It's About Time! Examining Received Dosage and Program Duration as Predictors of Change Among Non‐Distressed and Distressed Married Couple and Relationship Education Participants

Although Couple and Relationship Education (CRE) programs were intended to be preventive in nature, an emerging reality is that relationally distressed couples are attending programs. This has raised questions about both its general usefulness and what is known regarding predictors of change in CRE for distressed couples particularly. Previous work has identified dosage and duration as important moderators of changes, and there are myriad program contexts offered, highlighting the need to examine these among distressed couples. This study utilized a sample of community CRE participants and examined received dosage and program duration as predictors of change. Comparing results for distressed and non‐distressed participants, we found several group differences. Findings suggest that it is important to consider distress level and time spent in programs when placing participants. In addition, research should continue to examine these groups separately (or comparatively) to find out what works for whom.     

The Alliance in Relationship Education Programs

Couple relationship education (CRE) programs are associated with positive romantic relationship outcomes; however, the mechanisms by which these gains occur are less understood. The current study (122 couples) utilized actor–partner modeling to examine the association between the therapeutic alliance and dedication and negative and positive communication for racial/ethnic minority couples. Additionally, we examined whether gender and delivery format moderated these relationships. Results demonstrated that both men's and women's alliance scores were significantly related to their own outcomes. Higher ratings of alliance were related to partner outcomes for men only. The association between partners' alliance and dedication outcomes was stronger within the group format as compared to the couple format. Implications for leaders of CRE programs are offered.     

Incorporating Internet‐based Interventions into Couple Therapy: Available Resources and Recommended Uses

Although there are a number of highly efficacious in‐person treatments designed to ameliorate relationship distress, only a small proportion of distressed couples seek out in‐person treatment. Recently developed internet‐based interventions based on these in‐person treatments are a promising way to circumvent common barriers to in‐person treatment and give more distressed couples access to these efficacious interventions. The overarching aims of this review are to provide couple and family therapists with a broad overview of the available internet‐based interventions and provide suggestions about how these interventions might be utilized before, during, or after in‐person treatment. The majority of the review centres on internet‐based interventions for distressed couples and covers four distinct types of resources: relationship advice websites; assessment/feedback interventions; enrichment interventions for satisfied couples; and interventions targeting at‐risk or distressed couples. Included is a case study of one couple's journey through a newly developed intervention targeting at‐risk couples, OurRelationship.com . Internet‐based interventions targeting individual psychopathology (e.g. anxiety and depression) are also reviewed. These interventions would be particularly useful as an adjunctive resource for in‐person couple or family therapy when referrals for a concurrent in‐person individual therapist are not feasible (because of time, financial, or geographic constraints). We close with three appendices: two appendices with information on currently available internet‐based interventions; and one appendix with recommendations on how to incorporate these resources into in‐person therapy.     

The effectiveness of PREP with lower-income racial/ethnic minority couples

The current study examined the effectiveness of the Prevention and Relationship Enhancement Program (PREP) with lower-income and racial/ethnic minority (African American and Latino/a) couples. Additionally, we tested whether relationship outcomes varied based on the delivery format (i.e., group format vs. couple format). The sample included 321 unmarried couples expecting a child or who have a child 3 month old or younger. The couples participated in 16 hr of PREP via a group or a couple format over the course of 2-3 months. Couples relationship quality was assessed prior to and directly after the program. The results showed that men and women demonstrated significant gains in their communication skills, relationship functioning, friendship, dedication, and relationship confidence. Couples who participated in PREP via the couple format had better outcomes on three of the seven relational outcomes as compared to couples who participated in PREP via the group format.     

Characteristics of Couples Who Attend Family Services Counselor Visits in Relationship Education

Case management services for low-income couples receiving relationship education have been required by federal funding agencies. Studies examining relationship education outcomes for low-income couples have yet to address participant characteristics of those who attend case management services (e.g., distressed vs. nondistressed). Thus, this study examined the influence of baseline relationship satisfaction and demographics on attendance at case management visits for 2,628 low-income, partnered participants who attended relationship education. Findings indicated that participants who reported higher baseline relationship distress attended more family services counselor (FSC) visits. However, when we added demographics to the model, relationship distress no longer predicted FSC visits, whereas income served as a predictor for men and women, with those reporting greater monthly income attending more FSC visits.     

Factors That Differentiate Distressed and Nondistressed Marriages in Army Soldiers

Data from U.S. Army soldiers (N = 697) were analyzed to determine the factors that differentiate distressed from nondistressed relationships. Results show that most soldiers had relationship satisfaction scores that categorized them as nondistressed. In addition, soldiers in dual-military marriages had relationship satisfaction scores similar to those of soldiers in military-civilian marriages. Finally, several variables including rank, relocation status, relationship length, and relationship status differentiated distressed from nondistressed relationships. Implications for intervention programming and future research directions are discussed.     

Depression, marital satisfaction, and marital and personality measures of sex roles*

The present study examined the relationship between depression, marital satisfaction, and marital and personality measures of sex roles. Subjects included 50 couples in which the woman was clinically depressed (and of which 26 were maritally distressed), and 24 nondepressed, nondistressed control couples. Results indicated that compared to nondepressed couples, husbands and wives in relationships in which the wife was depressed showed greater inequality in decision making and dissatisfaction with the distribution of decision making and household tasks; wives additionally indicated greater dissatisfaction with distribution of childrearing responsibilities. The relationship between marital roles and depression was largely mediated by the impact of marital distress in the clinic couples. In addition, depressed wives were less masculine than nondepressed wives, and women with high levels of masculinity reported less depression than women with low levels.     

PROBLEM SOLVING SELF-APPRAISAL AND COPING EFFORTS IN DISTRESSED AND NONDISTRESSED COUPLES*

The present study sought to investigate the relationship between problem solving self-appraisal (i.e., perceived confidence, personal control, approach-avoidance), specific coping efforts (negotiation, optimistic comparisons, advice seeking, emotional discharge, selective ignoring, and resignation) and marital distress. Seventy-five couples completed the Problem Solving Inventory, the Marital Coping Questionnaire, and the Dyadic Adjustment Scale. When compared to nondistressed spouses, distressed spouses showed less problem solving confidence, a tendency to avoid different problem solving activities, and poor strategies to control their behavior. In addition, three coping efforts-optimistic comparisons, negotiation, and resignation–differentiated distressed from nondistressed spouses. However, the results of multiple regression analysis suggest that specific coping efforts are more important than problem solving self–appraisal in predicting marital satisfaction. These findings are discussed in terms of the role of cognitive factors in marital dysfunction.     

It Takes Two? An Exploration of Processes and Outcomes in a Two‐Session Couple Intervention

Although relationship distress is common, couples often forego professional help due to concerns such as time constraints, financial costs, and stigma. The two‐session relationship checkup is an alternative format of couple intervention developed to address these concerns. In this qualitative study, we interviewed 20 coupled participants and six clinicians to examine the checkup's processes and outcomes. The phenomenological themes that emerged revealed sequential processes by which this format works. Couple themes included client motivation, the therapeutic relationship, and therapeutic change in terms of perceptions and behaviors—particularly with regard to communication. Clinician data largely mirrored these themes. The results suggest the intervention addressed barriers to help‐seeking and may be a viable selective option for at‐risk couples.     

Why do couples seek relationship help online? Description and comparison to in‐person interventions

Couples are increasingly utilizing newly developed online adaptations of couple therapy; however, different presenting problems could drive couples to seek either online or in‐person services. This study compared the presenting problems of 151 couples seeking an online couple intervention for relationship distress (OurRelationship) with responses from 147 couples seeking in‐person couple therapy. Presenting problems were generally consistent across gender and whether or not the respondent was the initial help‐seeker. Online and in‐person samples frequently endorsed difficulties with communication and emotional intimacy; however, they differentially endorsed trust, time together, and child/parenting difficulties. Therefore, while basing online interventions on existing couple therapies is generally supported, efforts should be made to tailor online services to meet the unique needs of this population.     

Relationship Education and Therapy for Same‐Sex Couples

The gay and lesbian community suffers higher rates of discrimination, mental health problems, and relationship break‐up than their heterosexual counterparts. In this paper we analyse the challenges confronting same‐sex couples, and the implications for couple education and therapy with same‐sex couples. We describe some similarities in the challenges confronting heterosexual and same‐sex couples (e.g., negotiation of shared realistic relationship expectations, effective communication). These similarities suggest existing evidence‐based approaches to couple therapy and relationship education are likely to assist same sex couple relationships. We also describe distinctive challenges for same‐sex couples (e.g., homophobic discrimination, internalised homophobia, and low support from many families for same sex relationships). These distinctive challenges suggest some adaptation of existing approaches to couple education and therapy could enhance their relevance and effectiveness to same sex couples.     

Establishing Safety in Emotionally Focused Couple Therapy: A Single‐Case Process Study

Emotionally Focused Couple Therapy (EFT) is an effective approach to working with distressed couples. It is not only effective in reducing relationship distress, but also in successfully maintaining gains over time. In the current study, we sought to understand the therapy processes that result in the creation of safety during stage one of EFT. Safety is a key ingredient in stage one, setting the stage for deeper interpersonal and intrapsychic work in later stages of treatment. In order to achieve the study aim, we analyzed video recordings of the first six sessions of a single couple case from an EFT randomized controlled trial. Using a theory building case study approach, results reveal that all expected components related to the creation of safety were achieved. Additional findings from our analyses indicate that the therapist was highly active, especially in seizing key moments in the therapy provided by this particular case, which shifted the couple in the direction of safety and deescalated their interactional cycle. Implications of key findings are discussed.     

The State of Our Unions: Exploring Relationship Quality among Dyadic Couple Homeowners

Abstract

Relationship stability represents a major economic interest not only to Florida, but to every state in the nation. The cumulative expenses related to relationship dissolution (including litigation costs, foregone tax revenues, and federal assistance programs such as Medicaid, child welfare SCHIP, TANF, WIC and SNAP) are estimated to cost taxpayers billions annually. Overall detriments are also higher when considering longitudinal impacts of family instability on affected couples and children in terms of lost productivity and psychosocial impact. This study endeavors to better understand threats to family instability, relationship quality and contextual factors via data collected from a sample of Florida homeowners in three types of cohabiting relationships. Analysis shows that roughly 60% of the variability in relationship quality is accounted for by negative interaction and consensus scores. High measures of negative interaction among dyadic couples indicate that cohabiting relationships in Florida are significantly distressed. Implications for how residents of Florida and other states could benefit both economically and psychosocially from implementation of couple and relationship education (CRE) programs are discussed.     

The Development of a Reliable Change Index and Cutoff for the Revised Dyadic Adjustment Scale

The Revised Dyadic Adjustment Scale (RDAS; Busby, Crane, Larson, & Christensen, 1995) is a measure of couple relationship adjustment that is often used to differentiate between distressed and non‐distressed couples. While the measure currently allows for a determination of whether group mean scores change significantly across administrations, it lacks the ability to determine whether an individual's change in dyadic adjustment is clinically significant. This study addresses this limitation by establishing a cutoff of 47.31 and reliable change index of 11.58 for the RDAS by pooling data across multiple community and clinical samples. An individual whose score on the RDAS moves across the cutoff changes by 12 or more points can be classified as experiencing clinically significant change.     

Predicting Follow‐up Outcomes in Emotionally Focused Couple Therapy: The Role of Change in Trust,Relationship‐Specific Attachment,and Emotional Engagement

Emotionally Focused Couple Therapy (EFT), an evidence‐based couple therapy (Johnson, Hunsley, Greenberg, & Schindler, 1999), strives to foster lasting change through the creation of secure attachment bonds in distressed couples. Although studies have demonstrated lasting change in follow‐up (Wiebe et al., in press), research is needed to investigate predictors of long‐term outcomes. Our goal was to investigate predictors of long‐term outcomes in relationship satisfaction. Relationship satisfaction was assessed across 24 months in a sample of 32 couples who received an average of 21 EFT sessions. Decreases in attachment avoidance were most predictive of higher relationship satisfaction across follow‐up. These findings support the theoretical assumption that EFT helps couples foster lasting change in relationship satisfaction through the facilitation of secure attachment bonds.     

Determinants and Long‐Term Effects of Attendance Levels in a Marital Enrichment Program for African American Couples

Although most efficacious marital enrichment programs are multisession, few studies have explored whether outcomes differ according to session attendance, particularly among minority groups with lower than average participation in prevention programs. This study therefore investigates attendance levels and long‐term improvements in couple functioning among 164 couples participating in the Promoting Strong African American Families program. Structural equation models indicated session attendance predicted 2‐year changes for men's reports of communication, commitment, and spousal support (marginally) but not for women's. Individual and couple characteristics that predicted attendance levels were also identified. Results highlight distinct gender differences in the effects of sustained attendance as well as characteristics that provide early identifiers for African American couples at increased risk of low program attendance.     

Before They Said “I Do”: Discriminating Among Marital Outcomes Over 13 Years

One hundred couples were followed for 13 years from the premarital period well through the primary risk period for divorce. Results of discriminant analysis indicated that couples who remain satisfied, become distressed, and divorce can be reliably classified on the basis of premarital data. Further, both previously identified demographic risk factors and couple interaction variables contributed to classification accuracy, suggesting that both types of variables play important roles in relationship outcomes. The method employed here addresses weakness in previous studies by: (a) following couples for an extended period after marriage, (b) using multiple validated self‐report and observational measures, and (c) making predictions simultaneously for divorced, distressed, and satisfied couples.     

Internalizing and Externalizing Symptoms and Marital Relationship Functioning: The Mediating Role of Demand–Withdraw Communication Processes

Marital outcomes are associated with internalizing and externalizing symptoms; however, the processes by which these domains are associated with marital outcomes are not well understood. This study examined how demand–withdraw (DW) couple communication accounts for the association between symptoms of mental illness and marital distress. A mediational model was tested in a sample of 100 newlywed couples to determine: (a) whether internalizing and externalizing symptoms influenced own and partner's level of DW communication, and (b) whether this communication pattern was associated with relationship outcomes, including lower marital satisfaction and presence of conflict. Results suggested that DW communication had significant effects on both partner's marital outcomes and mediated the association between externalizing symptoms (for husbands) and marital distress.     

Couple Longevity in the Era of Same‐Sex Marriage in the United States

The author used a new longitudinal data set, the How Couples Meet and Stay Together surveys (N = 3,009), to generate the first nationally representative comparison of same‐sex couple stability and heterosexual couple stability in the United States. He measured the association between marriage (by several definitions of marriage) and couple longevity for same‐sex couples in the United States. Reports of same‐sex relationship instability in the past were due in part to the low rate of marriages among same‐sex couples. After controlling for marriage and marriage‐like commitments, the break‐up rate for same‐sex couples was comparable to (and not statistically distinguishable from) the break‐up rate for heterosexual couples. The results revealed that same‐sex couples who had a marriage‐like commitment had stable unions regardless of government recognition. A variety of predictors of relationship dissolution for heterosexual and for same‐sex couples are explored.     

Changes in Relationship‐Specific Attachment in Emotionally Focused Couple Therapy

Emotionally focused couple therapy (EFT; Johnson, The practice of emotionally focused couple therapy (1st/2nd edition). Brunner‐Routledge, New York, 2004) is an effective treatment of relationship distress (Johnson et al., Clinical Psychology: Science and Practice, 1999; 6, 67). However, less is known about EFT's impact on couples' relationship‐specific attachment bond. Using hierarchical linear modeling with a sample of 32 couples, we examined session‐by‐session changes in couples' relationship‐specific attachment anxiety and avoidance and pre‐ to posttherapy changes in their relationship‐specific attachment behaviors. Couples significantly decreased in relationship‐specific attachment avoidance, and those who completed a blamer softening significantly decreased in relationship‐specific attachment anxiety. Couples' attachment behavior significantly increased toward security. Finally, session‐by‐session decreases in relationship‐specific attachment anxiety and avoidance were significant associated with increases in relationship satisfaction across sessions. These results provide empirical support for the attachment‐based assumptions of EFT. Video abstract accessible by clicking here