Conversations for Connection: An Outcome Assessment of the Hold‐Me‐Tight Relationship‐Education Program,and Recommendations for Improving Future Research Methodology in Relationship Education

The Hold Me Tight (HMT) program is a new approach to relationship education based on Emotionally‐Focused Therapy (Johnson, 2004), an evidence‐based approach to couple therapy. In this exploratory longitudinal research, we examined individual growth in relationship satisfaction and trust for partners in 95 couples in 16 HMT groups across four occasions of measurement: Baseline, Pre‐Program, Post‐Program and at either 3‐ or 6‐month Follow‐Up. We found that relationship satisfaction and trust increased during program participation, and declined during follow‐up. We believe our findings provide support for the short‐term effectiveness of the HMT program, and suggest a longer period of program delivery may result in improved retention of gains. Finally, we present recommendations for improving the design of future longitudinal research in relationship education.     

The Development and Implementation of a Multi‐Couple Therapy Model with Torture Survivors in the Democratic Republic of the Congo

In this article, we present development and feasibility of implementation of a multi‐couple group for use with torture‐surviving couples. The model was developed in the Democratic Republic of the Congo in a community that experienced widespread torture during the wars from 1998 to 2004. The Torture‐Surviving Couple Group model is a short‐term intervention designed to use few human resources to address relational difficulties resulting from exposure to traumatic stressors. The model was guided by critical and feminist epistemologies and employed an ecological lens to incorporate neurobiology and attachment processes along with narrative therapy techniques. An existing multi‐couple group model for addressing violence (Stith, Rosen, McCollum, & Thomsen, 2004 ), and a stage model for healing trauma (Herman, 1992 ) also informed the structural development of the Torture‐Surviving Couple Group model. Couple groups were conducted using a 10‐session program with 13 couples who met weekly. Session themes were incorporated into four phases emphasizing: (a) preparation; (b) safety and stabilization; (c) processing the relationship effects of trauma and grief; and (d) reintegration and rebuilding couple and family life. Couples reported and showed remarkable progress in their relationships after participating in the groups. Clinical and research implications and discussed along with the feasibility of developing and testing the model in a post‐conflict low income setting.     

The Long‐Term Effects of Building Strong Families: A Program for Unmarried Parents

The authors present findings from a large‐scale, random‐assignment evaluation of Building Strong Families (BSF), a program offering group sessions on relationship skills education to low‐income, unmarried parents who were expecting or had recently had a baby. Findings based on a 3‐year follow‐up survey of over 4,000 couples indicate that BSF did not succeed in its central objectives of improving the couple relationship, increasing the quality of coparenting, or enhancing father involvement. In fact, the program had modest negative effects on some of these outcomes. BSF also had little impact on child well‐being, with no effect on children's family stability or economic well‐being and only a modest positive effect on children's socioemotional development. Impacts varied across the 8 study sites. Although attendance at group sessions was relatively low, there is little evidence of program effects even among couples who attended sessions regularly.     

Mindfulness‐Based Relationship Education For Couples Expecting Their First Child—Part 1: A Randomized Mixed‐Methods Program Evaluation

This article is Part 1 of a two‐part series, in which we report on our evaluation of a mindfulness‐based relationship enhancement program for couples who are expecting their first child. In this mixed‐methods randomized clinical trial, we assigned 33 couples to the 4‐week Mindful Transition to Parenthood Program treatment group (n = 16 couples) or to a waitlist control condition (n = 17 couples). Men in the treatment group significantly improved in relationship satisfaction, mindfulness, and negative affect; women had no significant treatment effects. Small to large effect sizes were present for treatment group men and women in multiple areas. Mixed‐methods analyses demonstrated that this intervention may be especially helpful for men because of differences in social support needs, effects of program enrollment, and relational processes in the prenatal period. Video Abstract     

Relationship Education in Community Settings: Effectiveness with Distressed and Non‐Distressed Low‐Income Racial Minority Couples

Couple relationship education (CRE) programs are intended to prevent negative couple outcomes, however, some evidence suggests couples in greater distress may still benefit. The current study examined pre‐ and postchanges in relationship functioning of 362 low‐income African American and Hispanic couples. Outcomes (dedication and communication) were assessed by examining differences between two distinct groupings of couples; distressed (both partners reporting clinically significant distress) and nondistressed (neither partner reporting clinically significant distress) couples. Distressed couples at predemonstrated large‐sized gains in all outcome variables, as compared to nondistressed couples. Those who participated in the single‐couple format demonstrated lower gains in positive communication as compared to those in the group format. Implications for distressed couples in CRE programs are offered.     

The impact of discernment counseling on individuals who decide to divorce: experiences of post‐divorce communication and coparenting

Discernment counseling is designed to help couples considering divorce arrive at a greater sense of clarity and confidence in their decision making about the future of their marriage. Possible outcomes include making no change to the marriage, divorcing, or attempting reconciliation through couples therapy. To date, no research has been done on whether or not discernment counseling helps couples who decide to divorce with their post‐divorce family life (i.e., coparenting). We surveyed 11 people (from male–female couples) and conducted in‐depth interviews with eight who had undergone discernment counseling and subsequently divorced to see what impact discernment counseling had on their post‐divorce coparenting relationship. We analyzed the data from a phenomenological perspective. Respondents described their discernment counseling experience as helpful for achieving clarity and honesty in the divorce decision‐making process, they shared their appreciation for the structure of the intervention, and indicated that it led to a greater coparental cooperation post‐divorce.     

Promoting Fathers' Engagement With Children: Preventive Interventions for Low‐Income Families

Few programs to enhance fathers' engagement with children have been systematically evaluated, especially for low‐income minority populations. In this study, 289 couples from primarily low‐income Mexican American and European American families were randomly assigned to one of three conditions and followed for 18 months: 16‐week groups for fathers, 16‐week groups for couples, or a 1‐time informational meeting. Compared with families in the low‐dose comparison condition, intervention families showed positive effects on fathers' engagement with their children, couple relationship quality, and children's problem behaviors. Participants in couples' groups showed more consistent, longer term positive effects than those in fathers‐only groups. Intervention effects were similar across family structures, income levels, and ethnicities. Implications of the results for current family policy debates are discussed.     

Motivating Action and Maintaining Change: The Time‐Varying Role of Homework Following a Brief Couples' Intervention

Studies regarding the effectiveness of homework assignments in cognitive‐behavioral treatments have demonstrated mixed results. This study investigated predictors of compliance with homework recommendations and the time‐varying relationship of recommendation completion with treatment response in a brief couples' intervention (N = 108). More satisfied couples and couples with more motivation to change completed more recommendations, whereas couples with children completed fewer. The association between recommendation completion and treatment response varied with the passage of time, with the strongest effect observed 6 months after the intervention, but no discernible differences at 1 year postintervention. Couples that completed more recommendations experienced more rapid treatment gains, but even those couples doing substantially fewer recommendations ultimately realized equivalent treatment effects, although they progressed more slowly. Implications are discussed.     

Couples Therapy for Intimate Partner Violence: A Systematic Review and Meta‐Analysis

Intimate partner violence is a serious public health problem accompanied by substantial morbidity and mortality. Despite its documented impact on health, there is no widely recognized treatment of choice. Some studies indicate that couples suffering from situational violence may benefit from couples therapy, but professionals are cautious to risk the possibility of violent retaliation between partners. After a comprehensive literature search of 1,733 citations, this systematic review and meta‐analysis compiles the results of six studies to investigate the effectiveness of couples therapy as a treatment for violence. Preliminary data suggest that couples therapy is a viable treatment in select situations.     

The Family‐Friendly Community and Its Life Course Fit for Dual‐Earner Couples

Much is known about family‐friendly workplaces. This article examines the less understood family‐friendliness of the communities in which dual‐earner couples reside. Using data from a representative sample of dual‐earner couples (N = 727) in upstate New York, we examine how individual, couple, and neighborhood characteristics are associated with perceptions of community family‐friendliness. Using a life course perspective, we find that couples with young children rate their communities more favorably than do other couples. Findings also indicate that for couples with children of their own, living in a neighborhood with many other families with children is associated with higher ratings of family‐friendliness. We term this match, between a couple's life stage and their neighborhood's demographic structure, life stage‐neighborhood fit.     

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.     

Separation and Post‐Separation Parenting within Lesbian and Gay Co‐parenting (Guild Parented) Families

Gay men and lesbian women have a long history of jointly creating families and co‐parenting their children together. This qualitative study aims to explore the experiences of separation and post‐separation parenting within same‐sex parented families. This involved semi‐structured in‐depth interviews with 22 separated same‐sex parents in Adelaide, Melbourne, Sydney, Brisbane, and regional Victoria. An adaptive theory approach was used for the collection and analysis of the data. The paper explores data from a cohort of six participants who came from three different multi‐parent families who had experienced a separation – either their own, or that of other parents in their parenting group. The term ‘co‐parenting families’ was found to be confusing due to the different connotations within separation/divorce and same‐sex parent literature. Consequently, the term ‘guild parented families’ was created to describe these families. Participants from these multi‐parent families had very different experiences of family formation and separation compared to others within the wider separated same‐sex parent study. Separation of one or more of the parent couples within these families complicated their original plans and kinship ideals. Each of the families resolved this differently in their post‐separation arrangements. After separation, whole family narratives and/or the role of individual parents, were either questioned or revised as a way of resolving the complexity of their new kinship situation. Following separation, parents often relied on Western kinship norms that privilege biological kinship and the dual‐parent family to construct their post‐separation kinship arrangements. More awareness of families that begin with more than two parents is needed within separation research and amongst separation services and service providers.     

Efficacy of a Web‐based Intervention for Concerned Spouses of Service Members and Veterans with Alcohol Misuse

Concerned partners (CPs) of service members and veterans who misuse alcohol face help‐seeking barriers and mental health problems. We used multiple regression to evaluate the efficacy of Partners Connect, a four‐session web‐based intervention (WBI) to address military CPs’ mental health and communication. We randomized 312 CPs to the WBI or a control group. Five months later, WBI CPs reported significant reductions in their anxiety and increases in their social support compared to control CPs. Intervention dose was also associated with improved WBI CP outcomes. Partners Connect appears to fill a need for families who face help‐seeking barriers and provides an alternative to traditional care for those who may not otherwise seek help.     

Observer,Self‐, and Partner Reports of Hostile Behaviors in Romantic Relationships

The present study examines how different observers of romantic relationships differ in their reports of hostility. Using confirmatory factor analysis with structured means, the results from 236 young adults and their romantic partners indicated that (a) the correlations among targets’ self‐reports, partners’ reports, and observers’ reports of targets’ behaviors were moderate; (b) targets’ self‐reports of their own level of hostility were lower than their partners’ reports of them; (c) young couples who were living together demonstrated a higher level of hostility than dating couples; and (d) women showed a higher level of hostility toward their partners than did men.     

The Self‐Directed Search as a Stand‐Alone Intervention With College Students

The Self‐Directed Search (SDS; Holland, 1994 ) is sometimes administered to large student groups outside of counseling to address common career development needs. This study evaluated the effectiveness of the SDS as a stand‐alone intervention by comparing a general sample of college students who completed the SDS (n = 39) with a no‐treatment control group (n = 41) on several outcomes. Completion of the SDS related to an increase in the number of career alternatives being considered 4 weeks later but did not relate to career exploration, career decision‐making self‐efficacy, career indecision, and seeking of career counseling services. If the SDS is used outside of counseling with broad student samples, the authors suggest providing additional intervention to ensure that it promotes exploration of any additional careers being considered.     

Improving the well-being of couples facing cancer: a review of couples-based psychosocial interventions

The purpose of this review article is to assess the available scientific evidence on the effects of couples-based psychosocial interventions for couples when one spouse faces cancer. For the present study, we conducted an extensive search of three electronic databases using a comprehensive search strategy. The literature search identified 14 studies evaluating couples intervention where one partner is facing cancer. Among them, eight studies concluded there was overall improvement for patients and eight studies reported overall improvement for partners, whereas an additional five studies showed partial improvement for patients and three demonstrated partial improvements for partners. Taken in the aggregate, these studies illustrated partial effectiveness--most had some positive results--but with clear limitations in terms of how many aspects of psychosocial well-being changed, lack of equal effectiveness for both patients and their partners, or limited maintenance of improvements over time, a common concern with brief psychosocial interventions. Although couples-based interventions may facilitate emotional support and dyadic coping, how these psychosocial interventions should be delivered, at what point in the illness and treatment they should be delivered, and how long they should continue remain as future challenges.     

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.     

Constructing Personal and Couple Narratives in Late‐stage Cancer: Can a Typology Illuminate the Caring Partner Perspective?

There is a large body of work focusing on the well‐being and relationships of couples facing late‐stage cancer. The systemic study underpinning this paper explored a less researched topic: How do people caring for a partner with terminal cancer construct their experience and relationships through personal and couple narratives? This UK‐based study drew upon dialogical approaches to narrative analysis to focus on six caring partners and their care relationships. Following individual case analysis, two methods of cross‐narrative analysis were developed, and an analysis of narrative themes and a typology of archetypal narratives were drawn from the data. This paper focuses on the typology. The clinical implications of the study are considered, focusing on the contribution of a typology to this and future studies.     

A Model of Engagement Promotion in a Professionally Facilitated Online Intervention for Couples Affected by Breast Cancer

Professionally facilitated web‐based interventions for couples affected by an illness such as cancer are growing in popularity. Attrition rates for such online programs, however, are substantially higher than what is observed in face‐to‐face therapeutic contexts, and lower levels of participant engagement are associated with poorer outcomes. In the present investigation, a task analysis was employed to develop a model of engagement promotion in an online intervention for couples affected by breast cancer called “Couplelinks.” Results indicated that facilitators utilized a variety of meta‐processes, such as humanizing the technology, and associated “eBehaviors,” to maintain three relationships involved in promoting online engagement: (a) between the facilitator and couple; (b) between the intervention and couple; and (c) between the partners within the couple.     

Discernment Counseling for “Mixed‐Agenda” Couples

This article describes discernment counseling, an approach to working with couples where one partner is leaning toward divorce and the other wants to preserve the relationship and work on it in couples therapy. These “mixed‐agenda” couples are common in clinical practice but have been neglected in the literature. The goal of discernment counseling is clarity and confidence regarding the next steps for the relationship, based on a deeper understanding of each partner's contributions. Sessions emphasize individual conversations with each partner. An analysis of 100 consecutive cases found that about half of the couples chose to start couples therapy in order to reconcile, with most of the rest choosing the divorce path. Longer term follow‐up information is also presented.