Based upon a qualitative metasynthesis of 49 articles centered on clients' experiences of their conjoint couple and family therapy, the investigators constructed a grounded formal theory of Clients' Relational Conceptions of Conjoint Couple and Family Therapy Quality. The theory suggests from pretherapy conceptions to posttherapy reflections, clients' perceptions of conjoint couple and family therapy quality appear to consist of clients' constructed meanings regarding a series of interrelated relationships between clients and their therapists and therapy environments, between clients and themselves, between clients and other family members, and between process and outcome both inside and outside therapy. Within and across these relationships, clients appear to focus on expectations, connections, balance, and change when evaluating the quality of their clinical experiences. Based upon this theory, the investigators recommend that researchers continue to explore this clinical phenomenon and that therapists regularly seek clients' conceptions of quality in therapy.

Although interprofessional teamwork and collaboration are considered key elements for improving patient outcomes, there are few reports of controlled studies involving interprofessional training of health care learners in the ambulatory primary care setting. We describe an educational program for teams of nurse practitioners, family medicine residents and social work students to work together at clinical sites in the delivery of longitudinal care in primary care ambulatory clinics. Year 1 was a planning year. Program evaluation completed at the end of the second curriculum (Year 3) indicated that the changes the team made at the end of the first curriculum (Year 2) resulted in increased appreciation of the training program, greater perception of value of care delivered by interprofessional teams among team learners as compared to non-team learners, and team learner self assessment of improved team skills including working with other professionals, resolving conflict, and integrating prevention and health promotion into health care. Team learners demonstrated an increased awareness of the limits of their own profession's approach to team care. We conclude that interprofessional ambulatory clinical training in primary care where learners work together providing care to patients can contribute to fostering both positive learner attitudes toward interprofessional work and development of team skills.

Family therapy has often been conceptualized as a conversational process whereby therapists and clients generate new meanings. Based on a 3‐year study of conversational practices observable in successful family therapy processes of Chilean families with a child/adolescent who is engaged in disruptive behaviors, we looked for clinical examples of Transforming Interpersonal Patterns (TIPs). TIPs are a key aspect of the IPscope, a framework we used to explore the meaning‐making processes in family therapy. TIPs constitute a novel approach to explore therapeutic processes by identifying empirically traceable conversational practices involved in generating “new meanings.” TIPs are involved in bringing forth and discursively articulating (“talking‐into‐being”) clients’ preferred ways of relating and living (i.e., relational preferences or RPs). We analyze conversational data from successful family therapy sessions/treatments, and present an emergent model of five categories of conversational practices making up TIPs, namely: Preparatory TIPs, Identifier TIPs, Tracker TIPs, Transformer TIPs, and Consolidator TIPs. We have called them “realizers” because these conversational practices help families talk‐into‐being (or “make real”) particular relational preferences. We also offer user‐friendly descriptors of realizers’ subcategories (e.g., Measuring TIPs) which may help practitioners to recognize, learn, and perform these conversational invitations. Theoretical consequences and future lines of research are discussed.

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