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.     

Using Relationship Education Programs with Same-Sex Couples: A Preliminary Evaluation of Program Utility and Needed Modifications

Same-sex couples represent a group likely to benefit from relationship education, given the many unique challenges they face. However, it is unclear whether existing programs, predominantly designed for married heterosexual couples, are appropriate for use with same-sex couples. In this article we highlight the need for quality relationship education programs for same-sex couples and review the literature to identify unique needs of same-sex couples that may not be met by existing programs. We then describe a small survey of couple therapists and researchers conducted to provide preliminary information about whether same-sex couples are perceived to benefit from existing relationship education programs and whether modifications to program content are needed. Twenty respondents indicated that a core set of relationship education components were useful when working with same-sex couples, although the presentation of these components generally required modifications to remove heterosexist bias and to improve applicability to same-sex couples. In addition, several novel program foci were suggested (e.g., stigma management). Implications for the design and delivery of relationship education to same-sex couples are discussed.     

Relationship education research: current status and future directions

The overarching aim of this article is to review the research on relationship education programs and approaches that has been published or accepted for publication since the last review article in 2003. This article provides a critical overview of the relationship education field and sets an agenda for research and practice for the next decade. A theme weaved throughout the article is the ways in which relationship education is similar and different from couples therapy, and we conclude that there can be a synergistic, healthy marriage between the two. We then provide recommendations for future directions for research in the relationship education field. Finally, the coauthors comment on our experiences in both the relationship education field and the couples therapy field as both researchers and interventionists.     

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.     

Examining Passive and Active Recruitment Methods for Low-Income Couples in Relationship Education

One of the most difficult aspects of studying low-income couples is the effective implementation of recruitment and retention strategies. Low-income couples face environmental stressors that make participation difficult, and research has yet to identify efficacious methods of recruiting and retaining low-income couples into funded studies. Researchers and practitioners targeting low-income participants rely on a “learn-as-they-go” approach. Therefore, we examined passive and active recruitment strategies for 394 married participants with children under age 18 and reporting a total household income within 200% of the Federal Poverty Guidelines who participated in a federally funded couples and relationship education program. Univariate ANOVAs indicated significant differences between recruitment method and total time spent in couples and relationship education workshops for both women and men. Further, results indicated a relationship exists between recruitment method and the number of follow-up contacts required before participants attended the initial intake appointment. Implications for practice and research are discussed.     

Freud,Grafenberg, and the neglected vagina: Thoughts concerning an historical omission in sexology

Because similarity between partners has been thought to be related to relationship quality, this study assessed similarities between partners in 44 married, 35 heterosexual cohabiting, 50 gay, and 56 lesbian couples on demographic characteristics, appraisals of relationship quality, and factors predictive of relationship quality. With regard to demographic characteristics: Partners' age was correlated for each type of couple; partners' income, education, and job prestige were correlated only for heterosexual cohabiting couples; and gay partners had the largest discrepancies in age, income, and education. With regard to appraisals of relationship quality: Partners' scores were correlated for each type of couple on relationship satisfaction but for only gay and lesbian couples on love for partner; partners across all couples differed in their assessments of relationship quality. With regard to the predictors of relationship quality: Partner scores were correlated for each type of couple only on shared decision making; these predictor scores were most frequently correlated for lesbian partners; differences between partners were least for lesbian couples on attractions to the relationship and perceived family support and greatest for cohabiting couples on dyadic attachment. Relationship quality was not related to discrepancies between partners' demographic variables but was negatively related to discrepancies in partners' dyadic attachment. In conclusion, partner homogamy was most pervasive in lesbian couples, and for all couples homogamy on dyadic attachment was related to relationship quality.     

Five factors in long-term marriages

The marriage relationship among 210 retired married couples was investigated as a function of sex, retirement status, relationship to children, commitment of the couple, and stage of ego development of the couple. The marriage relationship was assessed by measuring the expression of love between husbands and wives, and measuring their marriage problems. These older couples expressed less love to each other and had fewer marriage problems than younger married couples. Those couples who were committed to each other as persons, had fewer marriage problems. Those at more complex levels of ego development expressed more love to each other. Sex, retirement, and interaction with children were not related to the marriage relationship.This research was supported in part by NIMH Grant No. RO1 MH26933.     

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.     

Changes following Premarital Education for Couples with Differing Degrees of Future Marital Risk

The present study explored changes in individuals' relationship cognitions and behaviors following premarital education for couples with different risk profiles. The sample consisted of 63 couples who completed the PREPARE program and were classified for future marital risk based on dyadic information. A significant interaction effect was found between risk and time, with individuals in relationships classified as high risk exhibiting greater change at 4 weeks postprogram compared to low‐risk individuals. Perceived helpfulness of topics also varied by couple type. Findings provide support for adapting premarital education programs for high‐risk couples and offer clinicians and educators specific insights for areas of emphasis when working with different types of couples.     

The Value of Premarital Education

Premarital education programs have been designed with the aim of helping prospective spouses examine and evaluate their relationship prior to marriage. It is widely considered as preventative skills training and assumes that exposing couples to the skills to improve their relationship will help them deal with interpersonal difficulties as they arise. Skills commonly included in the programs involve communication, negotiation, problem-solving and decision making. There are a number of problems identified with the current status of premarital education programs including the atheoretical nature of most programs, the lack of specific goals in the program format, and poor evaluation procedures which are used to examine effectiveness. Overall it is concluded that although the concept of preparation for marriage is a good one, the current value of these programs is limited. A personal account of one premarital education program is also provided.     

Signs of Divorce Before Marriage: The Role of Premarital Events in Iran

Premarital relationships form the basis for couples’ future relationships. There are certain factors in couples’ premarital relationships that could play a role in divorce. This study was conducted to investigate the role of premarital events (courtship, engagement, and Nikah [marriage]) in marital conflicts leading to divorce. In this qualitative study, which was carried out in Iran using the phenomenological method, 23 divorced applicants were purposefully selected, and their experiences and perceptions were examined. Data were collected using semistructured interviews. Analysis of interviews showed that little opportunity to get to know each other, neglecting the guidance of family members, disregarding signs of defect in the spouse, starting and continuing the relationship with lies and secrecy, infidelity, financial problems, and eventually ignoring the spouse’s appearance and its underestimation during the courtship period are special factors that predispose couples to divorce; however, couples, due to the special context of their relationships, ignore these factors. The findings of the study include implications for couple therapists, counselors, and couples’ families, and they can be useful in premarital education and postmarital interventions.     

Exploratory Analysis of Factors Associated with Participation in Self-Directed and Traditional Marriage and Relationship Education

Although self-directed marriage and relationship education (MRE) has the potential to reach a larger or different audience than traditional MRE, little has been done to examine the characteristics of self-directed MRE participants. This study examined whether various individual, couple, family, and sociocultural context variables predicted participation in both self-directed and traditional MRE programs. A series of logistic regressions were conducted on a cross-sectional data set. Different factors predicted participation for each intervention. For self-directed programs, factors predictive of involvement included older age, religiosity, higher education, being more self-regulated, having a neurotic partner, more open relationship boundaries, a history of divorce, more relationship problems, and more family-of-origin problems. A wider range of factors predicted participation in traditional programs. Some factors increasing odds for participation in one intervention decreased odds in the other. Implications for MRE are discussed. This study provides evidence that some higher risk couples may choose self-directed MRE over more traditional programs.     

Measuring the Effectiveness of Experiential Date Nights: A Qualitative Study

ABSTRACT

This qualitative study examines the experience of 13 couples who attended a relationship education date night in two metropolitan areas in a western state. The intent of these date nights was to reach audiences that may not attend traditional classroom relationship education. Reasons for, benefits of attending, and impacts were explored with participants. Findings indicate that most participants had fun and enjoyed spending time together, learned qualities and skills of healthy relationships, and had positive learning experiences with other couples. Additionally, although most individuals’ reason for attending was to have fun, most experienced a positive impact on their relationships after the event, such as improved communication, increase in affection and gratitude, or spending more time together. This finding may indicate that regardless of the reasons for attending, it is possible to create an environment for learning relationship skills that can, and most likely will, extend beyond the night of the event and could potentially lead to long-term positive impacts in relationships. Based on findings and existing research, activity-based relationship education, such as date nights, needs to be taken seriously as a model for couple education and considered as part of a well-rounded approach to relationship education.     

In Circle: A Healthy Relationship,Domestic Violence,and HIV Intervention for African American Couples

While marriage and healthy relationship education has grown, limited interventions have been developed specifically to support the development and flourishing of African American couples. African Americans are also disproportionately impacted by HIV/AIDS and are more likely to experience lethality and serious injury due to domestic violence compared to Whites. Despite this, African American couples have been resilient and managed to thrive in relationships. Little has been done to capture these strategies, build on cultural strengths, and design an intervention specifically crafted for this population. This article describes an intervention “In Circle” developed, implemented, and evaluated for African American couples to support healthy relationship and healthy marriage education. The intervention is based on an Ancient Egyptian value system and undergirded by three integrated theoretical perspectives. The article also includes implications for practice and research.     

Newlywed Couple Leisure: Couple Identity Formation Through Leisure Time

An interpretative phenomenological study of newlywed couple leisure was conducted to understand the role of leisure in the development of relationship dynamics and couple identity. Nine couples were interviewed twice, using open-ended questions that explored the role of leisure in their relationship development. Data were analyzed using interpretive phenomenological processes. Couples viewed leisure as a crucial part of their relationships, helping them develop their identities as couples through creating shared meaning and opportunities to improve communication and conflict management skills. Findings can be used to encourage couple exploration of positive leisure experiences during courtship and early marriage, including therapeutic interventions and relationship education programs that teach couples to incorporate joint leisure strategically into their relationships.     

Sex therapy for couples: An italian perspective

This paper describes a sex therapy technique that utilizes three levels of intervention. The first level, which employs videotaping, is aimed at treating relationship conflicts and their expression. The second level is aimed at helping couples recover relationship and sexual skills. The third level is dedicated to direct treatment of the sexual dysfunction. Fifty‐five couples have been treated with this method, and the results suggest that this is a good strategy for the resolution of a sexual dysfunction, especially when couples are helped to reduce conflict in their relationship.     

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.     

Conceptual Framework for Marriage Education Programs for Stepfamily Couples with Considerations for Socioeconomic Context

Stepfamily couples face unique challenges that put them at higher risk for dissolution than non-stepfamily couples. Risks for stepfamily couples are magnified in the context of lower economic resources, making low-income stepfamily couples a key target population for intervention and for community education programs. Existing programs and services for couples often do not address the unique situations of stepfamilies. This article builds on previous reviews that have offered information on important research themes and assessment of available curricula for stepfamily couples and presents a more comprehensive conceptual model to guide program design and services for stepfamily couples inclusive of specific objectives, as well as conditions and antecedents affecting content and prioritized needs. The goal is to enhance efforts to strengthen more vulnerable couples in complex families.     

Remarried Couples in Premarital Education: Does the Content Match Participant Needs?

Although premarital education has been found to reduce risk factors of divorce, the use of premarital education has primarily been examined in first marriages, or in groups combining both first and later marriages. In this qualitative study, 8 remarried couples’ perceptions of the premarital education they received were explored. The coexisting core categories of the desire to create a loving relationship yet fear of repeated marital failure emerged. The results implied that remarried couples carried an additional fear of marital dissolution, which in conjunction with the complex tasks associated with stepfamily formation, promoted attachment insecurities. Clinical applications are included.     

Reactions to a partner-assisted emotional disclosure intervention: direct observation and self-report of patient and partner communication

Partner-assisted emotional disclosure is a couple-based intervention designed to help patients disclose cancer-related concerns to their spouses-partners. We previously found that, compared with an education/support control condition, partner-assisted emotional disclosure led to significant improvements in relationship quality and intimacy for couples in which the patient initially reported holding back from discussing cancer-related concerns (Porter et al., 2009, Cancer, 115, 4326-4338). The purpose of this study was to examine the process data from couples who participated in the disclosure sessions including (a) observational ratings of couples' communication during the sessions; (b) couples' ratings of their communication during the sessions; and (c) associations between participants' observed communication and their baseline psychological/relationship functioning. As rated by trained observers, couples' communication was in the moderate range of adaptive skills. Self-report data indicated that participants had positive perceptions of their communication. Observational and self-report ratings were weakly associated. Patients reporting lower levels of relationship quality, higher levels of holding back, and higher partner avoidance at baseline were rated by observers as more expressive during the sessions. Overall, these findings suggest that the intervention was acceptable to couples and was particularly helpful for patients who had difficulty talking with their partners on their own without skills training.