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In this paper, we assess factors that underlie the relationship between gardening and improved mental health and food security outcomes among displaced people. Drawing on a mixed method study of refugee gardeners in New York, we argue that a food sovereignty framework better incorporates crucial factors such as cultural appropriateness of food, autonomy over food choices, and promotion of health and community, as compared with a food security analysis. We draw commonalities between Indigenous food sovereignty scholarship and the resettled refugee experience, making connections across conceptual and material divisions in scholarly literature and funding institutions. Our work helps researchers and practitioners understand the impacts of gardening on social and material outcomes for displaced people, and suggests global linkages between dispossessed immigrant and Indigenous peoples' food sovereignty movements. [ABSTRACT FROM AUTHOR]

Executive Summary: Home and community gardening is emerging as a beneficial intervention for resettled refugee populations. Using an interdisciplinary lens, we examined whether gardening influences mental health, food security, and economic well-being. A mixed methods study (n = 29) was conducted with quantitative surveys to assess indicators of mental health, food security, and economic well-being. Qualitative, semi-structured interviews explored gardener participants' experience of gardening benefits (n = 10). Participants had on average been in the United States for seven and a half years, with most having lived in refugee camps prior to arrival. Findings showed gardeners reporting fewer symptoms of anxiety, depression, and trauma, and lesser food insecurity than non-gardeners, and similar indicators of economic well-being. Non-parametric regression analysis showed that being a gardener significantly predicted less psychological distress. Qualitative data substantiated these findings with gardeners reporting improved mental health, closer family, social relationships and connections with culture, and more access to fresh and organic food. The multiple, simultaneous benefits of gardening reported here provide strong support for building community-based health promotion programs to assist refugee integration, including long after arrival. The study further highlights the importance of examining these interrelated factors of mental health, food security, and economic well-being simultaneously and reevaluating the established goals of refugee resettlement, particularly in the United States. We offer the following recommendations: • Policymakers and refugee resettlement practitioners should integrate culturally appropriate community-based health promotion efforts in refugee programs long after the initial resettlement period. • Researchers on refugee integration outcomes should include interdisciplinary perspectives that offer comprehensive understanding of processes related to health outcomes. • Policymakers on refugee resettlement and integration should consider the linkages between mental health, food security, and economic well-being. [ABSTRACT FROM AUTHOR]

The hallmark feature of fairness in relationships in Ivan Boszormenyi-Nagy's contextual therapy theory has largely remained untested among couples in therapy. "Fairness" here refers to the broad concept of "give and take," which is influenced by experiences of trustworthiness, loyalty conflicts, and a sense of entitlement or indebtedness in relationships. The purpose of this study was to examine the impact of fairness, measured by the Relational Ethics Scale, on relationship satisfaction in a sample of 68 heterosexual couples seeking therapy. Findings indicated a significant correlation between both partners' reports of unfairness and relationship dissatisfaction. Further analysis using Hierarchical Linear Modeling showed that male partners' report of greater fairness in their relationship predicted a greater discrepancy in partners' report of relationship satisfaction. This finding provides strong evidence for addressing issues of fairness in couples therapy. Further, it makes an important contribution to the development of the contextual therapy theory. (Contains 2 tables, 2 figures, and 1 note.)

Youth who are homeless and gay, lesbian or bisexual (GLB) are one of the most disenfranchised and marginalized groups in our society. The purpose of this study is to examine and compare HIV in GLB homeless youth with their heterosexual counterparts. Participants for this study included 268 youth involved in treatment outcome studies with substance abusing homeless youth. Results suggest that GLB youth have greater HIV risks and that these risks are greater among bisexual females. In examining the predictors of sexual health risks, survival sex emerged as the most significant. Survival sex was high among females regardless of their sexual orientation and also among gay males. Implications of these findings suggest that a greater emphasis needs to be paid to preventive interventions among this population.

There is a dearth of research that examines the impact of family systems therapy on problems among sexually and/or physically abused youth. Given this void, differential outcome and predictors of substance use change were evaluated for abused, as compared with nonabused, runaway adolescents who were randomly assigned to family therapy or treatment as usual. Abused adolescents reported lower family cohesion at baseline, although both abused and nonabused adolescents showed similar substance use reductions. Utilizing hierarchical linear modeling, we found that substance use changed with change in cohesion over time. These findings link change in family functioning to change in adolescent substance use, supporting family systems theory. Findings suggest that a potent target of intervention involves focus on increasing positive communication interactions.

Drawing from the framework of community-academic partnerships, we describe the development and implementation of a training module to increase collaboration between interpreters and therapists in interpretermediated psychotherapy with refugees. Beginning with community engagement with local agencies and leaders to identify barriers to accessing psychotherapy services in the resettled refugee populations, this project involved multiple layers of collaboration to include multiple perspectives. The program was funded by a local community foundation and was implemented in three phases. In the first phase, we identified key community partners and stakeholders with first-hand knowledge of the needs of refugee populations. Phase two involved a two-day workshop for student therapists from different disciplines and interpreters working in the field. Phase three included a follow up to re-assess challenges in the field and refine our training. The need to build early collaboration between therapists and interpreters was highlighted throughout the development and implementation of the project. We discuss the project's impact, challenges encountered, and implications of lessons learned in developing community-engaged partnerships for graduate programs as a way of promoting social justice in practitioner training. [ABSTRACT FROM AUTHOR]

Background: The use of teletherapy has exponentially increased in the context of the ongoing COVID-19 pandemic. Studies on teletherapy documented substantial benefits of accessibility and convenience even before the start of the pandemic. Although recent studies show that this modality of therapy delivery is here to stay, few have studied who will most benefit from this trend. Objective: In this paper, we report predictors of continued teletherapy usage in a sample of licensed mental health professionals in the United States during a time period when pandemic-related restrictions began diminishing. As such, it is one of the first studies to examine factors related to continued benefits of teletherapy postpandemic. Methods: Participation from licensed mental health professionals was sought on listservs of national organizations of multiple mental health organizations. Data were collected via an anonymous link to a survey on Qualtrics between January 2021 and April 2021. Participants responded to questions on therapist demographics, practice setting, experiences of shifting to teletherapy, perspectives on continued use of teletherapy, and their client characteristics. Findings related to client characteristics that predicted continued teletherapy usage are presented here. Results: A total of 186 individuals consented to participate in the survey, with a final sample of 114 with complete data. A majority of participants identified as female (92/114, 80.7%), White (94/114, 82.5%), and having a master's degree (75/114, 65.5%) from a nationally accredited program (106/114, 93%). Data were analyzed using heteroskedastic regression modeling with client-related factors as predictors. Two models were run with and without distance travelled by clients as a control variable. Model estimates from both models showed that continued use of teletherapy postpandemic was predicted by the following factors: higher percentage of clients from rural areas, younger and older adult clients, clients with Medicare, and clients with marginalized gender and religious/spiritual identities. Significantly, having a higher percentage of clients from lower socioeconomic status, a higher percentage of those with Medicaid coverage, and a higher percentage of couples and families as clients predicted decreased use of teletherapy postpandemic. Conclusions: Findings from the study suggest that while some groups of clients are more likely to continue to receive benefits of teletherapy, vulnerable groups such as those in lower socioeconomic conditions, Medicaid beneficiaries, and those who seek couple and family therapy may be less likely to be served by it. These differences point to a need to address factors driving telehealth care disparities such as access to technology, housing, and childcare issues, as well as the need for continued training for licensed professionals. [ABSTRACT FROM AUTHOR]

Contextual family therapy offers a unique explanatory and clinically valuable framework to address complex multigenerational processes in families of immigrants who experience cumulative migration‐related traumas. In this paper, we offer a new extended, specific conceptualization of immigrant families' generational dynamics using existing literature within the five‐dimensional contextual therapy framework illustrated with a clinical example. We highlight the importance of social and relational justice, loyalty, entitlement, and parentification in transgenerational processes in addressing manifestations of these traumas that are frequently overlooked in clinical practice with different generations of immigrant families. Clinical guiding principles include acknowledgment of the social nature of situational injustices and their consequences for relational justices, exploration of loyalty conflicts (familial, cultural, and national), active dialogue of mutual care, exoneration, and stimulating constructive entitlement through active giving. This paper contributes to further development of contextual therapy theory and provides practical guidance for clinicians working with international migrants including second and third generations. [ABSTRACT FROM AUTHOR]

Trans-including couples experience systemic marginalization impacting their relationships, yet studies on these relationships or narratives of strength are few. The purpose of this qualitative study was to explore emotional bonding and perceptions of fairness between transgender women and their cisgender partners. Interpretative Phenomenological Analysis was utilized to answer the research question: What are the experiences of emotional bond and fairness between transgender women and their cisgender partners? This research was situated within frameworks of minority stress, romantic attachment, and contextual therapy. Seven couples of transgender women and cisgender partners were interviewed. Three themes emerged: Minority Stress Contexts and Relational Strengths; The Experience of Emotional Bond; and Negotiating Balance. Processes of boundary creation, attunement, affirmations, and balance of care were noted. Findings reframe partner relationships as opportunities to construct transphobia-resistant and resilient narratives. Recommendations for clinicians include prioritizing the couple subsystem as an avenue for building resilience against minority stress. [ABSTRACT FROM AUTHOR]

The authors investigated the role of perceived discrimination in the association between adverse childhood experiences and psychological distress in adulthood in a sample of individuals (n = 125) at a university-based couple and family therapy clinic. Results showed that a majority had experienced four or more adverse experiences, indicating a high risk of negative health outcomes. A significant indirect effect of adverse experiences through perceived discrimination on psychological distress, even with gender, race/ethnicity, and household income as covariates, was noted. Findings underscore the importance of incorporating assessment of perceived discrimination in therapy with clients presenting with childhood adversity and psychological distress. [ABSTRACT FROM AUTHOR]

This study's aim was to apply a Contextual theory lens on exploring whether knowledge of parental infidelity affects the Relational Ethics (RE) of adult children. The Relational Ethics Scale (RES) was used to capture horizontal (partner) and vertical (family of origin) relational ethics in a clinical sample of 195 participants. A repeated measures ANOVA tested the differences in RES scores among the participants who reported knowledge of parental infidelity and the participants who did not. Results showed that knowledge of parental infidelity is significantly associated with lower scores on the RES, which indicates problematic relationships, both in partners and with family of origin. Clinical implications on how parental infidelity can affect relational ethics are discussed. [ABSTRACT FROM AUTHOR]

In this article, we discuss incorporating the transnational intersectionality framework in family therapy with resettled refugees. Transnational intersectionality is an extension of the framework of intersectionality which helps to better understand complexities of power and oppression across national contexts and their influence on refugees' lives. Adopting this framework alerts family therapists to: (a) develop critical awareness of refugee's transnational contexts; (b) understand differences in experiences of social identities across contexts; (c) acknowledge postmigration factors of oppression affecting resettlement; and (d) critically reflect upon therapist-interpreter-client intersectionalities. This shifts our conceptualization of therapy with refugees to actively consider transnational contexts which refugees uniquely occupy. We describe the framework and provide two case illustrations to highlight its usefulness. [ABSTRACT FROM AUTHOR]

Using a cross-sectional, phenomenological design, this qualitative study sought to explore Iraqi refugees' experiences of family relationships resettled in a northeastern city in the United States after the start of the 2003 war. Participants' experience of family relationships was situated within the context of their displacement, which included fear and uncertainty during displacement, and experiences of safety and isolation during resettlement. Themes related to family relationships were as follows: shared experiences of losses; increased trust between family members; shifts in communication and gender roles; and constructing a family legacy. Findings from this study indicate that family relationships play a central role in making meaning of forced displacement and resettlement experiences, which have significant clinical implications for family therapists working with refugees. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine depressive symptoms and relationship satisfaction as problems related to relational ethics in one's family of origin and current partner relationships in a sample of 68 other-sex couples seeking therapy at a large university clinic. We used the Actor Partner Interdependence Model to analyze dyadic data collected prior to beginning therapy. Specifically, we found significant actor effects between relational ethics in one's family of origin and depressive symptoms, as well as between depressive symptoms and low relationship satisfaction for both male and female partners. We also found significant partner effects for relational ethics in current partner relationship, depressive symptoms, and low relationship satisfaction. Clinical application of contextual therapy theory is discussed. [ABSTRACT FROM AUTHOR]

Emotional and sexual aspects of intimacy in romantic relationships are important correlates of couples’ relationship satisfaction. However, few studies have examined the effect of emotional and sexual aspects of intimacy on relationship satisfaction within the context of the interpersonal relationship processes. In addition, the association between emotional and sexual aspects of intimacy remains unclear. With a sample of 335 married couples from the Flourishing Families Project, the authors examined the associations between couple communication, emotional intimacy, sexual satisfaction, and relationship satisfaction, using the couple as the unit of analysis. The results of path analysis suggested that sexual satisfaction significantly predicted emotional intimacy for husbands and wives, while emotional intimacy did not appear to have a significant influence on sexual satisfaction. Further, mediation associations were suggested within as well as between spouses. Within spouses (for each spouse), emotional intimacy and sexual satisfaction mediated the association between spouses’ appraisal of their partners’ communication and their own relationship satisfaction. Gender differences were revealed in terms of how a spouse's perception of sexual satisfaction is associated with his or her partner's relationship satisfaction. In this study, although wives’ relationship satisfaction was not associated with their husbands’ sexual satisfaction, husbands tended to report high levels of relationship satisfaction when their wives reported greater sexual satisfaction. Findings suggest that both components of intimacy—emotional and sexual—should be comprehensively addressed in research and clinical work with couples. [ABSTRACT FROM PUBLISHER]

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Research concerning therapeutic alliance and outcome is prevalent but relies heavily on data from individual treatment. In this article, the authors present data from cases in which an individual was seen and cases in which a couple was seen in order to investigate differences in therapeutic alliance and its trajectory depending on case type, therapist experience, and therapist sex. Participants included 96 couples and 52 individuals with 15 therapists from a large Midwestern training clinic for couple and family therapy. Data include the use of the Working Alliance Inventory–Shortened Version, and three-level models were estimated using hierarchical linear modeling. The results highlight differences in the trajectories of individual and couple clients’ therapeutic alliance, including evidence for a curvilinear trend in work scores for individual clients but not couple clients. The results also highlight differences in the sources of variation for couple cases versus individual cases. There is clearly complexity in the building of alliance with clients in general, and even more so with couple clients. [ABSTRACT FROM PUBLISHER]

The study uses 457 clients to investigate the impact of initial client factors on the development of therapeutic alliance. Data were collected longitudinally over the early portion of treatment. Cases included both individual and couple clients, allowing for examination of differences by case type. The study used the Working Alliance Inventory-Shortened Version () to measure therapeutic alliance. Initial factors considered included age, differentiation levels, prior stress, and depression. Couple clients showed differences from individual clients, and the variability prompted further investigation into relationship satisfaction and commitment as factors influencing the development of therapeutic alliance. Results highlight the increased complexity of developing an alliance with couples, and recommendations are provided for clinicians. [ABSTRACT FROM AUTHOR]

A major strength of the book is that authors provide examples of dialogue between clients and therapists to highlight specific strategies of alliance building. The authors also specify problematic alliance indicators such as the client questioning the value of therapy and avoiding eye contact with the therapist. Missing from this discussion is also the potential influence of addressing therapist-client intersectionality on alliance building. [Extracted from the article]