Treatment alliance and its association with family functioning, adherence, and medical outcome in adolescents with severe, chronic asthma.

OBJECTIVE: To examine the concept of treatment alliance in the care of adolescents with asthma. METHODS: Measures of treatment alliance were obtained from 60 adolescents with severe, chronic asthma admitted to a tertiary care facility, their parents, and their asthma specialists at the referral center. Associations were examined between the alliance measures and multimeasure, multiagent data concerning family functioning and asthma treatment adherence and outcome. RESULTS: Physicians' reports of treatment alliance were associated with concurrent family functioning and asthma medication adherence, as well as with asthma treatment adherence and outcome in the year after the stay at the asthma center. CONCLUSIONS: As emphasized in the recently revised Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma (NHLBI, 1997), the ability of children with asthma, their parents, and their physician to create a positive partnership, or treatment alliance, appears to have an important role in optimal asthma management.

Family-of-origin experiences and conflict resolution behaviors of young adult dating couples.

This study was conducted to explore the relationship among retrospective reports of family-of-origin functioning, reported perceptions of a laboratory-based conflict resolution discussion, and outsiders' ratings of communication behaviors between young adult dating couples, with a special focus on predicted gender differences. Sixty-three couples aged 18 to 24 participated in this study. A Revealed Differences task was used to elicit discussion about an issue identified as discordant for the couple on a Relationship Issue Questionnaire. Family-of-origin variables were related to both men's and women's perceptions of the conflict, as well as outsiders' ratings of their conflict resolution behaviors. However, the conflict resolution behaviors and perceptions of men and women were associated with distinctly different aspects of functioning in their families of origin. Further, women's families-of-origin factors were more prominent for the couples' communication behaviors because they indicated a greater number of significant correlations between the women's families of origin and: 1) perceptions of the conflict resolution discussion by both the men and women, and 2) the observed conflict resolution behaviors of both men and women. These findings are discussed in the context of both the relevant research and important social-political influences.