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Welsh ET, McIntosh JE, Vuong A, Cloud ZCG, Hartley E, Boyd JH. Design of Digital Mental Health Platforms for Family Member Cocompletion: Scoping Review. J Med Internet Res 2024; 26:e49431. [PMID: 38959030 PMCID: PMC11255536 DOI: 10.2196/49431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 12/13/2023] [Accepted: 05/04/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together. OBJECTIVE As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families. METHODS A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented. RESULTS Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver-care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself. CONCLUSIONS In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.
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Affiliation(s)
- Ellen T Welsh
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - Jennifer E McIntosh
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - An Vuong
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - Zoe C G Cloud
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - Eliza Hartley
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - James H Boyd
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Barton AW, Gong Q, Guttman S, Doss BD. Trajectories of Perceived Gratitude and Change Following Relationship Interventions: A Randomized Controlled Trial With Lower-Income, Help-Seeking Couples. Behav Ther 2024; 55:401-411. [PMID: 38418049 DOI: 10.1016/j.beth.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 06/20/2023] [Accepted: 07/25/2023] [Indexed: 03/01/2024]
Abstract
The current study was designed to advance basic and applied research on perceived gratitude from one's partner in established couple relationships. From a three-arm randomized controlled trial involving 615 lower-income, help-seeking couples (N = 1,224 individuals), study analyses examined (a) the trajectory of perceived gratitude from one's partner among couples assigned to the wait-list condition (i.e., absent of any intervention), and (b) changes in perceived gratitude for individuals assigned to either the OurRelationship (OR) or ePREP relationship intervention condition. With respect to the first aim, levels of perceived gratitude among wait-listed couples demonstrated no significant mean increase over the 6-month period; this rate of change was significantly different from rates of change observed in other relationship constructs (e.g., satisfaction, communication, support) during the wait-list period. Being married, female, and having more children were all associated with lower initial levels of perceived gratitude. For the second aim, individuals assigned to either the OR or ePREP treatment condition demonstrated significant improvements in levels of perceived partner gratitude compared to wait-listed couples. The magnitude of program effect sizes for gratitude (d = 0.33), however, was 3%-48% smaller compared to the magnitude of program effects of other relationship constructs (0.34 < d < 0.64). Results indicated that perceived gratitude is a distinct component of couple relationships, generally lower in more established relationships, and can be improved by participating in OR or ePREP relationship interventions. Implications for research and practice related to gratitude in couple relationships are discussed.
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Le Y, Roddy MK, Rothman K, Salivar EG, Guttman S, Doss BD. A randomized controlled trial of the online OurRelationship program with varying levels of coach support. Internet Interv 2023; 34:100661. [PMID: 37674656 PMCID: PMC10477807 DOI: 10.1016/j.invent.2023.100661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/15/2023] [Accepted: 08/23/2023] [Indexed: 09/08/2023] Open
Abstract
Online programs that reduce relationship distress fill a critical need; however, their scalability is limited by their reliance on coach calls. To determine the effectiveness of the online OurRelationship program with varying levels of coach support, we conducted a comparative effectiveness trial with 740 low-income couples in the United States. Couples were randomly assigned to full-coach (ncouples = 226; program as originally designed), automated-coach (ncouples = 145; as a stand-alone program with tailored automated emails only), contingent-coach (ncouples = 145; as an adaptive program where tailored automated emails are followed by more coaching if couples did not meet progress milestones), or a waitlist control condition (ncouples = 224). All analyses were conducted within a Bayesian framework. Completion rates were comparable across conditions (full-coach: 65 %, automated-coach: 59 %, contingent-coach: 54 %). All intervention couples reported reliable pre-post gains in relationship satisfaction compared to waitlist control couples (dfull = 0.46, dcontingent = 0.47, and dautomated = 0.40) with no reliable differences across intervention conditions. Over four-month follow-up, couples in full- and contingent-coach conditions maintained gains in relationship satisfaction and couples in the automated-coach condition continued to improve. Given the comparable completion rates and minimal differences in effect sizes across intervention conditions, all three coaching models appear viable; therefore, the choice of model can vary depending on available resources as well as couple or stakeholder preferences. This study was preregistered (ClinicalTrials.govNCT03568565).
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Affiliation(s)
- Yunying Le
- Department of Psychology, University of Denver, Denver, CO, United States of America
| | - McKenzie K. Roddy
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Karen Rothman
- Together CBT, New York, NY, United States of America
| | - Emily Georgia Salivar
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL, United States of America
| | - Shayna Guttman
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Brian D. Doss
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
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Gil M, Kim SS, Kim D, Han H, Lim B, De Gagne JC. Couple-Oriented Interventions for Mental Health: A Scoping Review. JOURNAL OF FAMILY NURSING 2023:10748407231198249. [PMID: 37846068 DOI: 10.1177/10748407231198249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
The purpose of this research was to systematically examine and collate evidence on couple-oriented interventions for mental health to identify trends in the literature, review research strategies, and suggest directions for future research. A systematic search included studies relating to couple-oriented interventions for preventing mental disorders and/or promoting mental health. We identified a total of 52 studies, which included 55 articles. Our findings revealed that interventions were delivered through various modes, including face-to-face, telephone, and online, with the majority of couple-oriented interventions operating in conjoint sessions. The most common intervention was for selective prevention, targeting patients with cancer and their partners. This review provided evidence of the applicability of theoretical frameworks, dyad analysis, and measurements associated with couple-oriented interventions. Findings can help family nurse practitioners and health care professionals advance strategies to develop and implement evidence-based, couple-oriented interventions for primary prevention of mental disorders and the promotion of mental health.
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Affiliation(s)
- Minji Gil
- Gangneung-Wonju National University, South Korea
| | | | - Daeun Kim
- Ewha Womans University, Seoul, South Korea
| | | | - Boram Lim
- Ewha Womans University, Seoul, South Korea
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5
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Kanter JB, Lannin DG, Rauer AJ, Yazedjian A. Relational concerns and change in relationship satisfaction in a relationship education program. FAMILY PROCESS 2023; 62:576-590. [PMID: 36792380 DOI: 10.1111/famp.12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 06/08/2023]
Abstract
Lower income couples tend to report more difficulty sustaining high-quality intimate relationships. As a result, policy initiatives have been enacted to fund relationship education (RE) programs that aim to increase lower income couples' relationship satisfaction. Generally, these programs demonstrate small, albeit statistically significant improvements in mean levels of relationship functioning. It is critical, however, to understand if RE programming influences the developmental course of intimate relationships, and if this influence depends on couples' initial levels of concerns about their relationships. Using dyadic group-based modeling and three waves of data from 6034 couples in the Supporting Healthy Marriages project, a randomized control trial of RE, we categorized couples into four relationship concern groups (No Relational Concerns, Both Relationally Concerned, Men's Relational Concerns, and Women's Relational Concerns) and explored how these groups moderated the long-term efficacy of RE programming. Results indicated that RE was associated with different developmental trajectories of satisfaction, but RE effects differed for men and women. Specifically, random assignment into RE was associated with men maintaining high levels of relationship satisfaction, whereas women's satisfaction decreased over time. These effects were not moderated by initial relationship concerns. The association between RE and relationship satisfaction trajectories was small in magnitude, suggesting that more comprehensive services are needed to strengthen lower income couples' intimate relationships.
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Affiliation(s)
- Jeremy B Kanter
- Department of Child and Family Studies, University of Tennessee, Knoxville, Tennessee, USA
| | - Daniel G Lannin
- Department of Psychology, Illinois State University, Normal, Illinois, USA
| | - Amy J Rauer
- Department of Child and Family Studies, University of Tennessee, Knoxville, Tennessee, USA
| | - Ani Yazedjian
- Office of the Provost, Illinois State University, Normal, Illinois, USA
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6
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Kim SS, Gil M, Kim D. Development of an Online-Coaching Blended Couple-Oriented Intervention for Preventing Depression in Middle Adulthood: An Intervention Mapping Study. Front Public Health 2022; 10:882576. [PMID: 35719656 PMCID: PMC9201043 DOI: 10.3389/fpubh.2022.882576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although middle-aged adults in Korea are vulnerable to depression, there are few preventive interventions for depression in middle adulthood. Studies consistently suggest that interventions that include both spouses are effective in decreasing depression and relationship distress. Considering the busy lives of middle-aged couples, it is essential to develop an online-coaching blended couple-oriented intervention. This study aimed to describe the development, implementation, and evaluation of an online-coaching blended couple-oriented intervention using an online program and coaching via videoconference to prevent middle-aged couples' depression; this was done using an intervention mapping (IM) protocol. Methods Six steps of IM were used to systematically develop a tailored multi-level intervention specific to middle-aged couples' depression. These steps of the IM protocol involve needs assessment, formulation of change objectives, theory-based methods, and practical strategies for program design, program development, program implementation, and program evaluation. Results The results of the six steps were as follows: (a) middle-aged couples' needs and mental health problems were identified through a scoping review study, mixed-method study, and expert interviews; (b) six performance objectives (POs) were formulated based on the results of Step 1, and intrapersonal, interpersonal, and temporal/transpersonal determinants were identified based on the self-transcendence theory. Change objectives were developed by combining POs with determinants; (c) self-regulated learning was chosen for theoretical teaching methods and practical strategies to change the determinants of each level; (d) four modules consisting of 16 sessions were developed based on the self-transcendence theory; (e) experts evaluated the program and coaches were trained; and (f) the evaluation plan for the program's feasibility, acceptability, usability, and preliminary effects was developed. Discussion The systematic process using IM allowed us to develop an online-coaching blended couple-oriented intervention to prevent depression and promote couples' relationships. The primary effects of this newly developed program should be evaluated in future studies. This may lead to the increased adoption and implementation of evidence-based and tailored interventions for psychological wellbeing in middle adulthood.
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Affiliation(s)
- Suk-Sun Kim
- Ewha Research Institute of Nursing Science, College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Minji Gil
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Daeun Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
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Fergus K, Tanen A, Ahmad S, Gardner S, Warner E, McLeod D, Stephen J, Carter W, Periera A. Treatment Satisfaction With Couplelinks Online Intervention to Promote Dyadic Coping in Young Couples Affected by Breast Cancer. Front Psychol 2022; 13:862555. [PMID: 35783696 PMCID: PMC9245623 DOI: 10.3389/fpsyg.2022.862555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background This study evaluated participant satisfaction with “Couplelinks,” an online psychological intervention designed for younger couples coping with breast cancer. The program included six experiential learning exercises (plus one optional module), psychoeducational information, and support from a personal mental health professional. Objective The primary objectives were to examine participants’ perceptions of: the online intervention’s structure and content; the value of including a professional facilitator; and benefits and drawbacks of the program. Methods A treatment satisfaction questionnaire comprised of Likert indices and open-ended questions pertaining to treatment satisfaction was completed by 26 patients and 27 male partners (N = 53) approximately 1–2 weeks following the intervention which occurred in the context of a randomized controlled trial. Descriptive statistics were used to summarize satisfaction ratings and generalized linear models with fixed effect for gender were used to test for differences in male-female outcomes. A thematic analysis was undertaken in order to understand, organize and summarize the qualitative textual feedback. Results Participants reported an overall satisfaction rating of 4.3 out of 5 (SD = 0.54) with patient satisfaction ratings being higher than that of male partners’ (p = 0.01). The majority of participants considered the facilitator’s role to be necessary 4.6 (SD = 0.60), and found the program to be convenient 4.1 (SD = 0.81) despite some participants struggling to keep up with the modules. Subjective data revealed participants valued the convenience and flexibility of the online intervention and appreciated the program’s involvement of both partners. Participants also reported that including a professional facilitator humanized the intervention, served as motivation to progress through the program, facilitated insight into their relationship, and was reassuring. Experiential gains noted by participants included that the program: helped couples to open channels of communication; prompted them to designate quality time for one another; evoked feelings of unity and togetherness; and inspired new insight in the relationship. Conclusion Such feedback supports the feasibility and acceptability of the Couplelinks program while offering directions for improvement of online couple-based interventions in cancer.
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Affiliation(s)
- Karen Fergus
- Psychosocial Oncology Lab, Department of Psychology, York University, Toronto, ON, Canada
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- *Correspondence: Karen Fergus, ,
| | - Adina Tanen
- School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Saunia Ahmad
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Toronto Psychology Clinic, Toronto, ON, Canada
| | - Sandra Gardner
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ellen Warner
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Deborah McLeod
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Joanne Stephen
- Clinical Neurosciences, Alberta Health Services, Calgary, AB, Canada
| | - Wendy Carter
- Toronto Academic Pain Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Amanda Periera
- Psychosocial Oncology Lab, Department of Psychology, York University, Toronto, ON, Canada
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Turner JJ, Bradford K, Higginbotham B, Juhasz E. Couple Relationship Education: Before and During
COVID-19. FAMILY JOURNAL (ALEXANDRIA, VA.) 2022; 30:10664807221104126. [PMCID: PMC9168412 DOI: 10.1177/10664807221104126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The restrictions imposed by the COVID-19 pandemic have required program planners
to re-evaluate the provision of relationship education (RE). The current
mixed-methods study focuses on the Healthy Relationships
[State] initiative's transition from in-person to virtual online RE
programing, measuring program impact and comparing the outcomes between the two
delivery methods for individuals participating in Couple LINKS,
a curriculum designed for adults in committed relationships. Comparisons between
delivery methods revealed that in-person participants showed greater gains than
virtual participants on key program measures; however, the outcomes were
positive for all. Qualitative responses of virtual participants revealed what
they liked most and liked least about the virtual format, citing their
appreciation for the curriculum, the opportunity to develop new skills,
facilitator quality, online accessibility, and couple time. Schedule conflicts
and uneven course pacing, reference materials, technology, and sharing personal
information were listed as things participants liked least about the virtual
program. Implications for the future delivery of RE programs are discussed.
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Affiliation(s)
- Joshua J. Turner
- Joshua Turner, Department of Human
Development and Family Studies, Utah State University, 2705 Old Main, Logan, UT,
84322-2705, USA.
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Troitskaya O, Batkhina A. Mobile application for couple relationships: Results of a pilot effectiveness study. FAMILY PROCESS 2022; 61:625-642. [PMID: 34904235 DOI: 10.1111/famp.12733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 06/14/2023]
Abstract
Mobile apps in mental health have seen a significant growth in recent years. Most of them are aimed at treating depression, anxiety, and stress disorders using cognitive behavioural therapy methods and relatively few apps are being developed to address interpersonal issues. This study tested the effectiveness of the iCognito Relationship Program, a self-help application for couple relationships based on the chatbot technology. A between-group experimental study was conducted in Russia using the bibliotherapy as a control condition (N = 58, female sample), with results showing that, after 2 weeks, iCognito's users had increased satisfaction, tenderness, constructive communication, as well as commitment to the relationship. Also, indicators for relationship self-efficacy, communicative skills in relationships, and self-esteem regarding relationship skills had significantly increased, while level of conflicts had decreased. A medium effect size was reported for most indicators. The participants of an experimental group expressed a high level of satisfaction with the technology and a generally positive attitude towards the idea of working with a "virtual psychologist"-chatbot on their personal issues. Despite the need to reproduce the research results, iCognito program demonstrates that both mobile application and chatbot technologies can be useful for training individuals' relationship satisfaction and communication skills, and that they can be more efficient in increasing satisfaction and reducing conflict in relationships than self-help books.
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Affiliation(s)
- Olga Troitskaya
- iCognito Inc., Moscow State Institute of International Relations, Moscow, Russia
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10
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Galovan AM, Hawkins AJ, Harris SM, Simpson DM. What are they doing? A national survey of help-seeking and relationship-repair behavior of individuals who are thinking about divorce. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:371-390. [PMID: 33405252 DOI: 10.1111/jmft.12480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
Guided by the Stages of Change (SOC) model, we explored relationship-repair behaviors among those thinking about divorce, employing a recent national longitudinal survey of married individuals (N = 745). Person-centered analyses explored whether there were distinct typologies of relationship-repair behaviors. We found four distinct classes: Intense Seekers (6%), who engaged at high levels of all kinds of repair behaviors, including professional services; Moderate-fading Seekers (14%), who engaged in moderate levels of various repair behaviors, including professional services, but did not sustain that behavior over a year; and Minimal-private Seekers (42%) and Private-sustained Seekers (38%), who eschewed professional services and engaged in low-to-moderate personal and private repair behaviors. We discuss possible applications of the SOC model to the divorce decision-making process and conclude with implications for practice, including the need to allocate greater attention to personal and self-help interventions that match the way most people try to repair their relationships.
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Affiliation(s)
- Adam M Galovan
- Department of Human Ecology, University of Alberta, Edmonton, AB, Canada
| | - Alan J Hawkins
- School of Family Life, Brigham Young University, Provo, UT, USA
| | - Steven M Harris
- Department of Family Social Sciences, University of Minnesota, St. Paul, MN, USA
| | - David M Simpson
- School of Family Life, Brigham Young University, Provo, UT, USA
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Carlson RG, Wheeler NJ, Barden SM, Romagnolo SM, Dillman Talyor D, Hipp CJ, Silverio N, Moran M. Using Intent-to-Attend to Predict Attendance in Community-Based Relationship Education. FAMILY PROCESS 2022; 61:130-145. [PMID: 33904591 DOI: 10.1111/famp.12662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Government-supported relationship education has provided resources for inclusion of economically vulnerable and ethnically diverse participants; however, many grantees and programs struggled to retain couples in longitudinal studies, which has likely influenced study effects and threatened internal validity. In the present study, we assessed 1,056 couples' baseline relationship satisfaction and intent-to-attend their next scheduled visit while participating in a randomized controlled trial of relationship education and evaluated the predictive ability of their responses to remain in the six-month study. We conducted actor-partner interdependence models for couples, using a probit cross-lagged regression with a structural equation modeling framework, to test the dyadic influence of intent-to-attend on future couple attendance. We also examined the influence of higher or lower baseline relationship satisfaction between partners and group assignment (treatment or wait-list control) on attendance. Intent-to-attend scores were associated with attendance for couples at the one-month follow-up, and early attendance was the biggest predictor of later attendance. Additionally, baseline intent-to-attend scores predicted later intent-to-attend scores for all follow-up time points. However, we found no partner effects, and no effects for the influence of baseline relationship satisfaction or group assignment. We discuss practical suggestions for including intent-to-attend in future studies, relationship education programming, and general therapy practice.
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Affiliation(s)
- Ryan G Carlson
- Department of Educational Studies, University of South Carolina, Columbia, SC, USA
| | - Naomi J Wheeler
- Department of Counseling and Special Education, Virginia Commonwealth University, Richmond, VA, USA
| | - Sejal M Barden
- Marriage and Family Research Institute, University of Central Florida, Orlando, FL, USA
| | - Shannon M Romagnolo
- School Counseling in the College of Education and Human Services, University of North Florida, Jacksonville, FL, USA
| | - Dalena Dillman Talyor
- Marriage and Family Research Institute, University of Central Florida, Orlando, FL, USA
| | - Christopher J Hipp
- Department of Educational Studies, University of South Carolina, Columbia, SC, USA
| | - Nicole Silverio
- Marriage and Family Research Institute, University of Central Florida, Orlando, FL, USA
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12
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Kim SS, Gil M, Kim D, Kim S, Heo D, Moon NY. Validity and Reliability of the Korean Version of the Couple Satisfaction Index. J Korean Acad Nurs 2022; 52:228-243. [DOI: 10.4040/jkan.21177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/18/2022] [Accepted: 03/08/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Suk-Sun Kim
- College of Nursing, Ewha Womans University, Seoul, Korea
- Ewha Research Institute of Nursing Science, Seoul, Korea
| | - Minji Gil
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Daeun Kim
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Sunhai Kim
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Dayeon Heo
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Nan Young Moon
- College of Nursing, Ewha Womans University, Seoul, Korea
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Markman HJ, Hawkins AJ, Stanley SM, Halford WK, Rhoades G. Helping couples achieve relationship success: A decade of progress in couple relationship education research and practice, 2010-2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:251-282. [PMID: 34783038 PMCID: PMC9298911 DOI: 10.1111/jmft.12565] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 10/12/2021] [Indexed: 05/25/2023]
Abstract
This article systematically reviewed 34 rigorous evaluation studies of couple relationship education (CRE) programs from 2010 to 2019 that met the criteria for Level 1 well-established interventions. Significant advances include reaching more diverse and disadvantaged target populations with positive intervention effects on a wider range of outcomes beyond relationship quality, including physical and mental health, coparenting, and even child well-being, and evidence that high-risk couples often benefit the most. In addition, considerable progress has been made delivering effective online CRE, increasing services to individuals rather than to couples, and giving greater attention to youth and young adults to teach them principles and skills that may help them form healthy relationships. Ongoing challenges include expanding our understanding of program moderators and change mechanisms, attending to emerging everyday issues facing couples (e.g., healthy breaking ups, long-distance relationships) and gaining increased institutional support for CRE.
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Affiliation(s)
| | | | | | - W. Kim Halford
- School of PsychologyUniversity of Queenstown, St LuciaBrisbaneAustralia
| | - Galena Rhoades
- Psychology DepartmentUniversity of DenverDenverColoradoUSA
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14
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Doss BD, Roddy MK, Wiebe SA, Johnson SM. A review of the research during 2010-2019 on evidence-based treatments for couple relationship distress. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:283-306. [PMID: 34866194 DOI: 10.1111/jmft.12552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 08/26/2021] [Indexed: 05/14/2023]
Abstract
The current article presents a review of the published research from 2010 to 2019 on the treatment of couple relationship distress; 37 studies met all criteria for inclusion. Behavioral Couple Therapy, Cognitive Behavioral Couple Therapy, Emotionally Focused Therapy, and Integrative Behavioral Couple Therapy meet criteria as "well-established" approaches, Insight-Oriented Couple Therapy is a "possibly efficacious" approach, and several other others are "experimental" treatments for treating couple relationship distress (Southam-Gerow & Prinstein, 2014). Furthermore, several less-intensive interventions-the Marriage Check-up, OurRelationship, and Hold Me Tight programs-have generated substantial support for their ability to improve relationships and are classified as "well-established" or "probably efficacious" interventions. We recommend that future research focus on expanding the reach of evidence-based interventions across a range of settings and populations, deepening our understanding of the mechanisms of change and underlying factors in the change process across approaches, and improving treatment success through treatment matching and progress monitoring.
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Affiliation(s)
| | | | - Stephanie A Wiebe
- Saint Paul University, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Susan M Johnson
- University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Couple and Family Institute, Ottawa, Ontario, Canada
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15
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Kanter JB, Williams DT, Rauer AJ. Strengthening lower-income families: Lessons learned from policy responses to the COVID-19 pandemic. FAMILY PROCESS 2021; 60:1389-1402. [PMID: 34553388 PMCID: PMC8652884 DOI: 10.1111/famp.12716] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 05/02/2023]
Abstract
Families are navigating an unstable economy due to COVID-19. Financial stressors have the potential to strain intimate relationships and exacerbate prior inequities across lower-income families. Notably, the economic impact of COVID-19 disproportionately influenced Black and Latinx families. As a response to families' economic adversity during the pandemic, the federal government initiated the CARES Act. This type of federal response to lower-income families, however, is not new. The purpose of this paper is to contextualize and historicize previous and current efforts to mitigate the consequences of financial hardship on families by comparing the assumptions and efficacy of the Healthy Marriages Initiative and the CARES act. We conclude with four recommendations to promote well-being in lower-income families: (1) acknowledging and reducing inequities that disproportionally impact families racialized as Black or Latinx; (2) intervening to mitigate stressors surrounding families; (3) using innovative methods to deliver relationship education; and (4) considering prevention versus intervention strategies.
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Affiliation(s)
- Jeremy B. Kanter
- Department of Child and Family StudiesThe University of TennesseeKnoxvilleTNUSA
| | | | - Amy J. Rauer
- Department of Child and Family StudiesThe University of TennesseeKnoxvilleTNUSA
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Hatch SG, Lobaina D, Doss BD. Optimizing Coaching During Web-Based Relationship Education for Low-Income Couples: Protocol for Precision Medicine Research. JMIR Res Protoc 2021; 10:e33047. [PMID: 34734838 PMCID: PMC8603166 DOI: 10.2196/33047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/03/2021] [Indexed: 11/29/2022] Open
Abstract
Background In-person relationship education classes funded by the federal government tend to experience relatively high attrition rates and have only a limited effect on relationships. In contrast, low-income couples tend to report meaningful gains from web-based relationship education when provided with individualized coach contact. However, little is known about the method and intensity of practitioner contact that a couple requires to complete the web-based program and receive the intended benefit. Objective The aim of this study is to use within-group models to create an algorithm to assign future couples to different programs and levels of coach contact, identify the most powerful predictors of treatment adherence and gains in relationship satisfaction within 3 different levels of coaching, and examine the most powerful predictors of treatment adherence and gains in relationship satisfaction among the 3 levels of coach contact. Methods To accomplish these goals, this project intends to use data from a web-based Sequential Multiple Assignment Randomized Trial of the OurRelationship and web-based Prevention and Relationship Enhancement programs, in which the method and type of coach contact were randomly varied across 1248 couples (2496 individuals), with the hope of advancing theory in this area and generating accurate predictions. This study was funded by the US Department of Health and Human Services, Administration for Children and Families (grant number 90PD0309). Results Data collection from the Sequential Multiple Assignment Randomized Trial of the OurRelationship and web-based Prevention and Relationship Enhancement Program was completed in October of 2020. Conclusions Some of the direct benefits of this study include benefits to social services program administrators, tailoring of more effective relationship education, and effective delivery of evidence- and web-based relationship health interventions. International Registered Report Identifier (IRRID) DERR1-10.2196/33047
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Affiliation(s)
- S Gabe Hatch
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Diana Lobaina
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Brian D Doss
- Department of Psychology, University of Miami, Coral Gables, FL, United States
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Curtis A, Booth B, Gruenert S, Long CM, Karantzas G, Harries T, Mullins E, Miller PG. Identified support needs for intimate partner violence engagement in an alcohol and other drug treatment sample. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2020.1867660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ashlee Curtis
- School of Psychology, Deakin University, Geelong, Australia
- Centre for Drug Use, Addictive and Anti-social Behaviour Research, School of Psychology, Deakin University, Geelong Australia
- Odyssey House Victoria, Richmond, Australia
| | | | | | | | - Gery Karantzas
- School of Psychology, Deakin University, Geelong, Australia
- Centre for Drug Use, Addictive and Anti-social Behaviour Research, School of Psychology, Deakin University, Geelong Australia
| | - Travis Harries
- School of Psychology, Deakin University, Geelong, Australia
- Centre for Drug Use, Addictive and Anti-social Behaviour Research, School of Psychology, Deakin University, Geelong Australia
| | - Ellie Mullins
- School of Psychology, Deakin University, Geelong, Australia
- Centre for Drug Use, Addictive and Anti-social Behaviour Research, School of Psychology, Deakin University, Geelong Australia
- Odyssey House Victoria, Richmond, Australia
| | - Peter G. Miller
- School of Psychology, Deakin University, Geelong, Australia
- Centre for Drug Use, Addictive and Anti-social Behaviour Research, School of Psychology, Deakin University, Geelong Australia
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Barraca J, Nieto E, Polanski T. An Integrative Behavioral Couple Therapy (IBCT)-Based Conflict Prevention Program: A Pre-Pilot Study with Non-Clinical Couples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199981. [PMID: 34639282 PMCID: PMC8508421 DOI: 10.3390/ijerph18199981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/14/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022]
Abstract
Integrative Behavioral Couple Therapy (IBCT) has demonstrated its efficacy treating severe couple conflict. Nevertheless, its capacity to prevent such conflicts before they appear has not been analyzed. The following empirical study examines the effectiveness of a conflict prevention program based on IBCT's main therapeutic strategies (empathic joining, unified detachment). A sample of 12 individuals (six couples) from the Community of Madrid completed the DAS (Spanier, 1976; Martín-Lanas et al., 2017), IBCTQ (Barraca et al., 2017), and ASPA-A (Carrasco, 1996) pre-treatment, posttreatment, and at a three-year follow up. Three of these couples were randomly assigned to the experimental group, in which they received five, 120-minute sessions of an IBCT-based conflict prevention program. The three remaining couples were assigned to a control group and received no treatment. Results indicated that the experimental couples grew in their acceptance of differences and significantly improved their level of empathic joining and unified detachment; they also manifested greater satisfaction in their total DAS score. At the three-year follow up, neither group showed significant changes with regard to their posttreatment scores. Although the data are based on a small number of couples and should be replicated, the results suggest that a program based on IBCT strategies can help prevent couple conflict up to three years after its application.
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Affiliation(s)
- Jorge Barraca
- Department of Psychology, Universidad Camilo José Cela, Calle Castillo de Alarcón 49, Urbanización Villafranca del Castillo, 28692 Madrid, Spain
- Correspondence:
| | - Elvira Nieto
- Private Practice, Calle Goya 83–3º Derecha, 28001 Madrid, Spain;
| | - Thomas Polanski
- Private Practice, Mariano Paredes N70-122 and Moisés Luna Andrade, Quito 170303, Ecuador;
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Keller A, Babl A, Berger T, Schindler L. Evaluation des webbasierten PaarBalance®-Partnerschaftsprograms bei beratungsbegleitendem Einsatz. VERHALTENSTHERAPIE 2021. [DOI: 10.1159/000518692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
<b><i>Hintergrund:</i></b> Beziehungsprobleme gehen mit psychischen und physischen Problemen einher. Auch wenn effektive Behandlungsmöglichkeiten existieren, suchen viele Paare spät oder keine professionelle Hilfe. Die Kombination eines Online-Programms mit einer Paarberatung kann helfen, Barrieren wie hohe Kosten, lange Anfahrtswege oder Wartezeiten zu reduzieren und den Zugang zu effektiver Beratung zu erleichtern. <b><i>Methoden:</i></b> Die Studie prüfte die Wirksamkeit des PaarBalance®-Online-Programms zur Verbesserung der Beziehungszufriedenheit in Kombination mit einer niederfrequenten Face-to-Face-Paarberatung in einem unkontrollierten Prä-post-Design. In diesem naturalistischen, an die Routinepraxis der Beratenden (<i>n</i> = 8) angelehnten Design erhielten die 92 Teilnehmenden, welche über die Beratungsstellen oder über Zeitungsartikel rekrutiert wurden, während eines 15-wöchigen Interventionszeitraums neben wenigen Beratungsterminen einen Zugang zum Online-Programm. Gemessen wurde die Auswirkung des kombinierten Unterstützungsangebots auf Beziehungszufriedenheit, Depressivität und Angst zu drei Messzeitpunkten (Prä, Post nach 15 Wochen und Follow-up nach 12 Wochen). Die Daten wurden mit hierarchisch linearen Modellen analysiert. <b><i>Ergebnisse:</i></b> Die Beziehungszufriedenheit verbesserte sich signifikant während der Interventionsphase (Cohens <i>d</i> = 0,29) und blieb während der Follow-up-Phase stabil. Für Depression und Angst zeigten sich keine signifikanten Veränderungen. <b><i>Schlussfolgerungen:</i></b> Die Ergebnisse weisen darauf hin, dass das PaarBalance®-Programm in Kombination mit einer niederfrequenten Paarberatung ein effektives Mittel zur Verbesserung der Beziehungszufriedenheit darstellen könnte. Zukünftige kontrollierte Studien sind nötig, um die Wirksamkeit dieses Modells abschließend zu klären.
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Roddy MK, Rhoades GK, Doss BD. Effects of ePREP and OurRelationship on Low-Income Couples' Mental Health and Health Behaviors: a Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:861-871. [PMID: 32108304 DOI: 10.1007/s11121-020-01100-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Relationship distress is a pervasive problem in the USA that disproportionally impacts couples with low-income levels. The goal of the present study was to evaluate the effectiveness of two online relationship interventions, OurRelationship and ePREP, both of which were supported by a paraprofessional coach, in improving mental health and physical health behaviors with low-income couples. Couples (N = 742) were randomized to either intervention or a 6-month waitlist control group and assessed pre-, mid-, and post-intervention as well at 4 and 6 months after randomization. Results from multilevel models indicated that during treatment, compared to couples in the waitlist group, couples in the intervention groups reported significantly greater improvements in mental health that were small to moderate in magnitude (psychological distress, anger, problematic alcohol use, and perceived stress) as well as improvements in physical health/health behaviors (perceived health, insomnia, and exercise) that were small in magnitude. Furthermore, the differences between intervention and waitlist groups were maintained over follow-up. Treatment gains in both mental health and physical health behaviors were generally stronger for those who began treatment with greater difficulties in those areas. Implications of these findings with regard to intervention and policy are discussed.
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Affiliation(s)
- McKenzie K Roddy
- Department of Psychology, Univeristy of Miami, Coral Gables, FL, USA. .,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX, 77030, USA.
| | | | - Brian D Doss
- Department of Psychology, Univeristy of Miami, Coral Gables, FL, USA
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21
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Zheng C, Ji H. Analysis of the intervention effect and self-satisfaction of sports dance exercise on the psychological stress of college students. Work 2021; 69:637-649. [PMID: 34120941 DOI: 10.3233/wor-213505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND College students are a high-risk subpopulation of psychological disorders. The problem of various adverse phenomena and consequences caused by excessive pressure on college students has gradually become the focus of social and psychological academic circles. However, studies related to individual self-concept and psychological pressure are rare. OBJECTIVE To explore the impact of sports dance exercises on college students' psychological pressure and improve the psychological effects of their self-satisfaction. METHODS College students were taken as research objects, randomly divided into a control group and an observation group. The observation group is intervened with sports dance exercises. The observation group was intervened with sports dance exercises. The stress response characteristic questionnaire and multidimensional self-satisfaction rating scale were utilized to measure college students' conditions before and after the intervention. Finally, the obtained data were statistically analyzed. RESULTS Generally, the psychological stress response of college students was mild, with self-satisfaction and various dimensions at a moderately higher level. No significant differences were discovered in the psychological stress response and self-satisfaction level between the control group and the observation group before intervention (P > 0.05), which were homogeneous. Compared with the data obtained before the intervention, after the intervention, the control group scores were slightly reduced in all dimensions of the psychological stress response and self-satisfaction. In contrast, the scores were significantly increased in the experimental group (P < 0.05). Psychological stress response could reliably explain 30.4%of the total self-satisfaction variance (P < 0.01). The negative self-evaluation was the most important variable affecting self-satisfaction, followed by poor interpersonal communication and poor sleeping quality. CONCLUSIONS Sports dance exercises could alleviate the psychological stress of college students and improve their self-satisfaction. Colleges and universities should include sports dance in the content of optional public courses and encourage more college students to actively participate in sports dance exercises to improve their mental health.
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Affiliation(s)
| | - Honghai Ji
- Changshu Institute of Technology, Changshu, Jiangsu, China
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22
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Megale A, Peterson E, Friedlander ML. How Effective is Online Couple Relationship Education? A Systematic Meta-Content Review. CONTEMPORARY FAMILY THERAPY 2021; 44:294-304. [PMID: 34025019 PMCID: PMC8127847 DOI: 10.1007/s10591-021-09585-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 12/24/2022]
Abstract
Due to logistical and financial barriers that keep many distressed couples from seeking psychotherapy, online relationship education is a more accessible alternative. In the decade since a web-based program showed equivalent effectiveness to traditional marriage education (Duncan et al., 2009), several fully online programs have been developed and evaluated. We reviewed nine studies of four different programs that sampled 2,000 + couples. Specifically, we rated each study's experimental rigor and compared research designs, theoretical and empirical grounding, average post-intervention and follow-up effect sizes, and differential effectiveness. Across studies, measured outcomes included relational (improved satisfaction, quality, confidence, commitment, communication; reduced conflict and aggression) and individual functioning on various indices of mental and physical health, emotional expression, and quality of life. Finally, we discuss the strengths and limitations of the research evidence, describe the two most evidence-based programs (ePREP and OurRelationship) in some detail and make recommendations for future study of these promising kinds of interventions.
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Affiliation(s)
- Allison Megale
- Department of Educational & Counseling Psychology, University At Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222 USA
| | - Emily Peterson
- Department of Educational & Counseling Psychology, University At Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222 USA
| | - Myrna L Friedlander
- Department of Educational & Counseling Psychology, University At Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222 USA
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Roddy MK, Knopp K, Georgia Salivar E, Doss BD. Maintenance of Relationship and Individual Functioning Gains Following Online Relationship Programs for Low-Income Couples. FAMILY PROCESS 2021; 60:102-118. [PMID: 32352573 DOI: 10.1111/famp.12541] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Initial evidence suggests that gains in relationship functioning from brief, web-based programs are maintained through one year following the intervention; however, whether these results generalize to a low-income sample is unclear. Furthermore, previous research from in-person couple therapy suggests there may be different shapes of maintenance slopes for behavioral versus acceptance-based techniques. This study contacted 668 individuals who enrolled in online behavioral (ePREP) or acceptance-based (OurRelationship) programs one year following completion of the program. Multilevel modeling was used to examine linear and quadratic rates of change in the year following the online intervention as well as total amount of change from pretreatment to 12-month follow-up for both relationship and individual functioning. The majority of couples who responded continued to be in a relationship with the same partner (68.3%). Examinations of relationship functioning indicated couples in both programs maintained their gains over follow-up (i.e., no significant linear or quadratic changes), with medium-to-large within-group effect sizes from pre- to one-year follow-up. There were no significant differences in relationship outcomes between OurRelationship and ePREP. Similarly, examinations of individual functioning outcomes indicated couples maintained their gains over follow-up or continued to improve. In total, couples experienced small-to-medium within-group effect sizes from pretreatment to one-year follow-up, with larger effects for individuals who were initially distressed. These results suggest that online programs create lasting change for low-income couples in relationship and individual functioning, with minimal differences between behavioral and acceptance-based orientations.
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Affiliation(s)
| | - Kayla Knopp
- VA San Diego Healthcare System, San Diego, CA
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Keller A, Babl A, Berger T, Schindler L. Efficacy of the web-based PaarBalance program on relationship satisfaction, depression and anxiety - A randomized controlled trial. Internet Interv 2020; 23:100360. [PMID: 33520669 PMCID: PMC7820550 DOI: 10.1016/j.invent.2020.100360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/13/2020] [Accepted: 12/21/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Although relationship distress is strongly associated with mental health problems, poorer social functioning and lower quality of life, only a minority of distressed couples engage in effective couples therapy. Common barriers are the financial burden, fear of being stigmatized, long waitlists and logistical concerns, such as the difficulty in scheduling appointments. Therefore, more accessible help for relationship distress is needed, such as internet-based interventions. METHOD This study evaluates the efficacy of the German web-based PaarBalance program, an 18-sessions online program for couples and individuals in an intimate relationship. Participants with relationship distress recruited via the internet had access to the unguided self-help program for twelve weeks. A total of 117 individuals (N = 60 participated as couples, N = 57 participated without a partner) were randomly assigned to begin the intervention immediately or to a 12-week waitlist control group. The primary outcome was relationship satisfaction. Secondary outcomes included symptoms of depression and anxiety. RESULTS The intervention group showed significant improvement in relationship satisfaction (Cohen's d =0.77) compared with the waitlist control group. Small to medium effect sizes in favor of the intervention group, but no statistically significant differences were found regarding depression (d = 0.43) and anxiety (d = 0.45). CONCLUSION PaarBalance seems to be an effective self-guided intervention to improve relationship satisfaction in people with relationship problems.
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Key Words
- Couples therapy
- DRKS, Deutsches Register Klinischer Studien
- GAD-7, Generalized Anxiety Disorder 7-item Scale
- HLM, Hierarchical linear modeling
- Marriage
- OR, OurRelationship program
- Online
- PFB, Partnerschaftsfragebogen
- PFB-K, Partnerschaftsfragebogen – Kurzform
- PHQ-9, Patient Health Questionnaire 9-item depression scale
- RCT, Randomized controlled trial
- Relationship satisfaction
- SD, Standard deviation
- WHOQOL, World Health Organization quality of life scale
- Web-based interventions
- ePREP, Prevention and Relationship Enhancement Program
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Affiliation(s)
- Alina Keller
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Germany
| | - Anna Babl
- Department of Clinical Psychology and Psychotherapy, University of Bern, Switzerland,Corresponding author at: University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland.
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Switzerland
| | - Ludwig Schindler
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Germany
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Barton AW, Lavner JA, Beach SRH. Can Interventions that Strengthen Couples' Relationships Confer Additional Benefits for their Health? A Randomized Controlled Trial with African American Couples. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 22:386-396. [PMID: 33009991 DOI: 10.1007/s11121-020-01175-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 11/26/2022]
Abstract
This study examined the effects of the Protecting Strong African American Families (ProSAAF) prevention program on adults' self-reported health outcomes 25 months after enrollment. ProSAAF is a couple-focused prevention program specifically designed to meet the needs of African-American families residing in the rural South. African-American couples (N = 346) with an early adolescent child participated in a randomized controlled trial of the program. Dyadic data analyses indicated significant direct effects on changes in couple functioning post-intervention as well as significant indirect effects of ProSAAF on changes in health through post-intervention improvements in couple functioning. These benefits were documented for men's and women's general health, depressive symptoms, and problematic sleep. There were no significant direct effects of ProSAAF participation on changes in health. Findings provide tempered optimism regarding the potential benefits of couple-focused programming for adults' physical, mental, and behavioral health.
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Affiliation(s)
- Allen W Barton
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 2024 Christopher Hall, MC-081, 904 W. Nevada St., Urbana, IL, 61801, USA.
| | - Justin A Lavner
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Steven R H Beach
- Department of Psychology, University of Georgia, Athens, GA, USA
- Center for Family Research, University of Georgia, Athens, GA, USA
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Barton AW, Hatch SG, Doss BD. If You Host It Online, Who Will (and Will Not) Come? Individual and Partner Enrollment in a Web-Based Intervention for Distressed Couples. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:830-840. [DOI: 10.1007/s11121-020-01121-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Because relationship discord and dissolution are common and costly, interventions are needed to treat distressed couples and to prevent distress among vulnerable couples. We review meta-analytic evidence showing that 60-80% of distressed couples benefit from behavioral and emotion-focused approaches to couple therapy, but we also note that treatment effects are weaker in actual clinical practice than in controlled studies, dissipate following treatment for about half of all couples, and may be explained by factors that are common across models. Meta-analyses of prevention programs reveal reliable but smaller effects, reflecting a need to know more about whether and how communication mediates effects, about how risk and diversity moderate effects, and about how technology-enabled interventions can reduce attrition in vulnerable populations. Interventions for couples are improving and expanding, but critical questions remain about how and for whom they work.
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Affiliation(s)
- Thomas N Bradbury
- Department of Psychology, University of California, Los Angeles, California 90095-1563, USA;
| | - Guy Bodenmann
- Department of Psychology, University of Zurich, CH-8050 Zurich, Switzerland;
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Roddy MK, Stamatis CA, Rothman K, Doss BD. Mechanisms of change in a brief, online relationship intervention. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:57-67. [PMID: 31380690 PMCID: PMC6994380 DOI: 10.1037/fam0000569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
[Correction Notice: An Erratum for this article was reported online in Journal of Family Psychology on Nov 14 2019 (see record 2019-69050-001). In the article, the effect sizes listed in the "Mech. slope the effect sizes listed in the "Mech. slope →CSI slope" and "Indirect effect of treatment" columns of Table 2 were calculated incorrectly and mistakenly reported as Cohen's d values. These errors do not change any of the conclusions of the study. However, the correct values, column heads, and associated footnote CSI slope" and "Indirect effect of treatment" columns of Table 2 were calculated incorrectly and mistakenly reported as Cohen's d values. These errors do not change any of the conclusions of the study. However, the correct values, column heads, and associated footnote are presented in the erratum.] Internet delivery of couple interventions is becoming increasingly popular; however, little is known about mechanisms of change during these interventions. One online, self-help relationship intervention-the OurRelationship program-has been shown to improve relationship satisfaction (Doss et al., 2016) during the intervention and to maintain gains through 12-months follow-up (Doss, Roddy, Nowlan, Rothman, & Christensen, 2019). This study seeks to understand mechanisms during and following this program using the same sample of 300 couples (600 individuals) randomly assigned to the program or a waitlist control group. Results from the bivariate growth curves revealed that greater increases in relationship satisfaction during the intervention were explained by improvements in negative communication, emotional intimacy, as well as target problem confidence and severity. However, changes in acceptance of targeted relationship problems, positive communication, and self-protective orientation were not related to changes in satisfaction during the intervention. Additionally, in a multivariate model, relationship target problem severity alone remained significant in the presence of other mechanisms. Improvements in positive and negative communication during the intervention and level of negative communication at the end of the intervention predicted maintenance of gains in satisfaction over 12-month follow-up. Results replicate previous findings that communication (Doss, Thum, Sevier, Atkins, & Christensen, 2005) and emotional intimacy (Doss et al., 2005; Hawrilenko, Gray, & Córdova, 2016) are key components in initial decreases in relationship distress. Furthermore, results suggest that improvements in communication may help couples more effectively navigate problems following the intervention-above and beyond its associations with prepost improvements in satisfaction. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Doss BD, Roddy MK, Llabre MM, Georgia Salivar E, Jensen-Doss A. Improvements in coparenting conflict and child adjustment following an online program for relationship distress. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:68-78. [PMID: 31380688 PMCID: PMC6994328 DOI: 10.1037/fam0000582] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Many children never receive treatment for their mental health symptoms-and those that do often receive it only after years of delay. Given that relationship and parenting conflict is an identified mechanism of child mental health symptoms, reducing distress in the parents' romantic relationship may help reduce this unmet need. In the current study, 213 couples with 1 or more children between the ages of 3 and 17 (inclusive) were randomized to receive the web-based OurRelationship program or to a 2-month waitlist condition. Intervention couples were also assessed in the year following the program. Couples in the OurRelationship program experienced a significant decrease in coparenting conflict during the intervention (Cohen's d = -0.27) but also a significant increase in coparenting conflict in the following year, reducing the long-term effects of the intervention (within-group d = -0.20 at 1-year follow-up compared with baseline). Additionally, parent-reported children's externalizing (within-group d = -0.40) and internalizing (within-group d = -0.27) symptoms significantly decreased from baseline to the 1-year follow-up. As hypothesized, improvement in relationship satisfaction during the program was significantly associated with a decrease in coparenting conflict which, in turn, was associated with reduction in both externalizing and internalizing symptoms in the children. These results indicate that online relationship-focused interventions offer an important, adjunctive approach to meet society's need for reducing children's mental health symptoms. Furthermore, the improvements in child functioning strengthen the evidence suggesting the cost-effectiveness of these relationship-focused interventions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Hatch SG, Roddy MK, Doss BD, Rogge RD, Esplin CR, Braithwaite SR. Texts 4 Romantic Relationships – A Randomized Controlled Trial. JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2019. [DOI: 10.1080/15332691.2019.1667936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- S. Gabe Hatch
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - McKenzie K. Roddy
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Brian D. Doss
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Ronald D. Rogge
- Department of Clinical and Social Science in Psychology, University of Rochester, Rochester, New York, USA
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A randomized controlled trial of different levels of coach support in an online intervention for relationship distress. Behav Res Ther 2018; 110:47-54. [DOI: 10.1016/j.brat.2018.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 08/20/2018] [Accepted: 09/07/2018] [Indexed: 11/18/2022]
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