Reflecting on the Past: A Content Analysis of Family Therapy Research from 2000-2015.

In this content analysis, researchers examine articles published from 2000 to 2015 in three family therapy journals, yielding a total of 948 empirical articles. The purpose is to provide an overview of the research being published, assess who is publishing, and investigate the current state of clinical effectiveness research in marriage and family therapy (MFT). Most first authors were affiliated with MFT programs and primarily included diversity and couples in their research. There was a significant increase of research on clinical process-though the number of clinical outcome studies held steady. There were no significant changes with regard to research funding. Implications support the use of innovative research methods to provide evidence of clinical effectiveness.

The State of Sex Research in MFT and Family Studies Literature: A Seventeen-Year Content Analysis.

The ability to conceptualize and treat sexual problems has been widely accepted as a crucial skill to master the MFT training. However, clients' sexual relationships are often ignored by clinicians because of a lack of experience or training, or personal discomfort. In this content analysis, we review sex and sex therapy research within MFT and family studies journals since the turn of the century. Of the 13,919 articles published within the 15 journals, 137 focused on sexuality or sex therapy. The articles were divided into five themes: sexual and relational health, sexual diversity, treatment and contributors of sexual dysfunction, sex therapy practices, and sexual education and development. Implications for clinical practices, sex therapy integration, and future research are discussed.

A Content Analysis of Quantitative Research in Journal of Marital and Family Therapy: A 10-Year Review.

We examined the trends of quantitative research over the past 10 years in the Journal of Marital and Family Therapy (JMFT). Specifically, within the JMFT, we investigated the types and trends of research design and statistical analysis within the quantitative research that was published in JMFT from 2005 to 2014. We found that while the amount of peer-reviewed articles have increased over time, the percentage of quantitative research has remained constant. We discussed the types and trends of statistical analysis and the implications for clinical work and training programs in the field of marriage and family therapy.

Does premarital education decrease or increase couples' later help-seeking?

Interventions intended to prevent relationship distress are expected to enhance relationship satisfaction and, in turn, reduce the need for later couples counseling. We test this prediction against an alternative possibility: participation in preventive interventions may operate as a gateway for later help-seeking, paradoxically increasing receipt of later couples counseling. A cross-sectional study of 2,126 married individuals examined whether participation in premarital education covaried inversely or directly with couples counseling. Consistent with the gateway hypothesis, receiving premarital education covaried with an increased likelihood of receiving couples counseling. The association between receipt of premarital education and pursuit of couples counseling was moderated by demographic indicators, with the association being stronger for African Americans and for individuals with lower incomes and less formal education. Encouraging the use of premarital interventions may increase the use of therapeutic interventions later in the relationship, especially among high-risk populations.

Marriage and family therapy: examining the impact of licensure on an evolving profession.

Regulatory responsibilities for the profession of marriage and family therapy have shifted from the American Association of Marriage and Family Therapy (AAMFT) to state regulatory boards. The impact of these changes has not been adequately addressed. The purpose of this article is to highlight many of these changes and explore their implications. The educational, experience, and supervision requirements of states regulating the profession of marriage and family therapy in 2007 are examined using descriptive data from 47 regulatory entities and then compared with the current (2012) regulatory standards from 51 regulatory entities. In turn, these are compared with AAMFT prelicensure clinical membership requirements. Results indicate a marked difference between AAMFT prelicensure and state licensure requirements in both 2007 and 2012, but that state requirements continue to evolve. Additionally, the changing roles of the AAMFT and the Association of Marital and Family Therapy Regulatory Boards (AMFTRB) within the profession are explored.

Shedding light on thirteen years of darkness: content analysis of articles pertaining to transgender issues in marriage/couple and family therapy journals.

What is the extent to which marriage/couple and family therapy (M/CFT) journals address transgender issues and how many of them say they are inclusive of transgender persons when they are not? To answer these queries, a content analysis was conducted on articles published in M/CFT literature from 1997 through 2009. Of the 10,739 articles examined in 17 journals, only nine (0.0008%) focused on transgender issues or used gender variance as a variable. Findings support the assertion that transgender issues are ignored and marginalized by M/CFT scholars and researchers alike.

Alliance and termination status in couple therapy: a comparison of methods for assessing discrepancies.

Much of the empirical data available about therapeutic alliance and its relationship to termination status come from individual psychotherapies. We know less about therapeutic alliance in couple therapy. A unique characteristic of alliance in couple or family therapy is the possibility of discrepancies in alliance between system members. In this study we sought to demonstrate three statistical techniques: standard deviations, the intraclass correlation to assess discrepancies in alliance over time during the initial stage of couple therapy, and the use of these various measures to predict termination status using a sample of 72 couples from a university-based training clinic. Differences in partners' alliances operationalized either as categorical or continuous variables but when analyzed separately at each time point were not predictive of termination status. When multilevel modeling was used, a difference in the way the discrepancies changed over a period of time was related to termination status.

Therapists' assessment and treatment of internet infidelity cases.

In this study, we investigated through an Internet survey of 508 practicing marriage and family therapists which treatment decisions varied by gender of the client and background variables of therapists. The subjects responded to several typical Internet infidelity scenarios. We varied the gender of the person initiating the infidelity for half of one sample. We also asked the family therapy participants to respond to how they might assess and treat each presenting problem. They also evaluated problem severity, prognosis of the case, number of sessions necessary for treatment, and the extent to which a therapist would focus individually or relationally. Results indicate that there were differences in how therapists assessed and treated clients based on client gender, therapists' age, therapists' gender, how religious therapists reported they were, and the extent of therapists' personal experience with infidelity.

Profile of adult patients attending a marriage and sex clinic in India.

BACKGROUND: Sexual disorders, which are usually influenced by multiple factors, are very prevalent across the globe but there are few studies which provide the pattern of help-seeking behavior in the Indian population. AIMS: The study aims to present the pattern of sexual dysfunction in the patients attending a marriage and sex clinic from 1979 to 2005. METHOD: Details are obtained from the records of the patients who attended the clinic. In accordance with the change in diagnostic classification, the data are presented: ICD-IX (for period 1979-1992) and ICD-X (for period 1993-2005). RESULTS: Out of a total of 1,242 patients, 566 patients attended the clinic during 1979 to 1992, and 676 patients during 1993 to 2005. More than half of the clinic population during the period was aged 20-29 years. Premature ejaculation is the most common complaint and the most commonly diagnosed clinical entity, followed by male erectile problems and culturally induced sexual behaviors such as dhat syndrome. CONCLUSION: Being more educated, married and from an urban background promotes help-seeking in tertiary care clinics but these findings may be due to selection bias. Sexual activity continues to be strongly influenced by culturally held beliefs. This influence is more troublesome for young and unmarried persons who have not changed over the period.

Outcomes from 40 years of psychotherapy in a private practice.

Of 1,969 patients seen by a clinical psychologist during 40 years of private practice, at the time the outcome data were analysed 1,374 were either in treatment or had completed treatment and all of these cases had produced outcome data. The results show that four (4) patients (0.29%) became Much Worse, 10 (0.73%) became Worse, 412 (29.96%) showed No Change, 467 (33.96%) became Better, and 482 (35.06%) were Much Better. The mean treatment effect size (ES) was 1.87. Outcome varied significantly across diagnostic categories. Outcome also varied by age groups. Outcome for males and females did not differ, but both kinds of individual patients did better than when couples were the focus of treatment. The dropout rate was 17%. The mean number of sessions per case was 17.43, the median was 10, and the range was 1 to 344. There was a significant positive correlation between number of treatment sessions and outcome. The therapist's effectiveness did not improve across the years. Managed care had a significant negative impact on treatment outcomes.

Evaluating a brief prevention program for improving marital conflict in community families.

Marital conflict is related to well-being in children and adults (E. M. Cummings & P. T. Davies, 2002). Marital conflict is likely most effectively ameliorated before it becomes clinically significant. However, families without significant problems may be unwilling to participate in couples therapies or other lengthy or intensive interventions. Responding to this gap, the authors developed a 4-session psychoeducational program about marital conflict for community families. Couples with children 4-8 years of age were randomly blocked into 1 of 3 groups: (1) a parent-only group (n = 24), (2) a parent-child group (n = 33), or (3) a self-study group (n = 33). Pre- and posttest and 6-month and 1-year assessments were conducted. This report evaluates (a) whether participation in a psychoeducational program for parents improved marital conflict, especially concerning ways of expressing disagreements, and (b) whether changes in marital conflict subsequently improved marital satisfaction, parenting, and child adjustment. Greater constructive and less destructive marital conflict was observed at all assessments for treatment groups, and these changes were linked with improvements in other family processes. The findings support the promise of brief, psychoeducational programs for improving marital conflict for community samples.

Characteristics and clinical practices of rural marriage and family therapists.

This report presents a subset of data collected from the American Association for Marriage and Family Therapy (AAMFT) Practice Research Network project conducted in 2002. A sample of 47 clinical members of AAMFT who indicated they practiced in a rural community provided descriptive information on demographic characteristics, training, clinical practices, and treatment of substance abuse disorders. Similarities and differences with the demographic characteristics and practice patterns of the overall sample of 285 are discussed.

Acceptance in romantic relationships: the frequency and acceptability of partner behavior inventory.

Despite the recent emphasis on acceptance in romantic relationships, no validated measure of relationship acceptance presently exists. To fill this gap, the 20-item Frequency and Acceptability of Partner Behavior Inventory (FAPBI; A. Christensen & N. S. Jacobson, 1997) was created to assess separately the acceptability and frequency of both positive and negative relationship behaviors. Data from 12,752 community individuals, 415 community couples, and 134 couples seeking marital therapy indicated that the FAPBI comprises four factors: Affection, Closeness, Demand, and Violation. These factors were consistent across gender, relationship type, and sexual orientation. Furthermore, the factors were internally consistent, correlated with relationship satisfaction, and differentiated couples seeking marital therapy from nondistressed couples in the community.

The influence of individual, marital, and family therapy on high utilizers of health care.

Research has shown that people reduce their use of health care after individual, marital, and family therapy, which is known as the "offset effect." However, little research has been done to learn if high utilizers of health care reduce health care usage after therapy. Medical records of research participants (n = 65) from a health maintenance organization (HMO) were randomly selected and examined for 6 months before, during, and after therapy. Persons who received individual, marital, or family therapy all reduced their health care use after therapy, with the largest reductions coming from those participants who had some form of conjoint therapy.

Characteristics and clinical practices of marriage and family therapists: a national survey.

This report presents data from a telephone survey of a randomly selected sample of 292 marriage and family therapists (MFTs) who were Clinical Members of the American Association for Marriage and Family Therapy. The study, designed to better understand the current state of the field of MFT, provides descriptive data on the demographic characteristics, training, clinical practices, and treatment of substance abuse disorders by MFTs. Participants reported they most commonly treat marital and couple difficulties, depression, anxiety, and problems of children and adolescents. It was also found that MFTs commonly assess for substance abuse problems, but these problems represent a relatively small percentage of their caseload. The data support the continued maturation and growth of the field. Implications for the field and comparisons to other national data are addressed.

Testing hypothesized predictors of change in conjoint behavioral alcoholism treatment for men.

BACKGROUND: The model on which alcohol-related Behavioral Couples Therapy (ABCT) is based posits three primary domains related to alcohol consumption: individual factors, the quality and nature of the spouse's response to alcohol-related situations, and the nature and quality of the couple's marital interactions. METHODS: This study tested the model underlying ABCT in a sample of 68 male alcoholics and their partners, who completed at least five sessions of a 15-session outpatient treatment study in which they received ABCT. Couples were assessed at baseline, during treatment, and for 6 months after treatment completion. Stepwise multiple regression was used to test specific predictors derived from the ABCT model. RESULTS: Some support was provided for each component of the ABCT model. Individual drinker variables predicted drinking outcomes, both during and after treatment. Specifically, greater drinking severity and drinking frequency at baseline predicted poorer drinking outcomes. Older client age and more education predicted less frequent but more intense drinking. Spouse coping was related primarily to measures of drinking intensity, rather than drinking frequency. Less intense drinking during treatment was predicted by greater spousal use of problem solving and social support to deal with problems and less use of self-blame, wishful thinking, and avoidance. After treatment, however, spouse coping had a less consistent relationship to drinking intensity. In the marital domain, drinking during treatment was unrelated to pretreatment marital satisfaction measures. However, in the 6 months after treatment, men's ability to remain abstinent was predicted by the quality of the pretreatment marital relationship, and the intensity of their drinking was predicted by the degree of their marital happiness immediately after treatment. CONCLUSIONS: Results provided substantial support for the ABCT model, particularly in relationship to the role of the spouse in affecting heavy drinking.

The influence of marital and family therapy on health care utilization in a health-maintenance organization.

Research has shown that people reduce their use of health care after individual psychotherapy. However, little research has been done to learn if marital and family therapy has a similar effect. Subjects (n = 292) from a health-maintenance organization were randomly selected according to the type of therapy they had received. Subjects' medical records were examined for 6 months before, during, and after therapy. Those who received marital and family therapy significantly reduced their use of health care services by 21.5%. These results show an "offset effect" for marriage and family therapy.

The relationship between psychiatrists' couple and family therapy training experience and their subsequent practice profile.

A 28-item questionnaire was returned by 291 psychiatrists who had completed training between 1962 and 1992. There were positive correlations between the amount of couple and family therapy training (CFTT) they received and the following: the extent to which graduate psychiatrists practice CFT; their involvement as supervisors, teachers, teaching program directors, or researchers; the extent to which they seek continuing education in CFT; their positive attitude toward CFT; and the extent to which they feel that their attitude to and interest in CFT has had a positive effect on the milieu in which they practice and on their personal lives.

Factors related to family therapists' breaking confidence when clients disclose high-risks-to-HIV/AIDS sexual behaviors.

This national survey of 309 marriage and family therapists examined what therapists do when their HIV-positive clients disclose that they are engaging in high-risk sexual behavior. The participants were given vignettes in which a fictitious client told the therapist about engaging in unprotected sex. Although the basic situations were the same, the client variables of age, gender, race, sexual orientation, and HIV status were systematically varied. The participants were more likely to break confidence regarding unsafe sex practices when their clients were male, young, gay, or African American. Moreover, therapists who were more likely to disclose were older, female, had less experience with gay/lesbian populations, were Catholic, were very religious, and were more likely to practice in urban areas. The authors discuss the implications of these and other findings.

Gender-related therapist attributions in couples therapy: a preliminary multiple case study investigation.

Differential treatment by gender has been an ongoing area of concern and uncertainty both in society at large and in clinical research. In this investigation, therapist attributions over the course of therapy for three different couples were coded and analyzed to determine if cause for positive and negative events was assigned differentially to females and males. Additionally, the stability and globality dimensions of the therapist's attributions about the couples were examined for stereotypical gender-related patterns. Results indicate no gender differences in locus of causal attributions but some gender-related patterns in stability and globality dimensions. Implications for both couples therapy and gender bias in couples research are discussed.