Depression is a common presenting problem, often affected by couple interactions in unique ways. However, research in the area of romantic relationship functioning and depression often replicates previous research or consists of literature reviews, limiting the clinical relevancy. The purpose of this preliminary study is to expand the research on the effects of relational processes on depression treatment outcomes. We tested whether initiator tendency, attachment anxiety, attachment avoidance, and marital satisfaction predicted improvement in depression for women with Major Depressive Disorder enrolled in a depression treatment clinical trial (n = 17). Women completed treatments of either pharmacotherapy or combined Emotionally Focused Therapy for couples and pharmacotherapy. We found that higher baseline levels of partner initiator tendency resulted in less change in depression (worse outcomes), regardless of treatment type and that higher baseline levels of attachment avoidance predicted better depression outcomes in treatment. Marital satisfaction, however, was not linked to change in depression. Initiator tendency is discussed as a critical romantic relationship factor for depression treatment outcomes.

Therapists often have to deal with situations that make them uneasy to leave their clients on their own. They can go home and wonder what their clients are doing, whether they are safe, have a place to stay, even whether or not they are fighting. These thoughts can be overwhelming for the therapist. They may think about their clients' safety, they may also be worried about their own professional way of dealing with these situations, and its implications for them as clinician. The aim of this paper is to assist therapists to manage their own anxiety and to help them help their clients in between sessions in difficult situations such as suicidality, child abuse and neglect, intimate partner violence, crisis and stress management.

The aim of this paper is to understand the effects of childhood sexual abuse on a survivor's later life. For understanding and treating the emotional distress and interpersonal problems resulting from childhood sexual abuse, attachment theory provides a valuable framework. When this framework is combined with family systems theory, it can help therapists understand the family context where sexual abuse occurs and how this affects health and functioning throughout the lifespan. Case examples of female adult sexual abuse survivors are also explored, with insight from the intersection of systems and attachment theories.

Research on relationship stability usually considers the effect of couple outcomes and individual differences on relationship stability in isolation from each other. These separate bodies of research often lead to inconsistent results. In order to better understand relationship stability and explain inconsistencies in the literature, it is important to investigate more complex models that integrate couple outcomes and behaviors with individual differences. Motivated by these considerations, we examined the complex interplay between personal characteristics, couple interactions, and relationship stability. In particular, we investigated the relationships among investment model, big five personality traits, attachment dimensions, relationship factors and relationship stability. Participants of this study included 162 individuals (Female N=117) who are currently in a relationship from a large Midwestern university campus. Analyses were conducted using Structural Equation Modeling. Examination of the structural path parameters indicated that attachment had significant direct effect on personality, relationship factors, and relationship stability. Personality also had a significant direct effect on relationship stability. Finally personality had no direct effect on relationship factors and relationship factors had no direct effect on relationship stability. These results suggest that the effect of personality on relationship stability is direct, rather than being mediated by relationship factors.

There are several important issues influencing the holding of confidences in family therapy, among them are privacy, family secrets, confidentiality, and privileged communication. Clinicians need to be aware that breach of confidentiality is considered a high-risk area in clinical practice, which could be brought within a "low profile" malpractice configuration by adopting certain risk management techniques. Family therapists have an obligation to maintain their practice under the guidance of professional ethics, agency policies/procedures, and within emerging judicial parameters. The questions of confidentiality that confront family therapists have no clear and easy answers and the legal dilemma is ever present.

This article presents reflections on and a critique of the recent revision of the AAMFT Code of Ethics on the multiple relationship ethical standard. A brief historical overview of terminology and the debate surrounding "dual" and "multiple" relationship ethical rules in marriage and family therapy is provided. The term "exploitation" is also delimited. Ethical principles and a set of standards addressing "detrimental" versus "potentially beneficial" interactions are introduced, deriving from works in other mental health professions. The article recommends: (a) the terms "dual" and "multiple" relationships should be abandoned; (b) the ethical principles underlying the AAMFT Code of Ethics need to be examined; and (c) the debate on the topic of detrimental therapist-client interactions in marriage and family therapy needs to be revisited, especially in light of a "positive ethics."

Research examining intimate partner violence (IPV) has lacked a comprehensive theoretical framework for understanding and treating behavior. The authors propose two complementary models, a treatment approach (Motivational Interviewing, MI) informed by a theory (Self-Determination Theory; SDT), as a way of integrating existing knowledge and suggesting new directions in intervening early with IPV perpetrators. MI is a client-centered clinical intervention intended to assist in strengthening motivation to change and has been widely implemented in the substance abuse literature. SDT is a theory that focuses on internal versus external motivation and considers elements that impact optimal functioning and psychological well-being. These elements include psychological needs, integration of behavioral regulations, and contextual influences on motivation. Each of these aspects of SDT is described in detail and in the context of IPV etiology and intervention using motivational interviewing.

Service providers and researchers note that youth with substance abuse problems are difficult to engage in treatment and, when engaged, often drop out early. Estimates of the alcohol and drug abuse rate of runaway youth range from 70% to 95%. This study evaluated predictors of therapy attendance in a sample of substance abusing youth recruited through two southwestern runaway shelters. Runaway youth and their families (N = 36) were engaged into a 15-session ecologically-based family therapy (EBFT) intervention. Fewer days between the pretreatment assessment and the first therapy session, as well as less perceived parental care, predicted more therapy sessions attended. No relationship was found between level of substance use and treatment attendance. The findings highlight the importance of engaging families in therapy soon after the youth's arrival to the shelter, as treatment motivation may decrease as the crisis lessens.

Although there is a rich body of literature on trauma and health, limited research has investigated the variables of gender, trauma symptoms, physical health, mental health, and daily stress together in a community sample. Considering the deleterious effects of trauma on health, our overarching inquiry was whether trauma symptoms can predict overall mental and physical health with attention to gender and daily stress as potential moderators. Participants ( = 103; 50.5% women) completed self-report measures of trauma symptoms, mental health, physical health, and daily stress, along with demographic information. Trauma symptoms predicted 25.2% of the variance in general health symptoms. Gender significantly added to the variance accounted for, but daily stress was not significant in the model. Trauma symptoms predicted 37.1% of the variance in mental health symptoms. Daily stress significantly added to the model, but gender did not. Results are interpreted through the integration of family stress theory and feminist frameworks, adding to the literature by further illuminating the relationships between gender, daily stress, health symptoms, and trauma in a community sample.

The provision and receipt of emotional support demonstrates benefits for relationships; however, little research has investigated how either global or day-to-day spousal support influences marital stability. This project assessed how global perception of support from a partner and daily provision and receipt of emotional support over 1 week contributed to divorce 10 years later, accounting for demographic covariates. There were no significant associations of support variables with future divorce. Greater education attainment was the only factor significantly associated with decreased risk for divorce. Results suggest that despite potential short-term benefits, global and daily support may not predict long-term marital stability.

Firefighters demonstrate heightened rates of posttraumatic stress disorder, depression, anxiety, and alcohol consumption, compared to the general population. This study examined whether firefighters who were satisfied with their romantic relationships experienced lower severities of commonly reported mental health symptoms compared to firefighters who were dissatisfied with their relationships. The sample included 200 firefighters (97% male; =41.4, =9.3) currently married or living with a romantic partner who completed self-report measures via online survey. An established cut-off score of 13.5 (Couples Satisfaction Index-4) was used to define groups. Firefighters who indicated that they were dissatisfied reported higher levels of all measured outcomes.