Dana N. Christensen

Postmastectomy Couple Counseling: An Outcome Study of a Structured Treatment Protocol

The evidence suggests that medical treatment of breast cancer produces psychosocial trauma in both the patient and her husband due to the loss of the breast and/or physical disfigurement. This study evaluated the effects of a structured couples treatment program on the psychosocial discomfort following a mastectomy. Twenty couples were randomly assigned to experimental and control conditions and were administered an assessment battery before and after treatment that measured change in marital happiness, sexual satisfaction, depression, self-esteem, helplessness, anxiety, alienation, and emotional discomfort. An analysis of variance yielded no significant difference between experimental and control conditions on any of the dependent variables. A supplemental analysis of covariance using the pretest as a covariate found that the treatment reduced emotional discomfort in both partners, reduced depression in the patient, and increased sexual satisfaction for both spouses. Recommendations were made for further study of the treatment, controlling for the subjects level of distress prior to treatment.

Solution-Based Casework in Child Welfare: Preliminary Evaluation Research

ABSTRACT The purpose of this research was to evaluate the effectiveness of the Solution-Based Casework (SBC) model for child welfare practice. Method: Two case review studies were conducted. The first study compared 48 cases from two worker groups differing in degree of training and implementation of the SBC model. The second study compared the outcomes of 100 high-risk cases based on implementation level of the SBC model. Results: These two studies found that SBC can be implemented across cases differing in type of maltreatment, comorbid factors, and other demographic variables. Results indicated that workers were more actively involved in case planning and service acquisition for families when SBC was implemented. Families were significantly more compliant with casework requirements and achieved more case goals and objectives. The model was particularly effective for families with a history of chronic involvement with the child welfare system. Conclusions: This research supports the effectiveness of SBC for promoting the worker–client relationship and goal achievement for complex child welfare cases.

The impact of the Solution Based Casework (SBC) practice model on federal outcomes in public child welfare

OBJECTIVE To test the effects of the Solution-Based Casework practice model on federal outcomes of safety, permanency and well-being. The Solution-Based Casework model combines family development theory, solution-focused skills and relapse prevention for the casework process in child protection. METHOD 4,559 public child welfare cases were reviewed through a CQI case review process. RESULTS This study found that cases with high levels of fidelity to the model demonstrated significantly better outcomes in the areas of child safety, permanency and well-being and exceeded federal standards, while cases with low fidelity to the model failed to meet federal standards. CONCLUSION Components of the Solution-Based Casework were significant predictors of these federal outcomes and accounted for variance in these outcomes better than any other casework process factors.

The impact of the within my reach relationship training on relationship skills and outcomes for low-income individuals.

A federal grant was awarded to provide the Within My Reach healthy relationships curriculum to low-income, at-risk individuals involved with various social service agencies. The effectiveness of this curriculum was evaluated for 202 participants through measures of training and relationship outcomes pre-, immediately post- and 6 months posttraining. Participants experienced high levels of training satisfaction; significant increases in knowledge, communication/conflict resolution skills, and relationship quality; as well as a trend in the reduction of relationship violence. An important implication of this research is that MFTs may broaden their service delivery to at-risk individuals by collaborating with community agencies to adapt established relationship enhancement programs, evidence-based tools, and principles that complement traditional couples therapy.

Understanding divorce stress on children: Implications for research and practice

Abstract This paper considers factors that make children “at risk” for postdivorce maladjustment. The risk factors include (a) demographic variables of sex, age and socioeconomic status; (b) predivorce family functioning; (c) postdivorce relationship with the ex-spouse; (d) postdivorce parentchild interaction; and (e) social support systems. Treatment programs incorporating these factors are briefly described. Recommendations are provided for the clinician and researcher.

An Evaluation of Healthy Relationship Education to Reduce Intimate Partner Violence

This research evaluated the impact of the Within My Reach healthy relationship education program on intimate partner violence for 419 high-risk adults in an urban area. Key outcomes such as relationship knowledge, communication/conflict resolution skills, relationship quality, and physical and emotional abuse were evaluated through survey research immediately post- and 6-months postprogram participation. Results suggest that participation in the Within My Reach program is associated with a statistically significant decrease in physical and emotional abuse, as well as isolation behaviors. Differences by participant demographics and the role of communication skills and relationship quality as mediators of these outcomes are also discussed.

Integrating Couple Teamwork Conversations Into Child Welfare Practice

ABSTRACT This article summarizes the importance of and challenges to addressing couple teamwork issues in the child welfare population. Although there is substantial evidence to support the importance of healthy adult relationships for child well-being and the prevention of child maltreatment, there are a number of barriers to addressing these couple relationships in child welfare. These barriers include diverse family configurations and uncertain relationship commitments, the individual presentation of maltreatment, and worker discomfort with these issues. Additionally, there are few relationship programs designed specifically for low income individuals, and a number of policy and environmental constraints affect couple relationships in this population. However, building upon a comprehensive practice model for child welfare known as Solution Based Casework, this article describes casework skills to initiate and maintain couple teamwork conversations. These initiation skills include assessing patterns in everyday life, building partnerships with families, normalizing and externalizing problems, and tracking interactional sequences related to parent teamwork. The maintenance skills described include maintaining a common language, utilizing family team meetings, recognizing small steps of change, keeping treatment providers on track, and making the most of setbacks. These practical guidelines will assist child welfare professionals with building couple teamwork for child protection.

Components of the Solution-Based Casework Child Welfare Practice Model That Predict Positive Child Outcomes

While a number of studies have shown the efficacy of the solution-based casework (SBC) practice model for child welfare (e.g., Antle, Christensen, van Zyl, & Barbee, 2012), the current analysis examines the top ranked behaviors in cases reaching outcomes of safety, permanency, and well-being in both high adherence and low adherence cases. Sixteen top behaviors seem to have the greatest impact on outcomes, all of which are key to the three major theoretical orientations utilized in SBC. Thus, these results not only narrow in on the key behaviors that drive success in the practice model, but also shows the utility of the theoretical underpinnings of the practice model.

RETHINKING WHAT IT MEANS TO SPECIALIZE IN MFT AT THE MASTER'S LEVEL

There has been an increase in specialization programs that offer an introduction to marital and family therapy at the masters level. These programs are often referred to as major, minor, track, sequence, or area of emphasis. They typically consist of one or two theory/overview courses housed within a traditional counseling/therapy department. This paper discusses some of the problems with this model and then offers an alternative that attempts to improve conceptual integration and skill development. The alternative model discussed is an interdisciplinary three-course sequence in family assessment concepts and skills. Course descriptions and objectives are provided and discussed.

Enhancement of Reducing the Risk for the 21st Century: Improvement to a Curriculum Developed to Prevent Teen Pregnancy and STI Transmission

To ensure that Reducing the Risk, a successful teen pregnancy prevention education curriculum, remains relevant for todays youth, covers all information youth need to know in order to make better choices, and is delivered in a standardized way, adaptations were made and enhancements were added. This article describes results of a pilot execution of initial adaptations to Reducing the Risk with 13 youth from impoverished neighborhoods between the ages of 14 and 18. After each pilot day, a focus group was held with these 13 youth and further adaptations and enhancements were added to the curriculum. The full adapted and enhanced version of Reducing the Risk was then tested as part of a larger efficacy study utilizing a three-arm cluster randomized controlled trial comparing the enhanced Reducing the Risk curriculum version with another curriculum that embeds sex education in the context of healthy relationship skill building, Love Notes, and a control condition curriculum. In order for other sites to replicate the work, this article details the findings from focus groups with youth participants in the pilot training that led to changes and additions in the curriculum. All changes and additions are described at length in this article.