Loma Linda University

Enrollment Information
Call us at: 909-558-1000

Faculty Directory
  
Carmen Knudson-Martin, PhD
Professor, Counseling and Family Science
Member, Counseling and Family Sci, SST, Faculty of Graduate Studies
Publications    Book Review - Scholarly Journals--Published
  • Knudson-Martin, C., Huenergardt, D., *Lafontant, K., *Bishop, L., *Schaepper, J., & *Wells, M. (in review). Competencies for addressing gender and power in couple therapy: A socio-emotional approach. Journal of Marital and Family Therapy ( 11/2008 - 9/2014 )
  • Knudson-Martin, C. (2013). Why power matters: Creating a foundation for mutual support in couple therapy. Family Process, 52, 5-18 ( 6/2012 - 9/2013 )
    Research shows that equal power help couples create intimacy and relationship success. However, though couples increasingly desire equal relationships, cultural models of mutual support are not well developed. Clinicians often approach heterosexual couple therapy as though partners are inherently equal, thus reinforcing unacknowledged gender inequities. This article examines research that shows why power imbalances are destructive to intimate relationships and focuses on four gender-related aspects of mutual support (a) shared relational responsibility, (b)mutual vulnerability, (c) mutual attunement, (d) shared influence. Case examples illustrate how socio-emotional attunement, interrupting the flow of power, and introducing alternative relational experience help couple therapists identify and address power disparities in these important relational processes. Encouraging the powerful person to take relational initiative and introducing alternative gender discourse are especially important.
  • Knudson-Martin, C. (2012). Attachment and adult relationships: A feminist perspective.   Journal of family theory and review, 4, 299-305. ( 1/2012 - 12/2012 )
  • Williams, K., Galick, A., Knudson-Martin, C., & Huenergardt, D. (2012). Toward Mutual Support: A Task Analysis of the Relational Justice Approach to Infidelity. Journal of Marital and Family Therapy. 10.1111/j.1752-0606.2012.00324.x ( 1/2012 - 9/2012 )
  • Williams, K., & Knudson-Martin, C. (2012). Do therapists address gender and power in infidelity? A feminist analysis of the treatment literature. Journal of Marital and Family Therapy. doi: 10.1111/j.1752-0606.2012.00303.x   ( 1/2012 - 9/2012 )
  Scholarly Journals--Submitted
  • Galick, A., *Patrick, E., & Knudson-Martin, C. (in review). Can anyone hear me? Does anyone see me? Women’s experiences of heart disease: Implications for optimal care. Families, Systems, & Health ( 9/2013 - 12/2014 )
  Scholarly Journals--Published
  • Jonathan, N. & Knudson-Martin, C. (2012). Attunement and gender equality in heterosexual relationships. Journal of couple and relationship therapy, 11, 95-111 ( 7/2009 - 8/2012 )
    Recent studies suggest that the effect of gender on relational attunement may help explain why gender equality contributes to relationship success.  This grounded theory analysis of interviews with thirty-five heterosexual couples identified three levels of attunement and describes the nature of their link with gender equality. Mutually Attuned couples carried equal weight regarding intentionality, continual communication, partnership, mutual understanding, and joint-decision making. Thwarted Attunement and the Unattuned were linked to gendered power imbalances. Implications highlight a need to address the gendered nature of attunement when helping couples build emotional connection. 
  • Knudson-Martin, C. (2010). Institutionalizeing revolution: current challenges in feminist family studies. Journal of Family Theory and Review, 2, 415-419. ( 3/2010 - 8/2011 )
    The two-sided task as “an agent of change when learning to wield the patriarch’s sword” (p. 14) raises a number of current challenges for the field of feminist family studies. My analysis of the Handbook identified four interwoven themes embedded throughout the chapters: (1) Practicing Theory, (2) Managing Complexity, (3) Capturing Lived Experience, and (4) Accessibility and Accountability. By crystallizing these themes here I hope to illuminate current key challenges in advancing the practice of feminist family studies and to share a bit of the wisdom offered by these committed scholars on how to address them.
  • Quek, K., Knudson-Martin, C., Orpen, S., & Victor, J. (2011). Gender equality during the transition to parenthood: A longitudinal analysis of dual earner couples in Singapore. Journal of Social and Personal Relationships. DOI: 10.1177/0265407510397989. ( 1/2009 - 8/2011 )
    Few studies of marital equality have addressed the issue in a collectivist context.This grounded theory analysis examined movement toward gender equality among 12 dual-career Singaporean couples interviewed as newlyweds and interviewed again five years later when all had children. The analysis focused on the relational processes that reproduced gender patterns and those that undid them. Whether or not parenting was shared depended on four factors: (a) mutual prioritization of women’s careers; (b) fathers’ willingness to restructure to actively engage in parenting; (c) conscious discussion of how to share parenting responsibility; and (d) availability of external support. Results suggest that to the extent that parenting is viewed as a shared family responsibility, the processes of gender equality may be somewhat different in collectivist contexts.
  • Knudson-Martin, C. & Hunergardt, D. (2010). A socio-emtional approach to couple therapy: Linking social conext and couple interaction. Family Process, 49, 369-386. ( 1/2009 - 12/2010 )
    This paper introduces Socio-Emotional Relationship Therapy (SERT), an approach that puts cultural and social context issues at the center by linking socio-cultural discourse to emotional experience and couple interaction. The therapy empowers couples to overcome limiting societal discourse and evolve mutually supportive relationships.   It begins with social constructionist assumptions regarding the fluid and contextual nature of gender, culture, personal identities, and relationship patterns and illustrates how these are physically and neurologically embodied in intimate relationships. Four conditions foundational to mutual support—mutual influence, shared vulnerability, shared relationship responsibility, and mutual attunement—guide clinical work. The paper illustrates how empathic engagement of a socio-culturally attuned therapist sets the stage for new socio-cultural experience as it is embodied neurologically and physically in the relationship and discusses therapy as societal intervention.
  • Quek, K. & Knuson-Martin, C. (2009). Relational harmony: A new model of collectivism and gender equality among Chinese American couples. Journal of Family Issues. doi:10.1177/0192513X09351162 ( 1/2008 - 12/2010 )
    Social harmony is a valued relational rule in collectivism. Few studies examine how Asian American couples who are exposed to two distinct and often conflicting cultural orientations define and create harmony in their marital relationships. Using data from in-depth interviews with 40 Asian-Americans, we study how husbands and wives interpret and negotiate their form of marital harmony within a bicultural context and how gender relates to the achievement of marital harmony. Though the concept of harmony unifies all couples, the result indicates two quite different forms of harmony: Structural harmony that is based on social norms which support obligation to the whole; and Relational harmony that focuses on “we-centered” and prioritizes the marriage relationship itself. Not all couples fall neatly in either of the two categories; Interactions from couples-in-transition experience a push and pull process between the collectivist and individualistic influences in their lives. The tensions are explored through six dimensions: (1) conflict between relational and structural goals, (2) communal versus dyadic obligation, (3) unclear authority structure, (4) intersection of family and workplace, (5) harmonizing multiple voices, and (6) incorporating personal agency. Implications for future research are addressed.
  • Knudson-Martin, C. & Silverstein, R. (2009). Suffering in silence: A qualitative meta-analysis of post-partum depression. Journal of Marital and Family Therapy, 35, 145-158. ( 9/2007 - 9/2009 )
     In this article we apply a relational lens to a grounded theory meta-data-analysis of qualitative studies on postpartum depression conducted between 1999 and 2005. Women in all studies report feeling that they have failed to live up to cultural standards for a “good mother.” Central to this experience is a sense that these negative feelings could not be spoken. The analysis shows how constructions of motherhood and the reactions of others combine with feelings of incompetence to precipitate isolation from others. Women survive depression though support that validates their experience and promotes eventual reconnection with others. Conclusions emphasize the need for persons trained to facilitate relational connection to develop interventions that address the interpersonal contexts of postpartum depression.
  • Cattich, J. & Knudson-Martin, C. (2009). Spirituality and relationship: A holistic analysis of how couples cope with diabetes. Journal of Marital and Family Therapy, 35, 11-124 ( 9/2007 - 9/2009 )
    This study explores how couples’ spirituality and relationship processes holistically interact to inform diabetes management. Qualitative analysis of interviews with twenty heterosexual couples identified five spiritual coping styles based on the spiritual meaning they ascribed to the situation and the nature of their relationships with God and each other. (a) Opportunists approach the illness as an opportunity for growth; (b) mutual problem solvers collaborate with their partners to respond to their disease; (c) individualistic problem solvers  take personal responsibility for managing their disease; (d) accepters, endure their disease; and (e) victims take a hopeless, discouraged approach. Results suggest that spirituality and couple communication and problem-solving patterns appear intertwined and integral to the practice of family therapy.
  • Moghadam, S., Knudson-Martin, C., & Mahoney, A. (2009). Gendered power in social contexts: Part II. Couple relationships in Iran. Family Process, 48, 41-54. ( 1/2008 - 5/2009 )
  • Maciel, J. A., van Putten, Z., & Knudson-Martin, C. (2009). Gendered power in cultural contexts: Part I. Immigant couples. Family Process, 48, 9-23 ( 1/2008 - 5/2009 )
  • Cowdery, R. S., Scarborough, N., Knudson-Martin, C., Seshadri, G., Lewis, M. E., Mahoney, A. R. (2009). Gendered power in cultural contexts: Part III. Middle class African American heterosexual couples with young children. Family Process, 48, 25-39. ( 1/2008 - 5/2009 )
  •   Tuttle, A. R., Knudson-Martin, C., Taylor, B., Andrews, J., & Levin, S. (2007). Parents’ Experiences in Child Protective Services: Analysis of a Dialogical Group Process. Family Process, 46, 367-380. ( 9/2007 - 12/2008 )
    The authors qualitatively examine parent experiences in groups for persons seeking parental rights through Child Protective Services (CPS). The study focuses on sixteen custody-seeking parent figures who participated in dialogical groups designed from a Collaborative Language Systems perspective. The grounded theory analysis shows that parents initially described overwhelming emotions and conflictual relationships with CPS. It also identifies five therapeutic group processes that appeared to influence perceptions of hope and personal power and contribute to how parents position themselves relative to CPS: validation, sharing practical information and networking, highlighting strengths and resources, supportive confrontation, and sharing stories of change. The analysis provides insight into CPS parents’ experiences and suggests that dialogical approaches may have potential to assist in reshaping experiences in CPS and draws attention to the need for interventions at the structural and administrative levels.
  • Quek, K. M. & Knudson-Martin, C. (2008). Reshaping marital power: How Dual Career Newlywed Couples Create Equality in Singapore. Journal of Social and Personal Relationships, 25, 513-534. ( 9/2007 - 9/2008 )
    The persistence of gender as a system that privileges men is well documented (e.g., Tichenor, 2005; Williams, 2000). Institutionalized gender inequality continues to structure the domestic life of heterosexual women and men (Jacobs & Gerson, 2004; Moen, 2003). At the same time, Sullivan (2006, p.15) provides compelling evidence of a “slow dripping of change” in Western industrialized countries. She argues that gender change happens incrementally and that there is a need to understand these change processes. In the study presented here we examine shifts in power processes among newly married dual earner heterosexual couples in Singapore. This example is particularly interesting because this “Asian miracle economy” (World Bank, 1996) has experienced a rapid shift in policies that encourages women to enter the workplace, yet culturally, Singapore retains a traditional gender ideology (Quah, 1998). This study extends Sullivan’s interest in the processes of change to the industrialized East where collectivist values are an important part of the social structure. 
  • Matta, D. S,. & Knudson-Martin, C.. "Father Responsivity: Couple Processes and the Co-Construction of Fatherhood." Family Process 45. (2006): 19-37. ( 1/2006 )
    Forty in-depth interviews of heterosexual parents of children five-years of age and younger are analyzed using a qualitative grounded theory approach to understand how couples co-produce fatherhood within their day-to-day relationships and in social, cultural, and economic context. The analysis identifies the construct ?responsivity? as a central process through which, to varying degrees, fathers are aware of the needs of their wives and children and able to take an active part in meeting them. Three groups of fathers are examined according to their level of responsivity: low, moderate, and high. Factors influencing degree of father responsivity include gender constructions, power and the wife?s influence, attunement, work schedules, and emotional tradeoffs. Implications for practice are suggested.
  • Silverstein, R., Bass, Linda B., Tuttle, A., Knudson-Martin, C., Huenergardt, D.. "). What does it mean to be relational? A framework for assessment and practice." Family Process 45. (2006): 391-405. ( 1/2006 )
    The authors begin with a question regarding how to better draw upon relational thinking in making case assessments and treatment plans. They first address issues regarding the cultural construction of self and relationships, integrating women?s psychology, family systems, and collectivist culture literatures within a discussion of power. Then they present a heuristic framework for how individuals orient themselves within relationships that include two dimensions (focus and power) and evolves out of the social context. From these two dimensions a typology of four basic relational orientations is presented. These include position directed, rule directed, independence directed, and relationship directed. Case examples from couple?s therapy and suggestions for practice are provided.
  • Bass, L. B., Taylor, B., Knudson-Martin, C., & Huenergardt, D. . "Making sense of abuse: Case studies in sibling incest." Journal of Contemporary Family THerapy . (2006): -. ( 1/2006 )
    This case study focuseds on the process of making sense of abuse in two Latino families experiencing sibling incest. Participants included five male children ranging in age from 8-15 that were members of two families dealing with the issue of sibling incest. The purpose of this study was to build understanding regarding how families experiencing sibling abuse and its role in their families. Clinical data from therapy sessions was analyzed to reveal that families made sense of the abuse in different ways including abuse as normal and abuse as a mistake. Central concepts that explained how the families responded to the abuse included (1) level of family cohesion, (2) role of secrecy, and (3) view of outside systems. The findings suggest that treatment needs to include an in-depth assessment regarding these issues.
  • Cowdery, R. S. & Knudson-Martin, C.. "Motherhood: task, relational connection, and gender equality." Family Relations 54. (2005): 335-345. ( 1/2005 )
  • Knudson-Martin, C. & Laughlin, M.. "Gender and sexual orientationin marital and family therapy: A post-gender approach." Family Relations . (2005): 101-115. ( 1/2005 )
  Scholarly Journals--Accepted
  • Maciel, J. A. & Knudson-Martin, C. (in press). Don’t end up in the fields: Identity construction among Mexican adolescent Immigrants, their parents, and socio-contextual processes. Journal of Marital and Family Therapy ( 7/2012 - 9/2014 )
    This grounded theory study of 16 Mexican immigrant adolescents and 20 of their parents examines how they construct relational identities within their families, at school, with friends, and in the larger society. Results focus on a core identity bind faced by the adolescents: immigration messages from parents that say, “Don’t be like me” and the societal message, “You’re Not Like Us.”  Response to this bind was guided by two contrasting sets of identity narratives: Empowering narratives invited an intentional approach to school and life choices.  Restricting narratives maintained an ambivalent approach to school and life choices. Resolution of the identity bind was a collective, on-going process that has implications for Mexican immigrant families and the professionals who work with them.
  • Kim, L., *Tuttle, A., & Knudson-Martin, C. (in review). How second generation Korean-American Couples reconceptualize hierarchy and build Connection in the parent-child relationship, Family Process   ( 1/2012 - 12/2013 )
    Historically, parenting has been constructed hierarchically; however contemporary parenting models frequently emphasize parenting as relationship (Author, 2012a; Siegel & Hartzell, 2004).  Drawing on interviews with 20 North American born second generation Korean-American mothers and their partners, and sensitized by TP-CRO, a social constructionist framework for conceptualizing parent-child relational orientations, this grounded theory analysis identified three main processes that facilitate relational connection as a parenting orientation rather than the rule-directed approach historically associated with first generation Asian families.  These include: (a) emphasizing dominant culture values, (b) inviting open communication, and (c) promoting mutuality.  Results also show how parents integrate collectivist cultural values of their immigrant parents’ traditional culture into North American parenting ideals with which they primarily identify. The study demonstrates the usefulness of the TP-CRO for understanding parent-child relationships within multicultural parenting contexts and offers suggestions for working with second generation Korean families.
  • Sheshadri, G. & Knudson-Martin, C. (in press). How couples manage interracial and intercultural differences: What works. Journal of Marital and Family Therapy. ( 1/2010 - 12/2013 )
    This study focused on how couples managed their interracial and intercultural differences. To understand their experiences, a qualitative grounded theory analysis was used with semi-structured interviews (n=17). Analysis revealed that couples experienced most issues as cultural issues; race only was present to them during their interactions with “others”. They appeared to organize their response to racial and cultural differences according to four relationship structures: Integrated, Singularly Assimilated, Coexisting, and Unresolved. Successful couples in each of these structures managed daily process through four sets of relationship strategies: (1) creating a “we,” (2) framing differences, (3) emotional maintenance, and (4) positioning in relationship to familial and societal context. Specific interventions are suggested to mental health practitioners to help a couple identify what works.  
  • Tuttle, A., Kim, L., & Knudson-Martin, C. (2012). Parenting as relationship: A framework for assessment and practice. Family Process.51:73–89 ( 1/2010 - 12/2012 )
    Parenting tends to be framed as a set of actions directed toward the child rather than as a relationship.  This paper helps therapists, parent- educators, and researchers conceptualize parenting as a socio-culturally embedded relationship.  The authors apply the relational orientations typology (Silverstein, Bass, Tuttle, Knudson-Martin, & Huenergardt, 2006) to parent-child relationships.  The typology addresses two dimensions: whether the focus is on the child’s meeting parental expectations or on expectations of mutuality and whether power between parent and child is expected to be symmetrical or asymmetrical. Four relational orientations are described: (1) rule-directed, (2) position-directed, (3) independence-directed, and (4) relationship-directed. These relational orientations describe the nature of the reciprocal relationship between parent and child and offer a framework from which to address parenting issues. A case illustration shows how the relational orientations framework helps therapists incorporate a larger systems/relational perspective into what was originally framed primarily as a child behavior problem. 
  • Ward, A. & Knudson-Martin, C. (2012).  The impact of therapist actions on the balance of power within the couple system: A Qualitative Analysis of Therapy Sessions. Journal of Couple and Relationship Therapy, 11, 221-237. ( 8/2009 - 8/2012 )
    Power inequality is an important concern in couple therapy, yet little research addresses how therapists deal with this issue. This qualitative, grounded theory analysis of 21 transcripts of couple therapy sessions examined how therapist actions influenced the balance of power between partners in the moment to moment processes of therapy. The analysis identified five kinds of therapist actions that perpetuated power imbalances: (1) discounting person in the one-down position, (2) allowing the one-up person to define the conversation, (3) reinforcing dominant person’s negative comments about partner, (4) using professional privilege to assume experience of the one-down person, and (5) speaking as though the relationship was equal when it was not. Seven other actions helped interrupt current power imbalances and encouraged more equal power: (1) using therapist voice to create balance, (2) creating space for one-down voice, (3) naming power discrepancies, (4) validating competence of the one-down person, (5) suggesting new options, and (6) encouraging powerful partner to shift to a relational perspective. The results help couple therapists develop greater sensitivity and awareness of the impact of their interventions on the power balance of the couple.
  • Jones, E. E., Delgado, S., & Knudson-Martin. (2011).  How MFT students develop a contextual consciousness: A participatory action research project.  Journal of Marital and Family Therapy.doi: 10.1111/j.1752-0606.2011.00232 ( 1/2009 - 12/2011 )
    Contextual consciousness means having sensitivity to a client’s unique experience within larger societal and power contexts and addressing their relevance to client issues. It is a critical aspect of clinical training. In this action research project we systematically studied our own process as students learning to identify and work with these issues. The method involved an on-going analytic sequence in which we described what we did, reflected on our experience, evaluated the outcome, and then took new action to improve our work based on what we learned. We identified a three-stage learning process: (1) Raised awareness as the result of required foregrounding of contextual issues in clinical experimentation and developing a theoretical rationale for doing so; (2) Reflective questioning involving challenging old perspectives, identification with issues of privilege and marginalization, and positive new experience with clients; and (3) An intentional new lens based on personal responsibility and commitment. A safe and empowering group dynamic was important to creating a context for learning. Maintaining a contextual lens after the practicum required accessing other forms of support and accountability.       
  • Knudson-Martin, C. & Mahoney, A. R. (2009). Gendered power in cultural contexts: Capturing the lived experience of couples. Family Process, 48, 5-7. ( 1/2008 - 5/2009 )
  Books and Chapters
  • Knudson-Martin, C. (2012). Changing gender norms, roles, and relations.  In F. Walsh (Ed.), Normal family processes, 4th Ed. New York: Guildford. ( 1/2010 - 3/2012 )
  • Knudson-Martin, C. & Mahoney, A. R. (Ed.) (February, 2009) Couples, gender, and power: Creating change in intimate relationships. New York: Springer. ISBN 0826115217 ( 6/2008 - 1/2009 )
    The book is an edited collection of studies from the Contemporary Couples Study, Carmen Knudson-Martin, PI. Qualtiative studies examine how couples across varying life stages and cultural contexts deal with gendered power in their relationships. Each chapter includes specific implications for practice. Authors include 14 current and form LLU doctoral students from the department of Counseling and Family Sciences. Target audience is mental health professionals. Below is a review from Dr. Katherine Allen: Couples, Gender, and Power is just the book I''ve been waiting for--a comprehensive, critical, empirical, and practical compilation of investigations about how diverse couples are trying to implement change and pursue equality in their relationships. Knudson-Martin and Mahoney reveal their magnificent expertise in tackling this highly relevant and intriguing subject matter in a meticulously careful and compelling way. The chapters are accessible for a wide range of readers and especially exciting for classroom use. My students will thank me as much as I thank the authors for providing this rich resource on the dynamics of intimacy and power in gendered relationships.
  • Knudson-Martin, C. (2009). Capturing the lived experiences of couples: Our research process. In C. Knudson-Martin & Mahoney (Eds.). Couples, gender, and power: Creating change in intimate relationships (pp. 31-40). New York: Springer  ( 1/2007 - 1/2009 )