Married Individuals’ Attitudes Toward Family and Couple Therapy: A Qualitative Study in the Turkish Context

This paper provides a critical analysis and synthesis of the current status and emerging developments in contemporary couple therapy. Its narrative centers on the evolution of couple therapy into a prominent intervention modality and coherent body of practice. The review begins with the consideration of the field's strong empirical underpinnings derived from research on couple therapy and basic relational science. Couple therapy comprises the widely accepted method for reducing relationship distress and enhancing relationship quality. Moreover, both as a stand-alone intervention and in conjunction with other treatment formats, couple-based interventions have garnered considerable empirical support for their effectiveness in addressing a broad spectrum of specific relational dysfunctions as well as individual emotional and physical health problems. We highlight the convergence of methods through common factors, shared strategies, and remarkably similar arrangements across approaches. Our review also points to key differences among approaches, the importance of recognizing respective strengths and limitations linked to these differences, and building on differences across models when selecting and tailoring interventions for a given couple. The discussion concludes with a consideration of recent trends in the field including the impact of telehealth and related digital technologies, the expansion of specific treatments for specific problems and diverse populations, the interface of couple therapy with relationship education, and enduring challenges as well as new opportunities addressing broader systemic and global dynamics.

Background. There are differences between men and women in seeking psychological help, with men receiving it to a lesser extent. Researchers attribute this to the fact that men, subject to masculine gender role prescriptions, will strive to maintain a self-image as strong, invulnerable, and capable of handling all problems on their own, which hinders their intention to seek professional help. Furthermore, a lack of psychological help can lead to deterioration in well-being and quality of life, and in some cases, complete maladjustment. This emphasises the need for research into attitudes toward seeking for psychological help in men to understand what can increase their rate of help-seeking and, consequently, their well-being. In addition to its practical significance, this study offers a new perspective on gender personality type as a component of a person’s identity that can potentially undergo change during psychotherapy, thus contributing to comprehensive research on the psychological help. Objectives. The goal is to define differences in attitudes towards seeking for psychological help among people with varying gender roles and experiences of seeking for help. Study Participants. The study involved respondents (N = 296) aged 18 to 74 years (M = 32,2; SD = 14,5) including 160 females and 136 males. Methods. Groups of men and women were compared, (including women and men with different gender personality types), with regard to their attitudes towards seeking for psychological help, as well as men and women with different psychotherapy experiences as related to their attitudes toward seeking for psychological help and expressing masculinity. The Attitudes Toward Seeking Mental Health Services (IASMHS) and the Bem Sex Role Inventory were used. Differences were tested using the analysis of variance (ANOVA). A series of two-way ANOVAs was also conducted to examine the interactions between gender personality types, gender, and experience with psychological help. Results. The results of statistical data processing allow to state that women have more positive attitudes towards seeking psychological help than men and that in the men’s group there are differences in attitudes towards seeking psychological help among people with various gender roles. Also, people with different help-seeking experiences do not differ in masculinity. However, people with various psychotherapy experiences, women in particular, have different attitudes towards seeking for psychological help. No interaction between factors was found. Conclusions. Based on the study results, the assumption that experience in psychotherapy could change a person’s gender schema is not supported. It was found that men have a rather negative attitude as compared to women toward seeking for assistance from mental health professionals, and that masculinity in men negatively correlates with their willingness to seek psychological help. In women, experience in psychotherapy correlates with their attitudes towards seeking for psychological help. No interaction between factors of gender personality type and experience in psychotherapy was found, suggesting the existence of two distinct models in forming attitudes towards seeking for psychological help among individuals of different sexes.

Giammatti, Green, GLBTQ Couple and Family Therapy: History and Future Directions. Section I: Clinical Issues with LGBT Couples. Tunnell, Gay Male Couple Therapy: An Attachment-Based Model. Connolly, Lesbian Couple Therapy. Bradford, Affirmative Bisexual Couple Therapy. Malpas, Can Couples Change Gender? Couple Therapy with Transgender People and their Partners. Section II: Sex Therapy with LGBT Couples. Rutter, Sex Therapy for Gay Male Couples: Affirming Strengths and Stemming Challenges. Cobin, Angello, Sex Therapy with Lesbian Couples. Lev, Sennott, Trans-Sexual Desire in Differently Gendered Bodies. Section III: Clinical Issues with LGBT Families. Mitchell, Coming Out to Family: Adrift in a Sea of Potential Meanings. Tasker, Malley, Working with LGBT Families. Kuvalanka, The Kids May Be All Right, but Some Might Still End Up in Your Office: Working with Children of LGBTQ Parents. Fish, Harvey, Raising Lesbian, Gay, Bisexual Youth: An Affirmative Family Therapy Approach. Coolhart, Supporting Transgender Youth and their Families in Therapy: Facing Challenges and Harnessing Strengths. Gianino, Novelle, Considerations for Assessment and Intervention with Lesbian and Gay Adoptive Parents and their Children. Lynch, McMahon-Klosterman, The Gay and Lesbian Stepfamily: Past and Present Research and Implications for Therapy. Blando, Counseling Lesbian and Gay Individuals, Couples, and Families in Late Life. Section IV: Special Issues, Problems, and Populations in LGBT Couple and Family Therapy. Grever, Helping Heterosexual Spouses Cope when their Husbands or Wives Come Out. Singh, Harper, Intercultural Issues in LGBTQQ Couple and Family Therapy. Blank, Asencio, Descartes, Issues in the Health of Lesbian, Gay, Bisexual, and Transgender People for LGBT Couple and Family Therapy. Rostosky, Johnson, Riggle, Spirituality and Religion in Same-Sex Couples' Therapy. Linville, Chronister, Marsiglio, Brown, Treatment of Partner Violence in Gay and Lesbian Relationships. Anderson, Treatment of Substance Use Disorders in LGBT Couples and Families. Kerewsky, LGBT Couple Enrichment. Lyness, Therapeutic Considerations in Same-Sex Divorce. Section V: Training Issues. Carlson, McGeorge, LGB Affirmative Training Strategies for CFT Faculty: Preparing Heterosexual Students to Work with LGB Clients. Long, Grote, Queer Supervision. Section VI: Ethical Issues in LGBT Couple and Family Therapy. Riggs, Ethical Issues in LGBT Couple and Family Therapy. Serovich, Grafsky, Gangamma, Research on Reorientation Therapy. Lutes, McDonough, Helping Individuals and Families Recover from Sexual Orientation Change Efforts and Heterosexism. Reczek, Rothblum, A Little Bit Pregnant? The Ethics of Same-Sex Marriage.

Previous research on mental health disparities shows that persons from racial-ethnic minority groups have less access to mental health care, engage in less treatment, and receive poorer-quality treatment than non-Hispanic whites. Attitudes and beliefs about mental health treatment were examined to determine whether they contribute to these disparities. Data from the National Comorbidity Survey Replication (NCS-R) were analyzed to determine attitudes toward treatment-seeking behavior among people of non-Hispanic white, African-American, and Hispanic or Latino race-ethnicity. Additional sociodemographic variables were examined in relation to attitudes and beliefs toward treatment. African-American race-ethnicity was a significant independent predictor of greater reported willingness to seek treatment and lesser reported embarrassment if others found out about being in treatment. These findings persisted when analyses adjusted for socioeconomic variables. Hispanic or Latino race-ethnicity also was associated with an increased likelihood of willingness to seek professional help and lesser embarrassment if others found out, but these differences did not persist after adjustment for the effects of socioeconomic variables. Contrary to the initial hypothesis, African Americans and Hispanics or Latinos may have more positive attitudes toward mental health treatment seeking than non-Hispanic whites. To improve access to mental health services among racial-ethnic minority groups, it is crucial to better understand a broader array of individual-, provider-, and system-level factors that may create barriers to care.

Race-Ethnicity as a Predictor of Attitudes Toward Mental Health Treatment Seeking

Gurman, Foreword: Ushering in a New Era. Sexton, Weeks, Robbins, Preface: A New Era of Couple and Family Therapy. Part I: Understanding Families and Couples: The Foundations of Practice. Becvar, Eras of Epistemology: A Survey of Family Therapy. Robbins, Mayorga, Szapocznik, The Ecosystemic lens to Understanding Family Functioning. Falicov, Ethnicity and Culture in Family Therapy: New Variations on a Fundamental Theme. Part II: Major Theoretical Models of Couple and Family Therapy. J. Scharff, D. Scharff, Object-relations and Psychodynamic Approaches to Couple and Family Therapy. Nichols, Family of Origin Treatment. Duncan, Miller, Sparks, Interactional and Solution Focused Brief Therapies: Evolving Concepts of Change. Anderson, Postmodern Social Construction Therapies. Dattilio, Epstein, Cognitive-behavioral Couple and Family Therapy. Mitrani, Structural-strategic Approaches to Couple and Family Therapy. Lebow, Integrative Approaches to Couple and Family Therapy. Part III: Evidence Based Couple and Family Intervention Programs. Sexton, Robbins, Hollimon, Mease, Mayorga, Efficacy, Effectiveness, and Change Mechanisms in Couple and Family Therapy. Johnson, Emotionally-focused Couples Therapy: Empiricism and Art. Atkins, Dimidjian, Christensen, Behavioral Couple Therapy: Past, Present and Future.Sheidow, Henggler, Schoenwald, Multisystemic Therapy. Sexton, Alexander, Functional Family Therapy: A Mature Clinical Model for Working with At-risk Adolescents and Their Families. Part IV: Special Applications/Special Populations. Plaut, Donahey, Evaluation and Treatment of Sexual Dysfunction. Ruddy, McDaniel, Medical Family Therapy. Ozechowski, Waldron, Turner, The Treatment of Adolescent Conduct Disorders and Drug Abuse. L'Abate, Treatment through Writing: A Unique New Direction. DeMaria, Psychoeducation and Enrichment: Clinical Considerations for Couple and Family Therapy. Storm, McDowell, Long, The Metamorphosis of Training and Supervision. Part V: The Future of Couple and Family Therapy. Sexton, Weeks, Robbins, The Future of Couple and Family Therapy.

We explored the factors influencing attitudes of help-seeking behavior and counseling intentions. Four hundred and forty (440) Ghanaian students from two public universities were conveniently sampled for this study. Data were collected through a cross-sectional survey using standardized questionnaires, including the Intention to Seek Counseling Inventory, Inventory of Attitudes Toward Seeking Mental Health Services, Attitudes Toward Seeking Professional Psychological Help Scale, Self-Stigma of Seeking Help Scale, and the Stigma Scale for Receiving Social Support. The data obtained were analyzed using multiple regressions. Our results revealed that self-stigma was significantly associated with attitudes toward seeking help from a psychologist, while social stigma was significantly associated with attitudes toward seeking help from a mental health service provider. Self-stigma, but not social stigma, moderated the relationship between attitudes toward seeking professional psychological help and intentions to seek counseling. This suggests that when self-stigma is high, attitudes to seek professional psychological help become less impactful in driving intentions to seek counseling. Interventions should focus on reducing self-stigma and empowering adults to overcome their internalized negative attitudes toward mental disorders, ultimately encouraging them to seek mental health care.

Nursing students often experience stress due to their educational demands and developmental stage. This study focuses on nursing students to investigate the relationship between their attitudes toward seeking psychological help and their levels of perceived self-stigma and social stigma. This was a descriptive correlational study, in which 791 nursing students participated through convenience sampling between April and May 2022. Data were collected using the Attitude Towards Seeking Psychological Help Scale-R (ASPH-R), the Stigma Scale for Receiving Psychological Help (SSRPH), and the Self-Stigma of Seeking Help (SSOSH). The data were analyzed using Pearson correlation and multiple linear regression analysis. The article adheres to the STROBE checklist in its organization and presentation. Positive attitudes towards seeking psychological help were negatively correlated with self-stigma (r=-0.39, P<0.01) and social stigma perceptions (r=-0.17, P<0.01), while negative attitudes were positively correlated with self-stigma (r=0.50, P<0.01) and social stigma (r=0.47, P<0.01). Variables of sex, age, self-stigma, and social stigma significantly contributed to explaining attitudes towards seeking psychological help. Social stigma and particularly self-stigma significantly influence nursing students' attitudes towards seeking psychological help. Therefore, it is recommended that authorities develop psychoeducational interventions aimed at enhancing nursing students' mental health awareness and reducing self-stigma.

Background: Coercive control represents a pervasive yet under-recognized form of domestic abuse, particularly within marital relationships in Pakistan. Despite its high occurrence, limited empirical attention has been given to its typology, frequency, and psychological consequences. The present study aimed to conceptualize and develop a psychometrically robust scale for assessing coercive control among married individuals in Pakistan. Method: A sequential exploratory mixed-methods design employing convenience sampling was utilized. The study comprised two phases. Phase I involved qualitative exploration through Focus Group Discussions (FGDs) with married individuals (N = 57; age range = 34–50 years) and semi-structured interviews with marital counselors and psychologists (N = 3). Thematic analysis guided the generation of an initial item pool, from which 42 items were retained. A preliminary pilot test was conducted with married individuals (N = 60; age range = 23–70 years; M = 38.70, SD = 10.52) to refine the scale. Phase II consisted of determining the factor structure and psychometric properties of the scale through Exploratory Factor Analysis (EFA) using a larger sample (N = 500; men = 251, women = 249; age range = 20–70 years; M = 37.43, SD = 9.99). Results: The EFA results indicated a clear six-factor structure of coercive control. All subscales demonstrated satisfactory internal consistency, as evidenced by acceptable Cronbach’s alpha coefficients, establishing internal reliability. Construct validity was supported through significant inter-subscale correlations and strong correlations of each subscale with the total score, confirming convergent and internal construct validity. Content validity was ensured during item development through expert review and qualitative thematic analysis. Overall, the findings indicate that the scale possesses sound reliability and validity for measuring coercive control among married individuals. Conclusions: The study resulted in the development of an indigenous, psychometrically sound instrument for assessing coercive control among married individuals in Pakistan. Findings support the reliability and validity of the scale and highlight its potential utility for research, clinical assessment, and intervention planning in the context of marital abuse.

There are two recent meta-analytical reviews looking at the efficacy and the effectiveness of marital and family therapy (Shadish W. R., Ragsdale, K, Glaser, R. R. & Montgomery, L. M. (1995) The efficacy and effectiveness of marital and family therapy: a perspective from meta-analysis, Journal of Marital and Family Therapy, 21, pp. 345–360; DUNN, K. L. & SCHWEBEL, A. I. (1995) Meta-analytic review of marital therapy outcome research, Journal of Family Psychology, 9, pp. 58–68). Shadish et al. have attempted to make their earlier analysis of this area more reader friendly and the paper is certainly an easier read than the original. These two papers constitute the main reviews of marital therapy over the last five years, although, regrettably, most of the papers published this decade are not included in the reviews. For example, the Shadish et al. review includes 163 randomized studies, but only through to 1988. The findings clearly show that the marital therapy group (when they excluded the family therapy group) had a significant positive effect size, although this was not universal. The authors report that marital therapy produced a significant improvement in 41% of the treatment conditions studied. The review excluded those studies where the problem was a sexual dysfunction and where only traditional sex therapy was given.

Duration of marriage (DoM) and age are important characteristics of married individuals, who are the critical population for eliminating mother-to-child transmission (MTCT) of syphilis. A deep understanding of the preconception syphilis seroprevalence (PSS) and its distribution among this population may be able to help to eliminate MTCT. However, few population-based epidemiological studies have been focused on this group, and the association of DoM and age with PSS remains unclear. This study used data from 4,826,214 married individuals aged 21-49 years who participated in the National Free Preconception Health Examination Project in Guangdong Province, China, between 2014 and 2019. Syphilis was screened using the rapid plasma reagin (RPR) test. The seroprevalence time series, seroprevalence map, and hot spot analysis (HSA) were employed to visualize the spatiotemporal distribution. The restricted cubic spline (RCS) based on multivariate logistic regression was used to model the association of DoM and age with PSS. The interactions on the additive scale of DoM and age were also assessed. The PSS was 266.61 per 100,000 persons (95% CI: 262.03-271.24) and the burden was higher in economically underdeveloped area within the province. A strong J-shaped non-linearity association was observed between age and PSS. Specifically, the risk of seropositivity was relatively flat until 27 years of age among men and increased rapidly afterwards, with an adjusted odds ratio (aOR) of 1.13 (95% CI: 1.12-1.13) per unit. Among women, the risk of seropositivity was relatively flat until 25 years of age and increased rapidly afterwards with an aOR of 1.08 (95% CI: 1.08-1.09) per unit. DoM was negatively associated with PSS among married individuals. Moreover, the combined effects of age and DoM appeared to be synergistic. Our findings suggest that attention should be paid to preventing syphilis in underdeveloped areas and that syphilis screening in newly married individuals who are in their late 20s or older should be recommended. Additionally, early syphilis prevention strategies should be implemented among young people as early as possible.

A Systems Therapist Looks at Transference: Widening the LensShirley BravermanShirley BravermanAssociate Professor, Department of Psychiatry and School of Social Work, McGill University, and Department of Psychiatry, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec.Sir Mortimer B. Davis-Jewish General Hospital, Institute of Community and Family Psychiatry, 4333 Cote Sainte Catherine Road, Montreal, Quebec, Canada H3T 1E4Search for more papers by this authorPublished Online:July 2017https://doi.org/10.1521/jaap.1.1993.21.3.327PDFPDF PLUS ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutReferencesAichorn A. (1963), Wayward Youth, Viking Press, New York. Google ScholarBateson G. (1962), A note on the double bind, Fam. Process, 2, 154–161. Crossref, Google ScholarBraverman S. (1981), Family of origin: The view from the parents’ side, Fam. Process, 20, 431–437. Crossref Medline, Google ScholarDare C. (1986), Psychoanalytic marital therapy, in Jacobson N. S. and Gurman A. S. (Eds.), Clinical Handbook of Marital Therapy, Guilford Press, New York, pp. 13–28. Google ScholarDicks H. V. (1967), Marital Tensions, Basic Books, New York. Google ScholarFerenczi S. (1990), Introjection and transference, in Esman A. H. (Ed.), Essential Papers on Transference, New York University Press, New York and London, pp. 15–27. Google ScholarFramo J. L. (1972), Symptoms from a family transactional viewpoint, in Sager C. and Singer Kaplan H. (Eds.), Progress in Group and Family Therapy, Brunner/Mazel, New York, pp. 271–308. Google ScholarFramo J. L. (1982), Explorations in Marital and Family Therapy, Springer, New York. Google ScholarFreud A. (1936), The Ego and the Mechanisms of Defense, International Universities Press, New York. Google ScholarFreud S. (1905), Fragment of the analysis of a case of hysteria, Standard Edition, Vol. 7, pp. 1–123. Google ScholarGuttman H. (1991), Systems theory, cybernetics and epistemology, in Handbook of Family Therapy, Vol. 11, Brunner/Mazel, New York, pp. 41–62. Google ScholarJackson D. D. (1957), The question of family homeostatis, Psychiatr. Q., (Suppl.) 31, 79–90. Google ScholarKernberg O. (1987), An ego psychology object relations theory approach to the transference, Psychoanal. Q., 56, 197–221. Crossref Medline, Google ScholarLeites N. (1977), Transference interpretations only? Int. J. Psychoanal., 58, 275–287. Medline, Google ScholarMain T. F. (1966), Mutual projection in marriage, Compr. Psychiatry, 7, 432–439. Crossref Medline, Google ScholarMeissner W. W. (1978), The conceptualization of marriage and family dynamics from a psychoanalytic perspective, in Paolino T. J. and McGrady B. S. (Eds.), Marriage and Marital Therapy, Brunner/Mazel, New York, pp. 25–88. Google ScholarNadelson C. C. (1978), Marital therapy, in Paolino T. J. and McGrady B. S. (Eds.), Marriage and Marital Therapy, Brunner/Mazel, New York, pp. 101–164. Google ScholarSatir V. (1971), Symptomatology: A family production, in Howells J. (Ed.), Theory and Practice of Family Psychiatry, Brunner/Mazel, New York, pp. 663–670. Google ScholarScharff D., and Scharff J. (1987), Object Relations Family Therapy, Jason Aronson, Northvale, NJ. Google ScholarSlipp S. (1984), Object Relations: A Dynamic Bridge Between Individual and Family Treatment, Jason Aronson, Northvale, NJ. Google ScholarSkynner A. C. R. (1976), One Flesh: Separate Persons, Constable, London. Google ScholarWiener N. (1954), The Human Use of Human Beings: Cybernetics and Society, Doubleday, New York. Google ScholarZinner J. (1976), The implication of projective identification in marital interaction, in Grunbaum H. and Christ J. (Eds.), Contemporary Marriage: Structure, Dynamics and Therapy, Little, Brown, Boston, pp. 293–307. Google Scholar Next article FiguresReferencesRelatedDetails Cited byCited by1. The integration of individual and family therapyOnline publication date: Go to citation Crossref Google Scholar Volume 21Issue 3Sep 1993 Information© 1993 The American Academy of PsychoanalysisPDF download

In 1985, Virginia Goldner wrote an article for the Family Therapy Networker entitled Warning: Family Therapy May Be Hazardous to Your Health. In this one tongue-in-cheek title, Goldner captured a major theme and source of controversy in the discourse surrounding marital and family therapy over the last decade. This debate centers around the idea that some clients may not be well-served and, in some cases, may be harmed by marital and family therapy. More specifically, at the heart of this debate is the premise that marital and family therapy as traditionally practiced is oppressive to specific constituencies. In the last 10 years, questions have been raised and criticism leveled concerning biases in marital and family therapy that have ignored and, in some cases, pathologized three groups: women in families, racial-ethnic minority families, and gay and lesbian families. Although the critiques of the field of marital and family therapy's treatment of gender, race and ethnicity, and sexual orientation evolved independent of one another with no common theoretical framework, similarities exist in the criticisms offered and questions posed about the biases that exist in marital and family therapy. The purpose of this review article is to look at similarities in the critiques emanating from these different quarters and to examine the impact these critiques have had on the field of marital and family therapy. In addition, areas in which work is still needed will be identified. Prior to examining these critiques in greater detail, one point should be noted. Discussions of the treatment of minority families in marital and family therapy have often been clouded by an inconsistency in terminology. The term ethnicity is most frequently found, but is often used somewhat interchangeably with the term culture. Although there is a great deal of overlap in the terms culture and ethnicity, they are not synonymous; culture is broader in scope than ethnicity (Preli & Bernard, 1993). The term race, however, is less frequently used and often is treated as simply one component of ethnicity. Hardy and Laszloffy (1994) propose that the relative silence around race, achieved by subsuming it under ethnicity, is a way of marginalizing race and downplaying the domination of the White perspective in models of family therapy. Yet race--particularly skin color--is often a defining aspect of the experience of ethnic identity for people of color. In an effort to recognize that ethnicity is much more than just race, but that race assumes a primacy in structuring peoples' experiences, both race and ethnicity are used throughout this article, with the term racial-ethnic used where grammatically appropriate. CRITIQUES OF MARITAL AND FAMILY THERAPY Any cursory review of journals, workshops, and conference programs will reveal that the topic of marital and family therapy's insensitivity to, and in some cases, oppression of certain groups has been a dominant theme in the field in the last decade. Certainly, the feminist critique of the treatment of gender in the field was the most extensively articulated during this time (e.g., Goodrich, Rampage, Ellman, & Halstead, 1988; Luepnitz, 1388; McGoldrick, Anderson, & Walsh, 1989, Walters, Carter, Papp, & Silverstein, 1988), but a substantial body of literature also addressed the treatment of racial and ethnic minority families (e.g., McGoldrick, Pearce, & Giordano, 1982; Saba, Karrer, & Hardy, 1991; Tseng & Hsu, 1991). Although less systematic attention has been given to gay and lesbian families in mainstream family therapy research and treatment journals, the topic has been a controversial one and has been addressed with greater frequency in marital and family therapy book chapters (e.g., Brown & Zimmer, 1386, Goodrich, Ellman, Rampage, & Halstead, 1990; Sanders, 1993). These critiques of marital and family therapy have varied in the specific aspects of therapy that are thought to be insensitive or oppressive, yet all share a t common concern that the field has perpetuated the status quo. …

Family and marital therapies are rapidly becoming highly used methods of treatment of mental disorders and are no longer ancillary methods to individual psychotherapy. The last few decades have brought about an increasing awareness of the fact that, excluding organic etiology, practically all mental disorders are caused, fostered, and/or related to faulty interpersonal relations. As a rule, the .earlier in life one is exposed to noxious factors, the more severe is the damage. Thus, early child-parents' and child-siblings' interactions are highly relevant determinants of mental health and mental disorder. Moreover, parents themselves do not live in a vacuum. Their marital interaction significantly contributes to their own mental health or to its decline, and parent-child relationships are greatly influenced by the nature of intraparental relationships. Parental discord, conflicts, and abandonment affect the child's personality development. Thus, family and marital therapy is more than therapy; it is an important contribution to the prevention of mental disorder. The present volume is comprised of three parts. The first, primarily theoretical, analyzes the fundamental aspects of marital and family therapy. The second part describes the various therapeutic techniques and the last deals with several specific issues. It gives me great pleasure to acknowledge my gratitude to my coeditor, Dr. George Stricker. Without his thorough and devoted efforts, this volume could not have come into being. I am also profoundly indebted to our consulting editors, Dr. James Framo, Dr.

Despite a comparable need, research has indicated that on average men hold more negative attitudes toward psychological help seeking than women. Several researchers have suggested that the gender gap in service use and attitudes could be addressed through efforts to better market psychological services to men; however, a limited number of studies have tested this hypothesis. This study examined whether altering the labels for mental health providers (psychologist or counselor), settings (mental health clinic or counseling center), and treatments (problem or feeling focused) could result in less perceived stigma (social and self) by men. Participants, 165 male college students, were asked to read one of eight randomly assigned vignettes that described a man who was experiencing symptoms of depression and was considering seeking help. The vignettes differed in the labels that were used to describe the help that was being considered. Participants then completed measures assessing the stigma (self and social) associated with the treatment, and their preexisting experience of gender-role conflict and attitudes toward psychological help seeking. In summary, perceived stigma did not depend on the type of label that was used; however, 59% of the variance in attitudes was predicted by self-stigma (uniquely explaining 11%), gender-role conflict (uniquely explaining 10%), and social stigma (uniquely explaining 5%). Specifically, higher levels of gender-role conflict, social stigma, and self-stigma were associated with more negative attitudes toward psychological help seeking. Based on the demographics of the sample, these findings primarily have implications for Caucasian college-educated young adult men. Further limitations with the study and recommendations for future research are discussed.