Why are divorce rates higher in cities than in rural areas?

Divorce rates are higher in cities than in rural areas. While many explanations for this have been proposed, a common one has been economic opportunity. City dwellers generally have higher incomes than their country counterparts, and perhaps can more easily afford to move on after a breakup.

Not so fast.

The publication of Barry Schwartz’s The Paradox of Choice led some to speculate that his thesis — in short, the more options you have to choose from, the less happy you will be with the choice you make — could apply to romantic relationships just as it could apply elsewhere. (Schwartz actually speculates a bit on this himself in the book.) In other words, city dwellers may be more likely to divorce not because they make more money, but because they have more and better alternatives to their current relationship readily available at all times. New evidence supports that idea.

In a study on speed dating, researchers found that as the size of the speed dating group increased, selections became more skewed toward just a few select participants. This happened, the researchers argue, because the daters were less willing to make tradeoffs — like accepting less physical attractiveness in exchange for greater intelligence — when presented with a greater variety of options.

Faced with too much choice, the authors argue, we resort to more crude decision-making techniques. To put it differently, it becomes all about looks. And when a choice of romantic partner is made solely on appearance, how likely is it to last?

I’m especially curious about how this applies to internet dating. Some sites go for quantity (Match.com), others for quality (eHarmony) in the matches they make. The sites that present quantity are more likely to be considered meat markets, where appearance is key. I’m led to wonder — if Match.com sought to create more lasting relationships (and thus higher marriage rates and lower divorce rates), would they actually be better served to limit the number of potential mates they show to members? Science seems to be saying yes.

A new genetic theory of mental disorders

Yesterday’s New York Times outlines a striking new theory of mental disorders. Put forward by Bernard Crespi and Christopher Badcock — neither of whom works in mental health — the theory goes roughly like this: Genes from the mother’s egg and father’s sperm compete for dominance in the offspring, in what the Times called an evolutionary tug-of-war.

A strong bias toward the father pushes a developing brain along the autistic spectrum, toward a fascination with objects, patterns, mechanical systems, at the expense of social development. A bias toward the mother moves the growing brain along what the researchers call the psychotic spectrum, toward hypersensitivity to mood, their own and others’. This, according to the theory, increases a child’s risk of developing schizophrenia later on, as well as mood problems like bipolar disorder and depression.

This is no less than a unifying theory of mental illness — a theory that puts all mental disorders onto the same spectrum. It naturally has its skeptics.

It does not account for various quirks of autism or schizophrenia, particularly the coexistence of both positive and negative symptoms found in both. Even critics, though, praise the theory for its creativity and plausability. And, though it is limited, there is some biological evidence to lend support to the theory.

Crespi’s name may sound familiar. A biologist by training, he has frequently waded into the murkier waters of sociology, focusing specifically on evolutionary influences in human behavior. In putting forward this theory of mental disorders, he teamed with Badcock, a sociologist. Family therapy has, throughout its existence as a profession, benefited from the contributions of outsiders. Psychology may now be getting a similar shot in the arm.

From the AAMFT Conference: Can you do effective therapy online?

There was much discussion at last week’s AAMFT Conference about online therapy: what it is, what the ethical standards are, and whether it can ever replace a therapy model where everyone is in the same room.

Beginning at the first question, the term “online therapy” is being used to reference a wide variety of approaches to offering therapeutic methods, from email to text messaging to online chat to videoconferencing. The most sophisticated model, offered by MyTherapyNet.com among others, pairs licensed therapists with clients via secure videoconferencing. Clients can use a simple webcam.

The ethical standards, while a bit more complicated, do not vary from the standards that always govern the field. They’re just harder to define and enforce. Confidentiality, for example, takes on a whole new level of importance when session data is being streamed across the internet. Furthermore, the constant accessibility that electronic communication offers — I’m rarely sans Blackberry — may create a “slippery slope” of boundary erosion through out-of-session emails, text messages, and so forth (Gutheil & Simon, 2005).

The final question is certainly the hardest: Can online therapy replace the traditional model of having all therapy participants — including the therapist — in the same room? Here’s at least some of what we seem to know so far, starting from attitudes and ending at outcomes. (Sorry for the lack of links, these are primarily restricted-access journal articles.)

  • Online therapy may bring in clients who would not ordinarily attend therapy. It’s easiest to think about this in regard to clients in rural settings, where a licensed therapist may be an hour’s drive away or more. But even in densely-populated areas, clients who believe there is a stigma associated with therapy or with their specific problem may be more willing to see a therapist online than in person (Nyazema, 2005).
  • The kids don’t like online therapy as much as you might think. In spite of strong computer literacy and great comfort in gathering information online, college students overall actually report negative attitudes toward seeking help online, and prefer face-to-face therapy (Chang, Chang, & Kim, 2002).
  • Online therapy is less dependent on therapeutic alliance. In face-to-face therapy, the quality of the relationship between therapist and client is strongly predictive of therapeutic outcome. In online therapy, there is still a connection between the two, but it is far weaker (Knaevelsrud & Maercker, 2006).
  • Online interventions work, but are rarely compared directly against face-to-face therapy. Online therapy has been shown effective in treating panic disorder, eating disorder, posttraumatic stress, and grief, and has shown promise for a range of other conditions (Rocklen, Zack, & Speyer, 2004). However, few studies have directly compared online therapy with face-to-face therapy, and those that do are by nature questionable. A therapist interacting online with a client will, necessarily, behave differently than a therapist in a face-to-face setting. Where differences exist, are they due to the computers themselves, or those related behavior changes on both ends?

I find myself continually torn about whether, and how, to advocate for the use of online therapy. As an educational tool, online interactions work well. As a therapeutic process, I’m less convinced — but that’s a “jury’s still out” less convinced, not an “I just don’t believe it” less convinced. Your thoughts are most welcome.


Chang, T., Chang, R., & Kim, N. Y. (2002, August). College students’ on-line help-seeking attitudes and behaviors. Poster presented at the annual meeting of the American Psychological Association, Chicago.

Gutheil, T. G., & Simon, R. I. (2005). E-mails, Extra-therapeutic Contact, and Early Boundary Problems: The Internet as a ‘Slippery Slope’. Psychiatric Annals, 35(12), 952-960.

Knaevelsrud, C., & Maercker, A. (2006). Does the quality of the working alliance predict treatment outcome in online psychotherapy for traumatized patients? Journal of Medical Internet Research, 8(4), no pagination specified.

Nyazema, N. D. (2005). HIV/AIDS stigma and shame: On-line psychotherapy. In N. S. Madu & S. Govender (Eds.), Mental health and psychotherapy in Africa, pp. 441-449. Sovenga, South Africa: UL Press of the University of Limpopo – Turfloop Campus.

Rocklen, A. B., Zack, J. S., & Speyer, C. (2004). Online therapy: Review of relevant definitions, debates, and current empirical support. Journal of Clinical Psychology, 60(3), 269-283.

Executive functioning: Smarter than intelligence?

I’m quickly becoming a fan of Wray Herbert, who writes the blog We’re Only Human. His posts are concise and interesting, and at the forefront of psychological science.

In a new piece for Newsweek, Herbert talks about “executive function,” a not-new concept being given new life through the educational system. It has shown promise as a method of bringing children (younger ones in particular) who otherwise may have difficulty attending to tasks up to speed in the classroom.

While apparently I attended much kinder schools than he did — I’ve never known of a kid being tagged with an antisocial personality label for simply being fidgety, as his lead paragraphs suggest — I will be particularly interested in seeing how some of these same methods work in trials as treatment for ADHD. Good stuff.

From the AAMFT Conference: The transformation of marriage

I’m in Memphis for the big AAMFT Conference, and today saw probably the best presentation in the 10-ish years I’ve been going to the thing.

I’ve always been a fan of the work of Stephanie Coontz, in particular her book “Marriage, a History: How love conquered marriage.” Today, though, rose her to another level. Racing through as much data as she could in a 55-minute speech, she covered far more ground than I can describe or even recall here, and pretty much ensured that I’ll be buying the conference recordings.
That said, she made a couple of statements that were especially notable. I’ll paraphrase as best as I can.
First, marriage as an institution is weaker than it was some decades ago. But the very forces that weaken marriage as an institution appear to also be strengthening the safety and fairness in marriage. For example: While the percentage of US residents who now say divorce is morally acceptable is at an all-time high (70%), so too are the percentages saying domestic violence and male adultery are morally unacceptable. As a country, we appear to be reaching consensus that a marriage plagued by abuse or adultery is a marriage worth leaving.
Second, parental anxiety and political hand-wringing about the time parents fail to spend with kids is probably misplaced. Yes, single mothers spend less time interacting with their children than married mothers do. But single mothers today actually spend more time interacting with their children than married mothers did in 1965. Both mothers and fathers spend more time with their kids, in fact. There is a cost: Parents only have so much time to give, and it appears that the extra time they spend with kids is coming at the expense of time alone, or more often, time with friends, neighbors, and other community influences. The very idea that the breakdown of “community” is linked to increases in parenting time is a radical one, but Coontz has the data to back it up.
She largely stayed away from politics, except to chastize both the left and the right for oversimplifying the dilemmas facing modern families and doing more posturing than working to really help families who could use it. All in all, a great presentation, and a great end to my conference. More on what I’ve seen this weekend soon.

Study: MFTs not as pro-marriage as you might think

The new issue of the Journal of Couple and Relationship Therapy is out, and it gives me the rare and happy opportunity to put in a plug for my own work. It includes a couple of surprises.

In a study I coauthored on marriage and family therapists’ attitudes toward marriage, MFTs suffered the same steady, age-related decline in positivity toward marriage previously seen among non-therapists. The big surprise was that experience doing couples therapy more than offset this decline. As therapists gained experience working with couples over the years, they grew more positive about marriage — a strong testament to the power of our field to influence clients and therapists alike.

So, ideally, if you want a supremely marriage-positive therapist, you should find someone who is about 30 years old and has about 40 years of experience.

Other findings in the new JCRT:

As an aside, I’ll be spending the rest of the week and the weekend at the AAMFT Annual Conference in Memphis, TN. I look forward to sharing what I learn upon my return to beautiful Los Angeles.

Internet Infidelity

The always-great Journal of Marital and Family Therapy is out this month with a special edition on MFT and Cyberspace. Among the findings:

  • MFTs should be aware that using the Internet as a social tool is now normal for kids and adolescents. There are assessment tools now available, including the Internet Sex Screening Test – Adolescent Version, to determine whether an adolescent’s behavior warrants treatment.
  • Just like in non-Internet relationships, men show greater concern over women’s sexual infidelity, and women show greater concern over men’s emotional infidelity.
  • Among a sample of university students, neither men nor women believed that a cybersex relationship implied a love relationship (or vice versa).
  • Over the past two years, therapists report an increased frequency of clients coming to therapy to address cybersex issues. Many therapists feel unprepared for this work.
  • Therapists apparently allow several biases to impact their assessment and treatment of internet infidelity cases. Therapist decisions are impacted by factors including the client’s gender, therapist’s age, therapist’s gender, therapist’s religiosity, and therapist’s personal experiences with infidelity. In regard to client gender, men are far more likely to be labeled “sex addicts” than are women engaging in identical behaviors.
  • For family members concerned about a loved one’s cybersex behavior, there is an empirically-supported and manualized method for bringing that person into treatment, known as the ARISE model.

All fascinating stuff. I’ve seen in my own practice a number of couples dealing with issues of internet infidelity over the past few years, and suspect that this will only become more common. It’s good to see our field pursuing assessment and treatment models that specifically address it.

Critical Incident Stress Debriefing

The print version of the LA Times in late July ran a story with the headline “Go Ahead, Hold It In.” (The headline on the web version is a little less pithy.) Apparently new research suggests that emotional expression after a traumatic event is not as helpful as once thought:

“In the immediate aftermath of a collective trauma, it’s perfectly healthy to not want to express your thoughts and feelings,” [University of Buffalo Psychologist Mark Seery] says.

In fact, it can do more harm than good. Some people have periods of what psychologists call “healthy denial.” Like Scarlet O’Hara, they cope by promising themselves to think about it tomorrow. Being pushed to give voice to their worst reactions too soon could embed the worst of it in memory and cause them to dwell on the tragedy. And if they can’t or won’t talk, urging them to act against their instincts could make them think that something is wrong with them.

In the aftermath of major traumas like the September 11 terrorist attacks, shootings at Virginia Tech, or natural disasters, counselors and therapists are often brought in by the hundreds. They provide what is called Critical Incident Stress Debriefing, a process in which victims or family members, usually in a group setting, are encouraged to express their emotions and talk about their experiences around the event.

The LA Times puts it politely in saying such work “has gotten ahead of the evidence on the best course of mental healthcare after a disaster.” Unfortunately, we’ve known this for some time, and the CISD business is booming.

This 2003 research summary in Psychological Science in the Public Interest summed up what we knew five years ago:

Although the majority of debriefed survivors describe the experience as helpful, there is no convincing evidence that debriefing reduces the incidence of PTSD, and some controlled studies suggest that it may impede natural recovery from trauma. Most studies show that individuals who receive debriefing fare no better than those who do not receive debriefing.

Two years later, in 2005, we had this summary of the state of CISD research:

The National Institute for Mental Health (NIMH), in conjunction with the Departments of Justice, Defense, Health and Human Services, Veterans Affairs and the American Red Cross, held a consensus conference on the mental health response to victims and survivors of mass violence. The researchers did not recommend CISM/CISD.

Finally, a 2006 article in the Review of General Psychology found that debriefing sessions accomplished nothing, good or bad, for those who participated in them.

Certainly, the method has its defenders. There’s a lively and mostly well-written defense of the field, dissecting many of the research findings (pro and con) about CISD here. You may want to skip to the end, where they discuss and attempt to refute the negative research, and address the issue of possible harm.

All of this is not an attempt to diminish the importance of having mental health services available after a disaster. Some individuals experience very real difficulties in coping and can be helped. And localized systems can easily become overwhelmed. But a massive influx of counselors and therapists after a disaster, acting as though therapy is somehow a necessity for all involved, is probably not helpful.

Getting back to the science, the whole debate on CISD reminds me a lot of the research-and-usage arc of the Drug Abuse Resistance Education (DARE) program in the 1980s and 1990s. DARE continued to be used for many years even after research had overwhelmingly declared it ineffective. Part of the reason for the continued use was that communities wanted to feel like they were doing something to combat adolescent drug use, even when they had clear evidence that their efforts were unproductive. (The fallback argument for DARE proponents, of course, begins with “If we helped even one child…” This argument ignores the studies that found DARE exposure actually increased later drug use among some groups.)

Similarly, here, we as therapists want to feel like we can be helpful in the wake of a tragic or traumatic event. Those who employ, contract with, or call upon debriefers similarly want to feel like they are doing something good. But until we devise and validate a better way to offer services in the wake of a crisis, we may be better off to stand a bit farther to the sidelines, and simply say, we’re here if you need us.


Bledsoe, B. (2005). Trying to reason with hurricane season. Available online at http://www.jems.com/columnists/bledsoe/articles/15303/ .

McNally RJ, Bryant RA, & Ehlers A. (2003). Does early psychological intervention promote recovery from posttraumatic stress? Psychological Science in the Public Interest. 4(2), 45-79.

Is marriage really for white people?

So reads the headline on this CNN.com story, a first-person account from one of the network’s producers who was gathering information for their “Black In America” series. In it, she talks of her experience as an unmarried African-American woman who is hoping to be married someday. She also relates just one of the many startling statistics on the racial divide in marriage: 45 percent of African-American women have never been married, almost double the percentage of never-married white women.

Kay Hymowitz, who wrote the spectacular-until-the-final-essay Marriage and Caste in America, put it a bit more directly:

When [fellow marriage researcher Stephanie Coontz] assures us that marriage is not on the verge of extinction, she’s right – if you’re white and went to college.

The white, college-educated crowd is especially likely to marry. That is, likely to marry someone else who is also white and college-educated. That white, college-educated couple will then probably proceed to have children (marriage and childbearing remain more closely linked in the white, college-educated community than elsewhere), and the children will eventually become college-educated.

Presumably they will remain white.

The separation of marriage from childbearing is particularly dramatic in the black community, Hymowitz adds, with about 70% of births to African-American women now occurring outside of marriage.

Whatever your perspective on the issue, it is clear that marriage patterns are becoming more distinct among specific classes in the US, both ethnically and economically. Whether that means that “marriage” belongs on Stuff White People Like, I’m not sure.

There’s a great deal more research on marital trends in the masterfully-done State of Our Unions report, published annually by the National Marriage Project at Rutgers. Recent editions have highlighted specific trends for focus, including the future of marriage in America, life without children, and which men marry and why. All are good reading.

An introduction

Welcome! I created this space when I realized how quickly things are changing for the profession of marriage and family therapy, both in California with legislation, and around the world through both scientific and regulatory advances.

I’m Ben Caldwell, and I’ll do my best to use this space for informative and timely discussion on topics important to our changing field. As I write this, I am a California-licensed Marriage and Family Therapist, an Assistant Professor and Site Director for the MFT master’s degree program at Alliant International University in Los Angeles, and chair of the Legislative and Advocacy Committee for AAMFT-California Division. Each of these positions are sources of tremendous joy and learning for me.

Of course, the opinions expressed here are my own. Unless explicitly labeled as such, the opinions expressed here do not in any way represent official positions of either Alliant or AAMFT-CA.

I learn something new in this field every day. Some days, every hour. I’m sure that some items I post here will reflect my knowledge, and others my ignorance. Whether you are in or outside the field, your comments and questions will continue to educate me on how MFTs can best help couples and families in distress. If you have thoughts on what topics should be covered in this space, please post them in the comments thread.