{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:59Z","timestamp":1790751419357,"version":"4.1.0"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Marital Family Therapy"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Family communication dysfunction significantly impacts HIV medication adherence and mental health outcomes among adolescents in sub\u2010Saharan Africa, yet evidence\u2010based family interventions remain scarce in resource\u2010limited settings. This qualitative descriptive study examined family communication transformation following culturally adapted Multiple Family Group Therapy (MFGT) for adolescents living with HIV and their families in rural Ghana. Focus group discussions were conducted with 20 caregivers and 19 adolescents who completed the 11\u2010session intervention. All core therapeutic content was delivered across sessions 1 through 10; the 11th session comprised a graduation ceremony and sustainability planning. Reflexive thematic analysis revealed four major themes: preintervention dysfunction (public shaming, adolescent defiance, spousal teknonymy, extended family triangulation); MFGT\u2010facilitated skills (tone modulation, privacy\u2010preserving correction, active listening); postintervention transformation (caregiver behavioral consolidation, adolescent reciprocal adaptation, spousal reconnection); and sustaining mechanisms (observational learning, metacognitive awareness, positive reinforcement, peer accountability). Communication improvements occurred bidirectionally, with caregiver changes catalyzing adolescent adaptations. Findings are theoretically interpreted through family systems theory, communication accommodation theory, social cognitive theory, and self\u2010determination theory. Culturally adapted MFGT successfully transformed communication patterns while preserving traditional authority structures, suggesting potential for integration within HIV care systems in resource\u2010limited settings.<\/jats:p>","DOI":"10.1111\/jmft.70180","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:07:41Z","timestamp":1790748461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Shouting to Calm Conversations: A Qualitative Study of Family Communication Transformation Through a Culturally Adapted Multiple Family Group Therapy in HIV\u2010Affected Families in Ghana"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6153-1273","authenticated-orcid":false,"given":"Dorothy Serwaa","family":"Boakye","sequence":"first","affiliation":[{"name":"Department of Health Administration and Education University of Education Winneba Ghana"},{"name":"Department of Mental Health Nursing, School of Nursing and Midwifery University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3844-5043","authenticated-orcid":false,"given":"David Atsu","family":"Deegbe","sequence":"additional","affiliation":[{"name":"Department of Mental Health Nursing, School of Nursing and Midwifery University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6036-811X","authenticated-orcid":false,"given":"Gladys","family":"Dzansi","sequence":"additional","affiliation":[{"name":"Department of Adult Health Nursing, School of Nursing and Midwifery University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8680-9203","authenticated-orcid":false,"given":"Adote","family":"Anum","sequence":"additional","affiliation":[{"name":"Department of Psychology School of Social Sciences University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9308-6031","authenticated-orcid":false,"given":"Samuel","family":"Adjorlolo","sequence":"additional","affiliation":[{"name":"Department of Mental Health Nursing, School of Nursing and Midwifery University of Ghana Accra Ghana"},{"name":"Research and Grant Institute of Ghana Legon Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0192513X13495399"},{"issue":"1","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1186\/s12889-022-14561-3","article-title":"Level and Comfort of Caregiver\u2013Young Adolescent Communication on Sexual and Reproductive Health: A Cross\u2010Sectional Survey in South\u2010Western Uganda","volume":"22","author":"Akatukwasa C.","year":"2022","journal-title":"BMC Public Health"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2018.02.005"},{"key":"e_1_2_12_5_1","unstructured":"Amoako E.2016. \u201cFactors that Influence Stigmatisation and Discrimination Against Persons Living With HIV In The Healthcare Delivery System of Ghana.\u201d Doctoral diss. 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