In response to a series of national policy reports regarding what has been termed the "quality chasm" in health and mental health care in the United States, in January 2003, the American Association for Marriage and Family Therapy convened a task force to develop core competencies (CC) for the practice of marriage and family therapy (MFT). The task force also was responding to a call for outcome-based education and for the need to answer questions about what marriage and family therapists do. Development of the CC moves the field of MFT into a leading-edge position in mental health. This article describes the development of the CC, outcomes of the development process for the competencies, and recommendations for their continued development and implementation.

Reservations about qualitative research often center around contentions that, since qualitative methods are so subjective and uncontrolled, the results of qualitative research are not valid and reliable. While many qualitative researchers in education have attempted to improve the trustworthiness of their results by making their methods more systematic, we argue that qualitative researchers cannot establish the trustworthiness of their findings, regardless of the methods they use. Rather, the legitimization of knowledge requires the judgment of an entire community of stakeholders. In the absence of certainty, knowledge is an ethical matter, one in which the judgement of each stakeholder must count.

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In going about this work, some qualitative researchers tend to favor traditions, practices, and forms from the humanities and arts, and some lean toward conventions of inquiry from the social and natural sciences (Eisner, 1985(Eisner, , 1991. Those from the artistic camp (e.g., Ellis 6 Bochner, 1996;Janesick, 1998) emphasize story, performance, interpretation, and sometimes present their work in various literary forms such as biography, autobiography, diaries, and poetry. Those from the scientific tribe (e.g., Creswell, 1994; Miles €J Huberman, 1994; Weitzman €r Miles, 1995) stress research design, sampling strategies, more traditional views of validity, reliability, and generalizability, compatibility with quantitative approaches, and computer-aided analysis of data.Researchers using qualitative methodologies attempt to study naturally occurring events from either an insider or an outsider perspective. In the "insider" approach, qualitative researchers go "to the field" (i.e., the setting or place of interest) and interview participants about their lived experiences, carefully observe them in action, or do both. Also, the researchers often become insiders and record their own impressions of being a part of the action. In the "outsider" approach, researchers stay apart from the phenomenon or setting. They collect recordings, study documents, and other artifacts from "the field." They then work to describe or interpret the patterns they "discover" or "construct" through their repeated interactions with the data (Mahrer, 1988).Qualitative researchers establish credibility for their work by constantly comparing what they learn from previous observations on a site, a group of people, or phenomenon with what they subsequently "see" in later samples from the site, the people, or phenomenon. Each observation of the phenomenon presents an opportunity for researchers to falsify their best story, description, coding, or interpretation of the phenomenon. Also, each visit with the data increases the researchers confidence that their analysis is the best and most fitting account of what they found in the field.In presenting their work, qualitative researchers must clearly describe their working methods, accounting for the choices they made in constructing their inquiry (Chenail, 1994;Constas, 1992). They describe the setting for their study and how they gained access to the site. In addition, they recount the process of generating and collecting their data, the means for processing and analyzing the data, the ways in which they will re-present their analytical observations, and how they conducted quality controls in their work. During this process, it is important for qualitative researchers to take great care to delineate who they are, what they are attempting to do in their work, and how they participate in their ongoing research endeavors (Wolcott, 1992). Through these self-reflective narratives, qualitative researchers estab-

Based upon a qualitative metasynthesis of 49 articles centered on clients' experiences of their conjoint couple and family therapy, the investigators constructed a grounded formal theory of Clients' Relational Conceptions of Conjoint Couple and Family Therapy Quality. The theory suggests from pretherapy conceptions to posttherapy reflections, clients' perceptions of conjoint couple and family therapy quality appear to consist of clients' constructed meanings regarding a series of interrelated relationships between clients and their therapists and therapy environments, between clients and themselves, between clients and other family members, and between process and outcome both inside and outside therapy. Within and across these relationships, clients appear to focus on expectations, connections, balance, and change when evaluating the quality of their clinical experiences. Based upon this theory, the investigators recommend that researchers continue to explore this clinical phenomenon and that therapists regularly seek clients' conceptions of quality in therapy.