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Recent research suggests that marital quality predicts the survival of patients with heart failure (HF), and it is hypothesized that a communal orientation to coping marked by first-person plural pronoun use (we talk) may be a factor in this. During a home interview, 57 HF patients (46 men and 16 women) and their spouses discussed how they coped with the patients' health problems. Analysis of pronoun counts from both partners revealed that we talk by the spouse, but not the patient, independently predicted positive change in the patient's HF symptoms and general health over the next 6 months and did so better than direct self-report measures of marital quality and the communal coping construct. We talk by the patient and spouse did not correlate, however, and gender had no apparent moderating effects on how pronoun use predicted health change. The results highlight the utility of automatic text analysis in couple-interaction research and provide further evidence that looking beyond the patient can improve prediction of health outcomes.

Contextual and essential explorations of how couples' interactions are gendered were compared by examining the relationship between demanding and withdrawing within couples and the partners' involvements outside the couple. Results showed that wives were more often in the demanding/pursuing role than their husbands and that this pattern was significantly correlated with the partners' outside involvements. (Author/MKA)

In a study of spousal support for smoking cessation, 34 couples in which one partner continued to smoke despite having a heart or lung problem used an adaptation of Cohen & Lichtenstein's (1990) Partner Interaction Questionnaire to describe the spouse's attempts to help the primary (ill) smoker quit. Female smokers received less support for quitting from their spouse or partner than male smokers did, regardless of whether the support was positive or negative, whether the partner also smoked, or whether the smoker or partner rated the partner's support behavior. Female patients in a treatment sub-sample were also less likely than men to achieve stable 1-year cessation if the couple had rated partner support at baseline as coercive or unhelpful Given known gender differences in relapse risk, cessation interventions for health-compromised female smokers might profitably include partners in addition to the smokers themselves.

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

In a laboratory smoking experiment. 25 couples in which 1 or both partners continued to smoke despite 1 of them having heart or lung disease discussed a health-related disagreement before and during a period of smoking. Immediately afterward, the partners used independent joysticks to recall their continuous emotional experience during the interaction while watching themselves on video. Participants in dual-smoker couples reported increased positive emotion contingent upon lighting up, whereas those in single-smoker couples reported the opposite. The results highlight the role of smoking in close relationships, particularly in regulating emotional closeness when both partners smoke. Attention to this fit between symptom and system may be useful in helping couples achieve stable cessation. Keywords: health-compromised smokers, couple interaction, emotion regulation, symptom-system fit

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jsat.2006.05.012 Byline: Varda Shoham (a), Michael J. Rohrbaugh (a), Sarah E. Trost (b), Myra Muramoto (c) Keywords: Smoking cessation; Family consultation; Health-compromised smokers Abstract: Although spousal support predicts the success of a smoker's cessation efforts, 'social-support' interventions based on teaching partners better support skills have had consistently disappointing results. We examined the potential utility of a family consultation (FAMCON) intervention based on family-systems principles in a treatment-development project involving 20 couples in which one partner (the primary smoker) continued to smoke despite having or being at significant risk for heart or lung disease. The 50% rate of stable abstinence achieved by primary smokers over at least 6 months exceeds benchmark success rates reported in the literature for other comparably intensive interventions, suggesting that a couple-focused intervention different in concept and format from social-support interventions tested in the past may hold promise for health-compromised smokers. The FAMCON approach appeared particularly well suited to female smokers and smokers whose partner also smoked -- two subgroups at high risk for relapse. Author Affiliation: (a) Department of Psychology, University of Arizona, Tucson, AZ 85721-0068, USA (b) Department of Psychology, Cardinal Stritch University, Milwaukee, WI, USA (c) Department of Family and Community Medicine, University of Arizona, Tucson, AZ, USA Article History: Received 8 March 2006; Revised 5 May 2006; Accepted 14 May 2006

Sex role differences in distress may vary by gender. Couples with one partner experiencing congestive heart failure showed female-patient couples having better relationships than male-patient couples.

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

Q-sorts by experts were used to compare four structural/strategic/systemic therapy models. Results suggest that the models share a practical, strategic orientation to change, emphasizing reframing, but attach different importance to history, inference, abstraction, and contextual breadth. (Author)

Examined therapy supervision in which supervisors (N=29), observing through one-way mirror, telephoned in suggestions to therapist during session. Found supervisors attached most importance to parsimony, clarity, and timing of phone-ins and affirmed supervisor's responsibility to clients in crisis, advocated flexibility in how therapists use phone-ins, and underscored parallel nature of supervisor-therapist and therapist-family interaction. (ABL)

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