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Family Conflict, Emotional Security, and Child Development: Translating

Research Findings into a Prevention Program for Community Families

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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
the physical and psychological health and well-being of
children, parents, and underlying family relationships is a
cause for concern. Inter-parental and parent–child conflict
are linked with children’s behavioral, emotional, social,
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
et al. in Journal of Family Psychology 22:497–505, 2008;
Sanders in Journal of Family Psychology 22:506–517,
2008), the present paper presents the development and
evaluation of a prevention program for community families
with children, concerned with family-wide conflict and
relationships, and building on Emotional Security Theory
(Davies and Cummings in Psychological Bulletin
116:387–411, 1994). This program uniquely focuses on
translating research and theory in this area into brief,
engaging programs for community families to improve
conflict and emotional security for the sake of the children.
Evaluation is based on multi-domain and multi-method
assessments of family-wide and child outcomes in the con-
text of a randomized control design. A series of studies are
briefly described in the programmatic development of a
prevention program for conflict and emotional security for
community families, culminating in a program for family-
wide conflict and emotional security for families with ado-
lescents. With regard to this ongoing program, evidence is
presented at the post-test for improvements in family-wide
functioning, consideration of the relative benefits for
E. M. Cummings (&)
J. N. Schatz
Department of Psychology, University of Notre Dame,
204 Brownson Hall, Notre Dame, IN 46556, USA
e-mail: cummings.10@nd.edu
123
different groups within the community, and preliminary
support for the theoretical bases for program outcomes.
Keywords Prevention
Psychoeducation
Community

Marital conflict
Adjustment
Introduction
Although a diversity of programs have been developed for
supporting parents, couples and/or children; the great
majority of these programs are not subject to rigorous or
cogent evaluation [e.g., randomized control design (RCT);
observational measures; and multivariate outcomes]. In
addition, the empirical and theoretical bases for many
programs are not clearly delineated or tested. Thus, many
questions remain as to which programs work and why. The
present paper describes a translational research approach
toward creating and evaluating theoretically based conflict
prevention program for community families with children.
Translational prevention science emphasizes the value of
explicitly translating research findings and theory into
applied program contents. Supported by the promise of
brief psycho-educational programs (e.g., Halford et al.
2008; Sanders 2008), this program is based on a psycho-
educational approach to making research findings on con-
flict and emotional security for the sake of the children
available to community families. Drawing from the
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
findings and pertinent theory.
The foundation of the program is grounded in an
empirically supported theoretical model, that is, Emotional
Clin Child Fam Psychol Rev (2012) 15:14–27
Security Theory (EST, Davies and Cummings 1994), and
furthers the promise for program efficacy. Specifically, this
theory provides a family-wide model for the effect of
conflict on children (Cummings and Davies 2010) and is
the conceptual foundation for the program. This theoretical
model and supportive research are extensively reviewed in
Cummings and Davies (2010), with a case made for EST as
providing an explanatory model for conflict and related
family influences on children’s functioning. This theoreti-
cal foundation and application of a translational approach
advances provides support for both implementing preven-
tion programming and rigorously evaluating outcomes.
In this paper, building upon this empirical and theoret-
ical framework, a series of studies are described that
highlight the translation of empirical research on marital
and family conflict and child development into a brief
prevention program. In the parlance of translational
research, to this point the work has focused on translating
research into effective prevention, that is, moving from the
bench to the bedside (Type 1 translational research). A next
step after efficacy is established is implementing and test-
ing the program widely in community settings, that is,
moving from the bedside into the community (Type 2
translational research). A notable characteristic that sup-
ports the possibility of broader implementation is that this
program has consistently earned high consumer satisfaction
among community families, as we will show later in this
paper, and in the most recent version of the program,
retention has been high.
Emotional Security Theory as an Overall Framework
EST provided the conceptual model to guide the develop-
ment of the program. Optimal prevention and intervention
programs are informed and guided by a theoretical
framework (Borkowski et al. 2007; Nation et al. 2003).
Theory both serves to integrate program elements into a
cohesive whole and also provides participants with a ‘‘big
picture’’ view of the take-home message of a program.
Tests of theory can cogently advance understanding the
conceptual foundation for any success of the program,
furthering contributions to science as well as practice.
Notably, EST articulates a comprehensive theoretical
model for both the direct effects of inter-parental conflict
on children and those mediated by negative effects on
parenting and other family relationships (Cummings and
Davies 2010). An example of a direct pathway is the
impact of inter-parental conflict on children’s emotional
insecurity about their parents’ relationship. The impact of
inter-parental conflict on insecure attachments to the par-
ents illustrates an indirect pathway of influence. If conflict
is pervasive in parental relationships, particularly if
15
characterized by destructive forms, children’s emotional
insecurity about multiple family relationships is under-
mined. These effects can be traced to the emotional, social,
cognitive, and physiological dysregulation associated with
insecurity (Cummings and Davies 2010). The EST model
thus serves as a framework for understanding family con-
flict’s implications for child and family functioning and
also as an overarching theoretical foundation from which to
build prevention or intervention approaches.
EST holds that children’s sense of protection, safety,
and security about their parents’ relationship and about the
family as a whole are related to their well-being and
adjustment over time. Children’s emotional insecurity
about family relationships is posited as a primary mecha-
nism toward explaining the effects of parental and family-
wide conflict on their later maladjustment. According to
EST, the meaning of inter-parental and family conflict is
related to children’s assessment of emotional security
implications, which is not merely a hypothetical construct,
but can be discerned operationally from assessments of
children’s emotional, behavioral, and cognitive reactions.
For example, specifically testing these assumptions,
Harold, Shelton, Goeke-Morey, and Cummings (2004)
longitudinally examined relations between inter-parental
conflict, children’s emotional security about inter-parental
conflict, parenting, and child adjustment. Distinct pathways
of regulatory functioning in response to exposure to con-
flict were differentiated, including children’s emotional
regulation, cognitive representations, and behavioral regu-
lation. An indirect pathway through children’s emotional
insecurity about parenting to their maladjustment was
also supported. As another example, Cummings et al.
(2006) longitudinally demonstrated relations between inter-
parental discord and child maladjustment in two studies,
involving 9- to 18-year-olds (Study 1), and 5- to 7-year-
olds (Study 2), respectively. Despite the differences in
samples and age periods, both studies provided consistent
support for the EST model for relations among inter-
parental discord, emotional security, and child adjustment.
That is, emotional insecurity was identified as an explan-
atory mechanism for changes in children’s maladjustment
over time, among children across a wide age range,
including adolescence.
With regard to program goals, as we will elaborate
further below, EST has provided an empirical starting point
in research for identifying behaviors that (a) diminish
children’s security, which are held in the context of our
prevention program as behaviors for parents to avoid and
(b) conflict behaviors that increase children’s security,
which are encouraged in the context of our prevention
program as behaviors to engage in during conflicts. In
addition, some forms of parent–child conflict and com-
munication are supported empirically as increasing, and
123
16
others as decreasing, the security of parent–child relation-
ships, with corresponding recommendations for parents in
the context of the psycho-educational presentations made
in our prevention program. Moreover, another theme in our
program based on EST is that behaviors and outcomes of
conflict that foster children’s emotional security are
advanced as of higher-order importance to family members
than winning conflicts, or other short-term outcomes.
Fostering children’s emotional security about family rela-
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,
and over the long-term, adjustment. Thus, an underlying
theoretical proposition of our prevention program is that
improvements in children’s emotional security about fam-
ily conflict and relationships are important goals for the
program, posited to mediate more positive child develop-
ment outcomes over time. Thus, a demonstration of
improved emotional security constitutes what is expected
to be an initial indicator of program efficacy from the
perspective of children’s well-being.
Family Conflict is Related to Child and Family
Dysfunction
A theoretical tenet of EST that supports targeting improved
family conflict is that negative family conflict holds the
potential to undermine child and family well-being and
adjustment. Inter-adult conflict creates an at-risk family
environment for adults and children (Cummings and
Davies 2010). Higher rates of depression, anxiety, and
alcohol-use are found among adults in relationships char-
acterized by destructive conflict behaviors (Cummings and
Davies 2002). Each of these outcomes in turn, potentially
compounds the effects of parental conflict for children as
well as contributes to an increase in destructive inter-
parental conflict behaviors (Cummings and Davies 2002;
Whisman 2001). For instance, homes characterized by
inter-parental aggression are also strongly associated with
child maltreatment (Hughes 1988). Parental drinking is
linked with destructive marital conflict, with negative
implications for child and family functioning and adjust-
ment (Keller et al. 2008).
Parental and parent–child conflict are linked with chil-
dren’s behavioral, emotional, social, academic, and health
problems and identified as primary predictors of malad-
justment, especially within families characterized by a dis-
tressed inter-parental relationship. Multiple family
relationships are undermined by the effects of inter-adult
conflict, including inter-parental, mother–child, and father–
child relationships (Cummings and Davies 1994, 2010).
Moreover, inter-adult conflict contributes to parenting
123
Clin Child Fam Psychol Rev (2012) 15:14–27
problems and parent–adolescent conflict (e.g., Buehler and
Gerard 2002). Child, parental, and family outcomes are at
risk for problems in the context of high family conflict,
even in households without clinically significant problems
(Cowan et al. 1996; Liberman et al. 2005). Thus, the social
problem posed by inter-adult conflict to the physical and
psychological health and well-being of children and par-
ents, as well as family relationships is a cause for sub-
stantial concern.
Inter-Adult Conflict Specifically Relates to Child
Maladjustment
Consistent with the assumption of EST that negative family
conflict negatively affects children’s emotional security
and adjustment, children show discriminated and distressed
responses to parental anger at an early age—empirically
documented with infants as young as 6 months (Cummings
and Davies 1994). The distress that children show when
exposed to destructive inter-parental conflicts may be
manifested through a wide range of reactions. For example,
children may become aggressive or behaviorally dysregu-
lated, or get involved in parents’ disputes (Cummings and
Davies 1994). Although demonstrations of relations with
internalizing and externalizing symptoms have been a
focus of research (e.g., El-Sheikh et al. 2007b), effects on
many other outcomes and relationships are also frequently
demonstrated, including peer and romantic relationships
(e.g., Du Rocher Schudlich et al. Cummings 2004;
Kinsfogel and Grych 2004). Moreover, children do not
need to be present for inter-adult conflicts to feel the
impact, rather the family environment that is left in the
wake of persistent destructive conflicts (i.e., distracted,
emotional parents; upset siblings) can also contribute to
maladjustment and behavioral reactions. Children appear to
be quite well-aware of inter-parental conflicts, even if they
are not physically present in the same room to observe
these conflicts (Cummings and Davies 2010).
Further emphasizing the far-reaching consequences of
inter-adult conflict is the body of work that shows the
repercussions on children’s physiology (Davies et al.
2007). Davies et al. (2008) showed that children’s fear
responses to inter-parental conflict were predictors of their
elevated cortisol reactivity to conflict, especially for chil-
dren exhibiting involvement in conflicts. El-Sheikh et al.
(2007a) reported that marital conflict was linked with
children’s sleep disruptions, with sleep problems associ-
ated with children’s behavioral, emotional, and academic
difficulties, including math, language, verbal, and nonver-
bal achievement (El-Sheikh et al. (2007a). Longitudinal
pathways relating marital conflict, attentional difficulties,
and school problems have also been identified (Davies
Clin Child Fam Psychol Rev (2012) 15:14–27
et al. 2008). Children are sensitized in responding across
multiple domains by repeated exposure to inter-parental
conflicts (e.g., Cummings et al. 2003, 2004; Davies et al.
1999), with sensitization supported longitudinally as well
(Davies et al. 2006).
Emotional Security Theory (EST) Provides Criteria
for Identifying Destructive Versus Constructive
Conflict: A Distinction Relevant to Prevention
Programming
The effects of conflict on families depend on how conflicts
are expressed (Cummings and Cummings 1988), with
some forms having negative effects and others having
benign, or even positive, effects (Cummings and Davies
2002). With regard to inter-parental conflict, children seem
to function as emotional ‘‘Geiger counters’’, able to infer
the occurrence and outcomes of conflicts from an early age
without directly observing the conflicts or conflict resolu-
tion (Cummings et al. 1993; Cummings and Wilson 1999).
Conflict can be considered harmful if the security of the
child is threatened; from this perspective multiple
destructive behaviors have been identified including
physical and verbal aggression, withdrawal/avoidance,
nonverbal and verbal anger, and the use of insults. Con-
versely, constructive conflict behaviors, which support or
foster children’s sense of security, have also been descri-
bed: calm discussion, support, (some forms of) humor,
problem-solving, and physical and verbal affection.
For example, with regard to the categorization of inter-
parental conflict, children’s emotional reactions during
conflict provide the groundwork for distinguishing between
classifications of parental behaviors. Accordingly, based on
EST, parental conflict tactics eliciting more negative than
positive emotional reactions are considered ‘‘destructive’’,
since such responding suggests that children’s security is
reduced. By contrast, inter-parental conflict tactics result-
ing in more positive than negative emotional reactions are
classified as ‘‘constructive’’, given that such responding
implies enhanced security.
Moving from the research-informed theory-building and
the identification of specific destructive tactics to examin-
ing those behaviors in relation to child outcomes, evidence
shows that the conflict behaviors identified by EST criteria
as destructive are consistently associated with negative
outcomes. More specifically, children make distinctions
among verbal, non-verbal, and physical expressions of
conflict as evidenced by their varying emotional, behav-
ioral, and cognitive responses (Cummings et al. 1989).
Exposure to physical violence is related to children’s
adjustment problems (Jouriles et al. 1989; McDonald
and Jouriles 1991). El-Sheikh et al. (2008) demonstrated
17
relations between inter-parental aggression and children’s
mental and physical health.
With regard to constructive inter-parental conflict,
Goeke-Morey et al. (2003) examined the responses of
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
negative behaviors were categorized as ‘‘constructive,’’
based on the principle that positivity indicated well-being
was increased. Applying these criteria, support, problem-
solving, and affection were identified as constructive
behaviors. That is, children’s reports of positive emotional
responding were significantly greater than negative emo-
tional responding to these behaviors. Moreover, EST places
importance on the overall feeling of the conflict, particu-
larly the degree of resolution. For instance, complete res-
olution of conflict may ameliorate the negative effects of
exposure to conflict (Cummings et al. 1989). Children’s
distress is diminished as a function of the degree of reso-
lution (Cummings et al. 1991). Distress reactions are
reduced even if conflicts are not fully resolved, and chil-
dren can benefit from learning about later resolution of
conflict (Cummings et al. 1993). Kerig (1996) reported that
marital conflict resolution was more consistently associated
with child well-being (i.e., reduced adjustment problems)
than even negative elements of conflict (e.g., high fre-
quency). Based on a three-wave longitudinal study,
McCoy, Cummings, and Davies (2009) demonstrated
relations between constructive marital conflict behavior,
increased emotional security about marital relations, and
children’s prosocial behavior.
These studies, among many others, provide further
support for Emotional Security Theory and research on
inter-parental conflict and children’s responses for recom-
mendations for parents on how to engage in conflict for the
sake of the children. Although destructive conflict increa-
ses children’s insecurity leading to problematic adjustment,
constructive conflict behaviors support family security and
promote positive functioning in multiple domains. For
instance, exposure to constructive conflict between parents
can lead to increases in children’s positive affect and
decreases in both behavioral and cognitive indices of
insecurity. McCoy and colleagues (2009) found that emo-
tional security mediated the relationship between con-
structive inter-parental conflict behaviors and children’s
prosocial behaviors over time; recent work has also iden-
tified pathways between constructive marital conflict, par-
enting, and positive school adjustment (McCoy et al.
2011). Given evidence that increasing constructive conflict
management between the parents promotes children’s
emotional security and adjustment, constructive conflict
can be seen as a critical goal for inter-parental and family
conflict-focused intervention.
123
18
Gaps in the Development of Programs on Couple
Conflict for the Welfare of Children
Despite the extensive empirical and theoretical evidence for
the effects of inter-parental conflict on children, research-
based supports for children have been largely neglected in
programs for couple conflict. Psycho-educational programs
for couples have widely ignored children and a research-
grounded parenting curriculum in program development
and evaluation (Markman et al. 2010); the rare exceptions
typically have focused on very young children (Cowan et al.
2005, Typically, prevention/intervention programs are
implemented for couples to change conflict behaviors in
order to increase relationship satisfaction by decreasing
destructive behaviors and increasing constructive ones
(Blanchard et al. 2009). For example, the Prevention and
Relationship Enhancement Program (PREP) is intended to
lay a positive communication foundation before the marital
relationship begins (Markman et al. 1988). Markman,
Stanley, and colleagues have provided evidence for the
long-term effectiveness for couples’ communication skills
of the PREP intervention, a program for teaching couples
communication and conflict resolution skills derived from
behavioral marital therapy (e.g., Laurenceau et al. 2004;
Markman et al. 1988, 1993). Programs based on couple
research have received support, although with mixed find-
ings (Cowan et al. 2010); however, an important piece of
the puzzle is missing—the child. Moreover, a solid,
research-grounded curriculum that could be empirically
evaluated is lacking in many instances.
Only a small number of extant programs have been
directed toward children and parenting as well as couples.
Among couples expecting their first child, Schulz et al.
(2006) found marital satisfaction was less negatively
affected among participants in a couple support program
during the transition to parenthood than among comparison
participants, indicating the effectiveness of the preventive
group intervention. Cowan and colleagues have reported
multiple long-term beneficial effects of a 16-week couples’
intervention with a marital or parenting emphasis, for
children in the transition to elementary school (Cowan
et al. 2005.) Another gap is that few preventive programs
for inter-parental and family conflict have been advanced
specifically targeting the adjustment and well-being of
adolescents and their families, translating theory and
research on inter-parental conflict and children into a brief
preventive approach for community families that is both
practical and feasible.
Moreover, the pervasiveness and threats posed by inter-
parental and family conflict support that prevention pro-
grams administered universally in communities may serve
to broadly elevate the health and well-being of children and
families. Negative conflict processes are more readily
123
Clin Child Fam Psychol Rev (2012) 15:14–27
ameliorated before conflict becomes escalated, cognitions
between couples become distorted (e.g., negative tracking),
and the emotional and behavioral reactions of couples to
each other become ensnared in a negative, spiraling cycle
(Cummings and Davies 1994). Relationship conflict is a
potential contributor to emotional distress and behavior
problems, including psychopathology, for all community
families (Cowan et al. 1996). Brief prevention programs
are less costly and may help a broader range of families,
with brief, psycho-educational programs especially acces-
sible for community families. Although recent nationwide
trials of couple prevention programs for low SES, racially
diverse couples have been met with limited success, it may
be due to the challenge of these programs being directed
toward particularly high-risk couples (e.g. Building Strong
Families, Wood et al. 2010). Success may be more likely in
less high-risk samples. However, questions can also be
raised about the translational research underpinnings for
this program, which followed a different model for pro-
gram development than in our program’s development.
Minimally, although inspired efforts in many important
ways, these programs were not systematically informed by
the extensive literatures on conflict in families; couple
conflict and child development; theory on family func-
tioning, children and conflict; and child adjustment and
conflict. These programs also lacked application of an
underlying theoretical model to guide translation of
research on conflict into programming, and the package for
evaluation of outcomes was limited. Without rigorous tests
of these alternative hypotheses, it will remain unclear why
these programs unfortunately had limited success and make
comparability of these national programs to the present
program, beyond the interest in some selected common
themes (e.g., couple conflict), highly questionable.
Translational Research and Its Implications
in Prevention and Intervention Programming
Translational research is often described as taking the
research from the bench to the bedside (i.e., Type 1
translational research). The overall approach is considered
the bridge between science and application. According to
the tenets of translational research, the development of an
intervention and its curriculum should be based on a
foundation of proven research. These translational aspects
may involve who should be targeted, what content must be
focused upon to make a lasting change, and anticipating the
outcomes that will most likely be impacted by the program
and considered valid indicators of program success. When
based on a consistent cycle of building curriculum from
research, rigorously evaluating such programming, adjust-
ing the curriculum if necessary, and finally disseminating
Clin Child Fam Psychol Rev (2012) 15:14–27
results (Type 2 translational research), translational
research holds promise to advance the scientific commu-
nity as well as support families in our society. These goals
are adopted in the present line of translational research.
Growing emphasis on translational research in scientific
and applied arenas has challenged both scientists and
practitioners to apply science to intervention and preven-
tion programs. For example, new editorial guidelines at
journal outlets such as the Journal of Family Psychology
now uniformly challenge contributors to outline how
empirical findings may inform clinical practice and public
policy (Kazak 2004; Parke 1998). Likewise, modifications
in the organization and priorities of funding agencies like
the National Institute of Mental Health signify an over-
arching commitment to translating knowledge on behav-
ioral and social sciences to understanding and reducing
mental illness (Dingfelder 2004; National Advisory Mental
Health Council Behavioral Science Workgroup 2000; also
see Institute of Medicine 1994). Accompanying changes in
the infrastructure of the behavioral sciences is progress in
addressing the many significant gaps in integrating
behavioral theory and science with treatment and policy
initiatives (Cicchetti and Toth 2006; Toth and Cicchetti
2006).
The melding of theory, methodology, and application
are all relevant directions for both the development and
testing of prevention and intervention programs. However,
few existing programs (a) report data documenting their
effectiveness, (b) are guided by basic research in the area
of couples’ conflict, child development, and family-wide
functioning, (c) address consumer satisfaction with par-
ticipation, or (d) include long-term assessments of devel-
opmental trajectories for children and their parents (Braver
et al. 1993; Grych 2005; Grych and Fincham 1992;
Wolchik et al. 2002). Greater demands are being made on
practitioners by funding agencies to demonstrate how sci-
ence informs the development of prevention and inter-
vention programs. Knowledge of methodology is required
to test the effectiveness of treatment programs. Intervention
and prevention programs (e.g., schools, clinical treatment
centers) are increasingly demanding some scientific veri-
fication of the success of the clinical and community ser-
vices for children. Thus, it is becoming more and more
necessary for practitioners to become well-versed in
methodology (Heatherington et al. 2005).
Translating Research into Prevention Programs
for Community Couples with Children
The development of translational research at the level
of the procedures and materials is unfamiliar for many
19
investigators trained in scholarly research traditions. At the
same time, individuals comfortable in applied contexts
may have limited understanding of scholarly traditions for
evaluating evidence, including research design issues
essential to advancing the scientific bases for applied pro-
grams and the sophisticated approaches to evaluation.
These facts present significant and fundamental challenges
and obstacles to achieving the goal of developing programs
that effectively make available the insights of the best
empirical research in the context of adequately evaluated
applied programs.
Consistent with the notion of translational research, an
important element is the systematic translation of specific
results into program components. For example, we outline
a specific protocol for our program to be ‘‘directly
informed’’ by empirical research (for example, see
Cummings and Davies 2010). That is, a first step is to
discern the key messages from the most important and
rigorous empirical research that might serve as the
framework for a prevention program. Notably, prevention
research has been little informed by empirical research on
inter-parental conflict and family conflict and children,
reflecting the problem of spanning the gap between
research findings and the effective application of these
findings in the real world.
The development of effective program materials is as
much art as science. Although there is an emerging tem-
plate concerning the characteristics of the best programs
(Borskowski et al. 2007; Nation et al. 2003), the develop-
ment of program materials that translate research knowl-
edge into an effective program are a significant challenge.
Moreover, demands may vary depending on the goals of
the program. For example, common wisdom is that pre-
vention efforts should be comprehensive, but at the same
time, it is important to determine the ‘‘right amount of
treatment’’ (Borkowski et al. 2007). In some instances,
especially for the goals and samples addressed by pre-
vention programs, briefer programs may be more effective
(Bakermans-Kranenburg et al. 2003). Research also sug-
gests that an optimal way for presenting translational
research for community families in prevention trials may
be a psycho-educational approach. A substantial body of
evidence collected in the parenting literature supports the
promise of a psycho-educational approach (e.g., the Triple
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,
2010a, b). More intensive and lengthily approaches may be
needed to ameliorate chronically and seriously distressed
marriages, which are likely to require clinically trained
staff (Bradbury and Karney 2004; Christensen et al. 2004,
2010; Hahlweg et al. 2010).
123
20
Overview of Translational Work on Inter-Parental
Conflict and Children
Because all families experience conflict and many couples
may not seek counseling even after clinically significant
problems are present, the need for a program for commu-
nity families ideally to prevent conflict problems before
they become highly destructive is clear. Moreover,
research shows that negative conflict processes are more
easily remedied before conflict escalates, cognitions
become distorted, and the emotional and behavioral reac-
tions of partners to each other become a recurrent negative
cycle (Cummings and Davies 1994). In terms of financial
implications, brief prevention programs are less costly and
may help a more diverse range of families, with brief,
psycho-educational programs especially accessible for
community families (Hawkins et al. 2008; Johnston 1994;
Morgan et al. 1990; Pehrson and Robinson 1990; Shifflett
and Cummings 1999; Turner and Dadds 2001).
Our research team began its journey into translational
research with a one-visit program that provided qualified
evidence for beneficial effects (Faircloth and Cummings
2008). Fifty-five couples with an oldest child 6 years or
younger were randomly assigned to treatment or wait-listed
control groups, with assessments at pre-test, post-test, and
6- and 12-month follow-ups. Parents’ knowledge about
marital conflict and the effects of it on children was greater
relative to a wait-list control group at the post-test. Relative
to pre-test, couples in the treatment group displayed both
less hostility in front of their children and improved in
constructive conflict tactics at follow-ups. However, lack
of post-test comparisons between treatment and control for
these questions and reliance on self-report about marital
conflict limited interpretation of efficacy. The presentation
of the evidence-based information about marital conflict
was limited. Nonetheless, promise was indicated.
Based on this initial evidence for the promise of the
approach, a longer prevention program was developed
based on EST and research on marital conflict and children
that utilized a brief psycho-educational format to teach
couples about marital conflict and provide communication
training. Cummings et al. (2008) tested an elaborated four-
visit program for community families, including extensive
parent education about inter-parental conflict and children
and the addition of couples’ communication training. A
two-visit child psycho-educational program was also tes-
ted, focusing on teaching children how to cope with
parental conflict. Ninety couples with children between 4
and 8 years of age were randomly blocked into one of three
groups: (1) a parent-only group (n = 24); (2) a parent–
child group (n = 33); or (3) a self-study control group
(n = 33), with assessments at pre-, post-, and 6- and
12-month follow-ups. Post-intervention assessments of the
123
Clin Child Fam Psychol Rev (2012) 15:14–27
couples having an observed discussion highlighted several
significant program effects. The sessions were coded for
key conflict outcomes such as resolution, emotionality
during the discussion, and identified constructive conflict
behaviors. Findings showed treatment couples were more
supportive of their partners, more emotionally positive
during interactions, more likely to advance toward the
resolution of arguments, and more constructive during
conflict discussions. In addition, couples’ positive changes
in conflict behaviors in the treatment group were linked
with positive changes over time in relationship satisfaction,
parenting, and child adjustment. Changes in knowledge
over time were linked with changes in conflict behaviors,
suggesting that knowledge was an active agent in the post-
intervention improvements. Pertinent to the possibilities for
effective implementation in community samples, couples
reported high satisfaction with the program. Follow-up
tests demonstrated that effects were maintained at 1- and
2-year follow-ups (Cummings et al. 2008; Faircloth et al.
2011). The results thus supported promise for sustained
growth in constructive conflict and related outcomes in
community samples from a relatively brief program based
on this approach. However, evidence for beneficial child
effects was limited, attrition was relatively high, and the
child psycho-educational program yielded virtually no
gains (Mitchell et al. 2009). Conclusions drawn from these
outcomes were twofold: Simply teaching a young child
how to cope with a difficult situation does not provide
enough support to cope with inter-parental conflict and the
age of a child in developing an efficacious intervention
matters.
The next program we will review is ongoing and has
made advancements from this earlier work including
additional innovative elements and a more comprehensive
curriculum toward improving both inter-parental and
family-wide conflict. This direction is extended by adapt-
ing the program for couples with young children to apply to
couples with adolescents—a developmental period with
heightened conflict. This program also aims to improve
family-wide conflict and communication, including inter-
parental, father–child, and mother–child relationships.
Extending EST beyond children’s responses to inter-
parental conflict the program also advances a family-wide
perspective on emotional security and family conflict, that
is, a preventative intervention for family conflict and
communication, including inter-parental, mother–adoles-
cent, and father–adolescent relationships.
The project thus far includes 225 families (mothers,
fathers, and their 11–16-year-old adolescents) that have
been randomly assigned to the (a) parent–adolescent pro-
gram, (b) parent-only program, (c) self-study control, or
(d) no treatment control, with 213 of the 225 families
completing the program and post-test assessments to this
Clin Child Fam Psychol Rev (2012) 15:14–27
point. An innovative element was the inclusion in the four-
visit parent program of content on parent–adolescent con-
flict and communication. Responding to lack of success of
a program for children’s coping with conflict (Cummings
et al. 2008), a new direction was the development of a four-
visit program for adolescents, focusing on improving
adolescents’ conflict resolution skills, including in rela-
tionships with both the mother and father. Innovative
curriculum, drawn from the latest body of research on
family conflict and emotional security, was developed to
foster teens’ engagement and also to further engage fathers
and mothers, with an important goal to substantively
reduce attrition in comparison with the Cummings et al.
(2008) study. This goal was decisively achieved, that is, a
95% retention rate through the post-test was attained.
Evaluation was again based on a RCT design, with data
collection completed for the pre- and post-intervention
assessments, and continuing for 6- and 12-month, and
3-year follow-up assessments.
Beyond simply improving inter-parental relationship
satisfaction, this program was designed to strengthen
multiple family relationships; improve children’s emo-
tional security about their family relationships; and support
children’s social and emotional development all through
the provision of a broader direction in research-based
psycho-educational programs for community families with
adolescents. For example, the program was also designed
to ameliorate mother–adolescent and father–adolescent
conflict and communication, which are also linked with
both inter-parental conflict and adolescent adjustment and
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-
tive techniques to increase the effectiveness and engage-
ment with program content while promoting high
consumer satisfaction. Program participation is limited to 4
visits in a community center in order to increase practi-
cality and appeal for community families with adolescents.
Assessments include questionnaires designed to evaluate
child and family functioning; observational measures of
family conflicts; and daily diary assessments of inter-
parental and family conflict and relationships, and are
completed independently by mothers, fathers and adoles-
cents. Key issues are comparing parent-only versus parent
and adolescent programs, and evaluating efficacy in rela-
tion to no treatment and self-study controls. Project goals
include advancing the constructiveness and reducing the
destructiveness, of family conflict, including both inter-
parental and parent–adolescent conflict; fostering more
effective parenting, supporting parent–adolescent relation-
ships, and family communication; advancing the emotional
security of the couple and parent–child relationships from
21
the adolescent’s perspective; and improving the well-being
and adjustment of adolescents.
Moreover, the program itself advances the translational
research approach and extends previous programming for
couples’ conflict in several new directions. First, new
research findings suggest that children play a role in family
functioning; the current program includes both parents and
their adolescent in teaching constructive communication
strategies. Second, the program includes a multi-dimen-
sional component for parents and a separate but parallel
one for adolescents. Both parent and teen components
contain interactive activities; for the adolescents, the
activities are the foundation of their psycho-educational
training. For instance, popular movie clips are used to
demonstrate destructive and constructive conflict behaviors
and provide a starting point for discussions about conflict.
Other activities include role-playing, jeopardy-style review
sessions complete with buzzers, and the use of popular
conversation games to apply the communication knowl-
edge. Third, the current program extended the previous
program’s communication training in 2 manners: (1) a
popular device became a metaphor for the communication
training—an iPod—in order to make it teen friendly and
easily learned by both parents and their adolescents; and
(2) adolescents also receive the communication training.
The communication training and practice session with a
trained coach is an essential aspect of the program curric-
ulum. It is here that couples and adolescents can practice
their newly acquired skills and try them out in a safe
environment.
Empirical Support for the Program: Post-Test Results
Another innovative element is the rigorous, multi-domain
approach to assessment. Following the translational
research approach, the program was rigorously evaluated
with a multi-reporter, multi-context, multi-dimensional
assessment scheme to assess family-wide outcomes,
including questionnaires and observations. Mothers and
fathers completed questionnaires pertaining to inter-
parental conflict and satisfaction, parenting practices, and
family emotional climate. Adolescents completed ques-
tionnaires addressing their relationships with their mother
and father, their emotional and behavioral adjustment, and
the overall emotional climate in the home. In the sections
that follow, we present findings from the post-test results
based on this RCT design that support the program. The
initial set of statistically significant results are based on
comparisons between treatment and control groups using
multivariate analysis of covariance (MANCOVA), holding
constant pre-test scores.
123
22
Improved Knowledge About Research-Based
Take-Home Messages on Family Conflict
Fathers and mothers in the treatment groups showed sig-
nificant improvements in comparison with control groups
on knowledge about how to handle both inter-parental and
parent–adolescent conflicts more constructively. Adoles-
cents in the treatment group also increased in their
knowledge about how to deal with conflicts with mothers
and fathers in a constructive manner.
Implications of Intervention Results for EST
A key aim of the program from an EST perspective is to
improve adolescent’s emotional security about family
relationships, which is hypothesized to be a foundation for
later improvements in adolescent functioning. Results at
the post-test supported this prediction, consistent with the
goal of improving adolescent’s security about family
relationships by promoting more constructive conflict and
communication. Specifically, fathers in the treatment
groups reported that their adolescents were more emo-
tionally secure about both inter-parental and parent–ado-
lescent relationships. In addition, adolescents who received
the full intervention curriculum reported more secure
attachment to their fathers than teens in the control group.
The results to date thus are consistent with the underlying
theoretically based goal of improving children’s emotional
security about family relationships as a first step toward
preventing later adjustment problems.
Improved Family-Wide Conflict
Another key aim is to improve family-wide conflict
behaviors, which is one of the foundations to expecting
improvements in family-wide relationships. In this
instance, we will consider the observationally based data
on dyadic and triadic conflicts recorded in the laboratory
for all families and both the pre- and post-tests. In com-
parison with controls, mothers and fathers in the treatment
conditions demonstrated more constructive conflict
behavior in a couple’s conflict task and also greater reso-
lution of their conflicts. In comparison with controls, both
mothers and fathers in the treatment groups also showed
greater support for each other during the conflict task than
their control counterparts. In the triadic conflict resolution
task, specifically pertinent to documenting observable
family-wide benefits of the treatment conditions (beyond
simply couple effects), both mothers and fathers in the
treatment groups showed greater relatedness toward their
teens and demonstrated greater overall constructiveness in
123
Clin Child Fam Psychol Rev (2012) 15:14–27
their conflicts with each other and their adolescent. Ado-
lescents in the treatment group also showed greater overall
constructiveness and autonomy and made less negative
contributions to the discussion. Moreover, all family
members in the parent–adolescent treatment group reached
greater degrees of resolution than in the parent-only con-
dition and in the control groups.
Consumer Satisfaction in Dealing with the EST-Based
Constructs
To understand how the participating families felt about the
program from a consumer satisfaction perspective, parents
and teens reported upon completion of the post-test
assessments about consumer satisfaction. Satisfaction with
the intervention was almost universally reported among
those in the treatment conditions, even by fathers and teens.
For example, choosing among 4 response options, 100% of
fathers in the parent and teen program and 95% of the
fathers in the parent-only program rated the program as
good or excellent. Although our participants varied widely
in terms of educational background, 100% of fathers and
98.6% of mothers in the treatment group thought the pro-
gram material was easy to understand. These results sug-
gest a foundation for Type II translational research, that is,
the appeal to community families supports the possibility
of the translation of programs into application in everyday
community settings.
Efficacy as a Function of SES
A first point to note is that our sample was highly variable in
terms of SES. The sample was drawn from a community
that was diverse in terms of racial, economic, and educa-
tional backgrounds. For instance, parents endorsed annual
incomes ranging from less than $6,000 to over $120,000
(mean = $55,000–$74,999). Although results of nation-
wide trials of couple prevention programs for low SES,
racially diverse populations are not encouraging, the vali-
dation of treatment effects in the present program with a
relatively diverse community sample supports the feasibil-
ity of creating a universal program designed to support
community families in preventing and better handling
conflict, including relatively low-SES families. Clearly, the
present results are not necessarily generalizable to other
samples, and the racial diversity of the small Midwestern
city in which the present research took place is not neces-
sarily comparable to the sites of other studies, but another
possibility is that the nature of the program presented may
make a difference. Moreover, analyses with SES as a
moderator of intervention effects for the present program
Clin Child Fam Psychol Rev (2012) 15:14–27
failed to reveal significant interactions as a function of SES,
despite adequate power to detect these effects.
What are the Effects for Unhappy Couples?
Relatedly, from an intervention point of view, it is one
thing to encourage happy couples to engage in constructive
conflict, another to foster such behaviors in unhappy cou-
ples. In fact, a key argument for a prevention approach in
community samples is to avoid the many negatives asso-
ciated with escalated conflict process in distressed mar-
riages that make effective intervention difficult (Cummings
and Davies 1994). Thus, it would not be at all surprising if
the program based on theory (e.g., greater emotional
insecurity in distressed couples) and research (e.g., docu-
mentations of negative reciprocity in distressed marriages)
were less effective for distressed couples. Analyses to this
point suggest that the intervention was effective for all
marriages, regardless of marital satisfaction, but had less
positive effects for unhappy couples.
More specifically, 31% of fathers and 37% of mothers in
our sample reported levels of relationship dissatisfaction
meeting clinically significant cutoffs at the outset of the
program. Over the course of the 28 days of the program,
using multilevel models based on daily diaries completed
by parents about inter-parental conflict resolution in the
home each day, differential treatment effects were found
for the resolution of conflicts in the home dependent upon
the couples’ relationship dissatisfaction level at the time of
program onset. For example, the greatest increase in inter-
parental conflict resolution was evident for relationship
satisfied fathers who received treatment. Dads who entered
the program with clinically significant dissatisfaction with
their relationship still reported positive change but less
improvement than for relationship satisfied couples. Dads
in the control conditions reported no improvements. The
use of daily diaries to track improvements in the home
during the course of treatment is an innovative approach to
addressing this question. Although in one sense this finding
might be regarded as a limitation of the program, in another
it affirms a key proposition underlying our approach, that
is, prevention is an especially promising approach to
improving family conflict and emotional security.
Additional Information on the Program
Toward understanding implications for implementation,
additional information about the program is useful to
consider. Our intervention program was designed to be
conducted by a trained staff who would resemble those in
social service settings in everyday communities, making it
23
an easily replicated program for universal implementation.
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
involved with the project were required to read a body of
literature providing them with the foundational knowledge
that the translational program was built from. In addition,
interactive training about the communication technique
was an essential component for all individuals working on
the project. As an essential piece of the intervention,
communication coaches were required to pass an in vivo
role-play of a couple and family practicing the iPod tech-
nique and meet a minimum standard for correcting and
encouraging the participants in order to ensure reliability
across coaches and fidelity of this component of the pro-
gram. Individuals providing childcare were also trained in
child safety, sensitivity, and management protocol. Six
personnel were required to facilitate a full treatment ses-
sion with 5 families (15 intervention participants)—the
maximum number seen at one time. This breakdown
includes 1 facilitator for the adult program, 1 facilitator for
the adolescent program, and minimally 3 communication
coaches that would conduct individualized training ses-
sions with each of the families. Depending upon the
number of siblings in childcare, typically 1 to 2 personnel
would be sufficient to ensure the safety and well-being of
the children. Our intervention was primarily conducted by
3 full-time staff with communication coaching and child-
care provided by extensively trained university students.
Additionally, the program design was brief—only 4
visits were required to complete the intervention: each one
approximately 2 h in length and consisting of a psycho-
educational curriculum and a communication coaching
session. Moreover, the curriculum was designed to be
interactive and include multiple families for each session.
Because of this program feature, multiple families can be
reached at one time and distribution of the material to the
community can occur in a more rapid manner than with
individual intervention.
Finally, the program was geared toward increasing
constructive communication and decreasing destructive
family conflict behaviors, in families with adolescents.
These simple goals are applicable to every family no
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-
ber in their family.
Future Directions
Several new directions are essential to investigate in future
research, toward further understanding the effects of this
123
24
approach. First, investigation is needed into whether and
how any changes associated with multiple program ele-
ments occur. Despite a significant body of research in this
area, the role of spillover and bi-directional processes
remains to be investigated in the context of prevention
programs (Schermerhorn et al. 2008). Improvements in any
family system (i.e., inter-parental, mother– or father–ado-
lescent) are hypothetically expected to foster benefits for
the other family systems (e.g., Cummings et al. 2008;
Schermerhorn and Cummings 2008), but these questions
require empirical study. Another new direction is to
explore the interrelations between these systems, with the
expectation that these elements of the program targeting
inter-parental, mother–adolescent, and father–adolescent
conflict and relationships will have synergistic effects over
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
reasons behind these outcomes.
Millions of children grow up in households where care-
givers are not married. Notably, the couples studied in our
research are not required to be married but only to have had
a relationship with significant continuity (e.g., a year or
more). However, there is every reason to believe relation-
ship conflict training for single parents with significant
others in less-established relationships, and for parents with
adolescents, is also relevant to these families. We have
preliminary studies adapting our program for these families.
We have adapted our program to single parent households
and also for parents involved in custody disputes. These
new avenues have again been guided by research on family
conflict and EST in order to adapt the program curricula
appropriately to the new samples. For instance, research has
shown that litigation is associated with increased inter-
parental conflict and heightened negativity (Emery and
Wyer 1987; Kelly 2003). Moreover, ongoing inter-parental
conflict post-divorce has been shown to compromise a
positive co-parenting system for the children and is asso-
ciated with negative family outcomes (Bonach and Sales
2002). Our curriculum, when adapted for litigating parents,
focuses on reopening positive communication lines about
the children’s needs. Content for this group also includes
information about how to reduce ongoing inter-parental
conflict and support parenting practices associated with
healthy parent–child relationships.
Finally, a direction requiring further exploration is the
conceptual bases for program effects, which can be
addressed by testing theoretical models about program
effects. Few studies have advanced understanding of the-
oretical bases for effects for programs to improve inter-
parental conflict, a gap apparent for outcomes related to the
well-being of children. Our goal is to investigate EST as an
explanatory process for program effects. An alternative
123
Clin Child Fam Psychol Rev (2012) 15:14–27
theoretical model also merits study, the Cognitive Con-
textual Framework, which has also gained support (Grych
et al. 2000; Grych et al. 2003). Data from later follow-ups
(e.g., 6-month, 1-year) will be needed for longitudinal tests
of change models predicted by theory. As noted, findings
from our ongoing translational intervention program at
post-test have yielded some support for EST. Thus, fathers
in both treatment groups reported greater emotional secu-
rity in their adolescents by the end of the intervention, that
is, in post-test assessments, than fathers in the control
groups, even after controlling for pre-test security levels.
These findings indicate that our program contributes to
adolescents’ emotional security, thereby supporting the
hypothesized theoretical underpinnings for treatment
impact and related positive outcomes.
Conclusion
Given the well-established relations between inter-adult
conflict and children’s well-being and adjustment, there are
compelling supports for developing programs for inter-
vening for the sake of children and families. Moreover, the
strong evidence for (a) interrelations between inter-adult
conflict and parenting and parent–child relations and
(b) the impact of parent–adolescent conflict on adolescent
and family functioning supports the move to programs that
have a more comprehensive goal of improving family-wide
communication and conflict processes. This model for
program directions is further supported by emerging evi-
dence for bi-directional and transactional influence pro-
cesses in families, including the impact of adolescent
functioning on parental functioning.
Substantial evidence for relations between inter-parental
conflict and the adjustment of multiple family members
(adults and children) and relationships (mother–child and
father–child) supports the urgency for more comprehensive
outcome assessments than couple relationship satisfaction
or related constructs (Cummings and Davies 2010;
Whisman and Baucom 2011). Relatedly, for families with
children, there is strong evidence for including child and
adolescent assessments as well as evaluations of the par-
ents. Given the overwhelming evidence of impact, the
neglect of study of child outcomes in couple intervention
studies is a significant gap that needs to be addressed.
Family conflicts are potential problems for all families, not
only families meeting criteria for clinical diagnoses.
Interestingly, given the relative intractability of highly
escalated relationship conflict, universal prevention pro-
grams for community families may possibly hold more
promise for long-term as well as cost-effective success than
more intensive interventions for seriously and chronically
distressed couple relationships.
Clin Child Fam Psychol Rev (2012) 15:14–27
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