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Tseng CF, Miller DL, Huerta P, PettyJohn ME, Yzaguirre MM, Agundez JC, Wittenborn AK. Recruitment strategies in couple intervention studies: A systematic review of recruitment methods and sample characteristics in the United States from 2015 to 2020. FAMILY PROCESS 2023; 62:880-898. [PMID: 37086013 DOI: 10.1111/famp.12885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Abstract
Including diverse participants in couple intervention studies is critical for developing an evidence base that informs best practices for all potential clients. Research has shown that subgroups of clients respond differently to different interventions and that interventions that have been adapted to fit the needs of a given population are more effective than non-adapted interventions. Unfortunately, couple intervention samples often exclude participants with marginalized identities and culturally adapted couple intervention research is limited. The lack of information about best practices for diverse client subgroups perpetuates mental and relational health disparities. We conducted a systematic review to examine recruitment strategies and sampling characteristics of diverse races/ethnicities, incomes, ages, and sexual identities. We reviewed articles published between January 2015 and December 2020. Articles were eligible for inclusion in our review if they implemented an intervention with couples in the United States. Of 4054 articles identified, 54 articles were eligible for our review. Findings suggest that couple intervention studies lack diversity across multiple identity domains (i.e., races/ethnicities, incomes, ages, and sexual identities). Further, descriptions of recruitment strategies are often vague, limiting opportunities to better understand methods used to recruit diverse samples.
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Affiliation(s)
- Chi-Fang Tseng
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Debra L Miller
- Community Mental Health for Central Michigan, Mt. Pleasant, Michigan, USA
| | - Patricia Huerta
- Human Development and Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Morgan E PettyJohn
- Center for Violence Prevention, University of Texas Medical Branch, Galveston, Texas, USA
| | - Melissa M Yzaguirre
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - J C Agundez
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Andrea K Wittenborn
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
- Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, Michigan, USA
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Harris SM. State of research in MFT: Thoughts from the Editor's Chair: This article is a modified transcript of the keynote address given by Dr. Steven M. Harris, Editor of the Journal of Marital and Family Therapy, at the inaugural annual meeting of the Intervention Research Topical Interest Network of the American Association for Marriage and Family Therapy. The meeting was held on October 5, 2022 at the Kellogg Center on the campus of Michigan State University. JOURNAL OF MARITAL AND FAMILY THERAPY 2023; 49:5-17. [PMID: 36584074 DOI: 10.1111/jmft.12626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The Editor of JMFT discusses the state of research in systemic family therapy.
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Orlowski EW, Friedlander ML, Megale A, Peterson EK, Anderson SR. Couple and family therapists’ experiences with Telehealth during the COVID-19 pandemic: a phenomenological analysis. CONTEMPORARY FAMILY THERAPY 2022; 44:101-114. [PMID: 35400810 PMCID: PMC8978774 DOI: 10.1007/s10591-022-09640-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
Abstract
In designing this study, we aimed to obtain a rich, phenomenological understanding of the experiences of couple and family therapists who transitioned their practice to telehealth due to the COVID-19 pandemic. Twelve experienced therapists from the U.S., Spain and Australia were interviewed in depth about their experiences of this transition, particularly how they developed and maintained therapeutic alliances in a virtual context with couples and families suffering pandemic-related hardships. The qualitative analysis identified 40 themes reflecting participants’ initial impressions of telehealth and their positive and negative reactions and adjustments to practicing remotely. Upon overcoming some initial wariness about providing services virtually, many participants described advantages to this way of working with families. Indeed, participants were creative in adjusting to this novel therapy modality, finding new ways to connect emotionally with their clients, to work meaningfully with children, to assess in-session dynamics, and to ensure their clients’ privacy and safety. Notably, several participants commented on the relatively slower development of alliances with new cases and the challenge of repairing split alliances between family members. Many of these difficulties were described as due to having minimal access to their clients’ raw emotions and the inability to use typical systemic interventions, such as moving family members around physically. Participants also reflected on being a “participant observer” to the upheaval caused by the pandemic, a distressing experience they shared with the families in their care.
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Affiliation(s)
- Edmund W. Orlowski
- Department of Educational and Counseling Psychology, University at Albany/SUNY, Albany, USA
| | - Myrna L. Friedlander
- Department of Educational and Counseling Psychology, University at Albany/SUNY, Albany, USA
| | - Allison Megale
- Department of Educational and Counseling Psychology, University at Albany/SUNY, Albany, USA
| | - Emily K. Peterson
- Department of Educational and Counseling Psychology, University at Albany/SUNY, Albany, USA
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4
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Dwanyen L, Holtrop K, Parra-Cardona R. Reducing mental health disparities among racially and ethnically diverse populations: A review of couple and family intervention research methods (2010-2019). JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:346-365. [PMID: 34854480 PMCID: PMC10460517 DOI: 10.1111/jmft.12573] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/01/2021] [Indexed: 06/13/2023]
Abstract
Racially and ethnically diverse and globally underserved populations continue to experience mental health disparities. The goal of this review was to examine the extent to which diverse populations were included in couple and family intervention research over the past decade and whether these studies were conducted with attention to issues of diversity. We performed a review of 271 articles reviewed in the current special issue on the efficacy and effectiveness of couple and family interventions across 11 mental health topics. Overall, only 68 of the 271 (25%) articles included predominately racial/ethnic minority samples or globally underserved populations. Among articles (n = 60) describing US-based research with racial/ethnic minority samples, there was a pattern of inattention to methodological considerations relevant to diverse populations. Although some progress was noted, more research is necessary. Specifically, we call for research that advances social justice by using critically conscious methods to promote mental health equity.
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Affiliation(s)
- Lekie Dwanyen
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Kendal Holtrop
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Ruben Parra-Cardona
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
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Tseng CF, PettyJohn ME, Huerta P, Miller DL, Agundez JC, Fang M, Wittenborn AK. Representation of Diverse Populations in Couple and Family Therapy Intervention Studies: A Systematic Review of Race/Ethnicity, Sexual Orientation, Age, and Income in the United States from 2014 to 2019. FAMILY PROCESS 2021; 60:424-440. [PMID: 33434313 DOI: 10.1111/famp.12628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Disparities in mental health care among marginalized populations have been well-documented. Without research designed to study interventions for diverse populations, disparities in the quality of services will persist. A systematic review of articles evaluating couple and family therapy (CFT) interventions was conducted to evaluate the representation of diverse populations. More specifically, researchers sought to examine race/ethnicity, sexual orientation, income level, and age of sample participants. One hundred ninety-six studies evaluating CFT interventions in the United States in ten journals were included in the analysis. Findings indicate that family therapy research is more representative of racial minority and low-income participants compared with studies of couple interventions. Couple therapy research is often still conducted with predominately white, middle- to high-income samples. Following whites, African Americans and Hispanic/Latinos were the most common racial/ethnic groups included in both couple therapy research and family therapy research. Participants in same-sex relationships were absent from family intervention research and under-researched in couple intervention studies. Only one couple therapy study recruited a sample in which the average age was late adulthood. These findings are cause for concern given the widening mental health disparities in the United States.
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Affiliation(s)
- Chi-Fang Tseng
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Morgan E PettyJohn
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Patricia Huerta
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Debra L Miller
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Juan Carlos Agundez
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Meng Fang
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Andrea K Wittenborn
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
- Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA
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Harris SM, Hubbard AK. JMFT Annual Report 2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2020; 46:732-738. [PMID: 33141961 DOI: 10.1111/jmft.12459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Steven M Harris
- Department of Family Social Science, University of Minnesota
| | - Aimee K Hubbard
- Department of Family Social Science, University of Minnesota
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Burgoyne N, Cohn AS. Lessons from the Transition to Relational Teletherapy During COVID-19. FAMILY PROCESS 2020; 59:974-988. [PMID: 32692867 PMCID: PMC7404738 DOI: 10.1111/famp.12589] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
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.
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Affiliation(s)
- Nancy Burgoyne
- The Family Institute at Northwestern UniversityEvanstonILUSA
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Barbato A, D'Avanzo B. The Findings of a Cochrane Meta-Analysis of Couple Therapy in Adult Depression: Implications for Research and Clinical Practice. FAMILY PROCESS 2020; 59:361-375. [PMID: 32294797 DOI: 10.1111/famp.12540] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The association between depressive symptoms and distressed intimate relationships supported the assumption that couple therapy, by focusing on the interpersonal context of depression, might be more effective as a treatment for depression than individual psychotherapy or drug therapy. This issue was addressed by a Cochrane meta-analysis assessing the evidence from clinical trials of couple therapy for depression in comparison with individual psychotherapy, drug therapy, and no/minimal intervention, including fourteen studies with 651 participants. No study was found free of bias and the quality of the evidence was low, with major problems of small sample sizes, missing outcome data, selective reporting, lack of information on random sequence generation and allocation concealment, recruitment of people not representative of clinical practice, and allegiance bias. The meta-analysis showed that both couple therapy and individual psychotherapy improved depressive symptoms at end of treatment and after 6 months or longer, with moderate effect sizes, without any difference between the two treatments. Couple therapy was more effective in reducing couple distress. This effect was larger in studies with distressed couples only and should be considered as relevant in its own right. Couple therapy is a viable option for the treatment of a depressed partner, especially in discordant couples. Future research should address several issues left open to provide a sound empirical foundation for clinical practice.
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Affiliation(s)
- Angelo Barbato
- Unit for Quality of Care and Rights Promotion in Mental Health, Istituto di Ricerche Farmacologiche Mario Negri Sede di Milano, Milano, Italy
| | - Barbara D'Avanzo
- Unit for Quality of Care and Rights Promotion in Mental Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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