ABSTRACT In China, the Confucian norm of filial piety has historically framed eldercare as an important responsibility of adult children. Amid rapid population aging, caregivers frequently experience profound exhaustion. While traditional assessments capture caregiver burden, they may be less sensitive to role‐ and culture‐embedded experiences such as emotional detachment, relational strain, and value dissonance arising when caregiving realities conflict with internalized obligations. Although the phenomenon of Filial Caregiving Burnout (FCB) has been recently identified, it lacks a formal theoretical definition and measurement tool. To address this limitation, we conceptualize FCB and develop a culturally grounded, multidimensional scale. Using an exploratory sequential mixed‐methods design, qualitative interviews first generated the initial item pool. Subsequent quantitative evaluations across three independent caregiver samples ( N = 1653) refined and validated the structure via exploratory and confirmatory factor analyses, alongside measurement invariance testing. Finally, a two‐wave longitudinal design assessed predictive validity. The finalized 17‐item FCB Scale features a robust three‐factor structure: physical and mental exhaustion, relational detachment, and dysregulation of filial piety value. It demonstrated excellent internal consistency ( α = 0.948), acceptable model fit, and measurement invariance across gender and Hukou type. Longitudinally, higher baseline FCB significantly predicted lower subsequent family and job performance and higher subsequent family undermining and counterproductive work behavior. Moving beyond generic burden metrics, the FCB Scale captures relational and value‐laden aspects of filial caregiving burnout and provides a multidimensional tool for assessing burnout experiences among adult‐child caregivers.
ABSTRACT Adapting evidence‐based interventions (EBIs) to be sensitive to populations who have experienced trauma has been shown to improve engagement, retention, satisfaction, and effectiveness. Compared to civilian mothers, military‐connected mothers (MCM)—including service members, veterans, or their partners—face greater exposure to trauma across the life course, leading to mental health and parenting challenges. These may adversely affect their children's mental health and perpetuate generational trauma. EBIs aligned with people's life experiences and cultural backgrounds are critical to supporting the mental wellbeing and parental functioning of MCM. Informed by the Framework for Reporting Adaptations and Modifications‐Enhanced and utilizing rapid qualitative analysis—a rigorous method for quickly identifying key interview themes—this paper describes the process of adapting an innovative EBI, Parenting‐STAIR (P‐STAIR), which targets maternal trauma, emotion regulation, and parenting. Transcripts from interviews with administrators, clinicians, and MCM at clinics serving military families were systematically summarized, organized into matrices, and analyzed. Four emergent themes informed adaptations to P‐STAIR: (a) streamlined treatment and enhanced engagement, (b) flexibility and responsiveness, (c) mental health stigma reduction, and (d) military cultural relevance. Considering these priorities, which were expressed across participant groups, P‐STAIR was shortened from 23 sessions to a brief, modular 12–16‐session intervention that can be personalized to individual needs and uses approachable language (e.g., distress vs. trauma), which aims to reduce the impact of stigma on engagement and retention. A standalone guide was developed to accompany the intervention manual, which may help clinicians better understand the unique experiences of military families. The outcome of this process, PSTAIR‐M, is a briefer, modular intervention we anticipate will be suitable for delivery to MCM.
ABSTRACT Although primary interventions for suicidal ideation typically focus on individuals, couple‐based clinical interventions for this population remain underdeveloped. Despite emerging evidence suggesting that relational interventions may improve suicidal ideation, currently only one couple‐based intervention has preliminary evidence, and it was specifically designed for military couples. This gap highlights the need for systemic couple‐based interventions in outpatient settings. We piloted the Relational Suicide Intervention (RSI), a four‐session intervention grounded in Integrative Systemic Therapy and contemporary suicidology research, at a university clinic. Sixteen graduate student therapists consented to participate and received training in the intervention. Of four couples screened, three met eligibility criteria, consented, and completed the study. We used a mixed‐methods approach to evaluate qualitative and quantitative data. Findings provided preliminary support for the safe and feasible implementation of RSI in this small pilot sample. Relationship satisfaction showed small average increases, particularly among partners with higher suicidal ideation, whereas suicidal ideation did not improve on average. Participants generally described the intervention as helpful, particularly regarding suicide safety planning, understanding relationship patterns, and learning mental health coping strategies. These preliminary findings suggest promise for RSI, with future research needed to replicate findings with larger samples, diverse clinical settings, and longer treatment durations comparable to traditional couple therapy.
ABSTRACT Relational (or couple) well‐being has begun to be conceived from an integrative perspective that transcends mere satisfaction or stability in couples and may include dimensions such as emotional connection, joint growth, and shared purpose. This study evaluated the criterion‐related validity of the Couple Flourishing Measure (CFM) in comparison with the Dyadic Adjustment Scale (DAS) in a Spanish sample of people in affective‐sexual relationships ( n = 118; Mage = 40.3, SD = 8.77). Differences between participants receiving affective‐sexual therapy services ( n = 67) and community participants ( n = 51) were analyzed, as well as their discriminative ability using ROC curves. The results showed that the CFM had a greater ability to discriminate between the two groups (AUC = 0.81, 95% CI [0.74, 0.89]) than the DAS (AUC = 0.71, 95% CI [0.62, 0.81]). In turn, a preliminary cutoff score for CFM was identified (61.5), with moderate sensitivity (0.64) and high specificity (0.94). These findings provide preliminary evidence supporting the criterion‐related validity of the CFM for distinguishing outpatients receiving affective‐sexual therapy from community participants without previous therapeutic experience and suggest that the measure may offer complementary information beyond traditional indicators of relationship adjustment. Implications, limitations, and directions for future research are discussed.
ABSTRACT This study aimed to evaluate the effectiveness of expressive writing interventions on the psychosocial health outcomes of family caregivers and to synthesize the available evidence. It was conducted in accordance with the PRISMA 2020 guidelines. Studies published up to May 2025 were searched in PubMed, Web of Science, CENTRAL, SCOPUS, and MEDLINE. The methodological quality of included studies was assessed using the Cochrane Collaboration Risk of Bias Tool 2.0, and standardized mean differences were calculated for depression, anxiety, stress, and caregiver burden. A total of 13 studies met the inclusion criteria and were included in the meta‐analysis. The included interventions varied considerably in writing content, session number, writing duration, intervention intervals, and comparator conditions. Most studies were judged to have a high overall risk of bias. Most interventions were short‐term, and the observed benefits were not maintained over the long term. The available evidence provides limited support for the broad effectiveness of expressive writing among family caregivers. A small short‐term effect was observed for anxiety (SMD = −0.22; p = 0.041). However, no significant effects were found for depression (SMD = −0.17; p = 0.084), stress (SMD = −0.21; p = 0.167), or caregiver burden (SMD = −0.02; p = 0.905). The observed anxiety effect should be interpreted as preliminary evidence rather than definitive evidence of efficacy. Further research is needed to clarify the effects of expressive writing on psychosocial outcomes in family caregivers.
