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AAMFT accredited adolescents Alliant International University American analysis approach assessment attachment injury attachment theory behavior beliefs beneﬁts child clinical clinicians COAMFTE conﬂict context core competencies couple therapy cultural deﬁned depression difﬁcult doctoral education doctoral programs emotional epistemology evaluation experience factors faculty Family Process family therapy feel ﬁeld ﬁnd ﬁndings ﬁrst ﬁt ﬁve focus focused follow-up GARF genogram identiﬁed inﬂuence integration interaction interventions interview issues joumal Journal of Marital lesbian LGB clients Likert scale Marital and Family marriage and family master’s measures medication mental health MFT doctoral one’s OSCE outcome parents participants partner perspective postmodern practice problems professional Psychology psychotherapy qualitative research reﬂect relationship scale scores sessions sexual sexual orientation signiﬁcant signiﬁcantly skills social social capital speciﬁc spiritual Sprenkle stepfamily supervisor teaching theory therapeutic therapists treatment University variables York