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To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1545-5300.2009.01267.x Byline: MICHAEL J. ROHRBAUGH (*), VARDA SHOHAM (*), EMILY A. BUTLER ([dagger]), BRANT P. HASLER (*), JEFFREY S. BERMAN (s.) Keywords: Health-compromised smokers; Couple interaction; Emotion regulation; Symptom-system fit Abstract: Couples in which one or both partners smoked despite one of them having a heart or lung problem discussed a health-related disagreement before and during a period of laboratory smoking. Immediately afterwards, the partners in these 25 couples used independent joysticks to recall their continuous emotional experience during the interaction while watching themselves on video. A couple-level index of affective synchrony, reflecting correlated moment-to-moment change in the two partners' joystick ratings, tended to increase from baseline to smoking for 9 dual-smoker couples but decrease for 16 single-smoker couples. Results suggest that coregulation of shared emotional experience could be a factor in smoking persistence, particularly when both partners in a couple smoke. Relationship-focused interventions addressing this fit between symptom and system may help smokers achieve stable cessation. Abstract (French) RESUMEN Varias parejas en las que uno o ambos miembros fueron fumadores a pesar de que uno de ellos padeciese una enfermedad cardiaca o pulmonar hablaron de cierto desacuerdo en cuestiones de salud antes y durante un periodo de sesiones de laboratorio. Inmediatamente despues, los miembros de estas 25 parejas utilizaron unos joysticks independientes para recordar su continua experiencia emocional durante la interaccion mientras se observaban a si mismos en el video. Un indice de sincronia afectiva a nivel de la pareja, que reflejaba cambios correlacionados frecuentes en las valoraciones de los joysticks de ambos miembros, tendio a incrementarse de la linea de base a fumar en el caso de 9 parejas en las que ambos miembros eran fumadores, pero a disminuir en el de 16 parejas con un solo fumador. Los resultados sugieren que la corregulacion de una experiencia emocional compartida podria ser un factor de persistencia del habito de fumar, especialmente cuando ambos miembros de la pareja fuman. Las intervenciones centradas en la relacion dirigidas a esta corelacion entre sintomas y sistema podrian ayudar a los fumadores a dejar de fumar definitivamente.Palabras clave: interaccion de pareja, fumadores con problemas de salud, regulacion emocional, correlacion entre sintomas y sistema Abstract (Spanish): Couples in which one or both partners smoked despite one of them having a heart or lung problem discussed a health-related disagreement before and during a period of laboratory smoking. Immediately afterwards, the partners in these 25 couples used independent joy sticks to recall their continuous emotional experience during the interaction while watching themselves on video. A couple-level index of affective synchrony, reflecting correlated moment-to-moment change in the two partners' joystick ratings, tended to increase from baseline to smoking for 9 dual-smoker couples but decrease for 16 single-smoker couples. Results suggest that coregulation of shared emotional experience could be a factor in smoking persistence, particularly when both partners in a couple smoke. Relationship-focused interventions addressing this fit between symptom and system may help smokers achieve stable cessation. couple interaction, health-compromised smokers, emotion regulation, symptom-system fit Author Affiliation: (*)Department of Psychology, University of Arizona, Tucson, AZ. ([dagger])Department of Family Studies/Human Development, University of Arizona, Tucson, AZ. (s.)Department of Psychology, University of Memphis, Memphis, TN. Article note: Correspondence concerning this article should be addressed to Michael J. Rohrbaugh, Department of Psychology, University of Arizona PO Box 210068, Tucson AZ 85721. E-mail: michaelr@u.arizona.edu

Communal coping occurs when relationship partners view a stressful health problem as "ours," rather than yours or mine, and take collaborative action to deal with it. Although research employing linguistic (we‐talk) and other measures of communal coping demonstrates relevance to a variety of chronic illnesses, the literature offers little about how clinicians can actively promote we‐ness and teamwork to help patients and their partners achieve the health benefits this appears to confer. This paper highlights clinical and supporting scientific features of a narrative intervention designed to foster communal coping by couples in which one partner has a chronic illness. The illustrative illness is diabetes, but with modification the protocol is suitable for other chronic conditions as well. Grounded in systemic and narrative models of problem maintenance and change, the communal coping intervention represents a distillation of research and clinical experience with family consultation over several decades. In contrast to more directive and educational approaches, the intervention consists entirely of questions, with no direct suggestions or instruction about how patients, partners, or couples should change. These questions comprise 8 sequential modules (Coping Challenges, Trajectory and Focus, Illness as External Invader, You as a Couple, Past Teamwork in Overcoming Adversity, Present and Future Teamwork, Obstacles to Teamwork, and Wrap‐Up), described here in manual‐like detail. [ABSTRACT FROM AUTHOR]

As evidence‐based family treatments for adolescent substance use and conduct problems gain traction, cutting edge research moves beyond randomized efficacy trials to address questions such as how these treatments work and how best to disseminate them to community settings. A key factor in effective dissemination is treatment fidelity, which refers to implementing an intervention in a manner consistent with an established manual. While most fidelity research is quantitative, this study offers a qualitative clinical analysis of fidelity failures in a large, multisite effectiveness trial of Brief Strategic Family Therapy (BSFT) for adolescent drug abuse, where BSFT developers trained community therapists to administer this intervention in their own agencies. Using case notes and video recordings of therapy sessions, an independent expert panel first rated 103 cases on quantitative fidelity scales grounded in the BSFT manual and the broader structural‐strategic framework that informs BSFT intervention. Because fidelity was generally low, the panel reviewed all cases qualitatively to identify emergent types or categories of fidelity failure. Ten categories of failures emerged, characterized by therapist omissions (e.g., failure to engage key family members, failure to think in threes) and commissions (e.g., off‐model, nonsystemic formulations/interventions). Of these, "failure to think in threes" appeared basic and particularly problematic, reflecting the central place of this idea in structural theory and therapy. Although subject to possible bias, our observations highlight likely stumbling blocks in exporting a complex family treatment like BSFT to community settings. These findings also underscore the importance of treatment fidelity in family therapy research. [ABSTRACT FROM AUTHOR]

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