Parental divorce is widely associated with increased psychological risk among adolescents, yet adaptation varies considerably across individuals. Existing resilience research has largely emphasized traits and protective factors, offering limited insight into the subjective processes through which adolescents make sense of adversity. Addressing this gap, this study conceptualizes resilience as a dynamic process of narrative identity reconstruction within a counseling context. Using a qualitative narrative inquiry design, this study examines the lived experiences of three adolescents navigating parental divorce in an Indonesian collectivist context. Data were generated through in-depth counseling sessions and analyzed across three temporal phases: pre-counseling, during counseling, and post-counseling, with a focus on how personal narratives are constructed and transformed over time. Findings indicate that resilience unfolds as a meaning-driven and temporally dynamic process, evolving from survival-oriented coping and narrative fragmentation toward greater coherence, agency, and future orientation. Narrative counseling facilitated this transformation through mechanisms such as externalization, re-authoring, and value-based action, enabling participants to reinterpret adversity and reconstruct adaptive identities. Resilience emerged not as the resolution of distress, but as the integration of adverse experiences into coherent life narratives. The findings also highlight the role of sociocultural context, showing how values such as familial harmony and relational responsibility both constrain and enable narrative reconstruction. By reconceptualizing resilience as a narrative and evolving process, this study contributes a culturally grounded framework for understanding adolescent adaptation and informs narrative-based counseling practices.
Gottman's Four Horsemen have become one of the most influential frameworks for understanding destructive communication within intimate relationships, demonstrating how criticism, contempt, defensiveness, and stonewalling contribute to relationship distress and instability. Comparatively little attention has been given to how children developmentally interpret repeated exposure to these communication patterns. The present theoretical article offers a developmental interpretation of Napier and Whitaker's concept of the Family Crucible, proposing that children are not passive observers of family communication but active interpreters of repeated relational experiences. Through ongoing interactions within the family, children gradually assign meaning to recurring communication patterns, organize those interpretations into increasingly coherent relational understandings, and, over time, develop enduring relational beliefs about themselves, other people, close relationships, and emotional safety. The Family Communication Crucible provides a developmental interpretation of established relational theories by examining how repeated family communication may contribute to children's meaning-making, relational belief formation, and expectations of future relationships. Clinical implications are discussed for family therapists, couple therapists, child clinicians, parent education, and prevention-oriented practice. Directions for future research include longitudinal investigations, observational studies of family communication, the development of relational belief measures, and the examination of protective communication, relational repair, and corrective relational experiences.
Cancer survivorship and caregiving emerged as a focus on disease remission to a brief paradigm multifaceted needs of patients post-treatment. The oncological care theories emphasised biomedical outcomes neglecting the psychological, socio-emotional and spiritual practices and concerns. The Multidimensional Approaches for Comprehensive Well-Being is a patient-centred holistic model of cancer survivorship prioritising the whole person for a care continuum. It examines evidence-based models, policy frameworks and clinical practices, prioritise survivors’ experience, autonomy and overall quality. The key components of holistic survivorship model are health, symptom, management, physio-psychological, socio- emotional support, spiritual care, community reintegration, and financial and practical assistance. Multidisciplinary interventions like rehabilitation, counselling, social support groups, vocational rehabilitation and financial counselling become essential for restoration and resilience building to reintegrate into daily life and reduce aftereffects of treatments. Recent approaches like telehealth, digital transformative survivorship care, extended consultation, symptom monitoring, AI and data-analytical predictive modelling, personalised treatments have emerged. Integrative therapies like mindfulness, acupuncture, exercise and massage are supplementing the traditional. Community-based programs and survivor-led advocacy have increased social connectedness and empowered belongingness. Despite improvements, challenges in ensuring equitable access, culture-free care, resource allocation and training for holistic care exit. This chapter is a roadmap to contemporary research and a practical model of patient-centred holistic survivorship care which highlights wellbeing and not just absence of disease and guides clinicians, policy makers and researchers in developing scalable, evidence-based models that fulfil the evolving needs of cancer survivors globally.
Intimacy within romantic relationships is shaped by the broader sociocultural and structural conditions in which couples are embedded. Sexual scripts, socially constructed frameworks guiding how individuals interpret and enact intimate behaviors, serve as a mechanism through which these structural forces operate. When internalized scripts conflict with a person's authentic sense of self, a clinically significant tension emerges. This paper synthesizes sexual script theory and structural competence frameworks to introduce the concept of identity-role misalignment: the experience arising when socially prescribed sexual and intimate roles diverge from an individual's genuine identity, producing disconnection, reduced satisfaction, and impaired communication in couple relationships. Applying the Social Determinants of Sexual and Reproductive Health framework as extended to integrative sex and couples counseling, this paper situates sexual distress within structural and sociocultural contexts. By examining sexual scripts and erotic templates as structurally produced phenomena, it centers identity-role misalignment as a clinical focus and proposes sexual script renegotiation as a primary mechanism of therapeutic change. These dynamics are illustrated through a fictional cisgender heterosexual case vignette. Implications for structurally competent counseling practice and future research directions are discussed.
Artificial intelligence (AI) is increasingly shaping graduate mental health education, yet its influence extends beyond technical skill development to relational reflection, professional identity formation, and culturally situated meaning-making. This mixed-methods study examined the relationship between AI literacy and human flourishing among graduate mental health students in the United States and Iran. Quantitative findings indicated that higher AI literacy was significantly associated with greater self-awareness, emotional insight, relational awareness, and sense of purpose. U.S. students reported higher AI literacy, particularly in access, frequency of use, and perceived competence, while Iranian students described greater ethical caution and sociopolitical awareness. Qualitative findings suggested that students experienced AI not only as an academic tool, but also as a reflective dialogue partner that supported emotional processing, perspective taking, and professional development. At the same time, participants raised concerns about authenticity, dependency, bias, cultural limitations, and the absence of human relational presence. Findings position AI literacy as a systemic, relational, and culturally embedded competency rather than a purely technical skill. Implications are discussed for culturally responsive AI pedagogy, therapist training, ethical reflection, and future research on AI in mental health education.
The health status of elderly family members is shaped by complex biological, psychological, and social factors; however, the role of healthcare practitioner behavior and system-level practices within family-oriented and plural healthcare contexts remains under-explored, particularly in low- and middle-income countries. This study examined how medical practitioners conceptualize determinants of elderly family members’ health outcomes in Pakistan's plural healthcare system. Using a qualitative exploratory design, 22 practitioners, including physicians, homeopathic, and traditional providers, were selected through purposive maximum variation sampling. Data were collected via semi-structured interviews in Urdu and analyzed using thematic analysis informed by Colaizzi's phenomenological approach. Findings indicated that the health outcomes of elderly family members are influenced by multi-morbidity, age-related decline, health literacy, medication adherence, and healthcare system factors. Importantly, practitioners highlighted the central role of family members in caregiving, treatment decision-making, financial support, and communication with healthcare providers, which significantly shaped health outcomes in the elderly. Practitioner-related issues, including communication gaps, inconsistent prescribing, time constraints, and non-standard practices, further influenced interactions between healthcare providers and families. Grounded in the biopsychosocial model, the study emphasizes integrating family-centered approaches into healthcare delivery to improve geriatric care in resource-constrained and plural healthcare settings.
Objective This study investigates the premarital readiness levels of couples applying for marriage, examining the interplay between marital maturity, marriage attitudes, and attachment styles through a gender-oriented lens. Background Marriage is a critical life transition influenced by socio-economic motivations and socially constructed gender roles. While premarital readiness is vital for marital stability, it remains under-researched in the Turkish context, particularly regarding how gendered “performances” shape expectations. Method A quantitative research design was employed, utilizing the Premarital Readiness Scale, Inonu Marriage Attitude Scale, and Three-Dimensional Attachment Styles Scale. The sample consisted of 100 couples ( N = 200) recruited via random sampling at the Keçiören Marriage Registry Office in Ankara. Results Findings revealed significant gender differences in maturity dimensions; women scored higher in emotional and biological maturity, while men scored higher in economic and social maturity. Most participants (71% of women, 75% of men) exhibited secure attachment, which significantly correlated with higher readiness and more positive attitudes. Financial issues emerged as the primary premarital challenge, especially for men. Conclusion Premarital readiness is a socially and culturally constructed process rather than a purely individual trait. The study confirms that gendered scripts—reinforced by economic provision for men and emotional caregiving for women—continue to structure marital preparations. Implications Findings emphasize the necessity of mandatory, gender-sensitive premarital education programs facilitated by social workers. Such interventions should aim to deconstruct traditional gender hierarchies to foster more egalitarian and resilient marital foundations.
Counseling is inherently goal-oriented, governed by theoretical, ethical, and legal standards of practice. Consequently, the behavior of counseling practitioners during sessions is crucial, not only for achieving favorable counseling outcomes but also for fostering genuine rapport between clients and counselors. Counseling students are introduced to key theories during their training programs and are expected to apply their theoretical knowledge in practice. Therefore, it is anticipated that their behavior during counseling sessions reflects the principles of the theories they have studied. Systems theory is one such framework typically included in training curricula. This manuscript aims to elucidate the behaviors associated with this theory.
This study examines how transgender adults in Italy negotiate intimate relationships before and after gender affirmation, with particular attention to couple and family processes. Existing research has often framed transgender intimacy in terms of minority stress and vulnerability or as an outcome of individual authenticity. While these perspectives offer important insights, they may underemphasize the relational processes through which intimacy is negotiated across interconnected systems. Drawing on written narratives from 98 transgender adults, we conducted a constructionist thematic analysis of participants’ accounts of couple experiences prior to coming out and following gender affirmation. Findings suggest that, before affirmation, intimacy was frequently experienced as unavailable, uncomfortable, or unsustainable within cisnormative relational and family scripts. After affirmation, participants described expanded possibilities for intimacy, alongside ongoing challenges involving disclosure, fear of rejection, embodiment, and the renegotiation of gendered expectations. These processes extended beyond the couple, involving families of origin and broader social networks that shaped recognition, belonging, and relational continuity. The concept of relational agency is proposed as an interpretative lens to understand how transgender individuals actively negotiate intimacy within—and sometimes in the absence of—viable relational positions. The findings highlight gender affirmation as a relational and family transition that involves shifts in roles, boundaries, and forms of recognition across systems. Implications for family and couple counseling include supporting disclosure processes, navigating relational loss and reconfiguration, and addressing structural conditions that may limit access to sustainable intimate relationships.
Research examining how childhood family relationships shape adult romantic orientations in African contexts remains limited. This qualitative narrative study explored how parent–child relationships within single-parent households influence young adults’ orientations toward romantic relationships in Roma, Lesotho. Guided by attachment theory, in-depth interviews were conducted with twelve young adults aged 18–35 who were raised in single-parent households. Data were collected in Sesotho, translated into English, and analyzed thematically. The findings suggest that family structure alone does not determine later romantic outcomes. Rather, the quality of parent–child relationships plays a central role in shaping adult romantic orientations. Participants who described emotionally supportive, communicative, and nurturing relationships with custodial parents expressed greater openness to intimacy and relational stability. In contrast, participants exposed to emotional distance, harsh parenting, parental rejection, or intimate partner violence reported avoidance of commitment, mistrust, and uncertainty regarding romantic involvement. Limited involvement from non-custodial parents also contributed to identity insecurity and relational caution. The study extends attachment-informed family research within a Southern African context and highlights the enduring influence of early relational experiences on adult romantic functioning.
The consequences of adverse childhood experiences on children, adolescents, and young adults are well documented; however, a gap exists in the literature regarding the relationship between childhood adversity and romantic relationships among older adults. The purpose of this study was to examine the relationship between childhood violence exposure and later-life romantic relationships; this included assessing relationship happiness, partner reliance, relational functioning, and communication among partnered older adults. We used cross-sectional data from the National Social Life, Health, and Aging Project Round 3. The sample included 3,121 community-dwelling U.S. adults aged 56 and older. Weighted ordered logistic and logistic regression models were used. Participants with childhood violence exposure had 39% lower odds of higher relationship happiness (odds ratio ( OR ) = 0.61, p < .001) and 34% lower odds of partner reliance ( OR = 0.66, p < .05). They also demonstrated 29% lower odds of relationship functioning ( OR = 0.71, p < .05). Conversely, they had 75% higher odds of talking to their partners about problems ( OR = 1.75, p < .01). These findings are consistent with attachment theory and reiterate the long-term consequences trauma can have on romantic relationships. This highlights the need for trauma-informed relationship counseling among older adults.
In the current digital era, developing healthy technological habits is critical, particularly during adolescence, when patterns of Internet use are established and the risk of problematic use increases. Internet use is also a common source of conflict between adolescents and their parents, with parents often expressing concern about potential health risks, while adolescents may perceive the issue differently. Although research has primarily focused on individual correlates of adolescent problematic Internet use, fewer studies have examined its relational aspects. The present study explores the experiences of both parents and adolescents to understand how the “problem” is conceptualized from each perspective. Twenty parent–adolescent dyads participated in semi-structured interviews, and data were analyzed using thematic analysis. Three superordinate themes emerged: problem definition, adolescents’ experiences, and parents’ experiences. Findings revealed differences in how parents and adolescents conceptualize problematic Internet use, highlighting the role of communication gaps and relational dynamics in exacerbating conflicts. The study also provides insights into the individual experiences of both parties and discusses implications for supporting healthy parent–adolescent relationships in the digital context.
Purpose The study offers a developmental framework on family business succession by examining the role of mentoring in shaping successors’ career decisions. Based on attachment theory and vocational psychology, it offers career decidedness as a foundational construct. It recognizes career self-efficacy as a significant mediating mechanism that precedes formal succession planning and conditions the effectiveness of mentoring interventions. Design/methodology/approach This conceptual study synthesizes research in family business succession, mentoring, attachment theory, and social cognitive career theory. It establishes a developmental framework explaining how early relational experiences determine career self-efficacy and career decidedness, ultimately dictating the reception and efficacy of parental mentoring. Findings This framework demonstrates that career decidedness evolves through longitudinal relational processes rooted in attachment orientations and mediated by career self-efficacy. Repositioning mentoring as a downstream, temporally sensitive mechanism reveals that parental interventions reinforce pre-existing career orientations rather than reshaping them. This perspective explains the heterogeneous outcomes of identical mentoring practices, proving that sustainable family business succession depends on developmental foundations established before formal planning. Consequently, six propositions delineate how attachment, self-efficacy, career decidedness, mentoring reception, and timing interact to dictate intergenerational continuity over mentoring intensity alone. Originality/value The study advances family business scholarship by conceptualizing career decidedness as a distinct developmental construct, mediated by career self-efficacy. Integrating attachment theory challenges the prevailing assumption of universal mentoring efficacy, reframing succession as the culmination of longitudinal relational and developmental processes. Consequently, this framework explains the documented variance in mentoring outcomes and establishes a robust theoretical foundation for future empirical investigations into intergenerational continuity.
This generic qualitative study explored mental health counselors’ experiences of cultural attunement engagement working with Asian American clients in the United States. Guided by sociocultural learning theory, this study addressed the research question, “How do the counselors describe their experience of cultural attunement engagement with Asian Americans?” Ten licensed mental health counselors from across the United States were recruited using purposive and snowball sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis. Findings indicated that cultural attunement is an ongoing process shaped by counselors’ commitment to lifelong learning and awareness of clients’ sociocultural contexts. Participants identified the characteristics of culturally attuned practice, as well as the challenges and interventions that influence counseling engagement and treatment outcomes. Implications for counselor education and supervision, and for clinical practice, are discussed, along with recommendations for future research exploring culturally attuned engagement with Asian American populations in counseling settings.
Media portrayals of autism have often reflected deficit-oriented perspectives that frame autistic traits as symptoms requiring correction. Drawing on process-based therapy, contextual behavioral science, and neurodiversity-affirming scholarship, this study examines how the film Ezra (2023) represents autism through relational, environmental, and contextual processes rather than diagnostic labels alone. Using qualitative narrative inquiry, the film was analyzed with attention to caregiver responses, relational dynamics, sensory experiences, and environmental influences. Four themes emerged: autism as a meaningful contextual adaptation, relational misattunement as a contributor to distress, caregiver psychological flexibility as a mechanism of change, and environmental responsiveness as a foundation for regulation and connection. Rather than positioning the autistic child as the primary site of change, the film highlights how well-being emerges through shifts in relationships and environments. Findings suggest that Ezra offers a neurodiversity-affirming narrative that challenges deficit-based portrayals and supports more relational, systemic, and contextually grounded understandings of autistic experience.
This study aims to reveal the thoughts and perceptions of Turkish married individuals regarding relational robustness. Fourteen married individuals took part in the study. Content analysis yielded four themes and 16 sub-themes. The findings suggest that respect, trust, commitment, emotional and sexual intimacy, expressing love, managing conflict, and cooperation are all key aspects of relational robustness in marriage. It has been established that relational robustness in marriage is distinct from relational resilience, the latter of which is employed to cope with trauma and crises.
This study investigates mobile phone addiction (MPA) within Ghanaian families, addressing a gap in the literature that has largely examined usage patterns without considering the relational dynamics that shape and are shaped by technology use. Guided by Family Systems Theory, the study situates MPA within the context of family cohesion, adaptability, communication and conflict. Adopting an explanatory sequential mixed-methods design, the study integrated quantitative data from 2,660 participants with qualitative interviews of 40 purposively selected individuals. Key Family Systems Theory concepts, including differentiation of self, emotional triangulation, subsystem boundaries and intergenerational transmission, guided the interpretation of findings. Data were collected using an adapted Smartphone Addiction Scale and subscales from Family Adaptability and Cohesion Evaluation Scale IV and analysed through descriptive statistics, correlation, hierarchical regression and thematic analysis. Findings revealed higher MPA among adolescents and urban residents, strong negative associations with cohesion and communication, and positive associations with conflict, while adaptability remained stable. These patterns were interpreted through systemic and relational processes within Ghanaian family structures. The study concludes that MPA functions as a systemic disruption to family relational regulation and recommends contextually grounded interventions targeting communication, shared routines and intergenerational relational repair.
Trust is a central component of healthy adult relationships, yet many discussions of attachment focus primarily on identifying attachment styles rather than understanding the processes through which trust and security are developed. This article introduces the healthy adult attachment cycle, a conceptual framework designed to help clinicians and couples understand how secure attachment is built and maintained in adult intimate relationships. Drawing from attachment theory, Emotionally Focused Therapy, and the Gottman Method the framework organizes relationship functioning into four interconnected domains: Needs, Emotions, Relating, and Trust. Clinical applications are discussed, highlighting how the model can support couples in therapy. The Healthy Adult Attachment Cycle offers clinicians a practical and integrative approach to fostering secure attachment and relationship health.
Data on reproductive choices and contraceptive behaviors in Italy are limited, despite low fertility rates. This study investigated reproductive intentions, fertility management, and family-planning choices in a convenience sample of Italian couples, through an anonymous online questionnaire. Descriptive statistics were presented, and group comparisons were performed using Chi-square, Fisher's exact test, and Mann–Whitney test. Respondents were 987, mostly women, with high educational levels, and were Catholic. Fertility issues were reported by 14.9%; 41.8% declared having postponed having children. 49.8% were using a contraceptive or natural family planning method, with a demand for further information. Respondent' gender and values influenced childbearing decisions. Work–home balance and financial support strongly affected the number of children. This survey provides novel insights into the reproductive choices of a “high-fertility” segment of Italian couples and of personal and social factors influencing reproductive choices; it supports the development of integrated educational, social, and family-policy interventions to address Italy's demographic decline.
Marital disillusionment is a key factor contributing to declines in relationship quality and marital instability, particularly in the early years of marriage. However, its underlying psychological mechanisms remain insufficiently understood. This study examined whether attachment to parents is directly associated with marital disillusionment and whether differentiation of self (DoS) mediates this relationship in Japanese newlyweds. A cross-sectional online survey was conducted with 1,049 participants aged 18–29 who had been married for less than 5 years. Attachment to parents, DoS, and marital disillusionment were assessed using validated self-report measures. Structural equation modeling indicated that parental attachment anxiety was directly and positively associated with marital disillusionment. Additionally, mediation analysis demonstrated that emotional cutoff, a key dimension of DoS, significantly mediated the relationship between attachment anxiety and marital disillusionment. These findings suggest that difficulties in regulating emotional closeness and distance may serve as a mechanism linking early attachment experiences to negative perceptions of marital relationships. Clinically, the results highlight the importance of addressing unresolved parental attachment issues and fostering healthier DoS in interventions targeting marital disillusionment.
