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Children and adolescents who are having difficulty coping with stress often present with complaints of physical discomfort. Effective treatment approaches exist for many of these issues. Among high‐conflict parents, however, children's medical issues can become another canvas for conflict, with parents focused more on blaming one another for the child's distress than on options for assisting the child. Professionals can be drawn into the conflict to such a degree that they overlook essential steps for addressing and managing these issues. The authors present a research‐informed model for managing medical and psychophysiological issues amid parental conflict. Key points for the family court community: Children at the center of conflict, and those who have been exposed to other Adverse Child Experiences, are at higher risk of developing medical illness, psychological dysfunction, and conditions that reflect an interaction of factors.Children at the center of conflict often exhibit dysfunction early, failing to master developmental tasks or developing other symptoms. This includes their ability to cope with physical discomfort and anxiety.Children may be at increased risk if parents or professionals make assumptions about the causes of symptoms and fail to consult the child's physician and follow medical recommendations for assessing and managing symptoms.Effective protocols exist for managing many pediatric and adolescent complaints; these may need to be adapted for the family law context.Interdisciplinary cooperation and careful case and therapeutic management can enhance children's functioning and therapeutic progress. [ABSTRACT FROM AUTHOR]

When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship‐based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years, we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context's constraints and exploiting its strengths is key to providing high‐quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add‐on to a face‐to‐face practice. [ABSTRACT FROM AUTHOR]

Family therapy does not consist of just a single way of working with people but is composed of many different approaches. This article divides family therapy into four historical groupings and explores the degree to which Adler’s ideas have influenced, whether directly or indirectly, the various models of family therapy. Family systems therapy, often without recognition, has incorporated much of what Adler and his associates brought to the understanding of human nature and the contexts in which humans live and work. [ABSTRACT FROM AUTHOR]

There is an intimate connection between mitochondrial DNA (mtDNA) methylation and some diseases, such as cancer. MtDNA is almost strictly maternally inherited. However, whether the aberrant mtDNA methylation involved in breast cancer progression and whether mtDNA methylation can be transmitted through maternal line are poorly understood. Here we applied bisulfite sequencing to global mitochondrial DNA and whole genomic DNA methylation array from fifteen members of five three-female-generation families with one breast cancer patient in each family. We found that mtDNA methylation was maternally inherited in D-loop region and eight aberrant mtDNA methylation sites were correlated with breast cancer. Furthermore, conjoint analysis showed that mtDNA methylation sites could be potential biomarkers combined with nuclear DNA methylation sites for breast cancer risk prediction. [ABSTRACT FROM AUTHOR]

The article discusses a study focusing on the use of conjoint treatment to reduce client trauma symptomology and improve engagement in HIV care for women in the U.S. Topics discussed include the syndemics of trauma and substance abuse in women, the potential efficacy of joint therapeutic approaches, and the use of conjoint treatment to prevent provider burnout and secondary trauma.

Background: Patient engagement in end-stage renal disease (ESRD) is expected to result in a more patient-centered approach to care that aligns with patients' values, preferences, and goals for treatment. Nevertheless, no previous studies of which we are aware have evaluated patients' benefit-risk preferences for the management of anemia associated with ESRD. The primary objective of this study was to quantify the tradeoffs patients are willing to make between cardiovascular risks associated with some anemia medicines and red blood cell (RBC) transfusions. A secondary objective was to quantify the importance of avoiding transfusion-related risks.Methods: A survey instrument was developed from the clinical literature, clinician input, patient-education resources, and a patient focus group. The survey instrument was qualitatively pretested before its administration to a broader sample of patients. The National Kidney Foundation invited individuals in the United States to participate in the survey. In a discrete-choice experiment (DCE), respondents chose between two hypothetical anemia medications in a series of questions. Each medication was defined by symptom relief, frequency of transfusions, cardiovascular risk, mode of administration, and out-of-pocket cost. The survey also included a best-worst scaling (BWS) exercise to quantify the importance of avoiding attributes of blood transfusions. Results from the DCE were used to estimate relative importance and marginal willingness to pay. Results from the BWS were converted to relative importance weights.Results: A total of 200 individuals completed the survey. Patients were willing to accept a 6% medication-related risk of heart attack to avoid having two RBC transfusions per month. Symptom relief and mode of administration were of moderate importance. The most important transfusion-related risk to avoid was transfusion-related lung injury.Conclusions: Patients with ESRD and anemia have measurable treatment preferences and are willing to accept risks associated with anemia medications to avoid transfusions. [ABSTRACT FROM AUTHOR]

Although Couple and Relationship Education (CRE) programs were intended to be preventive in nature, an emerging reality is that relationally distressed couples are attending programs. This has raised questions about both its general usefulness and what is known regarding predictors of change in CRE for distressed couples particularly. Previous work has identified dosage and duration as important moderators of changes, and there are myriad program contexts offered, highlighting the need to examine these among distressed couples. This study utilized a sample of community CRE participants and examined received dosage and program duration as predictors of change. Comparing results for distressed and non-distressed participants, we found several group differences. Findings suggest that it is important to consider distress level and time spent in programs when placing participants. In addition, research should continue to examine these groups separately (or comparatively) to find out what works for whom. [ABSTRACT FROM AUTHOR]

According to some relational approaches, mental health is expressed by the ability to move between various self-states while maintaining the adequate presence of the illusion that the self is continuous in time and space. Patients undergoing combined therapy are granted with the inimitable space existing between the two forms of therapy—individual and group therapy. Within the combined therapy patients, as well as therapists, are challenged by the multiplicity of self-states arising in light of this complex situation as part of a mutual intersubjective process. The article analyses the advantages of the combined therapy in light of the theories dealing with multiple self states. A clinical vignette will be presented to illustrate the theoretical notions. [ABSTRACT FROM AUTHOR]

Texture provides crucial information about the category or identity of a scene. Nonetheless, not much is known about how the texture information in a scene is represented in the brain. Previous studies have shown that the parahippocampal place area (PPA), a scene-selective part of visual cortex, responds to simple patches of texture ensemble. However, in natural scenes textures exist in spatial context within a scene. Here we tested two hypotheses that make different predictions on how textures within a scene context are represented in the PPA. The Texture-Only hypothesis suggests that the PPA represents texture ensemble (i.e., the kind of texture) as is, irrespective of its location in the scene. On the other hand, the Texture and Location hypothesis suggests that the PPA represents texture and its location within a scene (e.g., ceiling or wall) conjointly. We tested these two hypotheses across two experiments, using different but complementary methods. In experiment 1, by using multivoxel pattern analysis (MVPA) and representational similarity analysis, we found that the representational similarity of the PPA activation patterns was significantly explained by the Texture-Only hypothesis but not by the Texture and Location hypothesis. In experiment 2, using a repetition suppression paradigm, we found no repetition suppression for scenes that had the same texture ensemble but differed in location (supporting the Texture and Location hypothesis). On the basis of these results, we propose a framework that reconciles contrasting results from MVPA and repetition suppression and draw conclusions about how texture is represented in the PPA. [ABSTRACT FROM AUTHOR]

The author presents the clinical application of the "The Natural Principles of Love" by John Gottman and Julie Gottman, as one of the method of couples therapy. Topics discussed include the research and sound relationship house theory in the article "Principia Amoris: The New Science of Love" and the assessment of couples through multifaceted approach.

The authors presents their perspectives as trainers on the article "The Natural Principles of Love" by John Gottman and Julie Gottman. Topics discussed include key principles summarized by the authors for relationship house theory, the Gottman method couples theory and the training format through stage process such as the first-level training for broad overview of research findings.

Background: Several scientific psychologists consider the approach for the study of perceptive problems of the Experimental Phenomenology is problematic, namely that the phenomenological demonstrations are subjectively based and they do not produce quantifiable results. Aim: The aim of this study is to show that Experimental Phenomenology can lead to conclusions objective and quantifiable and propose a procedure allowing to obtain objective measuring using the Rasch mathematical model able to describe the experimental data gathered in Experimental Phenomenology procedures. Method: In order to demonstrate this, a Psychophysics simulated study is proposed. Results/conclusions: It is possible to carry out a fundamental measurement starting from Experimental Phenomenology by way of the Theory of Conjoint Measurement. [ABSTRACT FROM AUTHOR]

Children often need help before their parents are ready to stop fighting. Children at the center of high-conflict disputes, particularly those who resist contact with a parent, face extraordinary risks of maladjustment. Years of investigation and litigation may precede any meaningful attempt at intervention, based on the questionable belief that all elements of causality (or blame) must be established before any effective treatment can occur. Children's functioning may continue to deteriorate during this time, undermining their future adjustment and reducing the chance of successful intervention later. We illustrate the application of the coping-focused, multisystemic Child Centered Conjoint Therapy model to assisting these families. Methods to assist children without compromising external investigations are discussed. [ABSTRACT FROM AUTHOR]

Objective: While empirically-supported treatment (EST) choices are continually expanding, choices regarding formats for delivery (individual only, group only, or conjoint [simultaneous individual & group]) are often determined by agency resources or clinician preference. Studies comparing individual and group formats have produced mixed results, while recent meta-analytic reviews support format equivalence.Method: We employed a multilevel model to test for outcome differences using the OQ-45 on an outpatient archival data set of clients receiving individual-only (n = 11,764), group-only (n = 152) or conjoint (n = 1557).Results: Individual and group outcomes were equivalent with some analyses showing conjoint trailing. Moderators of change included initial distress, treatment duration, intra-group dependency, and format.Conclusions: Results support meta-analytic findings of format equivalence in a naturalistic setting for group and individual. Referral practices and future results are discussed. [ABSTRACT FROM PUBLISHER]

Improving a patient's ability to form and maintain satisfactory interpersonal relations is an important goal in many therapies. A mentalization-based approach to treatment is ideally suited to achieve this end to the extent it's designed to help improve a patient's ability to form more nuanced guesses about why others act as they do, based on a more accurate 'read' of that individual's beliefs and desires. Interpersonal difficulties often issue when patients remain insistent on their own interpretation of another's motives that fly in the face of that individual's understanding of what is 'driving' them. Helping patients explore the basis upon which they'd formed their conclusions about others goes a ways toward opening their mind to the possibility that things are a bit more complicated than first imaged. This in turn leads to greater curiosity and willingness to explore their own narratives and perceptions. [ABSTRACT FROM AUTHOR]

Posttraumatic growth (PTG) is defined as a positive psychological change that can emerge following a traumatic life event. Although documented in noninterventional studies of traumatized individuals, there are scant data on the potential for therapy to induce or improve PTG. Thus, the primary goal of this study was to examine changes in PTG in a controlled trial of cognitive-behavioral conjoint therapy for posttraumatic stress disorder versus waitlist (CBCT for PTSD; Monson & Fredman, 2012). We also examined whether pretreatment relationship satisfaction and PTSD symptomatology moderated change in PTG. There were 40 couples (75% with a female partner with PTSD) who were randomized to either immediate CBCT for PTSD or a 3-month waitlist (WL). Compared to WL, individuals who received treatment immediately demonstrated a significant increase in PTG. There was a moderate effect size between-group difference (Hedge's g = 0.45). There was a nonsignificant relationship with a moderate effect size (Hedge's g = 0.65) for the positive effect of pretreatment relationship satisfaction on the trajectory of PTG, but no effect of pretreatment PTSD symptoms. Results suggested that CBCT for PTSD facilitated PTG, even with a limited focus on PTG in this conjoint intervention. Future research should target PTG as a treatment goal and further examine the role of close others in facilitating development of PTG. [ABSTRACT FROM AUTHOR]

We examined sex differences in explicitly supportive behavior exchanges between husbands and wives using naturalistic video-recordings of everyday couple interactions inside the home. Thirty dual-earner, middle class, heterosexual couples with school-age children were recorded in their homes over 4 days. Specific instances of face-to-face explicit couple support in the video-recordings were identified, and the support role assumed by each partner (recipient vs. provider), the method of support initiation (solicitations vs. offers), and the type of support (instrumental vs. emotional) in each interaction were coded. Paired samples t tests examined sex differences in husbands' and wives' supportive behavior, and bivariate correlations tested the associations among spouses' support initiation behaviors. Findings counter prior research that has largely found a "support gap" favoring husbands as support recipients. Instead, results indicate that wives received significantly more support of an instrumental nature from husbands (than husbands did from wives), a finding driven by wives' active support-soliciting behavior. Among husbands, a tendency to be the solicitor of support was positively correlated with a tendency to offer support. Within couples, rates of offers of support by 1 spouse were correlated with offers by the partner. Naturalistic observations highlight processes that may not be detected by self-reports or laboratory data, in an ecologically valid context in which social behavior reflects the natural rhythms and pulls of everyday life. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Background: The College of General Practitioners of Malaysia and the Royal Australian College of General Practitioners held the first Conjoint Member of the College of General Practitioners (MCGP)/Fellow of Royal Australian College of General Practitioners (FRACGP) examination in 1982, later renamed the Conjoint MAFP/FRACGP examinations. The examination assesses competency for safe independent general practice and as family medicine specialists in Malaysia. Therefore, a defensible standard set pass mark is imperative to separate the competent from the incompetent. Objective: This paper discusses the process and issues encountered in implementing standard setting to the Conjoint Part 1 examination. Discussion: Critical to success in standard setting were judges' understanding of the process of the modified Angoff method, defining the borderline candidate's characteristics and the composition of judges. These were overcome by repeated hands-on training, provision of detailed guidelines and careful selection of judges. In December 2013, 16 judges successfully standard set the Part 1 Conjoint examinations, with high inter-rater reliability: Cronbach's alpha coefficient 0.926 (Applied Knowledge Test), 0.921 (Key Feature Problems). [ABSTRACT FROM AUTHOR]

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Interventions for family violence in Aboriginal communities should take a culture-based approach and focus on healing for the whole family. The purpose of this research was to identify risk issues from the perspective of service providers for couples counseling with Aboriginal clients following intimate partner violence. A total of 25 service providers participated in over the phone interviews concerning risk with Aboriginal men in couple counseling. Five concepts emerged including (a) collaterals, (b) commitment to change, (c) violence, (d) mind-set, and (e) mental health. It was concluded that culturally competent interventions should involve the entire community and have a restorative approach. The concepts were compared and contrasted with the available literature. [ABSTRACT FROM AUTHOR]

Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes across treatment in clinician-rated PTSD symptom clusters and patient-rated trauma-related cognitions in a randomized controlled trial comparing CBCT for PTSD with waitlist in a sample of 40 individuals with PTSD and their partners (N = 40; Monson et al., 2012). Compared with waitlist, patients who received CBCT for PTSD immediately demonstrated greater improvements in all PTSD symptom clusters, trauma-related beliefs, and guilt cognitions (Hedge's gs -.33 to -1.51). Results suggest that CBCT for PTSD improves all PTSD symptom clusters and trauma-related cognitions among individuals with PTSD and further supports the value of utilizing a couple-based approach to the treatment of PTSD. [ABSTRACT FROM AUTHOR]

Behavioral interventions delivered across home and school settings can promote positive outcomes for youth with autism spectrum disorders (ASD). Yet, stakeholders who deliver these interventions may struggle to implement interventions as intended. Low levels of treatment integrity can undermine potentially positive intervention outcomes. One way to promote implementers' treatment integrity is Implementation Planning, a logistical planning and barrier reduction strategy that is supported by emerging school-based research. The current study extended the research on Implementation Planning and evaluated the effectiveness of the strategy with parents implementing a behavioral intervention at home within a Conjoint Behavioral Consultation model. The behavioral intervention aimed to increase compliance and decrease aggression for two children with ASD at home. Initially, parents struggled to deliver the intervention consistently; however, after Implementation Planning, parents' treatment integrity increased and, subsequently, child outcomes improved. Implications for future research and consultation are presented. [ABSTRACT FROM PUBLISHER]

We examined the trends of quantitative research over the past 10 years in the Journal of Marital and Family Therapy (JMFT). Specifically, within the JMFT, we investigated the types and trends of research design and statistical analysis within the quantitative research that was published in JMFT from 2005 to 2014. We found that while the amount of peer-reviewed articles have increased over time, the percentage of quantitative research has remained constant. We discussed the types and trends of statistical analysis and the implications for clinical work and training programs in the field of marriage and family therapy. [ABSTRACT FROM AUTHOR]

Meta-analyses of randomized controlled trials of couple therapy find large improvements in couple adjustment, but published evaluations of the effectiveness of couple therapy in routine practice find only small-to-moderate effects. The current study analyzes possible explanations for the research-efficacy to practice-effectiveness gap and offers suggestions for enhancing couple therapy effectiveness. Major recommendations are that therapists should clarify whether couples' therapy goal is to clarify commitment to the relationship or to improve the relationship; use standardized assessment of the individual partners and the relationship; and use systematic monitoring of therapy progress and the therapeutic alliance. It is also possible that the greater use of evidence-based therapies when treating couple relationship distress could enhance couple therapy outcome. [ABSTRACT FROM AUTHOR]

Purpose: For years, older patients have been prescribed multiple blood-thinning medications (complex antithrombotic therapy [CAT]) to decrease their risk of cardiovascular events. These therapies, however, increase risk of adverse bleeding events. We assessed patient-reported trade-offs between cardioprotective benefit, gastrointestinal bleeding risk, and burden of self-management using adaptive conjoint analysis (ACA). As ACA could be a clinically useful tool to obtain patient preferences and guide future patient-centered care, we examined the clinical application of ACA to obtain patient preferences and the impact of ACA on medication adherence. Patients and methods: An electronic ACA survey led 201 respondents through medication risk-benefit trade-offs, revealing patients' preferences for the CAT risk/benefit profile they valued most. The post-ACA prescription regimen was categorized as concordant or discordant with elicited preferences. Adherence was measured using VA pharmacy refill data to measure persistence of use prior to and 1 year following preference-elicitation. Additionally, we analyzed qualitative interviews of 56 respondents regarding their perception of the ACA and the preference elicitation experience. Results: Participants prioritized 5-year cardiovascular benefit over preventing adverse events. Medication side effects, medication-associated activity restrictions, and regimen complexity were less important than bleeding risk and cardioprotective benefit. One year after the ACA survey, a 15% increase in adherence was observed in patients prescribed a preference-concordant CAT strategy. An increase of only 6% was noted in patients prescribed a preference-discordant strategy. Qualitative interviews showed that the ACA exercise contributed to increase inpatient activation, patient awareness of preferences, and patient engagement with clinicians about treatment decisions. Conclusion: By working through trade-offs, patients actively clarified their preferences, learning about CAT risks, benefits, and self-management. Patients with medication regimens concordant with their preferences had increased medication adherence at 1 year compared to those with discordant medication regimens. The ACA task improved adherence through enhanced patient engagement regarding treatment preferences. [ABSTRACT FROM AUTHOR]

Adaptive choice-based conjoint analysis was used to study the anti-cyberbullying program preferences of 1,004 university students. More than 60% reported involvement in cyberbullying as witnesses (45.7%), victims (5.7%), perpetrator-victims (4.9%), or perpetrators (4.5%). Men were more likely to report involvement as perpetrators and perpetrator-victims than were women. Students recommended advertisements featuring famous people who emphasized the impact of cyberbullying on victims. They preferred a comprehensive approach teaching skills to prevent cyberbullying, encouraging students to report incidents, enabling anonymous online reporting, and terminating the internet privileges of students involved as perpetrators. Those who cyberbully were least likely, and victims of cyberbullying were most likely, to support an approach combining prevention and consequences. Simulations introducing mandatory reporting, suspensions, or police charges predicted a substantial reduction in the support of uninvolved students, witnesses, victims, and perpetrators. Aggr. Behav. 41:369-385, 2015. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Drawing on public commitment theory, this research examined the association between Facebook self-presentations of coupledom and relationship longevity among college-aged dating partners. Using a longitudinal design and a path model analytic approach, this study shows that Facebook self-presentational cues (i.e., being listed as 'in a relationship,' posting dyadic photographs, writing on the partner's wall) were associated with an increase in relationship commitment for dating couples, which, in turn, increased their likelihood of remaining together after 6 months. Contrary to predictions, the number of mutual Friends and the number of posts written by partners on participants' walls were negatively related to relationship commitment. This study is the first to apply public commitment theory to an online romantic relationship context, and one of the few to examine the effects of Facebook on the state and fate of romantic relationships. [ABSTRACT FROM AUTHOR]

Psychotherapists often encounter generational differences between themselves and their adolescent clients. Understanding these differences can enhance the communication, interventions, and trust between the therapist and adolescent client. The use of text messages in the lives of adolescents has increased. While there is emerging literature on the significance of texting for an adolescent's feelings of connection with his/her peers, much less is known about the addition of this form of communication within counseling sessions. This paper uses one case of conjoint therapy with a father and daughter to explore these issues. The role of texting for the adolescent is explored, the role the texting inhabited in the sessions is discussed, and clinical significance of social media on psychotherapy are explored. [ABSTRACT FROM AUTHOR]

Insulin and glucagon are glucoregulatory hormones that contribute to glucose homeostasis. Plasma insulin is elevated during normoglycemia or hyperglycemia and acts as a suppressor of glucagon secretion. We have investigated if and how insulin and glucose contribute to the regulation of glucagon secretion through long term (48 h) elevated insulin concentrations during simultaneous hypoglycemia or euglycemia in mid-lactating dairy cows. Nineteen Holstein dairy cows were randomly assigned to 3 treatment groups: an intravenous insulin infusion (HypoG, n = 5) to decrease plasma glucose concentrations (2.5 mmol/L), a hyperinsulinemic-euglycemic clamp to study effects of insulin at simultaneously normal glucose concentrations (EuG, n = 6) and a 0.9% saline infusion (NaCl, n = 8). Plasma glucose was measured at 5-min intervals, and insulin and glucose infusion rates were adjusted accordingly. Area under the curve of hourly glucose, insulin, and glucagon concentrations on day 2 of infusion was evaluated by analysis of variance with treatments as fixed effect. Insulin infusion caused an increase of plasma insulin area under the curve (AUC)/h in HypoG (41.9 ± 8.1 mU/L) and EuG (57.8 ± 7.8 mU/L) compared with NaCl (13.9 ± 1.1 mU/L; P < 0.01). Induced hyperinsulinemia caused a decline of plasma glucose AUC/h to 2.3 ± 0.1 mmol/L in HypoG ( P < 0.01), whereas plasma glucose AUC/h remained unchanged in EuG (3.8 ± 0.2 mmol/L) and NaCl (4.1 ± 0.1 mmol/L). Plasma glucagon AUC/h was lower in EuG (84.0 ± 6.3 pg/mL; P < 0.05) and elevated in HypoG (129.0 ± 7.0 pg/mL; P < 0.01) as compared with NaCl (106.1 ± 5.4 pg/mL). The results show that intravenous insulin infusion induces elevated glucagon concentrations during hypoglycemia, although the same insulin infusion reduces glucagon concentrations at simultaneously normal glucose concentrations. Thus, insulin does not generally have an inhibitory effect on glucagon concentrations. If simultaneously glucose is low and insulin is high, glucagon is upregulated to increase glucose availability. Therefore, insulin and glucose are conjoint regulatory factors of glucagon concentrations in dairy cows, and the plasma glucose status is the key factor to decide if its concentrations are increased or decreased. This regulatory effect can be important for the maintenance of glucose homeostasis if insulin secretion is upregulated by other factors than high glucose such as high plasma lipid and protein concentrations at simultaneously low glucose. [ABSTRACT FROM AUTHOR]

Objective The efficacy of a present-focused version of cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD) was examined in a community sample. Method Seven couples completed pretreatment assessments, including measures of clinician-, self- and partner-rated PTSD symptoms and relationship satisfaction. Six couples completed present-focused CBCT for PTSD and all posttreatment assessments. A seventh couple terminated their relationship prior to completing treatment; therefore, they completed posttreatment symptom measures, but not ratings of relationship satisfaction. Results Results revealed significant decreases in PTSD symptoms that were associated with medium-to-large effect sizes. Medium effect sizes for changes in relationship satisfaction were found, though were only significant for partners. Conclusion Results from this pilot study suggest that present-focused CBCT for PTSD may be a promising alternative for individuals who are unwilling to engage in a trauma-focused treatment. [ABSTRACT FROM AUTHOR]

We investigated the neural basis of conjoined processing of color and spatial frequency with functional magnetic resonance imaging (fMRI). A multivariate classification algorithm was trained to differentiate between either isolated color or spatial frequency differences, or between conjoint differences in both feature dimensions. All displays were presented in a singleton search task, avoiding confounds between conjunctive feature processing and search difficulty that arose in previous studies contrasting single feature and conjunction search tasks. Based on patient studies, we expected the right temporo-parietal junction (TPJ) to be involved in conjunctive feature processing. This hypothesis was confirmed in that only conjoined color and spatial frequency differences, but not isolated feature differences could be classified above chance level in this area. Furthermore, we could show that the accuracy of a classification of differences in both feature dimensions was superadditive compared to the classification accuracies of isolated color or spatial frequency differences within the right TPJ. These data provide evidence for the processing of feature conjunctions, here color and spatial frequency, in the right TPJ. [ABSTRACT FROM AUTHOR]

Despite the demonstrated efficacy of conjoint couple therapy, many clients seeking help for couple problems ultimately find themselves in individual therapy for these concerns. Individual therapy for couple problems ( ITCP) may evolve from a partner's refusal of conjoint therapy or from the treatment format preferences of either the client or therapist. Having acknowledged the role of partner refusals, we offer some perspectives about the idiosyncratic personal factors and professional background factors that may lead therapists to provide ITCP and discuss the significant pitfalls in its practice. We emphasize five central areas of concern in the ongoing practice of ITCP: structural constraints on change; therapist side-taking and the therapeutic alliance; inaccurate assessments based on individual client reports; therapeutic focus; and ethical issues relevant to both attending and nonattending partners. We conclude by urging that this very important but largely neglected topic be paid greater attention in psychotherapy research, training and continuing education. [ABSTRACT FROM AUTHOR]

Understanding patient preferences facilitates shared decision-making and focuses on patient-centered outcomes. Little is known about relapsing-remitting multiple sclerosis (RRMS) patient preferences for disease modifying therapies (DMTs). We use choice based conjoint (CBC) analysis to calculate patient preferences for risk/benefit trade-offs for hypothetical DMTs. Methods Patients with RRMS were surveyed between 2012 and 2013. Our CBC survey mimicked the decision-making process and trade-offs of patients choosing DMTs, based on all possible DMT attributes. Mixed-effects logistic regression analyzed preferences. We estimated maximum acceptable risk trade-offs for various DMT benefits. Results Severe side-effect risks had the biggest impact on patient preference with a 1% risk, decreasing patient preference five-fold compared to no risk. (OR = 0.22, p < 0.001). Symptom improvement was the most preferred benefit (OR = 3.68, p < 0.001), followed by prevention of progression of 10 years (OR = 2.4, p < 0.001). Daily oral administration had the third highest DMT preference rating (OR = 2.08, p < 0.001). Patients were willing to accept 0.08% severe risk for a year delayed relapse, and 0.22% for 4 vs 2 year prevented progression. Conclusion We provided patient preferences and risk-benefit trade-offs for attributes of all available DMTs. Evaluation of patient preferences is a key step in shared decision making and may significantly impact early drug initiation and compliance. [ABSTRACT FROM AUTHOR]

Couples who request conjoint treatment often demonstrate relationship problems that are exacerbated by emotional reactivity. Neurobiology research has clarified the process of emotional dysregulation, and the benefit of mindful interventions in managing and preventing hyperarousal. This paper examines the mechanics of emotional dysregulation and presents a case example that demonstrates how breathing and staying in the moment were used to help de-escalate an agitated couple. Mindful interventions can be used to help couples tolerate, understand, and manage emotional states that can otherwise become destructive. These techniques are particularly useful with volatile couples, and can be used in conjunction with other therapeutic interventions. [ABSTRACT FROM AUTHOR]

Only in working conjointly with couples and families do therapists literally witness clients struggling to improve their most intimate relationships. In writing this article, we realized that, in true systemic fashion, not only have many of our clients benefited from working with us, but also we have learned some invaluable lessons from them. Indeed, practicing couple and family therapy gives therapists many opportunities to learn about themselves, especially when it is done thoughtfully. In this article, we reflect on myriad ways in which couples and family therapy has affected each of us personally-as individuals, as partners, as parents, as adult children in our families of origin, and as educators. [ABSTRACT FROM AUTHOR]

This paper introduces the Modern Kleinian Therapy approach, examines a case of couples' treatment, and defines the important clinical elements encountered in analytic work with disturbed and disorganized couples. The concepts of pathological organization, psychic retreat, the death instinct, and projective identification are discussed in reference to the treatment of couples. Modern Kleinian Therapy is a theoretical and clinical approach that utilizes the main elements of Kleinian technique for patients often with more severe psychological disturbance in reduced frequency treatment and in the context of either individual or couples settings. Couples in which one or both partners may be neurotic, borderline, narcissistic, and even psychotic are common in our private practice settings. As a result, therapists are used to being the referee, peacekeeper, policeman, savior, negotiator, translator, decoy, diplomat, provocateur, container, and healer depending on what type of transference profile is bestowed upon the analyst by either each individual and/or by the couple. However, these transference modes can be difficult to handle because of the rigid projective identification mechanisms found in the pathological organization couples often use to maintain their unique level of psychic equilibrium. Using case material, the author shows how to work with hard-to-reach couples by means of an analytic exploration of the couple's pathological organization, the associated dynamics of the death instinct, and the last resort defense of the psychic retreat. [ABSTRACT FROM AUTHOR]

Research on memory has demonstrated that remembering material can cause forgetting of related information, which is known as retrieval-induced forgetting ( RIF). Macrae and Roseveare identified 'self' as one of the boundary conditions of this effect in the Western cultural context, showing that RIF was eliminated when material was encoded to be related to the self (known as self-referential effect), but not to significant others. In this study, we predicted and found that significant others could be another boundary condition in Japanese cultural contexts in which self and agency are more interdependent or conjoint; RIF was observed neither under best-friend-related encoding nor under family-related encoding in Japan. The effect of significant others is found uniquely in Japanese cultural contexts, suggesting that the cultural model of self has significant power in the spontaneous system of memory. [ABSTRACT FROM AUTHOR]

Situational couple violence (SCV) is a common problem in couples presenting for therapy. SCV, as seen through the lens of attachment, can be viewed as a result of an insecure attachment system within the couple. Although several authors have discussed individual attachment styles as predictors of both the receipt and perpetration of violence, in this article we seek to portray the attachment system as a relational and changing construct. As such, we argue for conjoint treatment for SCV as a way to restructure a more secure attachment system within the couple. Cautions for the appropriateness of couples counseling with ongoing violence are included. Finally, we discuss the use of an attachment-based safety plan and time-out strategy to use with couples experiencing SCV. [ABSTRACT FROM AUTHOR]

The article aims to explore the concept of TMI (transient mental illness) as a shared creation using 2 literary texts namely "The adventures of the Ingenius Hidalgo Don Quixote de la Mancha" by Miguel de Cervantes Saavedra and "Sybil" by Flora Rheta Schreiber. It indicates that the concept of TMI is a way of expressing and explaining distress and a conjoint creation of the therapist, patient and their particular historical and social circumstance.

Involvement of the family members in the therapeutic interventions for the benefit of the client has been traditionally part of various social work interventions. Psychiatric social workers (PSWs) in the family psychiatry centre, National Institute of Mental Health and Neurosciences (NIMHANS) conceptualise the case/problem referred to the unit as the resultant of the maladaptive family relationships and interactions. Interventions are carried out on the basis of standard procedures such as a comprehensive family assessment, framing a circular hypothesis, and a series of problem-solving initiatives directed at bringing about changes in the maladaptive family functioning. Apart from the therapeutic clinical services, preventive and promotive services are also done by PSWs at the centre. PSWs do teaching, trainings and research activities. [ABSTRACT FROM AUTHOR]

Although psychological aggression has been identified as a risk factor for physical aggression, the prevalence of psychological aggression is much higher than that of physical aggression. To further understand the relationship between psychological and physical aggression, the level of psychological aggression at which physical aggression becomes more likely was evaluated. A representative sample of 268 men and 299 women responded anonymously to a self-report measure of aggression (revised Conflict Tactics Scale [CTS-2]) at baseline, and then 1 year later. Using both cross-sectional and longitudinal analyses, this study evaluated the level of psychological aggression that is necessary before it is likely that one will be physically aggressive. When one was at the 80th percentile of psychological aggression, there was a 70% probability that a man would be physically aggressive and 85% probability that a woman would be physically aggressive. Longitudinally, when one was at the 80th percentile of psychological aggression at Time 1, there was a 40% probability that a man would be physically aggressive and 45% probability that a woman would be physically aggressive at Time 2. CTS-2 psychological decile scores are provided along with the probability of physical aggression to assist clinicians in interpreting client scores. Implications for research and couples therapy are discussed. [ABSTRACT FROM AUTHOR]

Community resilience is used to describe a community's ability to deal with crises or disruptions. The Conjoint Community Resiliency Assessment Measure (CCRAM) was developed in order to attain an integrated, multidimensional instrument for the measurement of community resiliency. The tool was developed using an inductive, exploratory, sequential mixed methods design. The objective of the present study was to portray and evaluate the CCRAM's psychometric features. A large community sample (N = 1,052) were assessed by the CCRAM tool, and the data was subjected to exploratory and confirmatory factor analysis. A Five factor model (21 items) was obtained, explaining 67.67 % of the variance. This scale was later reduced to 10-item brief instrument. Both scales showed good internal consistency coefficients (α = .92 and α = .85 respectively), and acceptable fit indices to the data. Seven additional items correspond to information requested by leaders, forming the CCRAM28. The CCRAM has been shown to be an acceptable practical tool for assessing community resilience. Both internal and external validity have been demonstrated, as all factors obtained in the factor analytical process, were tightly linked to previous literature on community resilience. The CCRAM facilitates the estimation of an overall community resiliency score but furthermore, it detects the strength of five important constructs of community function following disaster: Leadership, Collective Efficacy, Preparedness, Place Attachment and Social Trust. Consequently, the CCRAM can serve as an aid for community leaders to assess, monitor, and focus actions to enhance and restore community resilience for crisis situations. [ABSTRACT FROM AUTHOR]