Marriage And Family Relationships (Exam 4)

Front 1

American Mothers
STATS

Back 1

-Teens pregnancies decline
-10% of all births are teen mothers
-Costs $9Billion
-60% of 20% of single mothers are low SES
-1.5 Mill unmarried women gave birth in 2004
-35.7% births were to unmarried womein in 2004 (2008 was 41%) up from 28% in 1990
-20-24 yr old birth rate dropped
-25-29 yr olds birth rate was highest of any group
-20s is peak of their childbearing yrs
-birthrates increased in women in their 30s and 40s
-delay childberning to establish careers
-older women have more education

Front 2

Conception (Germinal)
3 Phases

Back 2

1. Begins with the fusion of sperm and egg. Cell duplication occurs-genetic information duplicates itself.

2. Cell differentiation-zygote has divided into 8 cells, cells take on genetically determined traits and forms.

3. Blastocyst forms and implants in the uterus.

Front 3

Infertility (when conception fails)

Back 3

Sterility-absolute inability to reproduce

Infertility-inability to conceive after a year of trying

Front 4

Women and Infertility

Back 4

-Probs w/ovulation are reponsible for most female infertility
-May be due to
...hormonal imbalances
...poor nutrition
...intense athletic training
...pituitary gland tumors (rare)

Front 5

Men and Infertility

Back 5

-1/3 of fertility difficulties due to male reproductive systems
-2 primary forms of infertility
-AZOOSPERMIA: no sperm cells are produced
-OLIGOSPERMIA: few sperm cells are produced
-adequate number of sperm is 20 million per milliliter of semen

Front 6

Improving Fertility in Men

Back 6

-Take proper vitamins and minerals
-Limit alcohol intake and stop smoking
-Stay cool...testicles need to be cooler than the rest of the body for healthy sperm production

Front 7

Assisted Reproductive Technology

Back 7

-In-vitro fertilization (IVF)
Average cost-$12,400 per/attempt
-Gamete intrafallopian transfer (GIFT)...UNFERTILIZED eggs and male's sperms are placed in the woman's fallopian tubes. Designed to foster natural fertilization. Implantation rates are higher for this technique ($10,000).
-Zygote intrafallopian transfer (ZIFT). FERTILIZED in laboratory placed in fallopian tubes rather than uterus allowing it to travel to uterus to implant naturally ($10,000).
-Surrogacy

Front 8

Pregnancy Trimesters

Back 8

1st-first 12 weeks
2nd wks 13-26
3rd wks 27-40

*Babies born prior to 37th week are considered pre-term (also based on weight)

Front 9

1st Trimester

Back 9

-Rapid cell differentiation
-4 wks:ambryo 1/4 inch long
-7 wks: less than 1" with beating heart, eyes, nose, arms, legs, digestive system
-9 wks: embryo reaches status of fetus
-12 wks: 3" long, 3 ounces
*completely formed with all of the anatomical structures and organs

Front 10

2nd Trimester

Back 10

-quickening: movements of the fetus around 20th wk
-begins to develop hair
-soft downy hair-lanugo
-begins to suck

Front 11

Smallest baby ever born

Back 11

8.6 oz

Front 12

Third Trimester-Baby

Back 12

-begins the 7th month of preg (women want to be done w/it)
-baby dev fatty tissue
-15 inches long
-weighs 2 1/2 lbs
-digestive and respiratory systems still dev
-8th mon-brain and nervous system nearly dev
-9th mon baby will gain 1-2 lbs/wk
-Will weight 6-10 lbs
-will reach length of 20-23 in

Front 13

Third Trimester-Mother

Back 13

-mother should feel at least 10 fetal movements from breakfast to dinner
-more fatigue
-pressure on bladder and persistent backache
-colostrum secreted from nipples
-braxton-hicks occur

Front 14

Labor and Delivery

Back 14

PHASE 1 (pre labor):
-0-3 centimtrs
-contractions 5-15 min apart
PHASE 2 (active labor):
-4-7 centi.)
-most challenging part
-contractions 3-4 min. apart
-baby descends further into birth canal
-may last 3-5 hrs
PHASE 3 (transition):
-8-10 cent.
-transition presents most physically challenging
-contractions 2-3 min apart
-descent of baby causes severe backache

Front 15

Cervical Dilation

Back 15

1 cm-cheerio
3 cm-slice of banana
4 cm-cracker
7 cm-soda can
10 cm-bagel

Front 16

Sex and Relationship Satisfaction

Back 16

-wait 6 wks to have intercourse
-allows episotomy to heal
-sexual desire lower for mother about 1st yr after birth
-some pain during first intercourse after deliv
-all changes place stress on new parents (67% of couples struggle)

Front 17

Unexpected Outcomes

Back 17

Caesarean section-delivery of fetus through incision in abdomen

1/4 of all babies born in 2004 were by c-section

Front 18

Pregnancy Loss

Back 18

-miscarriage: loss of a fetus or embryo before the 20th week of pregnancy
-early miscarriage-loss of fetus before the 12th week
-late miscarriage: loss of fetus between 12th and 20th week

Front 19

Neonatal Death

Back 19

-premature birth is a cause or contributor of about 20% of all neonatal deaths (when a baby dies within the first 28 days of life) *most common cause is birth defect

Respiratory Death Syndrome: babies born before 30 weeks have high risk of brain bleeds

Front 20

Protecting Your Reproductive Health

Back 20

-Sexually Transmitted Infections (STI): diseases transmitted through sexual contact.

-2/3 of all STI's are found in young adults under the age of 25

Front 21

Stress Defined

Back 21

Normal Psychological and Physical reaction to the demands of life (Mayo Clinic)

*what happens?...When the brain percieves a threat, it realeases a burst of hormones to fuel the "FIGHT or FLIGHT" responses.

**this is fine if your life is in danger, but not all the time.

Front 22

Stress Hormones

Back 22

-Hormone Regulation System is the Endocrine System

*In times of stress the body releases:
-cortisol: increases blood sugar, suppress immune system, and increase belly fat
-Norepinephrine: Increases heart rate, blood flow, blood pressure

Front 23

Who was Hans Selye, Ph.D.?

Back 23

-founder of the concept of stress
-professor and director of the Institute of Experimental Medicine and Surgery at the University of Montreal

Front 24

Types of Stress

Back 24

Acute Stress: "fight or flight response" Can cause PTSD or even heart attack

Chronic Stress: persistent stressors. Can lead to headaches or insomnia

Eustress: healthy, positive feelings. Good. ex. Rising to challenging situation

Distress: unhealthy. negative emotions.

Front 25

Stress Related Illnesses

Back 25

1. Cardiovascular Disease
2. Heart ATtack
3. High Blood PREasure
4. Obesity
5. Migraine and tension headache
6. Insomnia (70 million americans)
7. Ulcers
8. Cancer
9. Cold/Flu
10. Anxiety (40 million)
11. Depression
12. Irritable Bowel Syndrome

Front 26

Stress and the Family

Back 26

Chronic Stress='s a decrease in individual Well-Being

-Decrease in individual well-being ='s more negative behaviors which in turn ='s lower relationship satisfaction in marriage and parent/child interactions

Front 27

Stress and Marriage

Back 27

External Daily Stressors
-work stress
-traffic
-bad weather

*external daily stressors overall are worse for marriages than critical life events.

*Higher external daily stressors=an increase in marital dyad stress

*Higher external daily stressors=less sexual activity for women and more sexual activity for men

Front 28

Notes from Movie on Stress

Back 28

-stress can unravel our chromosomes
-ulcers were first disease discovered through stress (being stressed doesn't allow body to repair (causing ulcers)
-Stress effects memory in two ways
...can't remember things (chronic)
...can't remember for short time (high acute stress)
-Goal in life is to not get rid of stress but find good stress
-rank and stress=how you perceive where you are

Front 29

Basic Goals of Parenting

Back 29

Survival Needs of Infants
Food
Shelter
Safety
Security
Love

Socialization Needs of Children
Ensuring they become productive, contributing members of society

Front 30

Parenting
7 Essential Parenting Responsibilities

Back 30

Providing a safe environment
Providing basic needs
Teaching children moral and values
Developing mutual respect
Providing effective and age-appropriate discipline
Being involved in the child’s education
Knowing the child and communicating with him/her

Front 31

The 4 Parenting Styles

Back 31

-Started by Diana Baumrind (1927 – Present day)
-Clinical & Developmental Psychologist
-Works at UC Berkeley

Important Note!
Maccoby & Martin focused her research into the “4 parenting styles”
Neglectful (also called Uninvolved)
Indulgent (also called Permissive)
Authoritarian
Authoritative

Front 32

Neglectful (univolved) Parenting

Back 32

Low in:
-Responsiveness
-Warmth
-Affection (parents may reject and neglect their children)

Results:
-Children have poor self-control
-Low self-esteem
-Less competence

Front 33

Indulgent (Permissive) Parenting

Back 33

Indulgent parents (anything goes)
-High levels of warmth, affection and responsiveness toward their children
-Adequate to high levels of parent/child communication

Results:
Children have low self-control
Trouble with authority
Poor academic outcomes

Front 34

Authoritarian Parenting

Back 34

Obedience and status oriented
-Demanding and controlling of children
-Lack warmth or affection
-Rigid rules
-Parent child communication low
-Power is the key

Results:
Children are obedient
Low self-esteem
Low social competence

Front 35

Authoritative Parenting

Back 35

-Parents are responsive, have clear rules, and stick to them.
-Does not use shame, withdrawal of love, guilt to control behavior
-Typically has the best longitudinal outcomes for children. (But not always…)
-Provides children with balance of control and warmth

Results:
-Children are more social competent than others
-Lower levels of problem behavior at all levels
-Able to balance the demands of conforming to others’ expectations with their own needs
-Better academic results

-Long Term Results: Tend to do better in marriage

Front 36

Why People Decide to Have Children?

Back 36

-For the experience
-Improve status
-Biological Drive
-Sense of Purpose
-Natural Order of Life (everyone else is doing it)
-For the relationship
-For the moral worth
-To pass down your traditions, values, etc.
-So a part of you loves on.

Front 37

Why Couples Choose the No-Kids Track

Back 37

-Time
-Freedom
-Financial benefits/security
-Dual careers
-Can’t change your mind
-Overpopulation and environmental resources

Note: This is an increasing trend across much of the world

Front 38

Social Factors Linked to No-Kids Track

Back 38

-Increase in women’s education levels
-Participation in the job market
-Changing social values
-Decreasing importance of religion
-Access to legal abortion
-Effective contraceptives
-Financial security
-Job security

Front 39

Non-Child Trends

Back 39

-Becoming the norm in Canada, United Kingdom, New Zealand and other countries.

-Growing trend in the U.S.

-65% of couples ranked personal happiness and fulfillment as more important than having children – Pew Research Center (2006).

Front 40

Married with Children (Reasearch shows...)

Back 40

-90% of all marriages lower in satisfaction from year 1 to 5 anyways.

-One of the biggest contributors:
...When men take on a satisfactory “father” role, this increases the mother’s overall marital satisfaction, which in turn increases the father’s marital satisfaction.

Front 41

Juggling Parenting and Household Chores

Back 41

Second shift:
Mothers who work outside the home and still have the majority of the household task

Routine housework:
House cleaning, meal preparation, grocery shopping, laundry
Women still do a majority of housework, but gap is closing.

Residual tasks:
Bill paying, yard work, chauffeuring children

Front 42

Household Chores

Back 42

Factors that contribute to division of household chores

Women’s employment :
the more hours women work outside, the more men share household tasks

Men’s Employment:
men who work fewer hours outside the house, tend to share more in childrearing and household tasks

Education:
the higher the education, the fewer household tasks women perform, more often they will hire outside help;
men with higher levels of education engage in more household labor

Presence of Children:
when children enter relationship, household labor is less frequently shared

Front 43

Work-Family Spillover/Conflict

Back 43

Dual earner couples:
are more vulnerable to work-family conflict

Family to work spillover:
parent has an argument with a teenager before leaving for work and has a bad day at work

Work-to-family spillover:
bad day at the office and ends up being a bad day for the entire family
Remember the “Kick the Dog Syndrome”?

Front 44

Parent Role Changes

Back 44

26% of children under 18 live in single parent homes

2 million babies a year born to unmarried women

Over 2 million fathers are primary caregivers for their children
This number has been increasing
12% of all single parent homes are father led

Over 2 million grandparents are primary caregivers for their grandchildren
This number has been increasing

Front 45

Teen Parents

Back 45

1 million teenagers will become pregnant in the next year

500,000 teenagers will give birth – about one a minute

Front 46

Women As Single Parents

Back 46

-79 million single-parent households headed by women
-43% have never been married
-1/3 of these live below the poverty level
-60% are low SES
-Divorced single mothers fare better than never-married single mothers
-White single mothers are more likely to have been married

Front 47

Divorce Trends

Back 47

Crude Divorce Rate:
The number of divorces that occur per 1000 in a population
Useful for comparing trends over time

Trends:
Rates increased with no-fault divorce legislation in the 70s
Divorce rate began to decline in the 90s

1st time marriage, lifetime divorce rates.
Post Civil War: 5% divorce rate
1960: 2.2/1,000 divorce
1980 (peak): 5.2/1,000 divorce
2006: 3.6/1,000 divorce
Today: 43% - 46% divorce (Amato, 2010)

Front 48

Divorce Trends Cont'd

Back 48

Divorce is now more common than “death” as the end of a marriage (Pinsoff, 2002).

Between 25% of marriages end in separation or divorce within 5 years of marriage (Bramlett & Mosher, 2001).

Divorce costs the US Federal Government over 33 billion per year! (Schramm, 2006).

Utah Stats
18% divorce within the 1st year.

Front 49

Divorce: African American Culture

Back 49

African American Women are 50% more likely to divorce than Caucasian women (Bramlett & Mosher, 2001).

70% of all marriages to African American Women end in divorce (Raley & Bumpass, 2003).

Why?
Economic & Social Disadvantages – leads to:
Poor health care, school, social services, more gangs, drugs/alcohol
Racism creates chronic stress which hurts a marriage (Bryant et al., 2010).
55% enter marriage with at least 1 child from previous relationship compared to 22% for Caucasian.

Front 50

Divorce: Latino Culture

Back 50

Largest minority group in the U.S. (14%) – estimated to be around 25% by 2050 (USCB, 2008).

Around 52% divorce rate (Bramlett & Mosher, 2001).

Very religious (92% identify as religious) – mostly Catholic (Skogrand, et al., 2009).
There is much shame in divorce.

Many different sub cultures make up the total U.S. minority population, so don’t overgeneralize.
Of the 14%:
64% from Mexico
9% from Puerto Rico
7.6% from Central America
5.5% from South America
3.4% from Cuba

Front 51

Divorce: Other Cultures

Back 51

Asian Americans boast the lowest divorce rates – no exact number though (Chin et al., 2007).
Thought to be due to:
Strong commitment to family.

Native Americans:
Not enough research has been done – big resistance to outside influence (i.e., researchers) (Red Horse, 1997).

Need much more research on ethnic/racial minorities!
Grad school is calling 

Front 52

The Great Divide

Back 52

“Haves” and “Have Not's”
Top 20% SES owns 50% of the wealth in the US
Bottom 20% SES owns only 3.4% of the wealth in the US
Poorest of the poor (family who make less than $11,000/year) is growing.
Ethnic and Racial minorities tend to be low SES (60%).

Front 53

Correlates of Divorce

Back 53

Predictors of divorce
Couple’s age
Young age (less than 20 years old)

Premarital pregnancy
Or bringing a child from another relationship into marriage

Parental separation
If your parent’s were divorced

Cohabitation before marriage
Less emphasis on commitment and the institution of marriage.

Religiosity and religious homogamy of the couple
Believe/practice similar religion

Socio-economic background of the couple
Financial status/debt

Front 54

Sociocultural Causes of Divorce

Back 54

Secularization trends
Marriage no longer a covenant or binding union between husband and wife
Desacrilization contributes to temporary nature of marriage

Liberalization of divorce laws
No fault divorce laws
Divorce socially and culturally accepted

Front 55

Individualism Trends

Back 55

Western cultures have become more individualistic in recent years.

Marriage emphasizes individuals’ needs rather than mutual responsibilities.

Emphasis on individual fulfillment increases demands on the marriage.

Mutual support is sacrificed for individual fulfillment.

Front 56

Unrealistic Expectations-Newlyweds

Back 56

Most newlyweds have unrealistic expectations of marriage (Larson, 2002).

A difficult transition to marriage (i.e., high conflict, poor communication, low satisfaction) can actually carry on throughout a marriage longitudinally.
Problems early in marriage can lead to separation and or divorce as long as 13 years into a marriage (Gottman, et al., 1994; Huston, et al., 2004).

Front 57

Impact of Divorce for Individuals

Back 57

Lower overall well-being for children & adults (Amato, 2000).

Economic hardship for mother & children (Amato, 2000).

Greater risk for mental and physical health issues (Amato, 2000).

Increased risk of suicide (Amato, 2000).

Usually takes 2-3 years to recover emotionally and financially from the stress (Hetherington & Kelly, 2003).

Front 58

Sometimes Divorce is Good

Back 58

In cases of high conflict and or abuse (Amato, 2010; Choi & Marks, 2008).

In emotionally dead relationships (low conflict – low emotional connection and satisfaction).

Front 59

History of Marriage and Family Therapy

Back 59

-Seeds were planted in the 1940s
-Cybernetics originated from a conglomeration of various fields including mathematics, medicine, psychology, anthropology, anatomy, and sociology
-Growth of MFT has grown every decade since

Front 60

MFT vs. Social Work vs. Psychology

Back 60

Social Work:
General, macro perspective
Covers 11 areas including: Administration/Supervision; Aging; Alcohol, Tobacco and Other Drugs; Child Welfare; Children, Adolescents and Young Adults; Health; Mental Health; Private Practice; School Social Work; Social Work and the Courts and Social and Economic Justice & Peace.
personal well-being, prevent crises and to counsel individuals, families, and communities

Psychology:
Individually focused
Assessments
Usually requires doctorate

MFT:
More family focused
Systemic
From the AAMFT website:
brief
solution-focused
specific, with attainable therapeutic goals
designed with the "end in mind."

Front 61

Therapies within MFT

Back 61

Family Systems theory
Solution focused brief therapy
There are many different theories that fall under the MFT umbrella.
The therapist has many different tools to choose from in therapy.

Front 62

Benefits of Seeing a Therapist

Back 62

With high utilizers, those who participated in MFT showed significant reductions of 68% for health screening visits, 38% for illness visits, 56% for laboratory/X-ray visits, and 78% for urgent care visits (Crane and Christensen, 2008)

Decrease in dysfunction and increase in positive functioning

Front 63

What Prevents individuals from seeking therapy

Back 63

Insurance and payment concerns

Front 64

What does MFT treat?

Back 64

Clients with these problems:
-Depression
-Anxiety
-Parent-child issues
-adult schizophrenia
-affective (mood) disorders
-adult alcoholism and drug abuse
-children's conduct disorders
-adolescent drug abuse
-anorexia in young adult women
-childhood autism
-chronic physical illness in adults and children
-marital distress and conflict. 

65.6% of the cases are completed within 20 sessions

87.9% within 50 sessions

About half of the treatment provided by marriage and family therapists is one-on-one with the other half divided between marital/couple and family therapy, or a combination of treatments.

Front 65

Effectiveness of therapy overall

Back 65

3 out of 4 clients show improvement (decrease in dysfunctional symptoms and increase their positive functioning)

Depression, anxiety, substance abuse, adolescent delinquency, and childhood conduct disorder show improvement

Front 66

Not so effective for a minority of people

Back 66

Therapy does not show improvement for 20-30 percent of people

5 percent of clients might actually get worse

Front 67

Specific Target Groups

Back 67

Adolescent drug use :
-Reduced past month symptoms by 44 percent between intake and end of therapy
-At 3 month follow up, 64-65 percent of teens had not used drugs in the past month.

EFT has a 70 to 73 percent recovery rate for relationship distress

Marriage enhancement communication skills are better at the end of treatment and 6 months later

MFT shows clinically significant results in 40-50 % of individuals treated

Front 68

What leads to change in therapy?

Back 68

Empathy and the ability to connect is essential in therapy

Front 69

What to expect from therapy

Back 69

Time limits:
-The average number of sessions has been estimated to be anywhere from 3 sessions to 6-8 sessions.
...Can be more depending on the problem/issue and what the client wants
...Can be as few as 1 session

Costs: Anywhere from over$45 to $200 per session

Individuals can often find cheaper services through universities or training facilities

Front 70

Assessment Tools

Back 70

Pencil Paper Assessments
Outcome Questionnaire 45-2 (OQ 45-2)
Example: I have thoughts of ending my life (Never, Rarely, sometimes, frequently, all the time)
Revised Dyadic Assessment Scale (RDAS)
Beck Depression Inventory (BDI)
Marital Questionnaire (MQ)
Clinical Interview
Genogram-Family map or outline

Front 71

Diagnostic and Statsitical Manual (DSM-IVTR)

Back 71

Background: A group of experts determined the various categories and what constitutes the diagnosis.

Example
300.23 Social phobia
-A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people
-Exposure to the feared social situation almost invariably provokes anxiety
-The person recognizes fear is excessive
-The feared social or performance situations are avoided or else are endured
-Interferes significantly with the person’s normal routine
-Specify: Generalized includes most social situations

Front 72

Solution Focused Brief Therapy

Back 72

-The client has resources that can help them to overcome the problems they are experiencing
-Client is the expert of their lives
-The problem does not exist all of the time.
-Life is always changing

Common Interventions:
-Miracle question
-Looking for exceptions
-Scaling