Shayne R. Anderson

A dyadic analysis of the between- and within-system alliances on distress.

This study examines the relationship between the therapeutic alliance and distress using the couple rather than the individual as the unit of analysis. One hundred and seventy-three couples receiving treatment for relational distress at two university clinics participated in this study. The actor-partner interdependence model was used to analyze the relationship of each partners between- and within-system alliance scores and distress at session four. Results provide support for actor effects on relational distress for both male and female partners and for actor effects on psychological distress for female partners. Limited support was found for partner effects on distress. Furthermore, results indicate that the alliance between partners is a stronger predictor of improvement in early sessions in comparison with the alliance between the individual and the therapist.

The Development of a Reliable Change Index and Cutoff for the Revised Dyadic Adjustment Scale

The Revised Dyadic Adjustment Scale (RDAS; Busby, Crane, Larson, & Christensen, 1995) is a measure of couple relationship adjustment that is often used to differentiate between distressed and non-distressed couples. While the measure currently allows for a determination of whether group mean scores change significantly across administrations, it lacks the ability to determine whether an individuals change in dyadic adjustment is clinically significant. This study addresses this limitation by establishing a cutoff of 47.31 and reliable change index of 11.58 for the RDAS by pooling data across multiple community and clinical samples. An individual whose score on the RDAS moves across the cutoff changes by 12 or more points can be classified as experiencing clinically significant change.

Defining High Conflict

The term high conflict is used regularly across various literatures; such as divorce, family court, and psychotherapy; to describe relationships that are mired in conflict. Despite its widespread use, the term has not been precisely defined in a clinically meaningful way. This article offers a definition of high conflict based on a synthesis of previous literatures related to high conflict, observations of court personnel, and the authors’ own clinical experiences working with this population. A case study illustrates the pervasive negative exchanges and hostile insecure emotional environment that characterize these couples. The implications of this definition for clinical practice are also discussed.

Grandparent-Grandchild Relationships: From Families in Contexts to Families as Contexts

Relationships between grandparents and grandchildren provide an excellent framework for integrating family theory and family methodology. Systematic differences as a function of age, gender, life expectancy, and health as played out through generations suggest some topics are best studied by disentangling variability between and within families. Using data from 1,345 grandchildren (52% girls, mean age 13.69 years, range 9 to 20) reporting on 3,664 grandparents, we compare results obtained from studying grandparent-grandchild relationships individually and at the family level. Results suggest important predictors of relationship quality at the within-subject and between-subject levels. Future research should more carefully integrate each level into theory and design.

Assessing Physical Performance in Centenarians: Norms and an Extended Scale from the Georgia Centenarian Study

Centenarians display a broad variation in physical abilities, from independence to bed-bound immobility. This range of abilities makes it difficult to evaluate functioning using a single instrument. Using data from a population-based sample of 244 centenarians (M Age = 100.57 years, 84.8% women, 62.7% institutionalized, and 21.3% African American) and 80 octogenarians (M Age = 84.32 years, 66.3% women, 16.3% institutionalized, and 17.5% African American) we (1) provide norms on the Short Physical Performance Battery and (2) extend the range of this scale using performance on additional tasks and item response theory (IRT) models, reporting information on concurrent and predictive validity of this approach. Using the original SPPB scoring criteria, 73.0% of centenarian men and 86.0% of centenarian women are identified as severely impaired by the scales original classification scheme. Results suggest that conventional norms for older adults need substantial revision for centenarian populations and that item response theory methods can be helpful to address floor and ceiling effects found with any single measure.

The Intersection of Therapy Constructs: The Relationship Between Motivation to Change, Distress, Referral Source, and Pressure to Attend

Psychotherapy is a generally effective form of mental health treatment, yet difficulties with engagement continue to plague the field. Poor outcomes, including premature termination, are more likely to be achieved by poorly motivated clients (Prochaska & DiClemente, 1992) and highly distressed individuals and couples (Tambling & Johnson, 2008). This study examined links between motivation to change, initial levels of distress, referral source, and pressure to attend therapy in an archival sample of 587 people who attended therapy. Results indicated a relationship between distress and motivation and between the perceived pressure felt by a client and motivation to change.

Examining Attachment Avoidance and Attachment Anxiety Across Eight Sessions of Couple Therapy

This study examined initial levels of attachment anxiety and avoidance, as well as their patterns of change, across eight sessions of couple therapy. Participants were 461 couples in a treatment-as-usual setting. Dyadic latent growth modeling was used to determine whether couples started therapy at similar levels of attachment anxiety and avoidance and whether attachment anxiety and avoidance changed. An actor partner interdependence model was used to see whether partner attachment anxiety was related to avoidance. Results showed relative stability of attachment anxiety and avoidance over the course of therapy, with the only change being a slight decline in attachment anxiety among women. Results showed that a persons attachment anxiety was not related to their partners avoidance and vice versa.

Expectations About Couple Therapy: A Qualitative Investigation

Little is known about clients’ expectations about couple therapy. The present study provides the qualitative results of a mixed-methods investigation into client expectations about couple therapy. Participants were 20 individuals from 10 couples enrolled in couple therapy. Participants were interviewed with their partner prior to the first session of couple therapy using a semi-structured interview. Results of the qualitative content analysis of interview data indicated that couple members formed pre-therapy expectations about their therapist, the therapy process, therapy topics, partner behavior, and therapy outcomes. Expectations were fairly consistent across couples, with some diversity in expectations specific to couples’ presenting problems.

Client-Reported-Presenting Problems at an MFT Clinic

It is useful for clinicians and researchers to know why clients present for therapy in order to devise effective treatments. Using a feminist-informed, client-centered framework, this study provides information about clients’ perspectives on key presenting problems using self-report data from individuals, families, couples, and high-conflict coparenting dyads from a university-based counseling center. Clients most frequently reported anxiety/stress as the chief presenting problem. A number of people listed having been coerced into treatment or someone else’s problem as their chief concern. Common presenting problems varied by modality and were associated with the clients’ perceived pressure to attend therapy, readiness to change, dyadic adjustment, anxiety, and depression.

Treatment Duration and Termination Status Among Clients in a University-Based Counseling Center

Researchers have long been interested in understanding for whom therapy works and why. This study sought to identify ways in which clients differ with regard to treatment outcomes such as treatment length, success, and termination status. Data for this study were taken from the client documents completed prior to the first session of therapy and the therapist-completed termination summary for 305 cases from a university-based marriage and family therapy clinic. Results suggest that soft-mandated and voluntary clients show similar success rates in treatment. Also, cases that terminated unilaterally had the lowest success rates, though rates were approximately equal across modality. This study provides information about treatment across different client characteristics and modalities.