose a new factor—a therapist's way of being—that we believe is foundational to effective therapy. The model is proposed in pyramid format, with techniques on top, the therapeutic alliance in the middle, and therapist way of being as the foundation. The hierarchical relationships between these three concepts are discussed, along with implications for training, research, and therapy.     

The Couple That Prays Together: Race and Ethnicity,Religion, and Relationship Quality Among Working‐Age Adults

A substantial body of research has shown that relationship quality tends to be (a) lower among racial and ethnic minorities and (b) higher among more religious persons and among couples in which partners share common religious affiliations, practices, and beliefs. However, few studies have examined the interplay of race or ethnicity and religion in shaping relationship quality. Our study addresses this gap in the literature using data from the National Survey of Religion and Family Life (NSRFL), a 2006 telephone survey of 2,400 working‐age adults (ages 18–59), which contains oversamples of African Americans and Latinos. Results underscore the complex nature of the effects of race and ethnicity, as well as religious variables. In particular, we found that couples' in‐home family devotional activities and shared religious beliefs are positively linked with reports of relationship quality.     

A Framework for Hazardous Materials Transport Risk Assessment

In this paper, we provide a framework for quantitative risk assessment in hazardous materials transport. We first outline a basic model where population centers are approximated by points on a plane with the assumption that in the case of an incident all residents in a population center will experience the same consequences. Different versions of this model have been used by other authors in the literature. This model may be valid if the hazardous materials route goes by small population centers. Then we extend this basic model to assess risks of shipping hazardous materials through large population centers that cannot be modeled as single points on a plane. In the extended model, large population centers are treated as two-dimensional objects on the plane, which allows for a more accurate treatment of consequences than the basic model. To the extent of our knowledge the extended model is novel. We provide numerical examples for both the basic and the extended models, and finish by discussing limitations of the suggested risk assessment framework.