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Resistance or struggle in therapy looms large as a predictor of treatment outcomes. This study organizes the significant empirical data on struggle into a coherent, operational framework for use by therapists in preventing and/or ameliorating harmful struggle in therapy. First, we review the prevalence and significance of struggle. Second, we offer a historical and conceptual overview, with emphasis on a contemporary interactional/systemic perspective on struggle. Third, we provide a synthesis of peer-reviewed research, profiling struggle at speech-act and episode levels of interaction process and across assessment/joining, intervention, and integration-consolidation phases of therapy. Fourth, based upon this review, we propose a three-factor model--consisting of eliciting dialogue, enactments, and accommodation--for successful therapy process relative to the occurrence of struggle.

In recent decades there has been an increase in literature regarding sexual addiction as well as a growing number of clients presenting in therapy with problems related to their sexual behaviors (including internet sexual addiction). This article (a) presents a synthesis of the research on the impact of sexual addiction on the addict, the partner, and the couple; (b) outlines the process of healing for each based on the research synthesis; and (c) discusses the role of marriage and family therapy in facilitating both individual and relationship healing from sexual addiction. Implications for future research in sexual addiction, generally, and in marriage and family therapy, specifically, are presented.

Advocates of home-schooling claim a variety of positive educational and familial outcomes. Research is needed to examine possible effects of home-schooling on family relationships. We investigated family environment differences between home-schooling and public-schooling families matched in terms of family-centric orientation. Family cohesion was measured using FACES III, and parent–adolescent interaction styles were measured using the Interaction Styles Profile, an instrument formulated for limited research use by the second author based on previous work done with family interaction styles. Mothers, fathers, and adolescent students in 38 public-schooling and 35 home-schooling families completed the measures. The potential confound of preexisting values and commitment to highly cohesive, emotionally connected, cooperative family life in home-schooling families was controlled for by the selection of public-schooling families matched on this variable (family-centric orientation). Family-centric home-schooling families reported statistically significant, but only moderately higher levels of family cohesion and parent–child parallel interaction than family-centric public-schooling families. There were no significant differences between home-schooling and public-schooling families in self-reported symmetrical and complementary interactions. Thus, when controlling for preexisting family-centric orientation, the institution and practice of home-schooling alone appears to produce only moderate (clinically nonrelevant) shifts in family cohesion or positive parallel interaction, suggesting that family-centric families can realize their goals for family cohesion and positive interaction independent of their choice of schooling.

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