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Family Conflict, Emotional Security, and Child Development: Translating

Research Findings into a Prevention Program for Community Families

Article  in  Clinical Child and Family Psychology Review · March 2012

DOI: 10.1007/s10567-012-0112-0 · Source: PubMed

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Clin Child Fam Psychol Rev (2012) 15:14–27
DOI 10.1007/s10567-012-0112-0

Family Conflict, Emotional Security, and Child Development:

Translating Research Findings into a Prevention Program
for Community Families
E. Mark Cummings • Julie N. Schatz

Published online: 5 February 2012

Ó Springer Science+Business Media, LLC 2012

Abstract The social problem posed by family conflict to different groups within the community, and preliminary
the physical and psychological health and well-being of support for the theoretical bases for program outcomes.
children, parents, and underlying family relationships is a
cause for concern. Inter-parental and parent–child conflict Keywords Prevention
Psychoeducation
Community

are linked with children’s behavioral, emotional, social, Marital conflict
Adjustment
academic, and health problems, with children’s risk partic-
ularly elevated in distressed marriages. Supported by the
promise of brief psycho-educational programs (e.g., Halford Introduction
et al. in Journal of Family Psychology 22:497–505, 2008;
Sanders in Journal of Family Psychology 22:506–517, Although a diversity of programs have been developed for
2008), the present paper presents the development and supporting parents, couples and/or children; the great
evaluation of a prevention program for community families majority of these programs are not subject to rigorous or
with children, concerned with family-wide conflict and cogent evaluation [e.g., randomized control design (RCT);
relationships, and building on Emotional Security Theory observational measures; and multivariate outcomes]. In
(Davies and Cummings in Psychological Bulletin addition, the empirical and theoretical bases for many
116:387–411, 1994). This program uniquely focuses on programs are not clearly delineated or tested. Thus, many
translating research and theory in this area into brief, questions remain as to which programs work and why. The
engaging programs for community families to improve present paper describes a translational research approach
conflict and emotional security for the sake of the children. toward creating and evaluating theoretically based conflict
Evaluation is based on multi-domain and multi-method prevention program for community families with children.
assessments of family-wide and child outcomes in the con- Translational prevention science emphasizes the value of
text of a randomized control design. A series of studies are explicitly translating research findings and theory into
briefly described in the programmatic development of a applied program contents. Supported by the promise of
prevention program for conflict and emotional security for brief psycho-educational programs (e.g., Halford et al.
community families, culminating in a program for family- 2008; Sanders 2008), this program is based on a psycho-
wide conflict and emotional security for families with ado- educational approach to making research findings on con-
lescents. With regard to this ongoing program, evidence is flict and emotional security for the sake of the children
presented at the post-test for improvements in family-wide available to community families. Drawing from the
functioning, consideration of the relative benefits for extensive body of research on how inter-adult conflicts
affect children, and the importance of children’s emotional
security about family relationships to their well-being and
adjustment, program curricula is grounded in empirical
E. M. Cummings (&)
J. N. Schatz
findings and pertinent theory.
Department of Psychology, University of Notre Dame,
204 Brownson Hall, Notre Dame, IN 46556, USA The foundation of the program is grounded in an
e-mail: [email protected] empirically supported theoretical model, that is, Emotional

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Clin Child Fam Psychol Rev (2012) 15:14–27 15

Security Theory (EST, Davies and Cummings 1994), and characterized by destructive forms, children’s emotional
furthers the promise for program efficacy. Specifically, this insecurity about multiple family relationships is under-
theory provides a family-wide model for the effect of mined. These effects can be traced to the emotional, social,
conflict on children (Cummings and Davies 2010) and is cognitive, and physiological dysregulation associated with
the conceptual foundation for the program. This theoretical insecurity (Cummings and Davies 2010). The EST model
model and supportive research are extensively reviewed in thus serves as a framework for understanding family con-
Cummings and Davies (2010), with a case made for EST as flict’s implications for child and family functioning and
providing an explanatory model for conflict and related also as an overarching theoretical foundation from which to
family influences on children’s functioning. This theoreti- build prevention or intervention approaches.
cal foundation and application of a translational approach EST holds that children’s sense of protection, safety,
advances provides support for both implementing preven- and security about their parents’ relationship and about the
tion programming and rigorously evaluating outcomes. family as a whole are related to their well-being and
In this paper, building upon this empirical and theoret- adjustment over time. Children’s emotional insecurity
ical framework, a series of studies are described that about family relationships is posited as a primary mecha-
highlight the translation of empirical research on marital nism toward explaining the effects of parental and family-
and family conflict and child development into a brief wide conflict on their later maladjustment. According to
prevention program. In the parlance of translational EST, the meaning of inter-parental and family conflict is
research, to this point the work has focused on translating related to children’s assessment of emotional security
research into effective prevention, that is, moving from the implications, which is not merely a hypothetical construct,
bench to the bedside (Type 1 translational research). A next but can be discerned operationally from assessments of
step after efficacy is established is implementing and test- children’s emotional, behavioral, and cognitive reactions.
ing the program widely in community settings, that is, For example, specifically testing these assumptions,
moving from the bedside into the community (Type 2 Harold, Shelton, Goeke-Morey, and Cummings (2004)
translational research). A notable characteristic that sup- longitudinally examined relations between inter-parental
ports the possibility of broader implementation is that this conflict, children’s emotional security about inter-parental
program has consistently earned high consumer satisfaction conflict, parenting, and child adjustment. Distinct pathways
among community families, as we will show later in this of regulatory functioning in response to exposure to con-
paper, and in the most recent version of the program, flict were differentiated, including children’s emotional
retention has been high. regulation, cognitive representations, and behavioral regu-
lation. An indirect pathway through children’s emotional
insecurity about parenting to their maladjustment was
Emotional Security Theory as an Overall Framework also supported. As another example, Cummings et al.
(2006) longitudinally demonstrated relations between inter-
EST provided the conceptual model to guide the develop- parental discord and child maladjustment in two studies,
ment of the program. Optimal prevention and intervention involving 9- to 18-year-olds (Study 1), and 5- to 7-year-
programs are informed and guided by a theoretical olds (Study 2), respectively. Despite the differences in
framework (Borkowski et al. 2007; Nation et al. 2003). samples and age periods, both studies provided consistent
Theory both serves to integrate program elements into a support for the EST model for relations among inter-
cohesive whole and also provides participants with a ‘‘big parental discord, emotional security, and child adjustment.
picture’’ view of the take-home message of a program. That is, emotional insecurity was identified as an explan-
Tests of theory can cogently advance understanding the atory mechanism for changes in children’s maladjustment
conceptual foundation for any success of the program, over time, among children across a wide age range,
furthering contributions to science as well as practice. including adolescence.
Notably, EST articulates a comprehensive theoretical With regard to program goals, as we will elaborate
model for both the direct effects of inter-parental conflict further below, EST has provided an empirical starting point
on children and those mediated by negative effects on in research for identifying behaviors that (a) diminish
parenting and other family relationships (Cummings and children’s security, which are held in the context of our
Davies 2010). An example of a direct pathway is the prevention program as behaviors for parents to avoid and
impact of inter-parental conflict on children’s emotional (b) conflict behaviors that increase children’s security,
insecurity about their parents’ relationship. The impact of which are encouraged in the context of our prevention
inter-parental conflict on insecure attachments to the par- program as behaviors to engage in during conflicts. In
ents illustrates an indirect pathway of influence. If conflict addition, some forms of parent–child conflict and com-
is pervasive in parental relationships, particularly if munication are supported empirically as increasing, and

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16 Clin Child Fam Psychol Rev (2012) 15:14–27

others as decreasing, the security of parent–child relation- problems and parent–adolescent conflict (e.g., Buehler and
ships, with corresponding recommendations for parents in Gerard 2002). Child, parental, and family outcomes are at
the context of the psycho-educational presentations made risk for problems in the context of high family conflict,
in our prevention program. Moreover, another theme in our even in households without clinically significant problems
program based on EST is that behaviors and outcomes of (Cowan et al. 1996; Liberman et al. 2005). Thus, the social
conflict that foster children’s emotional security are problem posed by inter-adult conflict to the physical and
advanced as of higher-order importance to family members psychological health and well-being of children and par-
than winning conflicts, or other short-term outcomes. ents, as well as family relationships is a cause for sub-
Fostering children’s emotional security about family rela- stantial concern.
tionships is held as the organizing theme for program
contents. Relatedly, emotional insecurity is reflected in
regulatory processes that relate to children’s well-being, Inter-Adult Conflict Specifically Relates to Child
and over the long-term, adjustment. Thus, an underlying Maladjustment
theoretical proposition of our prevention program is that
improvements in children’s emotional security about fam- Consistent with the assumption of EST that negative family
ily conflict and relationships are important goals for the conflict negatively affects children’s emotional security
program, posited to mediate more positive child develop- and adjustment, children show discriminated and distressed
ment outcomes over time. Thus, a demonstration of responses to parental anger at an early age—empirically
improved emotional security constitutes what is expected documented with infants as young as 6 months (Cummings
to be an initial indicator of program efficacy from the and Davies 1994). The distress that children show when
perspective of children’s well-being. exposed to destructive inter-parental conflicts may be
manifested through a wide range of reactions. For example,
children may become aggressive or behaviorally dysregu-
Family Conflict is Related to Child and Family lated, or get involved in parents’ disputes (Cummings and
Dysfunction Davies 1994). Although demonstrations of relations with
internalizing and externalizing symptoms have been a
A theoretical tenet of EST that supports targeting improved focus of research (e.g., El-Sheikh et al. 2007b), effects on
family conflict is that negative family conflict holds the many other outcomes and relationships are also frequently
potential to undermine child and family well-being and demonstrated, including peer and romantic relationships
adjustment. Inter-adult conflict creates an at-risk family (e.g., Du Rocher Schudlich et al. Cummings 2004;
environment for adults and children (Cummings and Kinsfogel and Grych 2004). Moreover, children do not
Davies 2010). Higher rates of depression, anxiety, and need to be present for inter-adult conflicts to feel the
alcohol-use are found among adults in relationships char- impact, rather the family environment that is left in the
acterized by destructive conflict behaviors (Cummings and wake of persistent destructive conflicts (i.e., distracted,
Davies 2002). Each of these outcomes in turn, potentially emotional parents; upset siblings) can also contribute to
compounds the effects of parental conflict for children as maladjustment and behavioral reactions. Children appear to
well as contributes to an increase in destructive inter- be quite well-aware of inter-parental conflicts, even if they
parental conflict behaviors (Cummings and Davies 2002; are not physically present in the same room to observe
Whisman 2001). For instance, homes characterized by these conflicts (Cummings and Davies 2010).
inter-parental aggression are also strongly associated with Further emphasizing the far-reaching consequences of
child maltreatment (Hughes 1988). Parental drinking is inter-adult conflict is the body of work that shows the
linked with destructive marital conflict, with negative repercussions on children’s physiology (Davies et al.
implications for child and family functioning and adjust- 2007). Davies et al. (2008) showed that children’s fear
ment (Keller et al. 2008). responses to inter-parental conflict were predictors of their
Parental and parent–child conflict are linked with chil- elevated cortisol reactivity to conflict, especially for chil-
dren’s behavioral, emotional, social, academic, and health dren exhibiting involvement in conflicts. El-Sheikh et al.
problems and identified as primary predictors of malad- (2007a) reported that marital conflict was linked with
justment, especially within families characterized by a dis- children’s sleep disruptions, with sleep problems associ-
tressed inter-parental relationship. Multiple family ated with children’s behavioral, emotional, and academic
relationships are undermined by the effects of inter-adult difficulties, including math, language, verbal, and nonver-
conflict, including inter-parental, mother–child, and father– bal achievement (El-Sheikh et al. (2007a). Longitudinal
child relationships (Cummings and Davies 1994, 2010). pathways relating marital conflict, attentional difficulties,
Moreover, inter-adult conflict contributes to parenting and school problems have also been identified (Davies

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Clin Child Fam Psychol Rev (2012) 15:14–27 17

et al. 2008). Children are sensitized in responding across relations between inter-parental aggression and children’s
multiple domains by repeated exposure to inter-parental mental and physical health.
conflicts (e.g., Cummings et al. 2003, 2004; Davies et al. With regard to constructive inter-parental conflict,
1999), with sensitization supported longitudinally as well Goeke-Morey et al. (2003) examined the responses of
(Davies et al. 2006). 11- and 12-year-old US and Welsh children to laboratory
presentations of marital conflict behaviors. With regard to
classification, behaviors resulting in more positive than
Emotional Security Theory (EST) Provides Criteria negative behaviors were categorized as ‘‘constructive,’’
for Identifying Destructive Versus Constructive based on the principle that positivity indicated well-being
Conflict: A Distinction Relevant to Prevention was increased. Applying these criteria, support, problem-
Programming solving, and affection were identified as constructive
behaviors. That is, children’s reports of positive emotional
The effects of conflict on families depend on how conflicts responding were significantly greater than negative emo-
are expressed (Cummings and Cummings 1988), with tional responding to these behaviors. Moreover, EST places
some forms having negative effects and others having importance on the overall feeling of the conflict, particu-
benign, or even positive, effects (Cummings and Davies larly the degree of resolution. For instance, complete res-
2002). With regard to inter-parental conflict, children seem olution of conflict may ameliorate the negative effects of
to function as emotional ‘‘Geiger counters’’, able to infer exposure to conflict (Cummings et al. 1989). Children’s
the occurrence and outcomes of conflicts from an early age distress is diminished as a function of the degree of reso-
without directly observing the conflicts or conflict resolu- lution (Cummings et al. 1991). Distress reactions are
tion (Cummings et al. 1993; Cummings and Wilson 1999). reduced even if conflicts are not fully resolved, and chil-
Conflict can be considered harmful if the security of the dren can benefit from learning about later resolution of
child is threatened; from this perspective multiple conflict (Cummings et al. 1993). Kerig (1996) reported that
destructive behaviors have been identified including marital conflict resolution was more consistently associated
physical and verbal aggression, withdrawal/avoidance, with child well-being (i.e., reduced adjustment problems)
nonverbal and verbal anger, and the use of insults. Con- than even negative elements of conflict (e.g., high fre-
versely, constructive conflict behaviors, which support or quency). Based on a three-wave longitudinal study,
foster children’s sense of security, have also been descri- McCoy, Cummings, and Davies (2009) demonstrated
bed: calm discussion, support, (some forms of) humor, relations between constructive marital conflict behavior,
problem-solving, and physical and verbal affection. increased emotional security about marital relations, and
For example, with regard to the categorization of inter- children’s prosocial behavior.
parental conflict, children’s emotional reactions during These studies, among many others, provide further
conflict provide the groundwork for distinguishing between support for Emotional Security Theory and research on
classifications of parental behaviors. Accordingly, based on inter-parental conflict and children’s responses for recom-
EST, parental conflict tactics eliciting more negative than mendations for parents on how to engage in conflict for the
positive emotional reactions are considered ‘‘destructive’’, sake of the children. Although destructive conflict increa-
since such responding suggests that children’s security is ses children’s insecurity leading to problematic adjustment,
reduced. By contrast, inter-parental conflict tactics result- constructive conflict behaviors support family security and
ing in more positive than negative emotional reactions are promote positive functioning in multiple domains. For
classified as ‘‘constructive’’, given that such responding instance, exposure to constructive conflict between parents
implies enhanced security. can lead to increases in children’s positive affect and
Moving from the research-informed theory-building and decreases in both behavioral and cognitive indices of
the identification of specific destructive tactics to examin- insecurity. McCoy and colleagues (2009) found that emo-
ing those behaviors in relation to child outcomes, evidence tional security mediated the relationship between con-
shows that the conflict behaviors identified by EST criteria structive inter-parental conflict behaviors and children’s
as destructive are consistently associated with negative prosocial behaviors over time; recent work has also iden-
outcomes. More specifically, children make distinctions tified pathways between constructive marital conflict, par-
among verbal, non-verbal, and physical expressions of enting, and positive school adjustment (McCoy et al.
conflict as evidenced by their varying emotional, behav- 2011). Given evidence that increasing constructive conflict
ioral, and cognitive responses (Cummings et al. 1989). management between the parents promotes children’s
Exposure to physical violence is related to children’s emotional security and adjustment, constructive conflict
adjustment problems (Jouriles et al. 1989; McDonald can be seen as a critical goal for inter-parental and family
and Jouriles 1991). El-Sheikh et al. (2008) demonstrated conflict-focused intervention.

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18 Clin Child Fam Psychol Rev (2012) 15:14–27

Gaps in the Development of Programs on Couple ameliorated before conflict becomes escalated, cognitions
Conflict for the Welfare of Children between couples become distorted (e.g., negative tracking),
and the emotional and behavioral reactions of couples to
Despite the extensive empirical and theoretical evidence for each other become ensnared in a negative, spiraling cycle
the effects of inter-parental conflict on children, research- (Cummings and Davies 1994). Relationship conflict is a
based supports for children have been largely neglected in potential contributor to emotional distress and behavior
programs for couple conflict. Psycho-educational programs problems, including psychopathology, for all community
for couples have widely ignored children and a research- families (Cowan et al. 1996). Brief prevention programs
grounded parenting curriculum in program development are less costly and may help a broader range of families,
and evaluation (Markman et al. 2010); the rare exceptions with brief, psycho-educational programs especially acces-
typically have focused on very young children (Cowan et al. sible for community families. Although recent nationwide
2005, Typically, prevention/intervention programs are trials of couple prevention programs for low SES, racially
implemented for couples to change conflict behaviors in diverse couples have been met with limited success, it may
order to increase relationship satisfaction by decreasing be due to the challenge of these programs being directed
destructive behaviors and increasing constructive ones toward particularly high-risk couples (e.g. Building Strong
(Blanchard et al. 2009). For example, the Prevention and Families, Wood et al. 2010). Success may be more likely in
Relationship Enhancement Program (PREP) is intended to less high-risk samples. However, questions can also be
lay a positive communication foundation before the marital raised about the translational research underpinnings for
relationship begins (Markman et al. 1988). Markman, this program, which followed a different model for pro-
Stanley, and colleagues have provided evidence for the gram development than in our program’s development.
long-term effectiveness for couples’ communication skills Minimally, although inspired efforts in many important
of the PREP intervention, a program for teaching couples ways, these programs were not systematically informed by
communication and conflict resolution skills derived from the extensive literatures on conflict in families; couple
behavioral marital therapy (e.g., Laurenceau et al. 2004; conflict and child development; theory on family func-
Markman et al. 1988, 1993). Programs based on couple tioning, children and conflict; and child adjustment and
research have received support, although with mixed find- conflict. These programs also lacked application of an
ings (Cowan et al. 2010); however, an important piece of underlying theoretical model to guide translation of
the puzzle is missing—the child. Moreover, a solid, research on conflict into programming, and the package for
research-grounded curriculum that could be empirically evaluation of outcomes was limited. Without rigorous tests
evaluated is lacking in many instances. of these alternative hypotheses, it will remain unclear why
Only a small number of extant programs have been these programs unfortunately had limited success and make
directed toward children and parenting as well as couples. comparability of these national programs to the present
Among couples expecting their first child, Schulz et al. program, beyond the interest in some selected common
(2006) found marital satisfaction was less negatively themes (e.g., couple conflict), highly questionable.
affected among participants in a couple support program
during the transition to parenthood than among comparison
participants, indicating the effectiveness of the preventive Translational Research and Its Implications
group intervention. Cowan and colleagues have reported in Prevention and Intervention Programming
multiple long-term beneficial effects of a 16-week couples’
intervention with a marital or parenting emphasis, for Translational research is often described as taking the
children in the transition to elementary school (Cowan research from the bench to the bedside (i.e., Type 1
et al. 2005.) Another gap is that few preventive programs translational research). The overall approach is considered
for inter-parental and family conflict have been advanced the bridge between science and application. According to
specifically targeting the adjustment and well-being of the tenets of translational research, the development of an
adolescents and their families, translating theory and intervention and its curriculum should be based on a
research on inter-parental conflict and children into a brief foundation of proven research. These translational aspects
preventive approach for community families that is both may involve who should be targeted, what content must be
practical and feasible. focused upon to make a lasting change, and anticipating the
Moreover, the pervasiveness and threats posed by inter- outcomes that will most likely be impacted by the program
parental and family conflict support that prevention pro- and considered valid indicators of program success. When
grams administered universally in communities may serve based on a consistent cycle of building curriculum from
to broadly elevate the health and well-being of children and research, rigorously evaluating such programming, adjust-
families. Negative conflict processes are more readily ing the curriculum if necessary, and finally disseminating

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Clin Child Fam Psychol Rev (2012) 15:14–27 19

results (Type 2 translational research), translational investigators trained in scholarly research traditions. At the
research holds promise to advance the scientific commu- same time, individuals comfortable in applied contexts
nity as well as support families in our society. These goals may have limited understanding of scholarly traditions for
are adopted in the present line of translational research. evaluating evidence, including research design issues
Growing emphasis on translational research in scientific essential to advancing the scientific bases for applied pro-
and applied arenas has challenged both scientists and grams and the sophisticated approaches to evaluation.
practitioners to apply science to intervention and preven- These facts present significant and fundamental challenges
tion programs. For example, new editorial guidelines at and obstacles to achieving the goal of developing programs
journal outlets such as the Journal of Family Psychology that effectively make available the insights of the best
now uniformly challenge contributors to outline how empirical research in the context of adequately evaluated
empirical findings may inform clinical practice and public applied programs.
policy (Kazak 2004; Parke 1998). Likewise, modifications Consistent with the notion of translational research, an
in the organization and priorities of funding agencies like important element is the systematic translation of specific
the National Institute of Mental Health signify an over- results into program components. For example, we outline
arching commitment to translating knowledge on behav- a specific protocol for our program to be ‘‘directly
ioral and social sciences to understanding and reducing informed’’ by empirical research (for example, see
mental illness (Dingfelder 2004; National Advisory Mental Cummings and Davies 2010). That is, a first step is to
Health Council Behavioral Science Workgroup 2000; also discern the key messages from the most important and
see Institute of Medicine 1994). Accompanying changes in rigorous empirical research that might serve as the
the infrastructure of the behavioral sciences is progress in framework for a prevention program. Notably, prevention
addressing the many significant gaps in integrating research has been little informed by empirical research on
behavioral theory and science with treatment and policy inter-parental conflict and family conflict and children,
initiatives (Cicchetti and Toth 2006; Toth and Cicchetti reflecting the problem of spanning the gap between
2006). research findings and the effective application of these
The melding of theory, methodology, and application findings in the real world.
are all relevant directions for both the development and The development of effective program materials is as
testing of prevention and intervention programs. However, much art as science. Although there is an emerging tem-
few existing programs (a) report data documenting their plate concerning the characteristics of the best programs
effectiveness, (b) are guided by basic research in the area (Borskowski et al. 2007; Nation et al. 2003), the develop-
of couples’ conflict, child development, and family-wide ment of program materials that translate research knowl-
functioning, (c) address consumer satisfaction with par- edge into an effective program are a significant challenge.
ticipation, or (d) include long-term assessments of devel- Moreover, demands may vary depending on the goals of
opmental trajectories for children and their parents (Braver the program. For example, common wisdom is that pre-
et al. 1993; Grych 2005; Grych and Fincham 1992; vention efforts should be comprehensive, but at the same
Wolchik et al. 2002). Greater demands are being made on time, it is important to determine the ‘‘right amount of
practitioners by funding agencies to demonstrate how sci- treatment’’ (Borkowski et al. 2007). In some instances,
ence informs the development of prevention and inter- especially for the goals and samples addressed by pre-
vention programs. Knowledge of methodology is required vention programs, briefer programs may be more effective
to test the effectiveness of treatment programs. Intervention (Bakermans-Kranenburg et al. 2003). Research also sug-
and prevention programs (e.g., schools, clinical treatment gests that an optimal way for presenting translational
centers) are increasingly demanding some scientific veri- research for community families in prevention trials may
fication of the success of the clinical and community ser- be a psycho-educational approach. A substantial body of
vices for children. Thus, it is becoming more and more evidence collected in the parenting literature supports the
necessary for practitioners to become well-versed in promise of a psycho-educational approach (e.g., the Triple
methodology (Heatherington et al. 2005). P Positive Parenting Program, Sanders 2008). In the couple
literature evidence to support the value of psycho-educa-
tional approaches has been advanced (Halford et al. 2008,
Translating Research into Prevention Programs 2010a, b). More intensive and lengthily approaches may be
for Community Couples with Children needed to ameliorate chronically and seriously distressed
marriages, which are likely to require clinically trained
The development of translational research at the level staff (Bradbury and Karney 2004; Christensen et al. 2004,
of the procedures and materials is unfamiliar for many 2010; Hahlweg et al. 2010).

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20 Clin Child Fam Psychol Rev (2012) 15:14–27

Overview of Translational Work on Inter-Parental couples having an observed discussion highlighted several
Conflict and Children significant program effects. The sessions were coded for
key conflict outcomes such as resolution, emotionality
Because all families experience conflict and many couples during the discussion, and identified constructive conflict
may not seek counseling even after clinically significant behaviors. Findings showed treatment couples were more
problems are present, the need for a program for commu- supportive of their partners, more emotionally positive
nity families ideally to prevent conflict problems before during interactions, more likely to advance toward the
they become highly destructive is clear. Moreover, resolution of arguments, and more constructive during
research shows that negative conflict processes are more conflict discussions. In addition, couples’ positive changes
easily remedied before conflict escalates, cognitions in conflict behaviors in the treatment group were linked
become distorted, and the emotional and behavioral reac- with positive changes over time in relationship satisfaction,
tions of partners to each other become a recurrent negative parenting, and child adjustment. Changes in knowledge
cycle (Cummings and Davies 1994). In terms of financial over time were linked with changes in conflict behaviors,
implications, brief prevention programs are less costly and suggesting that knowledge was an active agent in the post-
may help a more diverse range of families, with brief, intervention improvements. Pertinent to the possibilities for
psycho-educational programs especially accessible for effective implementation in community samples, couples
community families (Hawkins et al. 2008; Johnston 1994; reported high satisfaction with the program. Follow-up
Morgan et al. 1990; Pehrson and Robinson 1990; Shifflett tests demonstrated that effects were maintained at 1- and
and Cummings 1999; Turner and Dadds 2001). 2-year follow-ups (Cummings et al. 2008; Faircloth et al.
Our research team began its journey into translational 2011). The results thus supported promise for sustained
research with a one-visit program that provided qualified growth in constructive conflict and related outcomes in
evidence for beneficial effects (Faircloth and Cummings community samples from a relatively brief program based
2008). Fifty-five couples with an oldest child 6 years or on this approach. However, evidence for beneficial child
younger were randomly assigned to treatment or wait-listed effects was limited, attrition was relatively high, and the
control groups, with assessments at pre-test, post-test, and child psycho-educational program yielded virtually no
6- and 12-month follow-ups. Parents’ knowledge about gains (Mitchell et al. 2009). Conclusions drawn from these
marital conflict and the effects of it on children was greater outcomes were twofold: Simply teaching a young child
relative to a wait-list control group at the post-test. Relative how to cope with a difficult situation does not provide
to pre-test, couples in the treatment group displayed both enough support to cope with inter-parental conflict and the
less hostility in front of their children and improved in age of a child in developing an efficacious intervention
constructive conflict tactics at follow-ups. However, lack matters.
of post-test comparisons between treatment and control for The next program we will review is ongoing and has
these questions and reliance on self-report about marital made advancements from this earlier work including
conflict limited interpretation of efficacy. The presentation additional innovative elements and a more comprehensive
of the evidence-based information about marital conflict curriculum toward improving both inter-parental and
was limited. Nonetheless, promise was indicated. family-wide conflict. This direction is extended by adapt-
Based on this initial evidence for the promise of the ing the program for couples with young children to apply to
approach, a longer prevention program was developed couples with adolescents—a developmental period with
based on EST and research on marital conflict and children heightened conflict. This program also aims to improve
that utilized a brief psycho-educational format to teach family-wide conflict and communication, including inter-
couples about marital conflict and provide communication parental, father–child, and mother–child relationships.
training. Cummings et al. (2008) tested an elaborated four- Extending EST beyond children’s responses to inter-
visit program for community families, including extensive parental conflict the program also advances a family-wide
parent education about inter-parental conflict and children perspective on emotional security and family conflict, that
and the addition of couples’ communication training. A is, a preventative intervention for family conflict and
two-visit child psycho-educational program was also tes- communication, including inter-parental, mother–adoles-
ted, focusing on teaching children how to cope with cent, and father–adolescent relationships.
parental conflict. Ninety couples with children between 4 The project thus far includes 225 families (mothers,
and 8 years of age were randomly blocked into one of three fathers, and their 11–16-year-old adolescents) that have
groups: (1) a parent-only group (n = 24); (2) a parent– been randomly assigned to the (a) parent–adolescent pro-
child group (n = 33); or (3) a self-study control group gram, (b) parent-only program, (c) self-study control, or
(n = 33), with assessments at pre-, post-, and 6- and (d) no treatment control, with 213 of the 225 families
12-month follow-ups. Post-intervention assessments of the completing the program and post-test assessments to this

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point. An innovative element was the inclusion in the four- the adolescent’s perspective; and improving the well-being
visit parent program of content on parent–adolescent con- and adjustment of adolescents.
flict and communication. Responding to lack of success of Moreover, the program itself advances the translational
a program for children’s coping with conflict (Cummings research approach and extends previous programming for
et al. 2008), a new direction was the development of a four- couples’ conflict in several new directions. First, new
visit program for adolescents, focusing on improving research findings suggest that children play a role in family
adolescents’ conflict resolution skills, including in rela- functioning; the current program includes both parents and
tionships with both the mother and father. Innovative their adolescent in teaching constructive communication
curriculum, drawn from the latest body of research on strategies. Second, the program includes a multi-dimen-
family conflict and emotional security, was developed to sional component for parents and a separate but parallel
foster teens’ engagement and also to further engage fathers one for adolescents. Both parent and teen components
and mothers, with an important goal to substantively contain interactive activities; for the adolescents, the
reduce attrition in comparison with the Cummings et al. activities are the foundation of their psycho-educational
(2008) study. This goal was decisively achieved, that is, a training. For instance, popular movie clips are used to
95% retention rate through the post-test was attained. demonstrate destructive and constructive conflict behaviors
Evaluation was again based on a RCT design, with data and provide a starting point for discussions about conflict.
collection completed for the pre- and post-intervention Other activities include role-playing, jeopardy-style review
assessments, and continuing for 6- and 12-month, and sessions complete with buzzers, and the use of popular
3-year follow-up assessments. conversation games to apply the communication knowl-
Beyond simply improving inter-parental relationship edge. Third, the current program extended the previous
satisfaction, this program was designed to strengthen program’s communication training in 2 manners: (1) a
multiple family relationships; improve children’s emo- popular device became a metaphor for the communication
tional security about their family relationships; and support training—an iPod—in order to make it teen friendly and
children’s social and emotional development all through easily learned by both parents and their adolescents; and
the provision of a broader direction in research-based (2) adolescents also receive the communication training.
psycho-educational programs for community families with The communication training and practice session with a
adolescents. For example, the program was also designed trained coach is an essential aspect of the program curric-
to ameliorate mother–adolescent and father–adolescent ulum. It is here that couples and adolescents can practice
conflict and communication, which are also linked with their newly acquired skills and try them out in a safe
both inter-parental conflict and adolescent adjustment and environment.
well-being (e.g., Allen et al. 1990, 1996, 1998, 2003;
Holmbeck 1996; Smetana 1996; Stattin and Klackenberg
1992).
The manualized treatment curriculum utilizes interac- Empirical Support for the Program: Post-Test Results
tive techniques to increase the effectiveness and engage-
ment with program content while promoting high Another innovative element is the rigorous, multi-domain
consumer satisfaction. Program participation is limited to 4 approach to assessment. Following the translational
visits in a community center in order to increase practi- research approach, the program was rigorously evaluated
cality and appeal for community families with adolescents. with a multi-reporter, multi-context, multi-dimensional
Assessments include questionnaires designed to evaluate assessment scheme to assess family-wide outcomes,
child and family functioning; observational measures of including questionnaires and observations. Mothers and
family conflicts; and daily diary assessments of inter- fathers completed questionnaires pertaining to inter-
parental and family conflict and relationships, and are parental conflict and satisfaction, parenting practices, and
completed independently by mothers, fathers and adoles- family emotional climate. Adolescents completed ques-
cents. Key issues are comparing parent-only versus parent tionnaires addressing their relationships with their mother
and adolescent programs, and evaluating efficacy in rela- and father, their emotional and behavioral adjustment, and
tion to no treatment and self-study controls. Project goals the overall emotional climate in the home. In the sections
include advancing the constructiveness and reducing the that follow, we present findings from the post-test results
destructiveness, of family conflict, including both inter- based on this RCT design that support the program. The
parental and parent–adolescent conflict; fostering more initial set of statistically significant results are based on
effective parenting, supporting parent–adolescent relation- comparisons between treatment and control groups using
ships, and family communication; advancing the emotional multivariate analysis of covariance (MANCOVA), holding
security of the couple and parent–child relationships from constant pre-test scores.

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Improved Knowledge About Research-Based their conflicts with each other and their adolescent. Ado-
Take-Home Messages on Family Conflict lescents in the treatment group also showed greater overall
constructiveness and autonomy and made less negative
Fathers and mothers in the treatment groups showed sig- contributions to the discussion. Moreover, all family
nificant improvements in comparison with control groups members in the parent–adolescent treatment group reached
on knowledge about how to handle both inter-parental and greater degrees of resolution than in the parent-only con-
parent–adolescent conflicts more constructively. Adoles- dition and in the control groups.
cents in the treatment group also increased in their
knowledge about how to deal with conflicts with mothers
and fathers in a constructive manner. Consumer Satisfaction in Dealing with the EST-Based
Constructs

Implications of Intervention Results for EST To understand how the participating families felt about the
program from a consumer satisfaction perspective, parents
A key aim of the program from an EST perspective is to and teens reported upon completion of the post-test
improve adolescent’s emotional security about family assessments about consumer satisfaction. Satisfaction with
relationships, which is hypothesized to be a foundation for the intervention was almost universally reported among
later improvements in adolescent functioning. Results at those in the treatment conditions, even by fathers and teens.
the post-test supported this prediction, consistent with the For example, choosing among 4 response options, 100% of
goal of improving adolescent’s security about family fathers in the parent and teen program and 95% of the
relationships by promoting more constructive conflict and fathers in the parent-only program rated the program as
communication. Specifically, fathers in the treatment good or excellent. Although our participants varied widely
groups reported that their adolescents were more emo- in terms of educational background, 100% of fathers and
tionally secure about both inter-parental and parent–ado- 98.6% of mothers in the treatment group thought the pro-
lescent relationships. In addition, adolescents who received gram material was easy to understand. These results sug-
the full intervention curriculum reported more secure gest a foundation for Type II translational research, that is,
attachment to their fathers than teens in the control group. the appeal to community families supports the possibility
The results to date thus are consistent with the underlying of the translation of programs into application in everyday
theoretically based goal of improving children’s emotional community settings.
security about family relationships as a first step toward
preventing later adjustment problems.
Efficacy as a Function of SES

Improved Family-Wide Conflict A first point to note is that our sample was highly variable in
terms of SES. The sample was drawn from a community
Another key aim is to improve family-wide conflict that was diverse in terms of racial, economic, and educa-
behaviors, which is one of the foundations to expecting tional backgrounds. For instance, parents endorsed annual
improvements in family-wide relationships. In this incomes ranging from less than $6,000 to over $120,000
instance, we will consider the observationally based data (mean = $55,000–$74,999). Although results of nation-
on dyadic and triadic conflicts recorded in the laboratory wide trials of couple prevention programs for low SES,
for all families and both the pre- and post-tests. In com- racially diverse populations are not encouraging, the vali-
parison with controls, mothers and fathers in the treatment dation of treatment effects in the present program with a
conditions demonstrated more constructive conflict relatively diverse community sample supports the feasibil-
behavior in a couple’s conflict task and also greater reso- ity of creating a universal program designed to support
lution of their conflicts. In comparison with controls, both community families in preventing and better handling
mothers and fathers in the treatment groups also showed conflict, including relatively low-SES families. Clearly, the
greater support for each other during the conflict task than present results are not necessarily generalizable to other
their control counterparts. In the triadic conflict resolution samples, and the racial diversity of the small Midwestern
task, specifically pertinent to documenting observable city in which the present research took place is not neces-
family-wide benefits of the treatment conditions (beyond sarily comparable to the sites of other studies, but another
simply couple effects), both mothers and fathers in the possibility is that the nature of the program presented may
treatment groups showed greater relatedness toward their make a difference. Moreover, analyses with SES as a
teens and demonstrated greater overall constructiveness in moderator of intervention effects for the present program

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failed to reveal significant interactions as a function of SES, an easily replicated program for universal implementation.
despite adequate power to detect these effects. The staff was not required to have a high level of education
or clinical training for adequate administration; only a
brief, intensive training was required. All staff and students
What are the Effects for Unhappy Couples? involved with the project were required to read a body of
literature providing them with the foundational knowledge
Relatedly, from an intervention point of view, it is one that the translational program was built from. In addition,
thing to encourage happy couples to engage in constructive interactive training about the communication technique
conflict, another to foster such behaviors in unhappy cou- was an essential component for all individuals working on
ples. In fact, a key argument for a prevention approach in the project. As an essential piece of the intervention,
community samples is to avoid the many negatives asso- communication coaches were required to pass an in vivo
ciated with escalated conflict process in distressed mar- role-play of a couple and family practicing the iPod tech-
riages that make effective intervention difficult (Cummings nique and meet a minimum standard for correcting and
and Davies 1994). Thus, it would not be at all surprising if encouraging the participants in order to ensure reliability
the program based on theory (e.g., greater emotional across coaches and fidelity of this component of the pro-
insecurity in distressed couples) and research (e.g., docu- gram. Individuals providing childcare were also trained in
mentations of negative reciprocity in distressed marriages) child safety, sensitivity, and management protocol. Six
were less effective for distressed couples. Analyses to this personnel were required to facilitate a full treatment ses-
point suggest that the intervention was effective for all sion with 5 families (15 intervention participants)—the
marriages, regardless of marital satisfaction, but had less maximum number seen at one time. This breakdown
positive effects for unhappy couples. includes 1 facilitator for the adult program, 1 facilitator for
More specifically, 31% of fathers and 37% of mothers in the adolescent program, and minimally 3 communication
our sample reported levels of relationship dissatisfaction coaches that would conduct individualized training ses-
meeting clinically significant cutoffs at the outset of the sions with each of the families. Depending upon the
program. Over the course of the 28 days of the program, number of siblings in childcare, typically 1 to 2 personnel
using multilevel models based on daily diaries completed would be sufficient to ensure the safety and well-being of
by parents about inter-parental conflict resolution in the the children. Our intervention was primarily conducted by
home each day, differential treatment effects were found 3 full-time staff with communication coaching and child-
for the resolution of conflicts in the home dependent upon care provided by extensively trained university students.
the couples’ relationship dissatisfaction level at the time of Additionally, the program design was brief—only 4
program onset. For example, the greatest increase in inter- visits were required to complete the intervention: each one
parental conflict resolution was evident for relationship approximately 2 h in length and consisting of a psycho-
satisfied fathers who received treatment. Dads who entered educational curriculum and a communication coaching
the program with clinically significant dissatisfaction with session. Moreover, the curriculum was designed to be
their relationship still reported positive change but less interactive and include multiple families for each session.
improvement than for relationship satisfied couples. Dads Because of this program feature, multiple families can be
in the control conditions reported no improvements. The reached at one time and distribution of the material to the
use of daily diaries to track improvements in the home community can occur in a more rapid manner than with
during the course of treatment is an innovative approach to individual intervention.
addressing this question. Although in one sense this finding Finally, the program was geared toward increasing
might be regarded as a limitation of the program, in another constructive communication and decreasing destructive
it affirms a key proposition underlying our approach, that family conflict behaviors, in families with adolescents.
is, prevention is an especially promising approach to These simple goals are applicable to every family no
improving family conflict and emotional security. matter the level of conflict: All families with adolescents
can potentially benefit from its curriculum and utilize the
information gained to build relationships with each mem-
Additional Information on the Program ber in their family.

Toward understanding implications for implementation,

additional information about the program is useful to Future Directions
consider. Our intervention program was designed to be
conducted by a trained staff who would resemble those in Several new directions are essential to investigate in future
social service settings in everyday communities, making it research, toward further understanding the effects of this

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24 Clin Child Fam Psychol Rev (2012) 15:14–27

approach. First, investigation is needed into whether and theoretical model also merits study, the Cognitive Con-
how any changes associated with multiple program ele- textual Framework, which has also gained support (Grych
ments occur. Despite a significant body of research in this et al. 2000; Grych et al. 2003). Data from later follow-ups
area, the role of spillover and bi-directional processes (e.g., 6-month, 1-year) will be needed for longitudinal tests
remains to be investigated in the context of prevention of change models predicted by theory. As noted, findings
programs (Schermerhorn et al. 2008). Improvements in any from our ongoing translational intervention program at
family system (i.e., inter-parental, mother– or father–ado- post-test have yielded some support for EST. Thus, fathers
lescent) are hypothetically expected to foster benefits for in both treatment groups reported greater emotional secu-
the other family systems (e.g., Cummings et al. 2008; rity in their adolescents by the end of the intervention, that
Schermerhorn and Cummings 2008), but these questions is, in post-test assessments, than fathers in the control
require empirical study. Another new direction is to groups, even after controlling for pre-test security levels.
explore the interrelations between these systems, with the These findings indicate that our program contributes to
expectation that these elements of the program targeting adolescents’ emotional security, thereby supporting the
inter-parental, mother–adolescent, and father–adolescent hypothesized theoretical underpinnings for treatment
conflict and relationships will have synergistic effects over impact and related positive outcomes.
time. This level of analysis has rarely ever been explored,
but will be particularly informative for interpreting any
new findings about intervention effects and the theoretical Conclusion
reasons behind these outcomes.
Millions of children grow up in households where care- Given the well-established relations between inter-adult
givers are not married. Notably, the couples studied in our conflict and children’s well-being and adjustment, there are
research are not required to be married but only to have had compelling supports for developing programs for inter-
a relationship with significant continuity (e.g., a year or vening for the sake of children and families. Moreover, the
more). However, there is every reason to believe relation- strong evidence for (a) interrelations between inter-adult
ship conflict training for single parents with significant conflict and parenting and parent–child relations and
others in less-established relationships, and for parents with (b) the impact of parent–adolescent conflict on adolescent
adolescents, is also relevant to these families. We have and family functioning supports the move to programs that
preliminary studies adapting our program for these families. have a more comprehensive goal of improving family-wide
We have adapted our program to single parent households communication and conflict processes. This model for
and also for parents involved in custody disputes. These program directions is further supported by emerging evi-
new avenues have again been guided by research on family dence for bi-directional and transactional influence pro-
conflict and EST in order to adapt the program curricula cesses in families, including the impact of adolescent
appropriately to the new samples. For instance, research has functioning on parental functioning.
shown that litigation is associated with increased inter- Substantial evidence for relations between inter-parental
parental conflict and heightened negativity (Emery and conflict and the adjustment of multiple family members
Wyer 1987; Kelly 2003). Moreover, ongoing inter-parental (adults and children) and relationships (mother–child and
conflict post-divorce has been shown to compromise a father–child) supports the urgency for more comprehensive
positive co-parenting system for the children and is asso- outcome assessments than couple relationship satisfaction
ciated with negative family outcomes (Bonach and Sales or related constructs (Cummings and Davies 2010;
2002). Our curriculum, when adapted for litigating parents, Whisman and Baucom 2011). Relatedly, for families with
focuses on reopening positive communication lines about children, there is strong evidence for including child and
the children’s needs. Content for this group also includes adolescent assessments as well as evaluations of the par-
information about how to reduce ongoing inter-parental ents. Given the overwhelming evidence of impact, the
conflict and support parenting practices associated with neglect of study of child outcomes in couple intervention
healthy parent–child relationships. studies is a significant gap that needs to be addressed.
Finally, a direction requiring further exploration is the Family conflicts are potential problems for all families, not
conceptual bases for program effects, which can be only families meeting criteria for clinical diagnoses.
addressed by testing theoretical models about program Interestingly, given the relative intractability of highly
effects. Few studies have advanced understanding of the- escalated relationship conflict, universal prevention pro-
oretical bases for effects for programs to improve inter- grams for community families may possibly hold more
parental conflict, a gap apparent for outcomes related to the promise for long-term as well as cost-effective success than
well-being of children. Our goal is to investigate EST as an more intensive interventions for seriously and chronically
explanatory process for program effects. An alternative distressed couple relationships.

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