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We tested the process of change in Alliance Empowerment Family Therapy (AEFT; Escudero, 2013), a systemic, team-based approach for treating child welfare involved families. Since building and balancing strong personal and within-family therapeutic alliances are crucial for motivating and sustaining change in these multistressed, overburdened families, we assessed alliance perceptions over time in relation to two indices of therapy outcome, youth functioning, and family-specific goal attainment. Specifically, we administered the self-report version of the System for Observing Family Therapy Alliances (Friedlander et al., 2006) following Sessions 3, 6, and 9 to 156 Spanish families seen by 20 therapists in six agencies whose mission is to serve child welfare referred maltreated youth. Results showed that AEFT delivered in M = 11.04 sessions (SD = 3.29) was effective in attaining family-specific goals and improving child functioning, d = 1.16, as rated by the therapist team in coordination with the referring caseworker. A unique aspect of the study was the modeling, at each time point, of the shared therapeutic system alliance, a latent variable consisting of the therapist's rating of the alliance as well as the alliance ratings of the youth and primary caregiver. As we hypothesized, shared alliance perceptions strengthened with time and positively predicted posttreatment outcomes. Moreover, a comparison of linear growth models with and without the therapist's perspective showed that inclusion of the therapist ratings in the shared alliance variables improved the predictability of child and family outcomes. Public Significance Statement: We studied the process and outcomes of Alliance Empowerment Family Therapy (AEFT), a treatment specifically developed for child welfare referred families that emphasizes the therapeutic alliance as the central component of change. As we predicted, the shared alliance perceptions of youth, caregivers and therapists increased in strength over time and positively predicted improved child and family functioning. [ABSTRACT FROM AUTHOR]

The purpose of this clinical practice guideline developed by the American Psychological Association (APA) is to provide recommendations concerning multicomponent behavioral treatment of obesity and overweight in children and adolescents. Intended users of the guideline include psychologists, other health and mental health professionals, patients, families, and policymakers. The guideline development panel (GDP) used a systematic review conducted by the Kaiser Permanente Research Affiliates Evidence-Based Practice Center as its primary evidence base (O'Connor, Burda, Eder, Walsh, & Evans, 2016). The GDP consisted of researchers and clinicians in psychology, medicine, nursing, and nutrition as well as adult community members who had childhood and adolescent experience with obesity. Critical outcomes used in rating evidence and formulating recommendations were change in body mass index (BMI or zBMI) and serious adverse events. For child and adolescent patients aged 2 to 18 years with obesity or overweight, the GDP strongly recommends the provision of family-based multicomponent behavioral interventions, with a minimum of 26 contact hours, initiated at the earliest age possible. Due to insufficient evidence, the GDP was not able to make recommendations about specific forms of family-based multicomponent behavioral interventions with respect to their comparative effectiveness; associations with adherence, engagement, or retention in treatment; or specific effectiveness with patients or families with particular characteristics. Considerations and challenges related to implementing the recommended interventions are discussed, and areas in which additional research is needed are identified. Public Significance Statement: The purpose of this article is to summarize the clinical practice guideline developed by the American Psychological Association to provide recommendations concerning multicomponent behavioral treatment of obesity and overweight in children and adolescents. Almost one third of youth aged 2 to 19 years in the United States are overweight or obese, which is concerning given the connection between obesity and multiple immediate as well as longer term health risks. The guideline recommends at least 26 contact hours of family-based multicomponent behavioral interventions for child and adolescent patients aged 2 to 18 with obesity or overweight, initiated at the earliest age possible. [ABSTRACT FROM AUTHOR]

Objective: To examine changes in quality of life (QoL) in adolescents receiving family problem-solving therapy (F-PST) following traumatic brain injury (TBI). Method: Adolescents hospitalized for moderate-to-severe TBI were randomized to 1 of 3 ten-session, 6-month long treatments: face-to-face F-PST (n = 34), therapist-guided online F-PST (n = 56), and self-guided online F-PST (n = 60). Participants included 96 boys and 54 girls, of whom 124 were White and 6 were Hispanic. Outcomes were assessed pretreatment and 6 and 9 months later. Adolescents and parents rated adolescent QoL and TBI-related symptoms on the PedsQL and Health and Behavior Inventory (HBI), respectively. We used mixed modeling to examine changes over time and moderators of treatment efficacy. Results: Therapist- and self-guided online groups demonstrated improvements in parent-proxy QoL from baseline to 9 months, Cohen's d = 0.75; p =.004 and Cohen's d = 1.30; p <.001, respectively. The face-to-face group had poorer parent-proxy QoL at 6 months (M = 62, SE = 3.4) than either the therapist- (M = 70.9, SE = 2.8) or self-guided online group (M = 71.1, SE = 2.6). There were no changes or group differences in self-reported QoL over time. Similar findings were observed on the HBI. Differential treatment effects on parent-proxy outcomes were found in boys versus girls and in those from single versus 2-parent households. Improvements in parent-proxy HBI ratings mediated QoL improvements. Conclusions: Both online treatments, but not face-to-face F-PST, were associated with clinical improvements, raising questions about our current delivery paradigm. Individual and family moderators of treatment efficacy underscore the potential of personalized treatment. This study suggests that both self- and therapist-guided online family problem-solving treatment are effective in improving quality of life in adolescents following moderate to severe TBI. Sex differences in treatment response, with boys benefiting more from therapist-guided family problem solving than girls, highlight the need to personalize treatment choices. Lack of improvement following face-to-face treatment suggest a need to reevaluate the current treatment paradigm and give greater consideration to telehealth approaches. [ABSTRACT FROM AUTHOR]

Perceived responsiveness has become one of the most important constructs in the relationship sciences. It is central to the development of a secure attachment style, the experience of social support, an internal locus of control, and the sense of control in close relationships. Conversely, an unresponsive environment is associated with learned helplessness and depression. Viewed through the lens of the social relations model (SRM), perceived responsiveness in family relationships could have multiple sources: the perceiver; the target or partner; the perceiver-target relationship; and the family group. This study used the SRM to determine the relative importance of these sources of perceived responsiveness in the relationships of 207 two-parent two-child families. Characteristics of the perceiver and the target each accounted for about 25% of the systematic variance in perceived responsiveness, whereas the perceiver-target relationship accounted for approximately 48%. At the individual level of analysis, reciprocity of perceived responsiveness was pervasive in the family relationships of the two children. Regardless of age, young people who generally perceived others as responsive were generally perceived by others as responsive. At the dyadic level of analysis, reciprocity was present in two dyads: mother-father and older child-younger child. Reliable target variances support the view that perceived responsiveness is not just "inside the head" of the perceiver, and reciprocity correlations suggest potentially useful systemic interventions. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Technological advances provide tremendous opportunities for couple and family interventions to overcome logistical, financial, and stigma-related barriers to treatment access. Given technology's ability to facilitate, augment, or at times even substitute for face-to-face interventions, it is important to consider the appropriate role of different technologies in treatment and how that may vary across specific instances of technology use. To that end, this article reviews the potential contributions of telemental health (aka, telehealth; e.g., videoconferencing to remotely deliver real-time services) and asynchronous behavioral intervention technologies (BITs; e.g., apps, web-based programs) for couple and family interventions. Design considerations-such as software and hardware requirements and recommendations, characteristics of intended users, ways to maximize engagement, and tips for integrating therapists/coaches-are included for both types of technology-based intervention. We also present suggestions for the most effective recruitment and evaluation strategies for technology-based couple and family interventions. Finally, we present legal and ethical issues that are especially pertinent when integrating technology into couple and family interventions. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Family-centered prevention programs are understudied for their effects on adolescent depression, despite considerable evidence that supports their effectiveness for preventing escalation in youth problem behavior and substance use. This study was conducted with 2 overarching goals: (a) replicate previous work that has implicated the Family Check-Up (FCU), a multilevel, gated intervention model embedded in public middle schools, as an effective strategy for preventing growth in adolescent depressive symptoms and (b) test whether changes in family conflict may be an explanatory mechanism for the long-term, protective effects of the FCU with respect to adolescent depression. This trial was conducted with 593 ethnically diverse families who were randomized to intervention (offered the FCU) or middle school as usual. Complier average causal effect (CACE) analysis revealed that engagers in the FCU evidenced less growth in depressive symptoms and family conflict from 6th through 9th grade, and post hoc analyses indicated that the FCU is related to lower rates of major depressive disorder. The second set of analyses examined family conflict as a mechanism of change for families who participated in the FCU. Families who reported short-term intervention benefits had significantly less escalation in family conflict over the middle school years; in turn, growth in family conflict explained risk for adolescent depressive symptoms. [ABSTRACT FROM AUTHOR]

Perceived criticism (PC) is a measure of how much criticism from 1 family member "gets through" to another. PC ratings have been found to predict the course of psychotic disorders, but questions remain regarding whether psychosocial treatment can effectively decrease PC, and whether reductions in PC predict symptom improvement. In a sample of individuals at high risk for psychosis, we examined a) whether Family Focused Therapy for Clinical High-Risk (FFT-CHR), an 18-session intervention that consists of psychoeducation and training in communication and problem solving, brought about greater reductions in perceived maternal criticism, compared to a 3-session family psychoeducational intervention; and b) whether reductions in PC from baseline to 6-month reassessment predicted decreases in subthreshold positive symptoms of psychosis at 12-month follow-up. This study was conducted within a randomized controlled trial across 8 sites. The perceived criticism scale was completed by 90 families prior to treatment and by 41 families at 6-month reassessment. Evaluators, blind to treatment condition, rated subthreshold symptoms of psychosis at baseline, 6- and 12-month assessments. Perceived maternal criticism decreased from pre- to posttreatment for both treatment groups, and this change in criticism predicted decreases in subthreshold positive symptoms at 12-month follow-up. This study offers evidence that participation in structured family treatment is associated with improvement in perceptions of the family environment. Further, a brief measure of perceived criticism may be useful in predicting the future course of attenuated symptoms of psychosis for CHR youth. [ABSTRACT FROM AUTHOR]

Presenting for a variety of reasons, a caregiver that exhibits behaviors that make them challenging to work with (e.g., stress, hostility, questioning, psychopathology) may prevent or impede gains when working within the context of a child-focused family therapy (i.e., therapy involving caregivers in the planning and implementation of child-centered treatments). Although some work has addressed the challenging patient, little research is available that has concisely translated such information into considerations, recommendations, and tips for preventatively facilitating strong rapport or managing any recognized challenging behaviors that the caregiver of the identified child patient may exhibit. For this reason, the current article aims to provide an integration of literature and clinician experience to provide practice-oriented considerations for those conducting child-focused behavioral or cognitive-behavioral family-based interventions. Discussion begins by outlining the initial contact and preparation with the family before reviewing techniques for ongoing treatment. Considerations for situations in which hostility, confrontation, or anger arises toward the clinician, as well as the patient (i.e., the child) are then discussed. Finally, clinician-focused factors to consider are examined. Effectively negotiating challenging caregiver behaviors within the context of a child treatment can enable clinicians to provide the often necessary and beneficial treatment that would otherwise not be possible. Through integration of proposed preventative and management considerations, a clinician may facilitate a strong relationship with the family, work to repair any ruptures in the relationship, and negotiate challenges brought forth by the challenging caregiver to avoid therapeutic disruptions or premature termination. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) is prevalent among users of the Veterans Affairs (VA) health care system. Effective approaches to involving family in care for PTSD are critical because family functioning both affects and is affected by treatment outcomes. Although multifamily group treatment is an evidence-based practice for schizophrenia and other serious mental illnesses, no data have been published on its effectiveness for those living with PTSD and their family members. This study examined the impact of participation in REACH (Reaching out to Educate and Assist Caring, Healthy Families), an adaptation of the multifamily group psychoeducation program tailored for delivery to veterans with PTSD and their family members. One hundred veterans with PTSD and 96 family members who participated in the 9-month, 3-phase clinical program between 2006 and 2010 also participated in this longitudinal evaluation. Veterans showed significant (p < .05) improvements over time on all measures (empowerment, family problem solving and communication, relationship satisfaction, social support, symptom status, knowledge of PTSD, self-efficacy in coping with PTSD, and quality of life). Family members showed similar statistically significant improvements on most measures. Changes over time in individual participants' relationship satisfaction, social support, symptom status, and quality of life were attributable to changes in program-targeted knowledge and skills. Study results suggest that multifamily group psychoeducation is useful in treatment of PTSD, leading to increases in targeted PTSD knowledge and skills, as well as improving family functioning and symptom status for both veterans and family members. Implications for clinicians and recommendations for further evaluation of this promising intervention are described. [ABSTRACT FROM AUTHOR]

The relations between 4 sources of family stress (marital dissatisfaction, home chaos, parental depressive symptoms, and job role dissatisfaction) and the emotion socialization practice of mothers' and fathers' responses to children's negative emotions were examined. Participants included 101 couples with 7-year-old children. Dyadic analyses were conducted using the Actor--Partner Interdependence Model and relations were tested in terms of the spillover, crossover, and compensatory hypotheses. Results suggest that measures of family stress relate to supportive and nonsupportive parental responses, though many of these relations differ by parent gender. The results are discussed in terms of the 3 theoretical hypotheses, all of which are supported to some degree depending on the family stressor examined. [ABSTRACT FROM AUTHOR]

A major challenge in the dissemination of evidence-based family interventions (EBFIs) designed to reduce youth substance use and other problem behaviors is effective and sustainable community-based recruitment. This understudied topic is addressed by a preliminary study of 14 community-university partnership teams randomly assigned to an intervention condition in which teams attempted sustained implementation of EBFIs with two cohorts of middle school families. This report describes attendance rates of recruited families maintained over time and across both cohorts, along with exploratory analyses of factors associated with those rates. When compared with community-based recruitment rates in the literature, particularly for multisession interventions, relatively high rates were observed; they averaged 17% across cohorts. Community team functioning (e.g., production of quality team promotional materials) and technical assistance (TA) variables (e.g., effective collaboration with TA, frequency of TA requests) were associated with higher recruitment rates, even after controlling for community and school district contextual influences. Results support the community-university partnership model for recruitment that was implemented in the study. [ABSTRACT FROM AUTHOR]

Much attention has been given to increased collaborative efforts between psychotherapists and the medical community. Medical family therapy (MedFT) provides a bridge between psychotherapy and medicine for individuals and families. The authors of this article present a literature review of the empirical research on the efficacy and effectiveness of MedFT as the primary form of psychotherapy treatment within an interdisciplinary medical treatment team. This literature review spanned a time period from 1965 through 2004. The authors discuss difficulties in defining MedFT and conducting research in the field, provide a review of the outcome benefits of including mental health professionals on collaborative health care teams, and provide suggestions for future research that demonstrates empirical support for the effectiveness of MedFT. [ABSTRACT FROM AUTHOR]

To advance research and inform practice, the authors developed an observational rating system of client behavior reflecting strong and weak therapeutic alliances in couple and family therapy. The System for Observing Family Therapy Alliances (SOFTA), in both English and Spanish, has 2 dimensions that are common across therapy modalities (‘emotional connection to the therapist’ and ‘engagement in the therapeutic process’) and 2 dimensions that reflect the uniqueness of conjoint treatment (‘safety within the therapeutic system’ and ‘shared sense of purpose within the family’). Psychometric support is provided by 5 reliability studies, an exploratory factor analysis with data from 120 diverse English- and Spanish-speaking couples and families, and meaningful associations with various process and outcome indices. Recommendations are made for using the SOFTA in research, training, and (self-)supervision. [ABSTRACT FROM AUTHOR]

Federal regulations, ethical standards, and state laws governing ethics do not adequately address important issues in couple and family research. Including multiple family members, particularly dependent minors, in research requires the special application of fundamental ethical issues, such as confidentiality, privacy, and informed consent. The sensitive, com mingled nature of couple and family information necessitates clear policies about data ownership and disclosure. Researchers need to have respect for the family as a unit and to evaluate benefits versus harms for the family as well as for individuals. This article highlights areas of potential concern and ambiguity related to abuse reporting and Certificates of Confidentiality and also addresses ethical issues with observational data, intervention studies, longitudinal designs, and computer-assisted research. [ABSTRACT FROM AUTHOR]

In our field, the study of therapeutic change processes lags behind the study of treatment efficacy. Nonetheless, in the past 10 years major strides have been made in delineating change process mechanisms in couple and family therapy. To focus the efforts of future change process researchers, the authors discuss 5 critical needs: (a) more well-articulated, midrange theory about systemic change processes; (b) more attention to client change processes; (c) more attention to covert intrapersonal processes (emotion, cognition, and clients' experience of the alliance); (d) better articulation of strategies for analyzing data from multiple participants; and (e) more focus on the degree to which various change processes work similarly (or not) for diverse couples and families. [ABSTRACT FROM AUTHOR]

Qualitative approaches have much to offer family psychology. Among the uses for qualitative methods are theory building, model and hypothesis testing, descriptions of lived experiences, typologies, items for surveys and measurement tools, and case examples that answer questions that surveys cannot. Despite the usefulness of these products, issues related to generalizability, subjectivity, and language, among others, block some researchers from appreciating the contributions that qualitative methods can make. This article provides descriptions of procedures that lead to these useful products and discusses alternative ways of understanding aspects of qualitative approaches that some researchers view as problematic. [ABSTRACT FROM AUTHOR]

This paper reports a case series of families participating in Integrated Family Treatment, a home-based parent training and family support program for parents with severe psychiatric disabilities. All 8 families who entered the program over 6 months were followed for 1 year. Seven families remained in treatment for more than 10 months and rated the program highly. Six of the seven parents (85.7%) remaining in treatment improved on one or more measure of parent skills. Integrated Family Treatment is a promising practice that warrants further study. [ABSTRACT FROM AUTHOR]

This study examined the relationship between alliance and retention in family therapy. Alliance was examined at the individual (parent and adolescent) and family levels (withinfamily differences). Participants were 34 families who received functional family therapy for the treatment of adolescent (aged 12-18 years) behavior problems. Families were classified as treatment dropouts (n = 14) or completers (n = 20). Videotapes of the first sessions were rated to identify parent and adolescent alliances with the therapist. Results demonstrated that individual parent and adolescent alliances did not predict retention. However, as hypothesized, dropout cases had significantly higher unbalanced alliances (parent minus adolescent) than did completer cases. These findings highlight the importance of alliances in functional family therapy and suggest that how the alliance operates in conjoint family therapy may be a function of systemic rather than of individual processes. [ABSTRACT FROM AUTHOR]

This article provides an overview of disability in families. The goal of the article is to raise awareness of the status of people with disabilities and their families to develop culturally relevant psychological support. Families have widely varying perspectives' on disability; those perspectives influence responses to disability from the preconception and prenatal developmental stages through old age. An international literature review is provided with consideration of cultural meanings of disability, preparation for dealing with disability, coping strategies, support, developmental dynamics, competing needs of family members, and ethics. Voices of people with disabilities and their families are included. [ABSTRACT FROM AUTHOR]

Focuses on the development of family psychology and family therapy in Japan. Origins of family psychology and family therapy; Problem of school refusal; Approach to cases of school refusal.

Discusses the development of family psychology discipline in Israel. Public awareness of family psychology; Community disasters; Effects of war stress on the family.

This study compared the immediate impact of therapist reframing, reflection, and elicit-structure interventions on family-member defensive communications in the initial session of family therapy with a delinquent adolescent. Defensive statements included family-member statements that criticized, blamed, or disagreed with other family members. Sequences of behaviors following defensive family-member statements were examined to determine which therapist interventions were the most effective in disrupting defensive family interactions. Thus, every sequence included a defensive family-member behavior, a therapist intervention, and a family-member response (sequence: family defensive-->therapist intervention-->family response). Results indicated that therapist reframing is more effective than other therapist interventions in reducing family-members' defensive statements. Moreover, adolescents responded more favorably to reframes than did fathers. [ABSTRACT FROM AUTHOR]

J. F. Alexander et al. (1995) provide a thoughtful and comprehensive framework for conceptualizing the process of developing, evaluating, and using observational coding systems. In this article, the authors attempt to link the framework of Alexander et al. with that proposed by F. Floyd (1989), and they discuss how observational methods may contribute to the advancement of family psychology. They discuss specific issues and recommendations that they believe will contribute to moving the field of behavioral observation forward, including, for example, the ascendance of global over microanalytic coding systems, the importance of considering effects of gender and ethnicity of coders on coding, difficulties in conducting observational research and analyzing observational data, and the persistent problem of capturing low base-rate behaviors using observational methods. [ABSTRACT FROM AUTHOR]

Observationally based coding systems represent one major source of information regarding the process of family therapy, the nature of change mechanisms, and the necessary components of intervention manuals. In this article, the authors introduce a two-dimensional framework for organizing the diverse approaches to observational coding that currently exist. These dimensions focus on the information used in identifying the coding unit and the degree of inference involved in assigning a code (i.e., meaning) to that unit. The goal in developing this framework is to provide a common basis on which observationally based family therapy process research initiatives can be developed, compared, and integrated. [ABSTRACT FROM AUTHOR]

The author recommends a systematic, context-sensitive method for using observation to increase understanding of how change actually occurs in couples and family therapy. In this method, a task analysis of in-session performances on a specific task leads to the building of a model of the change process. This approach is exemplified in the process of in-session conflict resolution in couples therapy. [ABSTRACT FROM AUTHOR]

This research examined how training and experience, family roles, and gender of observed family leadership affect ratings of both family and individual parent functioning, Seventy experienced therapists and 70 clinically naive individuals rated 2 videotaped family interviews. One interview demonstrated a matriarchal style of family interaction and the other demonstrated a patriarchal style. Ratings from the 2 groups of observers were compared to determine the effects of training and experience. The effects of leader gender were determined by comparing ratings of the 2 family interviews. Ratings of the mother and the father from the 2 interviews were compared to determine the effects of family roles. Results suggest that experienced observers in assessments of family functioning are vulnerable to biased views of mother-led families. In assessments of parent functioning, results suggest that although training and experience may promote more critical ratings, vulnerability to biased views of women as family leaders is not significantly affected. These findings underscore the importance of both therapists and researchers examining the role of gender in family therapy. [ABSTRACT FROM AUTHOR]

In examining the process of change in structural family therapy, we observed interpersonal control patterns within and across 15 sessions of inpatient treatment of a chronic anorexic family. Results showed that the primary therapist maintained a consistently active, dominant, and central position in the therapeutic system. As predicted, complementarity (Therapist one-up/Family Member one-down) was the predominant relational control pattern; with the anorexic daughter, complementarity was observed more frequently in the early and late phases of treatment than in the middle, restructuring phase. Although several hypotheses could not be adequately tested because of an unexpected low frequency of within-family interaction, there was some evidence that the therapist challenged family behaviors indicative of enmeshment and intergenerational coalitions and that changes in the family's rigid communication style may have occurred over time. [ABSTRACT FROM AUTHOR]

Cross-generational coalitions have long been linked by some family therapists to conflict in family relationships and symptomatology in family members. The relationship between cross-generational coalitions and measures of well-being in 572 nonclinical families was explored by conducting post hoe multivariate analyses on national survey data. The results indicate modest support for triadic models of family functioning. The methodology used in the analysis, particularly the way in which the variable cross-generational coalitions was created, provides a model for how new questions can be asked about existing data. [ABSTRACT FROM AUTHOR]

Little empirical support exists for the effectiveness of reattribution techniques (e.g., reframing) in family therapy, although these techniques are often recommended as ways to reduce blame. One hundred twenty undergraduate subjects were randomly assigned to the conditions of an experimental procedure designed to elicit blaming attributions similar to those found in distressed families. Results showed that an experimental reattribution similar to a therapeutic reframe/relabel significantly reduced the intensity of blaming attributions. Although not obtained in an actual clinical context, the findings strengthen the empirical underpinnings of therapies that use a reattributional approach. [ABSTRACT FROM AUTHOR]

The present research examined the effects of therapist and client sex roles on the behaviors of participants in family therapy. Two-parent families (n = 34) received treatment from male (n = 17) or female (11 = 17) therapist trainees. The trainees were members of Functional Family Therapy practica at a university clinical setting. Therapist and client behaviors during the first phase of therapy were transcribed and divided into thought units. Each thought unit was classified as being either a supportive, structuring, pejorative, or non-therapy-related act. Although an initial analysis of base rates revealed no significant gender effects, a contingency analysis detected different gender-linked sequential dependencies o[ therapist and client behaviors. This analysis indicated that family members respond differently to male and female therapist behaviors. The findings also suggest that female and male therapists respond differently to client behaviors. The findings were interpreted in the context of gender and therapist role conflicts, which may be especially important in a training context. [ABSTRACT FROM AUTHOR]

Difficulties on interpersonal and familial functioning are significantly associated with depression in women. However, there ix a paucity of work addressing gender-sensitive marital and family therapy with depressed women. This article reviews the literature on depressed women's family functioning and discusses a gender-sensitive object-relational approach to marital and family therapy with depressed women. In work with depressed women and their families, the central themes that emerge are the imbalance in power and the lack of intimacy. Characteristic interactional patterns arc marked by negative affect, coercion, and rejection. Thus family interventions should emphasize altering family interactional patterns to promote a more adaptive balance of intimacy and power in which the depressed woman, her spouse, and affectively integrated. [ABSTRACT FROM AUTHOR]

The article presents information on a study which determines the effect of family on individuals. The study shows that family support helps individuals to change health behaviors. The study findings suggest that family variables interact with individuals' psychology to ensure individuals' success in managing health-related problems.

Clinicians struggle to understand the relationship of physical ailments and family functioning. This commentary traces one clinician's evolution from the typical linear process to the circular model, which is the basis for describing M. Ochs et al.'s (2005) findings. [ABSTRACT FROM AUTHOR]

The author comments on the vision of Don Bloch and his colleagues in the Collaborative Family Health Care Association (CHFCA). He describes Bloch's ecosystemic perspective as well as his emphasis on families. He provides brief background information on CHFCA. The author describes Bloch as a synthetic thinker and a catalytic leader.