Search Results (21)

Background/Objectives: Disruptive behavior problems are common in early childhood, yet access to evidence-based parent training remains limited in many communities due to workforce shortages and service delivery barriers. Behavioral Skills Training for Families (BSF) is a Parent–Child Interaction Therapy (PCIT)-informed, home-based behavioral skills practice model designed to be delivered by bachelor’s-level paraprofessionals under close supervision. This pilot study evaluated the feasibility and preliminary caregiver and child outcomes associated with the Child-Directed Interaction (CDI) module of BSF to inform refinement of training and implementation protocols and guide future evaluation. Methods: Using a non-randomized pre–post design embedded within routine services, caregiver–child dyads (children ages 2–10 years) receiving BSF CDI across community-based agencies in Minnesota were included. Outcomes were assessed using observational coding of caregiver skills (Dyadic Parent–Child Interaction Coding System; DPICS) and caregiver-reported child behavior measures (Eyberg Child Behavior Inventory [ECBI]; Weekly Assessment of Child Behavior–Positive [WACB-P]). Paired-sample t-tests with intent-to-treat analyses examined changes from the baseline to the last attended CDI session. Results: Caregivers demonstrated statistically significant and large increases in observed positive parenting skills and reductions in negative verbalizations during child-led play. Children showed significant reductions in disruptive behavior intensity and problem scores on the ECBI, reflecting movement toward clinically meaningful improvement. No significant change was observed in caregiver-reported positive child behaviors on the WACB-P. Post hoc analyses were conducted to further explore these differences and found consistent changes in the ECBI for cases, regardless of no reported changes in positive child behaviors on the WACB. Conclusions: The results provide preliminary evidence that a structured, PCIT-informed CDI skills practice model can be feasibly implemented by paraprofessionals and is associated with meaningful improvements in caregiver behavior and child behavior outcomes in the first 2–3 months following service initiation. The findings support BSF as a promising workforce-embedded approach and inform future controlled studies examining effectiveness, sustainability, and broader implementation outcomes. Full article

Given the importance of relationship satisfaction and the detrimental effects of its decline in romantic couples, it is crucial to understand how relationship satisfaction develops over time in long-term stable relationships and to identify predictors that explain such long-term changes. Building upon previously identified subgroups with distinct trajectories of relationship satisfaction, our objective was to examine whether two types of relationship skills—dyadic coping and communication—predict subgroup trajectories. We followed 300 mixed-gender couples over 10 years in annual assessments and applied Dyadic Latent Class Growth models with predictors. Our results suggest that subgroups of relationship satisfaction trajectories can be differentiated by both baseline levels and changes in relationship skills. Couples with high and relatively stable satisfaction were distinguished from those with declining satisfaction primarily by baseline negative communication (women’s report) and a deterioration in dyadic coping. Couples with the lowest initial satisfaction exhibited the least beneficial relationship skills but increased their satisfaction over time, likely due to observed improvements in their skills. These findings have important public health implications, as modifiable relationship skills can be targeted in prevention, counseling, or therapy to help couples develop and sustain improvements in their relationship skills to protect their relational well-being in the long term. Full article

Background/Objectives: Family caregivers in palliative care often face complex physical, emotional, and logistical challenges, which can result in a significant caregiving burden. Dyadic interventions—designed to support both the patient and the caregiver simultaneously—have emerged as a promising holistic approach to enhancing well-being and quality of life. This systematic review aimed to evaluate the effects of dyadic support interventions in reducing caregiver burden among middle-aged and older adults receiving palliative care. Methods: A systematic literature search was conducted following PRISMA guidelines across five databases (CINAHL, MEDLINE, Web of Science, Scopus, and Google Scholar for grey literature) covering the period from 2019 to January 2025. Results: Of 653 records identified, 8 studies met the inclusion criteria. Interventions were typically delivered by multidisciplinary teams and included weekly in-person consultations, telephone follow-up, telemedicine, physical exercise sessions, laughter therapy, and music therapy over durations ranging from 16 weeks to 6 months. These programs resulted in reduced anxiety and depressive symptoms (PHQ-4, HADS, SDS, BAI, SAS), improved functional and social performance (SF-36), and/or enhanced quality of life (MQLQ, QOL-AD, KCCQ-12, EORTC QLQ-C30). In patients, they contributed to better symptom control (ESAS, CFS), while in caregivers, they effectively reduced burden (ZBI-12, FCBSI, CBI) and/or supported the anticipatory grief process (PGQ, AGS). However, not all studies reported consistently positive outcomes. Conclusions: Structured dyadic interventions that involve both patients and caregivers significantly improve outcomes in palliative care for middle-aged and older adults. Future research should examine their long-term impact and explore the integration of artificial intelligence to optimize intervention delivery. Full article

Cardiovascular disease encompasses a wide group of conditions that affect the heart and blood vessels. Of these diseases, cardiomyopathies and arrhythmias specifically have been well-studied in their relationship to cardiac dyads, nanoscopic structures that connect electrical signals to muscle contraction. The proper development and positioning of dyads is essential in excitation–contraction (EC) coupling and, thus, beating of the heart. Three proteins, namely CMYA5, JPH2, and BIN1, are responsible for maintaining the dyadic cleft between the T-tubule and junctional sarcoplasmic reticulum (jSR). Various other dyadic proteins play integral roles in the primary function of the dyad—translating a propagating action potential (AP) into a myocardial contraction. Ca²⁺, a secondary messenger in this process, acts as an allosteric activator of the sarcomere, and its cytoplasmic concentration is regulated by the dyad. Loss-of-function mutations have been shown to result in cardiomyopathies and arrhythmias. Adeno-associated virus (AAV) gene therapy with dyad components can rescue dyadic dysfunction, which results in cardiomyopathies and arrhythmias. Overall, the dyad and its components serve as essential mediators of calcium homeostasis and excitation–contraction coupling in the mammalian heart and, when dysfunctional, result in significant cardiac dysfunction, arrhythmias, morbidity, and mortality. Full article

Background/Objectives: Continuous positive airway pressure (CPAP) is the standard approach for treating obstructive sleep apnea syndrome (OSAS), but patient adherence is often low due to various influencing factors. Recently, researchers have increasingly begun to explore the influence of partner support on adherence to CPAP therapy. This systematic review seeks to consolidate current evidence regarding the impact of partner support on CPAP adherence in individuals with OSAS. Methods: A comprehensive literature search was carried out across PubMed, Scopus, Medline, PsycINFO, and Web of Science databases under PRISMA guidelines. Stringent inclusion criteria were used, and at least two independent reviewers screened all studies. The mixed methods appraisal tool (MMAT) was used to assess selected articles for quality. Data relevant to the review’s objectives were extracted and presented through narrative synthesis. The review protocol was preregistered (Prospero CRD420251016574). Results: Nine studies met the inclusion criteria. Findings highlighted the significant influence of adherence to CPAP. Partner support, relationship quality, and collaborative efforts emerged as facilitators of adherence, with partnered individuals exhibiting higher adherence to CPAP use. However, barriers such as anxiety, interruption in intimacy, and conflict in relationships were also identified. Conclusions: To the best of our knowledge, this is the first systematic review to synthesize evidence on the partner’s role in CPAP adherence and inform clinicians on the importance of providing personalized care based on biopsychosocial characteristics of patients; for example, assessing the partner support in the management of the illness. Furthermore, the findings emphasize the need for further research—particularly randomized controlled trials and dyadic designs—to deepen understanding of how partner dynamics influence effects of CPAP treatment. Full article

Black/African American individuals experience high rates of posttraumatic stress disorder (PTSD), which is frequently chronic and undertreated in this population. Intimate relationships are a salient resource for Black/African American adults’ psychological well-being. To help advance health equity, this study serves as an initial, proof-of-concept investigation of patient outcomes among Black/African American adults who received a disorder-specific couple therapy for PTSD. Participants were a subsample of seven Black/African American adults (mean age = 40.56 years, SD = 10.18; 85.7% male) who participated in an uncontrolled trial of an abbreviated, intensive, multi-couple group version of cognitive-behavioral conjoint therapy for PTSD with 24 military dyads. Treatment was delivered over 2 days in a weekend retreat format. Assessments were administered at baseline, 1 month post-retreat, and 3 months post-retreat. There were large and significant decreases in patients’ PTSD symptoms based on clinicians’ and patients’ ratings (ds −1.37 and −1.36, respectively) by the 3-month follow-up relative to baseline. There were also large and significant decreases in patients’ depressive, anxiety, and anger symptoms (ds −1.39 to −1.93) and a large, marginally significant decrease in patients’ insomnia (d = −0.85; p = 0.083). Patients reported a medium, non-significant increase in relationship satisfaction (d = 0.68; p = 0.146) and a large, marginally significant increase in joint dyadic coping (d = 0.90; p = 0.069). Findings offer preliminary evidence that treating PTSD within a couple context is a relevant strategy to reduce PTSD and comorbid symptoms among partnered Black/African American adults and a promising approach to enhance relationships. Full article

Although adults with depression struggle to effectively emotionally regulate themselves, these findings are limited to one partner in a romantic relationship, community samples, and cross-sectional designs. Hence, we aimed to address these gaps in the literature by investigating emotion regulation difficulties as a predictor of change in depression among couples in couple therapy. Additionally, we aimed to investigate whether emotion regulation difficulties mediated the well-established association between relationship satisfaction and changes in depression of couples in couple therapy. We examined 484 different-sex couples in couple therapy from the Marriage and Family Therapy Practice Research Network—a clinical dataset from clinics across the United States. Dyadic latent growth models revealed the actor and partner effects of emotion regulation difficulties at session 1, predicting decreases in depression trajectories across 16 sessions of couple therapy. Additionally, dyadic latent growth mediation models revealed that emotion regulation difficulties at session four did not mediate the associations between relationship satisfaction at session 1 with depression trajectories of sessions eight through 16. For couple therapy clinicians, emotion regulation difficulties can play a direct role in the treatment of depression. However, our results did not support emotion regulation difficulties as a mediator for the well-established association between relationship satisfaction and depression trajectories. Full article

Background/Objectives: The Prostate Cancer Patient Empowerment Program (PC-PEP) is a 6-month, home-based intervention aimed at enhancing mental health in men undergoing curative prostate cancer treatment. This exploratory secondary analysis evaluates PC-PEP’s impact on relationship satisfaction, quality of life, and support group attendance among partnered participants. Methods: In a crossover randomized clinical trial ClinicalTrials.gov identifier: NCT03660085) of 128 men aged 50–82 scheduled for curative prostate cancer surgery or radiotherapy, 119 participants in relationships were included. Of these, 59 received the 6-month PC-PEP intervention, while 60 were randomized to a waitlist-control arm, receiving standard care for 6 months before starting PC-PEP. The intervention included daily emails with video instructions on mental and physical health, diet, social support, fitness, stress reduction, and intimacy. Outcomes were assessed using the Dyadic Adjustment Scale (DAS) and the Functional Assessment of Cancer Therapy–Prostate (FACT-P). Results: While relationship satisfaction remained stable, a significant improvement in emotional well-being was observed at 12 months in participants undergoing radiation therapy (p = 0.045). The PC-PEP intervention also led to significantly higher support group attendance at both 6 months (p = 0.001) and 12 months (p = 0.003), emphasizing its role in fostering social support and community engagement. Conclusions: The PC-PEP program effectively maintains relationship satisfaction and enhances emotional well-being, particularly in patients with fewer physical side effects. Its design promotes comprehensive care by integrating physical, psychological, and social support, making it a valuable resource for improving the quality of life in prostate cancer patients and potentially applicable to other cancer types. Full article

Background: The literature highlights the profound psychological impact of war on children, families, and communities, emphasizing the prevalence of Post-Traumatic Stress Disorder (PTSD), anxiety, and other symptoms among affected individuals. Interventions, such as Child-Parent Psychotherapy (CPP) and music therapy, show promise in mitigating trauma effects, underscoring the need for holistic approaches that address familial and community dynamics alongside individual well-being. Methods: Aiming to explore the influences of dyadic music therapy sessions on parents’ capacity to support their children, this study involved four families displaced from their home-kibbutz as result of a terrorist attack. All dyads participated in music therapy sessions with a focus on parent–child interactions and trauma processing (CPP informed). Embedded in a qualitative, phenomenological approach, the research utilized interpretative phenomenological analysis (IPA) and micro-analytic methods to explore meaningful moments in the music therapy sessions. Results: Findings identified four central categories: (1) Discovering the child’s grounding song: identifying resources; (2) Musical improvisation sets the grounds for parent–child mutual recognition of the child’s traumatic experience; (3) Musical performance empowers child and parent; (4) A sense of agency is gained through controlling the musical environment. Conclusions: The significance of restoring the children’s freedom of play, the parents’ sense of competency, and of enhancing families’ capacity to connect to their traumatic experiences through the musical environment is discussed. Full article

Parent–child interaction therapy (PCIT) is a highly efficacious, evidence-based treatment for children with disruptive behaviors and their families. PCIT is a dyadic therapy designed to improve parent–child relationships and decrease children’s behavioral problems. PCIT research specific to Black families is currently sparse. Given findings that Black families have a higher attrition rate and demonstrate fewer significant improvements in parental well-being outcomes, we sought to assess clinicians’ perceived cultural alignment of PCIT with Black families. We conducted individual interviews via Zoom with 10 Black clinicians, trained in PCIT, who had experience treating Black families using PCIT. The research team generated the following themes using thematic analysis: cultural misalignment, manualization, barriers to treatment, generational patterns of discipline, racial considerations, and protocol changes. Findings indicate that Black clinicians have identified various points of cultural misalignment in providing PCIT with Black families, for which they have modified treatment or suggested changes to improve cultural sensitivity. Collating suggested clinician modifications to inform a cultural adaptation of PCIT for Black families may contribute to a reduction in the attrition rate and improvement in outcomes for Black families participating in PCIT. Full article

Background: Chronic spinal cord injury (SCI) significantly accelerates morbidity and mortality, partly due to the increased risk of cardiometabolic diseases (CMD), including neurogenic obesity, dyslipidemia, and impaired glucose metabolism. While exercise and dietary interventions have shown some transient benefits in reducing CMD risk, they often fail to improve clinically relevant disease markers and cardiovascular events. Moreover, SCI also places caregiving demands on their caregivers, who themselves experience health and functional decline. This underscores the need for more substantial interventions that incorporate appropriate physical activity, heart-healthy nutrition, and behavioral support tailored to the SCI population. Objectives: This randomized clinical trial (RCT) protocol will (1) assess the health and functional effects, user acceptance, and satisfaction of a 6-month comprehensive therapeutic lifestyle intervention (TLI) adapted from the National Diabetes Prevention Program (DPP) for individuals with chronic SCI and (2) examine the impact of a complementary caregiver program on the health and function of SCI caregivers and evaluate user acceptance and satisfaction. Caregivers (linked with their partners) will be randomized to ‘behavioral support’ or ‘control condition’. Methods: Dyadic couples comprise individuals with SCI (18–65 years, >1-year post-injury, ASIA Impairment Scale A-C, injury levels C5-L1) and non-disabled SCI caregivers (18–65 years). Both groups undergo lock-step circuit resistance training, a calorie-restricted Mediterranean-style diet, and 16 educational sessions focused on diet/exercise goals, self-monitoring, psychological and social challenges, cognitive behavioral therapy, and motivational interviewing. The outcome measures encompass the cardiometabolic risks, cardiorespiratory fitness, inflammatory stress, multidimensional function, pain, life quality, independence, self-efficacy, program acceptance, and life satisfaction for SCI participants. The caregiver outcomes include multidimensional function, pain, quality of life, independence, and perceived caregiver burden. Discussion/Conclusions: This study evaluates the effects and durability of a structured, multi-modal intervention on health and function. The results and intervention material will be disseminated to professionals and consumers for broader implementation. Trial Registration: ClinicalTrials.gov, ID: NCT02853149 Registered 2 August 2016. Full article

(1) Background: Very little is known about the inner therapeutic processes of psychotherapy interventions for patients suffering from treatment-resistant schizophrenia. Avatar therapy (AT) is one such modalities in which the patient is undergoing immersive sessions in which they interact with an Avatar representing their main persistent auditory verbal hallucination. The aim of this study is to identify the most prevalent dyadic interactions between the patient and the Avatar in AT for patient’s suffering from TRS. (2) Methods: A content analysis of 256 verbatims originating from 32 patients who completed AT between 2017 and 2022 at the Institut universitaire en santé mentale de Montréal was conducted to identify dyadic interactions between the patients and their Avatar. (3) Results: Five key dyads were identified to occur on average more than 10 times for each participant during the immersive sessions across their AT: (Avatar: Reinforcement, Patient: Self-affirmation), (Avatar: Provocation, Patient: Self-affirmation), (Avatar: Coping mechanisms, Patient: Prevention), (Patient: Self-affirmation, Avatar: Reinforcement), and (Patient: Self-appraisal, Avatar: Reinforcement). (4) Conclusion: These dyads offer a first qualitative insight to the interpersonal dynamics and patient-avatar relationships taking place during AT. Future studies on the implication of such dyadic interactions with the therapeutic outcome of AT should be conducted considering the importance of dyadic relationships in psychotherapy. Full article

Difficulties related to sexual desire discrepancy are among the most common complaints in people seeking help in therapy. The aims of the current study were to test a mediation model using a bootstrapping procedure where the quality of the dyadic sexual communication plays a key role in increasing or diminishing the degree of perceived sexual desire discrepancy through sexual satisfaction. An online survey was administered through social media to N = 369 participants involved in a romantic relationship, measuring the quality of dyadic sexual communication, sexual satisfaction, the degree of the perceived sexual desire discrepancy, and a series of relevant covariates. As expected, the mediation model showed that a better quality of dyadic sexual communication is related to a lower degree of perceived sexual desire discrepancy through increased sexual satisfaction (β = −0.17, SE = 0.05, [95% CI = −0.27, −0.07]). The effect held over and above the effect of the relevant covariates. The theoretical and practical implications of the present study are discussed. Full article

Parent-Child Interaction Therapy (PCIT) is one of the strongest evidence-based treatments available for young children and their families. Research has supported the use of PCIT for children with a history of trauma; however, the treatment does not directly address trauma in the child. PCIT is a dyadic treatment; yet, the impact of the carer’s trauma on the carer-child relationship is not assessed or incorporated into treatment. For these reasons, therapists, families, agencies, and funders tend to view PCIT as a trauma treatment with skepticism. PCIT therapists who currently address trauma within the intervention do so without a standardized approach. Trauma-Directed Interaction (TDI) is an adaptation developed to directly address these concerns. TDI maintains the key elements and theoretical underpinnings of PCIT while adding sessions to cover psychoeducation about trauma, carer response to a child’s trauma reactions (SAFE skills), and coping skills to aid both the child and the carer to manage trauma activators (COPE skills). The TDI module creates a consistent strategy for PCIT therapists to address trauma, thus allowing research and replication which will advance the dual fields of PCIT and family trauma. The theoretical conceptualization of TDI is presented along with next steps in its evaluation. Full article

Psychosocial interventions targeting the specific needs of people affected by younger-onset dementia are lacking. Younger-onset dementia refers to dementia where symptom onset occurs at less than 65 years old. Because of its occurrence in middle age, the impact on spouses is particularly marked and dyadic-based interventions are recommended. Music And Psychology & Social Connections (MAPS) is a novel online intervention, informed by the theory of adaptive coping by Bannon et al. (2021) for dyads affected by younger-onset dementia. MAPS combines therapeutic songwriting, cognitive behaviour therapy, and a private social networking group that focuses on the dyads. This will be a randomised controlled trial with a waitlist control. The primary aims are to assess whether MAPS improves depressive, anxiety, and stress symptoms in caregivers, with secondary aims to assess whether MAPS improves depressive symptoms in people with younger-onset dementia. The trial also aims to assess dyadic social connectedness; caregiver coping skills; and neuropsychiatric symptoms in people with younger-onset dementia. We will recruit 60 dyads to participate in a group-based weekly online program for 8 weeks facilitated by a credentialed music therapist and psychologist. Sessions 1 and 8 will include both caregivers and people with younger-onset dementia and Sessions 2–7 will involve separate group sessions for caregivers and those with dementia. There will be focus groups for qualitative feedback. Due to its online administration, MAPS has the potential to reach many dyads affected by younger-onset dementia. Full article