The How-to Parenting Program teaches parents how to provide autonomy support, structure, and affiliation, the three components of the parenting style shown to be beneficial for children's mental health. Using a waitlist RCT, we assessed its impact on school-aged children's externalizing and internalizing problems. We also tested whether family composition, participating parents' gender, child age, sex, and baseline mental health modified its effects. Parents (N = 293; 80.20% mothers) were randomly assigned to the French version of the 7-week program or a waitlist condition (i.e., immediate delivery vs. end of study). Parents rated child externalizing and internalizing problems before and after program delivery, as well as 6 and 12 months later. Controlling for unbalanced covariates and baseline levels of problems, multilevel multivariate analyses revealed that compared to the waitlist, the How-to Parenting Program led to greater decreases in children's externalizing problems immediately after program delivery and that this benefit was sustained over at least 6 months. However, decreases in children's internalizing problems were similar across both conditions. Considering this RCT's methodological strengths (e.g., intent-to-treat analyses) and limitations (e.g., intervention diffusion), along with the floor effects inherent to our universal prevention approach, the How-to Parenting Program's benefits, though small in size, indicate that it could prove an effective public mental health prevention strategy.

There is substantial research linking parenting stress to reduced parental self-efficacy; however, the mechanisms under which this process unfolds are less clear. In a longitudinal, dyadic study of 144 parents and their children spanning postpartum to preschool age, we investigated whether dyadic coparenting quality (i.e., how partners work as a team to parent their children) explains the link between parenting stress and a key domain of parental self-efficacy-perceptions of emotion regulation during parenting. The study utilized self-report measures while implementing structural equation modeling (SEM) and actor-partner interdependence modeling (APIM) frameworks. Higher levels of postpartum parenting stress predicted parental perceptions of impaired emotion regulation during parenting interactions with preschoolers through poorer quality coparenting during toddlerhood; however, results suggest that this pathway might be most salient for fathers, and that other unmodeled mechanisms might explain this link for mothers. A partner pathway also emerged such that postpartum parenting stress in one partner undermined parental confidence in regulating emotions during parenting in the other partner by reducing coparenting quality. These findings suggest that coparenting quality may be an essential mechanism driving parental self-efficacy in the domain of emotion regulation, while undermining the importance of understanding what promotes or hinders parental self-efficacy, and how this can be implemented into pre-existing parenting interventions.

Since the 1980's, attachment theory has increasingly become a useful conceptual framework for systemic therapy with couples, with a wide variety of models using attachment concepts to conceptualize intervention efforts. Scholars have regularly addressed the idea of how to change generalized attachment strategies to foster more secure relating. Nonetheless, recent scholarly efforts have suggested that it may be more useful to focus on changing the security of couple interactions (i.e., attachment behaviors) rather than trying to change generalized representations. Yet relatively little attention has been given to identifying the specific, attachment-related behaviors that intervention can address within systemic family therapy (SFT). In this paper, we explore Karen Wampler's revised Adult Attachment Behavior Q-Set (AABQ-R), which identifies 80 attachment-related behaviors that typically emerge during couple interaction. More specifically, we conceptualize six broad themes of behaviors-all anchored in attachment theory-that can be of utility as SFTs work with couples: model of self, model of partner/others, signaling behaviors, attunement and responsiveness, general affective strategies, and interactional quality. In this paper, we discuss each theme within the context of research and scholarly work on attachment, explain each class of behaviors within the AABQ-R, and then provide a brief overview of potential therapeutic considerations. Our hope is that this paper will help therapists be more deliberate in their attachment-anchored work with couples.

This study examines the role of differentiation of self (DoS) in the forgiveness process within romantic relationships, focusing on its moderating function between perceived offense severity and post-offense distress. The sample included 591 Spanish participants aged between 18 and 86 years (M = 42.66, SD = 17.06), and data were collected using validated questionnaires. Findings showed that DoS significantly moderates the relationship between offense severity and negative affect, negative cognition, and avoidance/resentment, but not with the positive dimensions of forgiveness (positive affect, benevolence, or positive behavior). Individuals with low levels of DoS experienced higher emotional distress after an offense, whereas those with high levels showed greater emotional regulation and a more realistic perception of the severity of the situation. These results highlight the importance of DoS as a regulatory resource for managing negative emotional responses but not necessarily as a promoter of prosocial attitudes or reconciliation. Results suggest that strengthening DoS in couples may help reduce the emotional burden of interpersonal transgressions. Future research could contribute longitudinal designs and dyadic analyses to capture the dynamic nature of forgiveness in romantic relationships.

Becoming a parent is one of life's most significant transitions and can be a challenging period for many couples. One factor that may increase the difficulty couples experience in adjusting to parenthood is having a history of childhood maltreatment. This study explored whether a history of childhood maltreatment in either partner is associated with couples' relationship functioning as they adjust to parenthood. Structural equation modeling was used to examine the association of childhood maltreatment history with relationship and coparenting quality in both partners of 398 heterosexual couples in the United States having their first child. Relationship quality was assessed during pregnancy, and both relationship quality and coparenting quality were assessed twice during the postpartum period at 10-12 months and 2 years after birth. Father's history of childhood maltreatment was negatively associated with mother's reports of relationship quality at both time points after birth (p < 0.05), and father's maltreatment history was negatively associated with mother's reports of coparenting quality 2 years after birth (p = 0.01). Follow-up analyses accounting for the interaction of both partners' maltreatment history revealed that a combination of maltreatment in both partners was associated with poorer relationship quality reported by mothers during pregnancy and 10-12 months after birth and with poorer coparenting quality ratings by mothers 2 years after birth (p < 0.05). Results suggest that a history of maltreatment in both parents can have negative impacts on relationship and coparenting quality during the transition to parenthood, with mothers appearing more sensitive to such effects than fathers. These findings highlight the importance of assessing both parents' histories of childhood maltreatment in postpartum clinical care to better identify families at risk and tailor supports that strengthen relationship and coparenting quality.

Adverse childhood experiences (ACEs) are significant public health concerns with long-term consequences for children's mental health, physical well-being, and socioeconomic outcomes. This study examines whether younger maternal age at childbirth (≤ 24 years) is associated with children's exposure to any ACE and whether parental emotional support moderates this association. This study analyzed 2022 National Survey of Children's Health data for 32,092 children ages 6-17. Logistic models adjusted for child age, sex, US-born status, special health care needs, highest household education, family poverty level, partnered status, and any adult employment. Younger maternal age was associated with substantially higher odds of any ACE. With child-level covariates (M1), the OR was 3.20 (95% CI [2.98, 3.43]); with family-level covariates (M2), 2.14 ([1.98, 2.31]); and in the fully adjusted model (M3), 2.05 ([1.90, 2.21]). In the fully adjusted moderation model (M4), the main effect for younger maternal age remained strong (OR = 1.75, [1.49, 2.06]). This study highlighted that risk concentrates where structural disadvantage and early parenthood intersect. Emotional support did not reduce children's ACE risk. Interventions should prioritize caregiver support services and structural supports, such as income, housing, childcare, and behavioral health for young families.

Family over-involvement, defined as emotions, thoughts, and behaviors indicating an over-protection of family members and preoccupation with family legacy, is recognized as a unique yet underexplored mechanism in the intergenerational effects of trauma. The study examined the role of family over-involvement in predicting post-traumatic stress disorder (PTSD) symptoms among Holocaust descendants following the October 7 attack and during the Israel-Hamas War. Using a longitudinal prospective design, Israeli Jew descendants from two generations (second and third generation to those who were living during WWII) completed questionnaires via a web-based survey company a year before the October 7, 2023 attack (W1, 2022, N = 1071) and two and 9 months during the war (W3, December 2023, N = 582, and W4, July 2024, N = 405). Results showed significantly higher levels of family over-involvement (i.e., descendants' efforts to compensate for their ancestors' suffering, shield ancestors from further suffering, and care for family continuation) in Holocaust descendants relative to comparisons. Path analysis showed that family over-involvement mediated the effect of having a Holocaust background on PTSD symptoms in W3 and the effect of having a Holocaust background on PTSD symptoms in W4 via PTSD symptoms in W3. Moderated mediation analysis revealed that the mediation effect of the compensation subscale of family over-involvement was stronger among the second generation relative to the third generation. The findings have crucial implications by highlighting family over-involvement as a unique interpersonal mechanism behind the intergenerational effects of Holocaust trauma, which clinicians should integrate in multi-generational interventions with Holocaust families, particularly when descendants face adversity.

Despite the detrimental impact financial stress has on mental health and relationships, couples experiencing it remain an under-researched group, especially in a therapy setting. In this study, we conducted interviews with 10 participants from five couples who struggled financially during residential couple treatment in Norway. The empirical material was analyzed using interpretative phenomenological analysis (IPA) to examine couples' experiences and subjective meaning-making. The findings revealed: (a) a sense of existential threat, (b) dyadic coping strategies with advantages and costs, (c) ways in which the community of helpers both supported and hindered the families. The core finding was a pervasive sense of shame that affected how the participants perceived themselves, their relationships, and their place in society. We discuss how shame and dyadic coping can influence both the couples' relationships and their finances, and how systemic and couple therapists can contribute by highlighting positive coping strategies and directly addressing financial shame.

Relational savoring, a prevention/intervention approach that involves reflecting on positive moments of connection with another person, promotes wellbeing in the parenting relationship. In this program, parents savor memories with strong attachment content (including Secure Base or Safe Haven memories), but it is currently unknown whether the benefits of relational savoring differ as a function of memory type. Within a sample of Iranian mothers of children younger than 6, this study examines impacts of RS administered in Persian on closeness to child, parental satisfaction/competence, and maternal caregiving quality. In this randomized controlled trial, 150 mothers from a city in Iran were randomized into three 50-member groups (relational savoring-Safe Haven [RS-Safe Haven]; relational savoring-Secure Base [RS-Secure Base]; Control Group). Participants completed assessments at pretest, posttest, and follow-up (3 months post-intervention). The two intervention groups (RS-Safe Haven, RS-Secure Base) participated in one-hour group relational savoring sessions that met weekly for four weeks. The Control Group received no intervention. RS interventions significantly improved maternal closeness, parental satisfaction, and maternal sensitivity/availability compared to control, with gains evident at both post-test and follow-up. While both RS-Secure Base and RS-Safe Haven groups showed comparable improvements on most outcomes, RS-Secure Base demonstrated stronger effects for parental efficacy, particularly at follow-up. These findings have important implications for future work with relational savoring, suggesting that savoring both Secure Base and Safe Haven memories can enhance maternal outcomes.

Validation from family members has been found to reduce emotion dysregulation among youth, yet no interventions teach the skill of validation exclusively. This convergent, mixed-methods pilot study examined the feasibility, acceptability, and utility of a single-session virtual validation intervention, as well as its impact on family members' knowledge of validation and perceptions of hope. Thirty-four family members on the waitlist for a Family Connections program in Canada participated in the 2-h intervention. Qualitative feedback supported the feasibility, acceptability and utility of the intervention. Family members highlighted practice exercises and self-validation content as particularly useful. Quantitative analyses indicated a significant increase in applied knowledge of validation and perceptions of hope (p < 0.05). This study offers preliminary evidence that learning validation as a standalone skill may be feasible and helpful for family members of youth experiencing emotion dysregulation and could be a timely way to support those awaiting comprehensive offerings. Further research is needed to explore the role of single-session interventions in family member engagement with long-term programs such as Family Connections.

Immigrant and refugee families experience heightened stress and trauma before, during, and after their migration journeys. In the last decade, research on parenting interventions for immigrant and refugee families has increased, inspiring researchers to explore effective, efficient, and sustainable methods that enhance service utilization and resilience. While trauma-informed preventive interventions are available in the United States and other high-income countries, accessible contextually and culturally appropriate interventions remain a challenge for forcibly displaced families. Considering the twin phenomena of 21st century globalization and digital technology, cultural adaptation and digitization of preventive interventions appear to be crucial to increasing access for families but overwhelming for interventionists to implement. Therefore, we present a step-by-step overview for researchers and family therapists to demystify the contextual adaptation and digitization process for cross-cultural evidence-based preventive interventions. This unique adaptation approach is intended to promote accessible programs developed for immigrant and refugee families from various cultures and with diverse migration experiences. The paper describes how a university-based program development team applied cultural adaptation frameworks, community-based participatory methods, and digital technology to contextually adapt and digitize Parenting in the Moment, the first digital trauma-informed parenting program for displaced families in the United States. Researchers and clinicians may use and test this unique adaptation approach with other family-based interventions.

There is a lack of research on the parenting practices of fathers who have engaged in intimate partner violence (IPV). And while many of these men participate in intervention programs, limited research has examined the effect of these programs on parenting warmth and involvement, particularly in fostering positive change. This study focuses on the interplay between psychological flexibility, masculinity, and parenting among a subsample of fathers (n = 143) participating in a randomized controlled trial of two court-mandated intervention programs. Self-report data were collected at pre- and post-treatment, approximately 7 months apart. Findings indicate significant improvement in psychological inflexibility, whereas there were no meaningful changes in flexibility, traditional masculinity ideology, and parenting warmth and involvement. Regression analyses revealed that post-treatment psychological flexibility and inflexibility significantly predicted parenting warmth and involvement, whereas traditional masculinity ideology did not. These results underscore the role of reducing psychological inflexibility in improving parenting among men who have engaged in IPV and highlight the potential for interventions to address not only violence but also father-child relationships. Limitations such as reduced sample size and incomplete data due to the COVID-19 pandemic must be considered when interpreting the findings. The study contributes to the growing body of research on IPV interventions and parenting, emphasizing the need for more targeted strategies such as increasing psychological flexibility to enhance positive fathering behaviors in this population.

Family support plays a vital role in cancer survivors' return-to-work process. However, there's currently no effective method to measure the level of family support. This study aimed to develop the return-to-work family support assessment questionnaire following standardized questionnaire development procedures. Data collection was conducted between June 2023 and November 2024 at two large general hospitals in Jiangsu Province, China. Questionnaire development and validation was divided into three research phases. Firstly, a systematic literature review, semi-structured interviews, Delphi expert consultations, content validity analysis and a small-sample pretest were conducted, which led to the refinement of the initial questionnaire items. Secondly, a pilot study with 266 participants was conducted, using exploratory factor analysis to uncover the underlying factor structure within the data. Finally, 273 participants were conveniently sampled for the formal survey to evaluate the reliability of the questionnaire, while confirmatory factor analysis was employed to validate the questionnaire's structural validity. The final questionnaire comprised three dimensions, totaling 18 items. Exploratory factor analysis revealed three common factors, accounting for a cumulative variance of 61.09%. The results of the confirmatory factor analysis indicated a stable factor structure for the questionnaire, demonstrating good model fit. The questionnaire-content validity index was 0.920, the overall Cronbach's alpha coefficient was 0.922, and the 2-week test-retest reliability was 0.816. The questionnaire exhibited good reliability and validity, serving as an effective measurement tool for assessing and quantitatively analyzing the level of return-to-work family support for cancer survivors.

Ecological models of coparenting propose reciprocal processes between coparenting and couple relationship dynamics, but previous literature has limited evidence of directionality. Using daily diary data in 89 families with a 3- to 5-year-old child from the Southwestern US, this report investigated within-day and time-lagged patterns of mother-father couples engaging in positive relationship behaviors and coparenting support. Dynamic structural equation modeling revealed day-to-day stability in mothers' coparenting perceptions and in fathers' positive relationship behaviors. Results primarily supported a unidirectional path where the previous day's perceptions of coparenting support positively related to the following day's reports of positive relationship behaviors after controlling for autoregressive effects in both variables. Our findings provide evidence of directionality in coparenting-couple processes-that the coparenting system may be shaping couple relationship dynamics more than the reverse. Clinical implications of this work include addressing the coparenting relationship as a prerequisite for managing problems within the marital relationship.

Common factors are therapeutic elements that transcend models, occur in many settings, and help facilitate change in clients. A key common factor in individual psychotherapy is corrective experiencing, which includes interactions where clients deeply experience emotions in new and unexpected ways. Corrective experiencing can involve helping clients (a) process challenging emotional issues that have been avoided, (b) express emotions in a deeper way, and (c) regulate emotions. Although corrective experiencing is well recognized as a common factor in individual therapy, it has not received attention as a common factor in systemic therapy. However, almost all couple therapy models include interventions that facilitate corrective experiencing, such as expressing and responding to emotions with more regulation, having constructive discussions, and preventing escalation. In this paper we discuss relational corrective experiencing as a common factor in couple therapy and share how a better understanding and application of the processes of corrective experiencing can help clinicians utilize this specific skill across couple therapy models and interventions.

Anxiety and insomnia are correlated in older adults and their caregivers, yet the moderating role of mental health literacy (MHL) is unclear. This study aimed to explore dyadic effects of anxiety on insomnia among Chinese chronically ill older adults and family caregivers across age groups and whether MHL moderates these effects. Data came from 1033 dyads of older adults and their family caregivers in China through the Guangdong Mental Health Survey. Anxiety was assessed with the Generalized Anxiety Disorder-7, insomnia with the Insomnia Severity Index, and MHL with the Chinese National Mental Health Literacy Scale (consisting of mental health knowledge, attitudes, and capacity). The Actor-Partner Interdependence Moderation Model was applied for analysis. Young caregivers' mental health attitudes, β = -0.558, p = 0.002, mitigated the effect of their anxiety on their insomnia, while older adults' mental health knowledge, β = 0.428, p = 0.019, enhanced this relationship. Older adults' mental health attitudes, β = -0.731, p = 0.004, reduced the impact of middle-aged caregivers' anxiety on the latter's insomnia. Middle-aged caregivers' mental health capacity, β = -0.367, p = 0.004, attenuated the effect of older adults' anxiety on caregivers' insomnia. No significant moderating effects were observed in the dyad group of older adults and older caregivers. Within caregiving dyads, enhancing MHL can potentially reduce the impact of anxiety on insomnia. Interventions aimed at improving the mental health attitudes of older adults and caregivers are more likely to alleviate anxiety and insomnia than mental health knowledge and capacity.

Family therapists, fertility counselors, and professionals working with children and donor-conceived families may benefit from a deeper understanding of their conversational processes of origin storytelling-particularly the less examined question of how to talk about donor conception. Elaborative reminiscing (Fivush 2019)-a specific conversational style about the past that supports children in developing autobiographical memories and identity-may be especially relevant in this context. Therefore, this study explores how donor-conceived families talk about origin stories. The sample comprised 45 participants belonging to 17 donor-conceived Chilean families with children aged between 3 and 8, representing heteroparental, homoparental, and monoparental family structures. Parents recorded naturalistic parent-child conversations in their home setting, which were analyzed using an elaborative reminiscing coding scheme. The results show that these conversations were intimate, mother-led, brief, co-constructed, with asymmetrical contributions from parents and children. On average, elaborative turns accounted for 37.5% of the conversation with both parents (43.9%) and children (28.3%) actively contributing. Given children's average age (4.9 years), their degree of elaboration is notable. Three distinct conversational styles emerged: (a) thoughtful and imaginative conversations; (b) narrative conversations with magical elements; and (c) realistic conversations with classic metaphors. These findings suggest that conversational processes may inform the development of interventions aimed at enhancing autobiographical memory and identity development in donor-conceived children.

This study examined whether decreases in parents' negative in-session behaviors predicted reductions in LGBTQ+ young adults' perceived parental rejection and increases in their perceived parental acceptance over the course of attachment-based family therapy for sexual and gender minority (ABFT-SGM) young adults and their nonaccepting parents. A total of 126 videotaped sessions from 22 families who participated in an open clinical trial of ABFT-SGM were coded to assess changes in parents' positive and negative in-session behaviors. Young adults' perceived parental rejection and acceptance were measured at baseline, 8 weeks, 16 weeks, 24 weeks, and 36 weeks. In line with findings from the open clinical trial, on average, perceived parental rejection decreased and perceived parental acceptance increased over the course of therapy. For both mothers and fathers, decreases in negative in-session behaviors moderated increases in young adults' perceived parental acceptance but not reductions in perceived parental rejection. Findings underscore the importance of reducing negative parental in-session behaviors, such as criticism and invalidation, during conjoint sessions with their LGBTQ+ young adult.

To understand the mutual influences of family and school contexts on youth's at-risk online behaviors, this study investigated the concurrent and interactive influences of Internet-specific parenting practices and school climate perception on the problematic Internet use (PIU). A total of 988 Chinese middle school students (M = 12.86 years, 51% girls) completed measures of Internet-specific parenting practices (parental restrictive and active mediation), school climate, and PIU. The data analysis was conducted using multiple regression analysis and the moderating effect model in the PROCESS macro. Results indicated that parental active mediation was associated with lower levels of PIU among boys and girls, while parental restrictive mediation was associated with lower levels of PIU among girls. The interaction between school climate and parental active mediation was significantly associated with PIU only among boys. However, the interaction between school climate and parental restrictive mediation was not significantly associated with PIU among both boys and girls. These findings highlight the important roles of Internet-specific parenting practices, school climate, and gender in the development of PIU among early adolescents, suggesting that coordinated family-school efforts may be essential for effective prevention and intervention.

Sexual offenses and other problematic sexual behaviors by youths are viewed in many countries as a legal problem rather than as a public health problem that can be treated. Multisystemic Therapy for Problem Sexual Behaviors (MST-PSB) was developed to address the dearth of effective treatments for youths with criminal and non-criminal sexual behavior problems. This article begins by describing the empirical and theoretical underpinnings of the MST-PSB treatment model and the various characteristics of the model that make it well suited for the treatment of youths with problem sexual behaviors. Next, we discuss the various clinical interventions used in MST-PSB and delineate how the model is operationalized and provided to youths and their families. Research findings that demonstrate the positive clinical outcomes, mechanisms of change, and economic benefits of MST-PSB are then reviewed, followed by a summary of how MST-PSB is implemented by provider organizations using a comprehensive approach to establishing and maintaining treatment fidelity. For family therapists who treat youths with problem sexual behaviors but are not practicing within an MST-PSB program, we hope that the conceptual framework, clinical interventions, and treatment principles described in this article can contribute to the effectiveness of your work. In addition, we suggest that administrators of programs that treat youths who engage in problem sexual behaviors should consider the current evidence base as they make decisions about the adoption of interventions for this clinical population of youths. Finally, we recommend that comprehensive, empirically supported treatment models such as MST-PSB be increasingly considered by policymakers when allocating scarce financial resources to treatments for youths with problem sexual behaviors.

The COVID-19 pandemic disrupted daily life and strained couple relationships, requiring adaptation to widespread resource loss. Empathy, particularly cognitive empathy, plays a vital role in social support during stress and may help foster adaptive relationship behaviors. This study was designed to explore whether a self-sustaining gain spiral-a theoretical process wherein resources reinforce one another described in the Conservation of Resources Theory-could be observed between cognitive empathy and attachment behaviors over time. We surveyed 535 cisgender heterosexual couples in April 2020 and again in July (N = 363) and October (N = 239), assessing self-reported resource loss, empathy, and attachment behaviors. Findings revealed a gain spiral: cognitive empathy and attachment behaviors showed positive bidirectional associations over time within individuals. Within individuals, higher levels of attachment behaviors in July predicted lower resource loss in October. Surprisingly, higher empathy in July predicted greater loss in October. Additionally, higher levels of attachment behaviors in April indirectly predicted lower resource loss in October. Finally, empathy in April predicted greater attachment behaviors in July across partners. These results underscore the potential for positive relational dynamics even amid collective stress. Interventions that strengthen empathy and attachment behaviors may help couples better cope with adversity by reinforcing mutually supportive patterns.