Relationship-focused Interventions Research Articles

Romantic Love is Not Only “Romantic”: A Grounded Theory Study on Love in Romantic Relationships

With romantic love having long been studied with a focus on the romantic component and how it is expressed, little is known about what love is as a feeling in romantic relationships from the recipient’s perspective. This study aimed to understand love as a feeling in romantic relationships by analyzing open-ended responses about what makes people feel loved by their romantic partner in a college sample of 462 undergraduates (age: M = 18.93, SD = 2.86; 77.92% female) and a community sample of 75 adults (age: M = 32.36, SD = 16.53; 93.18% female) using grounded theory methodology. Findings indicated that Positive responsiveness (to needs), Authentic connection, and A sense of stability were three core elements of love in romantic relationships. By comparing these three core categories (and their underlying categories and concepts) across both samples and demographic characteristics (i.e., gender, race, and household income), this study also provided preliminary evidence on the generalizability of this three-component framework: (1) all (core) categories were overlapping across two samples, and all concepts generated in the small community sample were a subset of those generated in the large college sample; (2) all categories and core categories were overlapping across gender, race, and household income, with “positive responsiveness” being the most common component across demographics consistently. This three-component framework of romantic love is consistent with love’s multifaceted nature, serves as an initial step toward integrating existing theoretical frameworks about love, and, if replicated, would inform relationship-focused interventions.

Effectiveness of community-based family-focused interventions on family functioning among families of children with chronic health conditions: A systematic review and meta-analysis.

Community-based family-focused interventions can offer support to families of children with chronic health conditions. This review aimed to evaluate the effectiveness of community-based family-focused interventions in improving family functioning, disease knowledge, and child health outcomes among families of children with chronic health conditions. Eight electronic databases (MEDLINE, EMBASE, CINAHL, CENTRAL, PsycINFO, Scopus, Web of Science, and ProQuest Dissertations & Theses Global) and one trial registry (ClinicalTrials.gov) were searched from their dates of inception to October 2022. Meta-analysis was performed under the random-effect model when appropriate otherwise, findings were narratively synthesized. I2 statistics and Cochran's Q chi-squared test were used to determine heterogeneity. Quality appraisal was conducted by the Cochrane risk of bias tool and the Grades of Recommendation, Assessment, Development, and Evaluation approach at the study and outcome level, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines guided this review. Eight studies were included in this review. Community-based family-focused interventions were viable methods that could support families of children with chronic health conditions. Family-focused interventions that incorporate guided role-playing exercises for parents and children, psychoeducational components, and elements from relationship-focused interventions could support families more effectively. However, current findings are mostly limited to interventions conducted in patients' homes, and the long-term effect of these interventions cannot be determined. Overall, community-based family-focused interventions have the potential to offer valuable support to families of children with chronic health conditions, and future research could seek to improve the effectiveness of these interventions.

The role of maternal interactive behavior and gestational age in predicting infant affect during the Still-Face Paradigm

Background: Emotion regulation develops through bidirectional affective communication. Aim: To investigate the role of maternal interactive behavior in predicting infant affect among preterm versus full-term infants. Study Design: The association between maternal interactive behavior (contingent, attention seeking, watching) and infant affect during a modified Still Face (SF) paradigm in a sample of 22 preterm and 28 full term infants (3 ½ - 4 ½ months old) was investigated. Methods: Maternal behavior and infant affect were coded in one second intervals. Results: Maternal contingent interaction was positively correlated with positive infant affect (p < 0.001 for Play; p < 0.001 for Reunion#1; p < 0.01 for Reunion#2, respectively), with a stronger association during the second reunion for preterm infants (p < 0.001). In the preterm sample but not in the full-term sample, attention seeking maternal interaction at Play (baseline), Reunion#1, and Reunion#2 were all positively correlated with negative infant affect at Still Face#2. Maternal watching was negatively associated with positive infant affect for the full sample for both Reunion episodes (p < 0.05). Full term infants' negative affect increased from baseline to the first SF episode and then plateaued, whereas preterm infants demonstrated greater negative affect and less recovery throughout. Mothers of full-term infants showed increased contingent responding after the first SF stressor, while mothers of preterm infants did not (p < 0.05). Conclusions: Preterm infants may be more susceptible to both positive and negative maternal behaviors and mothers of full-term infants may be more responsive to infants' increased distress. Relationship-focused interventions addressing maternal behaviors may enhance positive emotionality and improve self-regulation in medically at-risk infants.

Improvements in coparenting conflict and child adjustment following an online program for relationship distress.

Many children never receive treatment for their mental health symptoms-and those that do often receive it only after years of delay. Given that relationship and parenting conflict is an identified mechanism of child mental health symptoms, reducing distress in the parents' romantic relationship may help reduce this unmet need. In the current study, 213 couples with 1 or more children between the ages of 3 and 17 (inclusive) were randomized to receive the web-based OurRelationship program or to a 2-month waitlist condition. Intervention couples were also assessed in the year following the program. Couples in the OurRelationship program experienced a significant decrease in coparenting conflict during the intervention (Cohen's d = -0.27) but also a significant increase in coparenting conflict in the following year, reducing the long-term effects of the intervention (within-group d = -0.20 at 1-year follow-up compared with baseline). Additionally, parent-reported children's externalizing (within-group d = -0.40) and internalizing (within-group d = -0.27) symptoms significantly decreased from baseline to the 1-year follow-up. As hypothesized, improvement in relationship satisfaction during the program was significantly associated with a decrease in coparenting conflict which, in turn, was associated with reduction in both externalizing and internalizing symptoms in the children. These results indicate that online relationship-focused interventions offer an important, adjunctive approach to meet society's need for reducing children's mental health symptoms. Furthermore, the improvements in child functioning strengthen the evidence suggesting the cost-effectiveness of these relationship-focused interventions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The Effects of Home-based Responsive Teaching Curriculum on Interactional Behaviors of Mothers and Their Children with Autism Spectrum Disorder: A Mixed Design Study in Turkey

The effectiveness of Responsive Teaching (RT) Early Intervention Program which is one of the relationship-focused interventions (RFI) on five children diagnosed with autism spectrum disorder (ASD) and their mothers was studied. The study was conducted in “Mixed Research Design” in which both quantitative and qualitative data were collected. Quantitative data of the study were collected through single group pretest-posttest model and qualitative data were collected from field notes, diaries, video analyses and interviews. Findings gathered from pretest and posttest quantitative results revealed that the RT program was effective on interactive behaviors of five children with ASD and their mothers. Qualitative results supported the quantitative findings and revealed that mothers stated they became more sensitive and responsive to their children behaviors by using RT strategies.

Two sides of one coin? Relationships build resilience or contribute to burnout in child protection social work: Shared perspectives from Leavers and Stayers in Northern Ireland

Child protection is a stressful occupation that can result in burnout and job exit for some social workers. This article will focus on the positive and negative impacts of co-worker and manager relationships, reporting on the meaning applied by workers, and on how these relationships impact their ability to manage the challenges of child protection work. Semi-structured interviews with 15 social-workers who left and 15 who stayed reveal the critical importance of relationships at work for either building resilience or contributing to burnout. Recommendations call for employer-level interventions to promote relationship-focused interventions to enhance social worker resilience.

The Impact of Relationship Quality on Health-Related Outcomes in Heart Failure Patients and Informal Family Caregivers

Relationships can have positive and negative impacts on health and well-being. Dyadic relationships between heart failure (HF) patients and their informal family caregivers may affect both patient and caregiver outcomes. The aim of this study is to synthesize the literature to date on the associations between HF patient-caregiver relationship quality and communication and patient and caregiver health outcomes. An integrative review of the literature was conducted. Computerized literature searches in Medline, PsycInfo, CINAHL, Web of Science, and EMBASE yielded 13 articles of HF patients and caregivers. Included articles were reviewed and double-coded by 2 independent coders. Included articles measured relationship quality or aspects of communication within an HF patient-caregiver dyad and used both cross-sectional and longitudinal designs. Results of the longest prospective study suggested that better relationship quality between HF patients and their informal family caregivers was related to a reduced risk for mortality in patients. Results of 11 of the 12 other studies were consistent to the reference study, suggesting that better relationship quality and communication were related to reduced mortality, increased health status, less distress, and lower caregiver burden. Relationship quality and communication seem to matter in the health and well-being of both HF patients and their informal family caregivers. More research is needed to elucidate mechanisms and to design effective relationship-focused interventions.

Therapists’ attitudes about and preferences to use Relationship Focused Interventions: New tools to measure a critical component of Functional Analytic Psychotherapy (FAP).

The role of the therapeutic relationship is emphasized as an important factor across several therapies, including newer contextual behavioral therapies such as Functional Analytic Psychotherapy (FAP). FAP exclusively focuses on the use of the therapeutic relationship as a primary mechanism of therapeutic change. FAP requires that therapists assess for and consequate in-session behaviors that are characteristic of the client's presenting problems and approximations of behaviors related to their treatment goals. The focus on in-session behavior and the use of behavioral techniques to consequate in-session behaviors is termed in-vivo (Kohlenberg & Tsai, 1991). In-vivo interventions, briefly defined as the use of moment-to-moment therapy interactions (Kanter et-al., 2009), are believed to be potent therapeutic interventions because they enable therapeutic change to occur more rapidly or enhance the effectiveness of non-FAP related techniques (e.g., cognitive disputation) (Baruch et-al., 2009; Robert J. Kohlenberg, personal communication, March 27, 2007). Currently, there are no published measures of the factors (e.g., beliefs about in-vivo interventions, attitudes about in-vivo interventions) that may promote or inhibit therapists' use of this important class of interventions. The current study was a first step toward improving our understanding of the factors related to therapists' use of in-vivo interventions. For the purposes of the paper, the term Relationship Focused Interventions (RFIs) will be used in place of in-vivo interventions. The term relationship-focused intervention better captures the role of the therapeutic relationship in FAP. Also, invivo interventions are not unique to FAP and practitioners from other therapies may be more amenable to the term Relationship Focused Interventions. Thus, it may help facilitate research on RFIs by practitioners from other theoretical orientations or therapy approaches. Relationship Focused Interventions use the live momentto-moment interactions between the client and the therapist (Kanter et-al., 2009). Maximal behavior change occurs when a reinforcer is delivered close in time and location to the behavior's occurrence; thus, maximal therapeutic change is thought to occur when behaviors are consequated close in time and location to the behavior's occurrence (i.e., in-session behaviors; R. J. Kohlenberg, personal communication, March 27, 2007; cf. Baruch et-al., 2009 for a detailed examination of the empirical literature on basic behavioral principles underlying FAP). Basic behavioral research supports the idea that relationship focused processes are powerful behavior change strategies and many therapies promote the use of these processes (e.g., Beck, Rush, Shaw, & Emery, 1979). Several empirical studies suggest that RFIs are unique to interpersonally-focused therapies and that their addition may improve outcomes. A study of cognitive therapy for depression showed that the occurrence of RFIs was rare (Bolling, Parker, & Kohlenberg, 2000). This result was replicated in a second study that found that the use of RFIs in both behavioral activation and cognitive therapy was rare (Kanter et-al., 2009). A third study (Kohlenberg, Kanter, Bolling, Parker, & Tsai, 2002) suggested that the addition of RFIs to therapies that do not typically incorporate them might increase their efficacy. In this study, incorporating RFIs into typical cognitive therapy was related to increased satisfaction with social support and increased improvements in outside relationships. Research from Goldfried and colleagues (Goldfried, Castonguay, Hayes, Drozd, & Shapiro, 1997; Goldfried, Raue, & Castonguay, 1998; Wiser & Goldfried, 1998) also supports the idea that RFIs can improve therapy outcomes. In a study of expert psychodynamic therapists and cognitive-behavioral therapists, sessions that were identified as having an in-session impact on the client and that resulted in client change were found to have more in-session focus than lower clinically significant sessions (Goldfried, Raue, & Castonguay, 1998). …

Affective Synchrony in Dual‐ and Single‐Smoker Couples: Further Evidence of “Symptom‐System Fit”?

Couples in which one or both partners smoked despite one of them having a heart or lung problem discussed a health-related disagreement before and during a period of laboratory smoking. Immediately afterwards, the partners in these 25 couples used independent joysticks to recall their continuous emotional experience during the interaction while watching themselves on video. A couple-level index of affective synchrony, reflecting correlated moment-to-moment change in the two partners' joystick ratings, tended to increase from baseline to smoking for 9 dual-smoker couples but decrease for 16 single-smoker couples. Results suggest that coregulation of shared emotional experience could be a factor in smoking persistence, particularly when both partners in a couple smoke. Relationship-focused interventions addressing this fit between symptom and system may help smokers achieve stable cessation.

The role of maternal responsiveness in predicting infant affect during the still face paradigm with infants born very low birth weight.

There is limited empirical literature addressing infants' response to a standardized stressor with infants born very low birth weight (VLBW). The purpose of this study was to assess the relative strength of maternal responsiveness in predicting infant affect in response to the Still Face (SF) paradigm in a cross-sectional cohort of ethnically diverse infants born VLBW and their mothers (N = 50; infants 6-8 months old). Infant affect and maternal responsiveness were coded in 1-s intervals while dyads participated in the SF. In addition, perinatal medical status, developmental status, and infant temperament were assessed. Findings revealed that positive infant affect during and after the SF stressor were strongly associated with baseline infant positive affect and maternal responsiveness at the reunion episode, respectively. In contrast, when predicting negative infant affect during and after the SF stressor, prior infant negative affect was strongly and uniquely significant. Infant positive affect, negative affect, and maternal responsiveness were not significantly associated with gender, infant perinatal medical history, developmental status, or temperament. Future research is warranted to determine how these findings relate to infants' stress reactions in naturalistic settings and if relationship-focused interventions may reverse infant negative emotionality, enhance positive emotionality, and thereby improve self-regulation and longer term social and cognitive developmental outcomes in medically at-risk infants.

Implementing a teacher–student relationship program in a high-poverty urban school: Effects on social, emotional, and academic adjustment and lessons learned

The primary purpose of this investigation was to examine the effects of a program designed to improve adolescents' relationships with at least one teacher in an urban high school. All participating students were nominated by teachers as having significant emotional and behavioral problems and approximately half of these youth were randomly assigned to an intervention that included increased positive involvement between each student and one teacher within the school. Teacher ratings of students' social, behavioral, emotional, and academic adjustment at pre- and post-intervention indicated that students in the intervention group had higher grade point averages than did students in the control group following the 5-month intervention but no differences were observed on other variables. Challenges associated with conducting school-based, relationship-focused interventions in high-poverty urban environments and several lessons that were learned in the process of initiating this project are discussed.

Ethics and Early Intervention: Toward More Relationship-Focused Interventions

Value-based decisions affecting the lives of young children and their families are made on a daily basis in early intervention. This article explores the dimensions of ethical decision making in early intervention. Selected comments from parents and professionals involved in an ethnographic intervie