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Behavioral and physical health integration has been shown to be beneficial for overall health outcomes, as well as financial benefits. The current research clearly shows benefits, but lacks evidence specific to couples and family therapy (CFT) as a medium or profession within mental health integrated sites. This study tests the cost offsets of Mastering Each New Directions (MEND), a family system psychosocial approach to chronic illness (CI). Using retrospective charges from 107 CI adult patients, MEND (with an average of 25 sessions) was estimated to produce a 12-month cost savings of $16,684 or a 34.3% reduction in healthcare costs. This reduction significantly outweighed the cost of the intervention for a total net savings of $9,251 per participant in 12 months. Variations in cost reductions by demographic and treatment dosage are explored, and results suggest that a family systems psychosocial intervention can offer a health system an overall cost savings.Se ha demostrado que la integración de la salud conductual y física es beneficiosa para los resultados en la salud en general, y que a su vez tiene beneficios económicos. La presente investigación muestra claramente beneficios, pero carece de indicios específicos para la terapia familiar y de pareja como medio o profesión dentro de centros integrados de salud mental. Este estudio evalúa los costos y la compensación de Mastering Each New Directions (MEND), un enfoque psicosocial de sistemas familiares para las enfermedades crónicas. Utilizando los gastos retrospectivos de 107 pacientes adultos con enfermedades crónicas, se calculó que el enfoque MEND (con un promedio de 25 sesiones) produce ahorros de $16.684 en los costos de 12 meses o una reducción del 34,3 % en los costos de asistencia sanitaria. Esta reducción sobrepasó considerablemente el costo de la intervención por un total de ahorros netos de $9251 por participante en 12 meses. Se analizan las variaciones en las reducciones de costos por dosis demográfica y de tratamiento, y los resultados sugieren que una intervención psicosocial de sistemas familiares puede ofrecer ahorros en los costos generales del sistema de salud.行为健康和身体健康综合起来已被证明对整体的健康结果和经济效益都是有益的。本研究清楚地表明了各种益处，但在心理健康综合部门，伴侣和家庭治疗(CFT) 作为一种媒介或职业的特定数据是缺失的。这项研究测试了掌握每个新方向(MEND)这种方法的成本补偿，它是一种针对慢性疾病的家庭系统心理社会方法(CI)。此研究使用了来自107名慢性病成年患者的回顾性花销，MEND(平均25次治疗)估计可节省12个月累计16684美元的费用，或减少34.3%的医疗费用。这一减额大大超过了实施干预措施的费用，12个月里每个参与者总共净节省9 251美元。本研究探讨了人口统计学和治疗剂量在降低成本方面的差异，结果表明，家庭系统、社会心理干预可以为卫生系统整体节省成本。.

A critical and often overlooked issue is the lack of measurement tools that are congruent with the systemic and developmental guiding principles of the Marital and Family Therapy field. In this current study, we test the dyadic supervision evaluation (DSE) focusing on the internal consistency, specifically the developmental trajectory of trainee and supervisor factors during a year in supervision. This study demonstrates how these factors stabilize over time. The DSE psychometrics are evaluated with a sample of 205 dyads that are tested longitudinally over four time points. We employ repeated measures ANOVA with intra-class correlation (ICC) to measure the level of consistency of the subscales over time. The results of this analysis show that the factors for trainees have an ICC average range of 0.66–0.80, and the factors for supervisors have an ICC average range of 0.69–0.84.

Few measures parallel the robust depth offered in the existing multidimensional and ecologically informed theories of resilience. This study sought to evaluate the test–retest reliability, construc...

Assessments of power in couples’ relationships often only survey one partner, but they do not take into consideration both partners’ perceptions. Thus, many assumptions about power and equality in relationships have not been quantitatively tested due to a lack of dyadic measures of power. Therefore, the purpose of the Gender and Relationships Study was to develop and test a new scale of equality and relative power for couples, the Relationship Balance Assessment (RBA). The RBA may be useful for research and for clinical work with couples to help raise awareness of the balance of power in their relationship. A review of the literature has shown a shift away from focusing on monetary resources and decision-making dominance towards examining relationship processes and the connection between gender and power. This study prescreened a pool of process-oriented questions based on the qualitative literature. Then exploratory factor analysis of data from 268 individuals and 91 couples identified 12 consistent latent factors underlying relationship equality. These 12 subscales are summed up with the TREASURES acronym: Time Discretion, Relational Power, Emotional Power (Emotional Expression and Avoidance subscales), Accommodation, Spending and Saving subscales, Union or Sexual Dominance, Rational Power, Economic Role Power (Status and Childcare subscales), and Social Choices.

Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty-five families participated in a 21-session intensive outpatient family systems-based program for pediatric CI. Within this single arm design, families were measured on five domains of Health-Related Quality of Life (HRQL) self-report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning. Both survey and biological measures (stress: catecholamine) were used in the study. Results from multivariate general linear models showed positive pre-, post-, and 3-month posteffects in all five domains. The program effects ranged from small to moderate (η2 = .07-.64). The largest program effects were seen in the domains of cognitive functioning (η2 = .64) and stress (η2 = .27). Also, between disease groups, differences are noted and future implications for research and clinical practice are discussed. Conclusions suggest that the MEND program may be useful in helping families manage pediatric chronic illnesses. Study results also add to the growing body of literature suggesting that psychosocial interventions for pediatric chronic illness benefit from a family systems level of intervention.

In pediatric chronic illness, little is known about the relational interactions between adolescent patients, parents, and illnesses and how they influence self-management of illness. We conducted interviews with 32 individuals (16 dyads) representing adolescents diagnosed with a chronic illness and their primary parent who had been referred to a psychosocial treatment program for challenges with illness management. Interviews were conducted individually and analyzed dyadically using grounded theory to better understand the relational processes that may be contributing to illness management difficulties. Results include a theory of patient-parent illness responses and how parental illness meanings play a role in adolescent self-management. Results can be used to better understand and treat family relational patterns that may be influencing pediatric illness management challenges.

This study addresses the need for empirically validated tools to support the training, supervision, and the discovery of best practices in Marital and Family Therapy (MFT). This project represents a first step in developing the Dyadic Supervision Evaluation (DSE), an assessment tool that is grounded in developmental and systemic theory and is psychometrically strong. An Exploratory Factor Analysis (EFA) approach was applied to data from 88 trainee-supervisor dyads across four time periods during the first year of clinical training, resulting in 20 factors, including 9 factors for trainees and 11 factors for supervisors with internal reliabilities ranging from α’s = .82–.98. Discussion addresses the utility of the DSE in documenting the developmental and dyadic progression of supervision during the first year of MFT training.

Despite recent increases of psychosocial programs for pediatric chronic illness, few studies have explored their economic benefits. This study investigated the costs–benefits of a family systems-based, psychosocial intervention for pediatric chronic illness (MEND: Mastering Each New Direction). A quasi-prospective study compared the 12-month pre–post direct and indirect costs of 20 families. The total cost for program was estimated to $5,320. Families incurred $15,249 less in direct and $15,627 less in indirect costs after MEND. On average, medical expenses reduced by 86% in direct and indirect costs, for a cost–benefit ratio of 0.17. Therefore, for every dollar spent on the program, families and their third payers saved approximately $5.74. Implications for healthcare policy and reimbursements are discussed.

Although self-concept has been identified as salient to the psychosocial adjustment of adolescents dealing with a chronic illness (CI), little research has focused on its predictors it. Given that depression and parent-child attachment have been linked to self-concept in the population at large, the goal of this study was to evaluate these relationships longitudinally in a sample of adolescents with CI. Using participant data from the Mastering Each New Direction (MEND) program, a 3-month psychosocial, family based intensive outpatient program for adolescents with CI, we employed multilevel modeling to test longitudinal changes in self-concept, as predicted by depressive symptoms and parent-child attachment, in a sample of 50 youths (MAunque el autoconcepto se cosidera muy importante para la adaptación psicosocial de los adolescentes que sufren una enfermedad crónica (EC), pocas investigaciones se han centrado en qué lo predice. Teniendo en cuenta que la depresión y el apego entre padres e hijos se ha asociado con el autoncepto en la población en general, el objetivo de este estudio fue evaluar estas relaciones longitudinalmente en una muestra de adolescentes con EC. Utilizando datos de los participantes del programa Mastering Each New Direction (MEND), un programa ambulatorio psicosocial, familiar e intensivo de tres meses para adolescentes con EC, usamos modelos multinivel para evaluar los cambios longitudinales en el autoconcepto como los predicen los síntomas depresivos y el apego entre padres e hijos en una muestra de 50 jóvenes (Edad promedio = 14.56, desvío estándar = 1.82) que participaron en el programa MEND. Tanto el “tiempo pasado en el programa” como las disminuciones de los síntomas depresivos estuvieron asociados con aumentos en el autoconcepto con el paso del tiempo. Los niveles iniciales más altos de apego evasivo a la madre y al padre también estuvieron asociados con mayores niveles iniciales de autoconcepto. Enfocarse en los síntomas depresivos y apoyar los cambios adaptativos en el apego puede ser clave para promover un autoconcepto saludable en las poblaciones de pacientes pediátricos con enfermedades crónicas. La asociación entre el apego evasivo y los puntajes iniciales más altos de autoconcepto pueden reflejar diferencias en la autonomía, la autoconfianza o la depresión de los participantes. Entre las limitaciones del estudio se encuentran la variabilidad de la cantidad de tiempo pasado en el programa, la reducción de las valoraciones de los últimos intervalos de tiempo y la incapacidad de analizar y exponer completamente todas las posibles covariables debido a un tamaño muestral pequeño (p. ej.: poder).虽然自我概念已被确认为青少年应对慢性疾病心理社会调试的一个突出因素,然而很少有研究着重预测自我概念。鉴于抑郁和家长-儿童依恋在人群中和自我概念相关,该研究的目的即在一个有慢性病青少年样本中纵向评估这些关系。我们使用从”掌握每个新方向” (MEND)项目(一个为期三个月的针对有慢性病青少年的以家庭为基础的心理社会)中得来的参与者数据和多层面模型来测试自我概念在由50位参与MEND项目青少年(M

The goal of this study was to develop a broad, multidimensional assessment of individual, family, and community resilience for use in evaluating socioeconomic mobility programs. The Individual, Fam...

As a result of the high rate at which young Marines are getting married and divorced, a group of Navy chaplains created a new comprehensive three stage intervention program entitled, Intimate Relationships Awareness, Training, and Enrichment program (iRelate) to address the various relationship needs of the single, engaged, and married Marines. This article presents preliminary program evaluation data for Stage I and Stage II of the iRelate program, with additional data from Marines that are engaged to be married and Marines that were in the process of getting divorced. Results showed, prior to attending Stage I and Stage II of the program, Marines presented with high levels of marriage idealism and overconfidence. Twenty-nine percent stated, because they are Marines, they are capable of taking on adult responsibilities and 32.4 % believed that marriage would require some effort. Of the Marines that were in the process of getting divorced, 40 % indicated that they were too young to be married, 50 % stated if they could do it over again they would have taken more time to get to know their spouse prior to getting married. The post course data indicated that the Marines’ level of idealism and overconfidence decreased, as 63.2 % of the Marines developed a more realistic expectation of marriage, by realizing that marriage will require a lot of hard work. Additionally, Marines felt more prepared for their marriage [t (177) = 7.62, p

This article contributes to research practices in marital and family therapy, specifically the dyadic and development over time in clinical supervision, and describes and applies methodological strategies to develop measurements congruent with the systemic and developmental principles of the field. This project evaluates the psychometric properties of the dyadic supervision evaluation (DSE) in terms of measurement equivalence and causality. A structural equation analysis is conducted utilizing the actor–partner interdependent model resulting in a goodness of fit. This study presents a longitudinal model for evaluating the supervisory relationship and proposes a model of clinical supervision evaluation. The relationship among latent constructs in the DSE and its limitations related to inference and application are discussed.

Changing economic times and government policies are reshaping the way the U.S. Department of Housing and Urban Development (HUD) provides services nationwide; there is both a growing demand for housing and a desire to help families become self-sufficient. In this study, the authors examined factors that contribute to increased socioeconomic mobility through the lens of family resilience. Analyzing cross-sectional data from 411 families in the San Bernardino County HUD District using discriminant function analysis, results of this study show strong preliminary evidence that certain components of family resilience predict whether an individual head of household will have full-time employment. The results of this study provide implications for social service programs aimed at socioeconomic mobility.

Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child's chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness.

This interview with Dr. Szapocznik reveals the importance of building an intervention on the foundation of empirical evidence and family systems theory. Szapocznik is the director of the Center for Family Studies and professor at the University of Miami. He is a chair of the National Hispanic Science Network on Drug Abuse. Szapocznik is also the founder of brief strategic family therapy (BSFT). BSFT is a family-based model for adolescent problem behaviors, such as conduct problems and substance abuse. Throughout the research on BSFT, Szapocznik has been able to show that BSFT is effective and that it can be used with historically difficult populations. Finally, Szapocznik's research has shown that family approaches to adolescent problems are more efficacious than individual and group models of therapy.

Family businesses (FBs) are a significant population in the world and therefore part of most practicing marriage and family therapists (MFTs) clientele; however, little is mentioned about FBs in the training of MFTs. This article offers some guidance to practicing MFTs who service this population, as well as MFTs who wish to expand their practice into a focused consultation practices with FB systems. This article uses Doherty’s Levels of Family Involvement Model as a road map for MFTs to organize the vast amount of literature on FB systems as well as the many ways in which MFTs might serve FBs. We also offer suggestions for the necessary skills, experiences, and levels of engagement required at each level of intervention provided by MFTs.