Social withdrawal is often associated with a number of indices of adjustment and maladjustment, but little research exists that attempts to uncover potential protective factors. This study longitudinally examined the moderating role of parent extraversion and parent warmth on the association between two types of social withdrawal (shyness and unsociability) and later indices of adjustment and maladjustment. Participants were 463 families from the flourishing families project. Results showed no longitudinal associations between social withdrawal and later indices of adjustment or maladjustment. However, when parent extraversion was added as a moderator, shyness was positively associated with prosocial behavior for those with introverted parents, and positively associated with shame for those with highly extraverted parents. Implications are discussed.

The therapeutic alliance, a construct representing agreement and collaboration on therapy goals, therapy tasks, and the emotional bond between client(s) and therapist, is a robust predictor of therapy outcomes in individual, couple, and family therapy. One way to track the therapeutic alliance is through ruptures and repairs. Ruptures are breaks, tensions, or tears in the therapeutic alliance. Ruptures and repairs influence the therapeutic alliance and consequently therapeutic outcomes. Currently, there is a lack of research addressing ruptures and repairs in couple therapy. The first step in researching alliance ruptures is to have a reliable way to assess alliance ruptures. This study will describe the development of the Coding Rupture Indicators in Couples Therapy (CRICT). The CRICT is an observational coding scheme that measures ruptures in couple therapy. The CRICT was developed through collaboration with researchers in marriage and family therapy, creation of items, adaptation of items from established coding schemes from individual therapy, and input and feedback as the CRICT was used and tested by undergraduates in a coding class. This paper will review foundational research of ruptures and repairs as well as the construction and use of the CRICT coding scheme.

Background and aims: Impaired eating habits and reduced physical activity have become associated with obesity in children in the last three decades. Parents have a responsibility to be good models for their children regarding lifestyle patterns and habits. The aim of this thesis was to evaluate a family-based behavioural intervention programme (FBIP) for children with obesity designed for use in paediatric outpatient care. The specific aims were to investigate the clinical outcomes and programme adherence and to examine the children’s lifestyle habits according to their own and their parents’ reports, the agreement between these reports, and the correlations to change in z-BMI (standardized body mass index) from baseline to 12 months after the FBIP. Subjects and methods: This thesis is based on a prospective single-group before/after design. Twenty-six children, 14 boys and 12 girls aged 8.3–12.0 years, and their parents attended 25 group sessions, in 3 child and 3 parental groups, during a 2-year FBIP. The treatment manual, Group treatment for children with Overweight and Obesity and their Parents and the semistructured interview called MORSE, a Swedish term for Food and Activity, Social and Emotional adaptation, emphasizes cognitive and behavioural guidelines and the focus is to change eating and physical activity habits and to maintain the new changes. Results: The results showed that the children decreased their z-BMI from a mean of 3.3 (0.7 SD) at baseline to 2.9 (0.7 SD) 1 year after the completion of the programme. There was a significant decrease in z-BMI in boys from a mean of 3.5 (0.6 SD) at baseline to 3.0 (0.7 SD) (p = 0.001) at follow-up 12 months after completion of the programme; the z-BMI in the girls decreased from a mean of 3.0 (0.6 SD) at baseline to 2.7 (0.8 SD) (p = 0.155) at follow-up. The children’s waist/height ratio (the waist circumference in centimetres) divided by the height (in centimetres) showed no significant decrease over the same period. The biomedical markers of blood glucose metabolism and lipid status remained within the normal range at the 1-year follow-up after program completion compared with baseline. The rate of family adherence to the programme was high. The reports from the children and the parents regarding the children’s lifestyle habits showed a significant increase regarding the level of physical activity after the FBIP (24 months) compared with baseline. Agreement between the children and their parents improved after the FBIP (24 months) compared with baseline, regarding whether the children felt hungry most of the time and the children’s levels of physical and sedentary activity. Changes in the child or parental analyses of lifestyle were not significantly associated with reduced weight 1 year after the end of the FBIP. Conclusions: A 2-year FBIP against childhood obesity implemented in a paediatric outpatient setting can be seen as a potential model for children and their parents. It is important to offer interventions to children with obesity although this FBIP needs to be confirmed with larger populations in a randomized controlled trial.

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The number of families choosing to adopt a child internationally in the United States has increased exponentially on an annual basis (Johnson, 1997; Miller, 2000). The purpose of this study was to understand the adoption process experiences of families who have adopted a child between the ages of three and five years old from Russia or Romania after 1992. In this clinical sample, all participants' adopted children had been referred for and undergone neuropsychological, medical, speech, and/or language evaluation. Specifically, the research questions were designed to help therapists understand the role mental health care professionals, schools, family members, and friends played in the adoption process and how the participants' experiences compared with their preadoptive expectations. Twenty families were interviewed and several observations were conducted. Data analysis consisted of thematic analysis which elicited codes and themes across the interviews. This study's findings suggest that: 1) parents would have found more preparation before adoption helpful in the process; 2) health care professionals and schools need to be better educated about problems, concerns, and appropriate treatments specific to post-institutionalized children; 3) raising (a) special needs child(ren) puts significant strain on the caregiver(s) and their significant relationships; and 4) families with special needs children are extremely resilient. These findings are important for education and healthcare professionals, families who are planning to adopt internationally in the future and current adoptive families. / Ph. D.

The purpose of this Delphi study was to explore and identify a panel of experts' opinions of essential elements for successful multi-family group therapy (MFGT) and to propose the identified elements as guidelines for future MFGT theoretical and program development. Multi-family group therapy continues to be implemented while there is little empirical research to support how it is effective and with what populations and presenting problems it is best employed. A panel of MFGT experts identified 35 essential elements for successful MFGT. Many of the identified elements coincided with elements identified in the relevant literature. However, elements specific to MFGT were distinguished. The essential elements are presented as guidelines for MFGT theoretical and program development. The implications of this study for theory, research, and practice are discussed. / Ph. D.