Attachment injuries in couple relationships: a new perspective on impasses in couples therapy

This article identifies and operationalizes the newly defined construct of attachment injury. An attachment injury occurs when one partner violates the expectation that the other will offer comfort and caring in times of danger or distress. This incident becomes a clinically recurring theme and creates an impasse that blocks relationship repair in couples therapy. An attachment injury is characterized by an abandonment or by a betrayal of trust during a critical moment of need. The injurious incident defines the relationship as insecure and maintains relationship distress because it is continually used as a standard for the dependability of the offending partner. The concept of an attachment injury is defined here in the context of emotionally focused therapy, an empirically validated, short-term approach to modifying distress in couples. The broad theoretical underpinnings of this concept may be found in attachment theory as applied to adult romantic relationships. Through the delineation of attachment injury events and the ongoing development of a detailed model of resolution, couples therapists will be better able to identify, describe, and effectively treat such injuries and address the therapeutic impasses that are associated with them.     

The role of spirituality in the recovery process

Though innovative approaches to working with substance-abusing parents of maltreated children have emerged within the last few years, child welfare agencies continue to be challenged by the chronic nature of addictive diseases. This article discusses the often ignored element of spirituality as a critical component of recovery for parents. It also highlights how the regulation of spirituality by parents has a significant influence on their ability to responsibly care for their children.     

Varying Risk Comparison Elements: Effects on Public Reactions

Expanding a limited empirical base on effects of risk comparisons, a pilot experiment explored how varying elements of such comparisons might influence public response. The scenario used was a hypothetical trial of an asbestos-installing firm for putting students and staff at a junior high school at "unreasonable risk," first used by Slovic et al. (1990). Study participants played the role of jurors in the trial, asked to rate the risk, the firm's guilt, whether it should be made liable for future health effects, whether the school should be occupied in its current condition, and whether the asbestos should be removed at a cost of 3 million dollars. Opportunity samples of New Jersey residents (n= 309) received information intended to vary four comparison attributes: number of dimensions of comparison; single versus multiple ways of expressing mortality; a narrative to explain and justify the risk comparison; and the hypothetical role of the participant (juror vs. parent). The dependent variable was a hazard scale constructed from four of the five postcomparison judgments. ANOVA found format variations swamped in their effect by concern about asbestos, with the absence of a narrative and the parental role being the only attributes that increased negative risk reactions. Multiple regression analyses found that multidimensionality, narrative, role, and the presence of any risk comparison at all had significant effects when these (plus death formats) were the only independent variables. However, only multidimensionality (which increased negative reactions) retained significance when asbestos concern, risk beliefs (no safe level of exposure to a carcinogen; any exposure leads to cancer), and demographic variables were added to the analysis. Concern and risk beliefs alone explained 33% of variance in hazard scores; adding demographics and risk comparison variables only raised explained variance to 36% (having children at home and being exposed to multidimensional risk comparisons raised scores; age and income lowered them). The results underline the potentially small effect of risk comparison information on risk views (at least between subjects), but offer some insight into aspects of message design left unexplored in empirical literature to date.     

Evaluation of the effects of a smoking cessation intervention using the multilevel thresholds of change model

The multilevel thresholds of change model is used to analyze the effect of a smoking cessation intervention on stage of readiness to quit across a 2-year follow-up period. The intervention, targeted to females with high school or less education, consisted of a televised component and a written manual. Any exposure to the intervention had a significant effect on stages that precede quitting but not on quitting; participation in the intervention had significant effects at all levels of change, including quitting. The written component had a stronger independent effect than the televised component. Intervention effects were strongest within women who were initially precontemplative.     

Drug abuse treatment training in Peru. A social policy experiment

A social policy experiment is presented that was conducted from 1997 to 2000 in a setting with a high level of readiness for implementing a randomized experiment of therapeutic community (TC) drug treatment training in Peru. Seventy-six drug abuse treatment organizations were randomly assigned into three groups, and data were collected at multiple assessment periods. Staff and directors in organizations assigned to the training groups participated in either 6-week basic training or 8-week basic plus booster training sessions, which were theoretically grounded. Small- to medium-size positive effects were found on increased staff empowerment to use actual tools and principles from the training; medium and large positive effects were found on the implementation of TC methods with fidelity after the training. A follow-up with the funding and training organizations 1 year later showed use of the evaluation results in decision making in both organizations.     

Emotionally focused interventions for couples with chronically ill children: a 2-year follow-up

Couples with chronically ill children are particularly at risk for experiencing marital distress. The study presented here is a 2-year follow-up of a randomized control trial that assessed the efficacy of Emotionally Focused Therapy (EFT) in decreasing marital distress in a sample of couples with a chronically ill child. Thirteen couples with chronically ill children who received treatment were assessed to determine if the significant improvement in relationship distress observed at posttreatment and 5-month follow-up would be maintained at 2-year follow-up. Results demonstrated that improvements in marital functioning were not only maintained but, in some cases, enhanced at the 2-year follow-up. This uncontrolled follow-up study provides initial evidence of the longer-term benefits of EFT.