Jonathan G. Sandberg

Daily Hassles, Intimacy, and Marital Quality in Later Life Marriages

This study addressed the relationship between daily stress, intimacy, and marital quality in mature marriages in which the ages of husbands and wives ranged from 55 to 75 years. Four hundred and seventy-two individuals married to each other and randomly sampled from all fifty states completed the Kansas Marital Satisfaction Scale, the Personal Assessment of Intimacy in Relationships, and the Hassles and Uplifts Scale. Findings indicated that daily stress was negatively related to marital quality for both wives and husbands, and that intimacy mediated the relationship between stress and marital quality for both husbands and wives. Implications for marriage and family therapy practice are explored.

Problems That Couples Bring to Therapy: A View across the Family Life Cycle.

This study examined reports of marital problems from couples at different stages of the life course. Data were collected from 160 couples during intake at a family therapy clinic. Couples were asked to indicate their presenting problem, as well as their level of severity in 14 problem areas, such as communication and financial issues. Results indicated that presenting problems were generally the same, regardless of whether the couple was newly married, in the child-bearing years, or married over a decade. Moreover, wives reported more problems in their relationships than did husbands, especially among wives married longer than 10 years.

In search of a marital distress model of depression in older marriages

Traditional models of depression in later life describe the illness in terms of intra-physiologic and intra-psychic processes. In an effort to investigate and describe the interpersonal nature of depression, data on levels of depression, stress, health, and marital distress in 535 married couples was analyzed. Specifically, the results showed that marital distress was significantly associated with levels of depression for both partners and that wives distress was also significantly related to husbands depression. Results also showed, with a few exceptions, that levels of stress and/or health in either partner were directly and indirectly associated with depression for husbands and wives. Implications for clinical practice with and future research on later life couples experiencing depression are discussed.

Diabetes management assisted by telemedicine: patient perspectives.

This qualitative research focuses on understanding the experiences of elderly patients with diabetes who participated in a telemedicine case management intervention, to better understand the barriers to success of telemedicine with the elderly. Telephone interviews were conducted with elderly patients with diabetes prior to and 6 and 12 months after participating in a case management intervention delivered via a computer that allowed them to teleconference with a nurse and dietitian, upload blood glucose and blood pressure data, and access educational materials. Qualitative analyses revealed that patients enrolled primarily because healthcare providers encouraged them. Their goals were to improve diabetes control, with few expectations of an effect on emotional health or family relationships. After involvement, they particularly valued the emphasis on monitoring of health outcomes and supportive contact with diabetes staff to encourage, remind, and answer questions. Findings illustrate the potential value of telemedicine with elderly patients with diabetes, if supported by primary care providers and including consistent, supportive interactions with knowledgeable diabetes healthcare providers.

Research practices of marriage and family therapists

To date, no studies have described the attitudes and research practices of marriage and family therapists (MFTs). A questionnaire was mailed to a random sample of 100 clinical members of the American Association for Marital and Family Therapy in each of 3 geographically diverse states. The questionnaire assessed clinicians willingness to participate in research projects and their use of research in clinical practice. These data provide a profile of research practices of MFTs. Results indicated a moderate level of research involvement among practitioners. The hypothesis that training in research methods would predict research involvement was only partially supported.

A Qualitative Study of the Experiences and Satisfaction of Direct Telemedicine Providers in Diabetes Case Management

Telehealth interventions are feasible and efficacious. While patients are the focus of both quantitative and qualitative studies that assess their response to telehealth, little is known about the view of providers of telehealth services. The purpose of this study was to better understand the experiences of providers and the factors that they perceive to contribute to the success of telehealth interventions as well as to their own satisfaction. Face-to-face or telephone interviews were conducted with 10 diabetes educators (nurses and dietitians) who served as providers of a telemedicine case management intervention for older adults who have diabetes. Qualitative analyses revealed that providers were very satisfied with their experience and felt their efforts with patients were generally successful. Providers also identified a number of unique benefits to telehealth interventions. These included opportunities for more frequent contact with patients, greater relaxation and information due to the ability to interact with the patients in their own homes, increased ability to reach the underserved, more timely and accurate medical monitoring, and improved management of data. The primary disadvantages of telehealth they identified were technology problems and a concern about the lack of physical contact with patients. Findings illustrate providers perspectives on the unique advantages of telehealth and offer insight as to how to make telehealth interventions more effective, as well as more satisfying for those who do the day-to-day work of providing the interventions.

He Said, She Said

Abstract Couple research has shown spousal support is associated with better treatment adherence, illness adaptation and blood sugar control in studies of individuals with diabetes. However, few studies have investigated gender differences and how they impact spousal supporting behaviors. In this study, seventy-four individuals (patients and spouses) participated in semi-structured interviews regarding spousal support relating to diabetes management. Transcripts of these interviews were rigorously coded and analyzed by a team of researchers. A sampling of quotes is provided illustrating gender differences in the areas of dietary and regimen specific support as well as perceptions of nagging behavior. Potential explanations for differences and implications for clinicians are discussed including the role of marital therapists on collaborative treatment teams.

Alternative Methodologies in Research Literature Review: Links Between Clinical Work and MFT Effectiveness

Traditionally, good outcome research has referred to laboratory-based, controlled studies that report the efficacy of a given treatment on a specific population. Although useful and needed in the struggle to establish MFTs as accepted mental health service providers, this type of research does not address whether MFT is effective in real world settings. In order to highlight the clinical and professional relevance of existing effectiveness research, this article reviews 15 years of clinical research in three major family therapy journals. The results suggest that 1) MFT effectiveness is under-represented in major review articles, 2) clinicians can use a variety of methodologies to establish the effectiveness of their work, and 3) more research is needed that investigates how and why MFT works in real world settings. Implications for practice and future research are discussed.

An Addendum to the 1997 Outcome Research Chart.

In 1997, an article in the American Journal of Family Therapy was published that summarized the outcome research regarding the efficacy of specific approaches of Marriage and Family Therapy in treating certain disorders (Sandberg et al ., 1997). The article updated the original matrix of findings reported by Gurman, Kniskern, and Pinsof (1986) by reviewing the relevant research through 1995, and provided a summary of findings in an updated version of the original 1986 chart. Since the publication of that article (Sandberg et al ., 1997), feedback has been received from a number of MFT researchers who pointed out some omissions and oversights in the updated chart. After responding to their feedback, it has been concluded that a number of changes must be made to the 1997 summary chart to present a more complete summary of MFT outcome research up through 1995.

The Impact of Texting on Perceptions of Face-to-Face Communication in Couples in Different Relationship Stages

The authors examine both actor and partner effects of the use of texting on face-to-face communication behaviors in three groups: dating couples (n = 1,217), engaged couples (n = 2,167), and married couples (n = 1,336). Data were taken from the RELATE project (www.relateinstitute.org). Overall, the more an individual used texting to discuss serious issues, broach confrontational subjects, and apologize, the more conflictual face-to-face communication behaviors existed for both themselves and their partners. Similar partner effects were found. When couples used texting to express affection, the less conflictual face-to-face communication behaviors existed for both partners. Clinical implications will be discussed.