The path to couples therapy: A descriptive analysis on a Veteran sample

The therapeutic alliance in couple therapy: Patterns by treatment and sex in a randomized controlled trial of emotionally focused therapy and treatment as usual

The formation and development of the therapeutic alliance in couple therapy is a complex process and a key contributor to positive treatment outcomes. This study explored differences in trajectories of therapeutic alliance by sex and treatment condition among 24 couples randomized to receive Emotionally Focused Therapy or treatment as usual. The results identified a curvilinear growth pattern for alliance across both treatment groups. Female partners reported higher alliance than male partners after the first session across treatment groups, and female partners receiving Emotionally Focused Therapy reported higher initial alliance than female partners receiving treatment as usual. The rates of change for alliance did not differ by sex or treatment condition. The implications of the change pattern and differences in alliance formation by sex and treatment are discussed.

Brief relationship support as a selective suicide prevention intervention: Piloting the Relationship Checkup in veteran couples with relationship and mental health concerns

INTRODUCTION

Close relationship problems play a key role in many contemporary theories of suicide. However, the potential of relationship support in suicide prevention is understudied. This study explores the feasibility, safety, acceptability, and promise of utilizing the 3-session Relationship Checkup (RC) in veterans with mental health and romantic relationship concerns.

METHODS

We conducted a single-arm pilot of telehealth RC in veterans with a positive mental health screen and their romantic partners. Couples completed baseline and post-treatment assessments of study outcomes.

RESULTS

Feasibility analyses showed we were able to recruit an elevated-risk sample (30% history of attempts or interrupted attempts), take them through the service (90% treatment completion), and had minimal harm events (no suicidal behavior, no physical harm in arguments). Multimethod acceptability analyses suggested high satisfaction with the program, though some desired more intensive services. Couples reported improvements in relationship functioning, emotional intimacy, thwarted belongingness, depression, and posttraumatic stress. Perceived burdensomeness only improved for identified patients and drinking did not change for either partner.

CONCLUSION

The RC is a feasible, safe, and acceptable strategy for providing relationship support to couples at elevated risk. Although further randomized trials are needed, RC shows promise to reduce relationship-level and individual-level suicide risk factors.

Hoe lang wachten mensen voordat zij hulp zoeken voor relatieproblemen? Een onderzoeksnotitie

Een vaak aangehaalde, maar slecht onderbouwde opvatting over relatietherapie is dat koppels gemiddeld zes jaar wachten voordat zij met relatietherapie beginnen voor ernstige relatieproblemen. Deze opvatting gaat vaak hand in hand met het idee dat veel koppels “te laat” komen en dat de vooruitzichten op herstel niet goed zijn. Dit is de eerste studie met een grote steekproef naar de tijd tussen het begin van de relatieproblemen en de start van relatietherapie (N = 270) of individuele therapie (N = 101). We hebben hierin een gemiddelde interval geconstateerd van 2,68 jaar; vanaf het begin van de problemen tot de start van de relatietherapie. De meeste koppels starten binnen twee jaar met de therapie. De bevindingen voor individuele therapie voor relatieproblemen zijn vergelijkbaar. De belangrijkste klinische implicatie is dat therapeuten zich geen zorgen hoeven te maken over het aantal koppels dat zo lang wacht met therapie dat hun problemen niet meer op te lossen zijn.

Trajectories of relationship and individual functioning among waitlisted couples for an online relationship intervention

To inform research and practice with distressed couples, the current study was designed to examine patterns of change among distressed, help-seeking couples prior to receiving an intervention. Data from this study originate from 221 couples assigned to the waitlist control condition of a randomized controlled trial for couples seeking online help for their relationship. All couples self-selected into the online program and agreed to withhold seeking additional services for their relationship during the waitlist period. In contrast with prior findings, results from the current study indicated a general pattern of mean improvement in both self-reported relationship functioning (e.g., increased relationship satisfaction, partner emotional support) and self-reported individual functioning (i.e., decreased psychological distress, anger) over the six-month waitlist period. Nonetheless, the majority of couples continued to remain relationally distressed despite these improvements. Findings from the study indicate that distressed couples can, in fact, exhibit some degree of improvement absent of intervention. At the same time, overall levels of distress remained elevated, indicating that these improvements are not sufficient to result in high levels of functioning and suggesting that many distressed couples may benefit from empirically supported programs to realize greater gains. These results also highlight and underscore the importance of including control conditions in studies examining the efficacy of relationship interventions with distressed couples to ensure that any observed improvements in relationship functioning are attributable to the intervention rather than to naturally occurring changes.

How long do people wait before seeking couples therapy? A research note

A widely cited but poorly supported idea in the couples therapy field is that the average couple waits six years before starting therapy for serious relationship problems. This figure is often accompanied by the notion that many couples come "too late" and have poor prospects for recovery. This is the first large-sample study on the delay between the onset of serious marital problems and entry into couples therapy (N = 270) and individual therapy (N = 101) for relationship problems. We found an average interval of 2.68 years from onset of problems and entering couples therapy, with the great majority of couples entering therapy within two years. Findings were similar for seeking individual therapy for relationship problems. The main clinical implication is that therapists have little reason to be pessimistic about the majority of couples waiting so long before starting therapy that their problems are not resolvable.