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Crenshaw AO, Whitfield KM, Collins A, Valela R, Varma S, Landy MSH, Ip J, Donkin V, Earle E, Siegel A, Samonas C, Bushe J, Mensah DH, Xiang A, Doss BD, Morland L, Wagner AC, Fitzpatrick S, Monson CM. Partner outcomes from an uncontrolled trial of Couple HOPES: A guided online couple intervention for posttraumatic stress disorder and relationship enhancement. J Trauma Stress 2023; 36:230-238. [PMID: 36116104 DOI: 10.1002/jts.22878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 11/11/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with significant individual and relationship impairment for people with PTSD and their romantic partners. Conjoint treatments, such as cognitive behavioral conjoint therapy for PTSD (CBCT), are designed to address individual and relationship factors, yet significant barriers impede accessing in-person therapy. Couple HOPES (i.e., Helping Overcome PTSD and Enhance Satisfaction) is a coach-guided, online couple intervention for PTSD based on CBCT that was designed to address these barriers. Previous investigations have found preliminary efficacy of Couple HOPES for improving PTSD symptoms, relationship functioning, and some individual functioning domains for the partner with probable PTSD. However, no study to date has tested individual outcomes for romantic partners, which is needed to fully evaluate the intervention's promise. The current study tested these partner outcomes in a combined, uncontrolled sample of 27 couples. Intent-to-intervene analyses found significant improvements at postintervention in four of eight tested outcomes, including ineffective arguing, g = 0.74; anger, g = 0.32; perceived health, g = 0.67; and quality of life, g = 0.56. Depressive symptoms, generalized anxiety, alcohol misuse, and work functioning did not significantly change, gs = 0.17-0.42. Among participants who completed a 1-month follow-up assessment, generalized anxiety, g = 0.43, and perceived health, g = 0.73, significantly improved over follow-up, whereas anger, g = -0.48, lost gains previously made. Results were largely consistent in the completer sample. These findings show the potential of Couple HOPES to have broad benefits not only for individuals with probable PTSD but also for their romantic partners.
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Affiliation(s)
| | | | - Alexis Collins
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | - Robert Valela
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | - Sonya Varma
- Department of Psychology, York University, Toronto, Canada
| | - Meredith S H Landy
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada.,MindBeacon, Toronto, Canada
| | - Jennifer Ip
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | - Victoria Donkin
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada.,Department of Psychology, York University, Toronto, Canada.,MindBeacon, Toronto, Canada
| | | | - Ashley Siegel
- Department of Psychology, York University, Toronto, Canada
| | - Christina Samonas
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | - Julianne Bushe
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | | | - Angela Xiang
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | - Brian D Doss
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Leslie Morland
- VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Anne C Wagner
- Remedy, 703 Bloor St. W, #201, Toronto, ON, M6G 1L5, Canada
| | | | - Candice M Monson
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
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Monson CM, Wagner AC, Crenshaw AO, Whitfield KM, Newnham CM, Valela R, Varma S, Di Bartolomeo AA, Fulham L, Collins A, Donkin V, Mensah DH, Landy MSH, Samonas C, Morland L, Doss BD, Fitzpatrick S. An uncontrolled trial of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement. J Fam Psychol 2022; 36:1036-1042. [PMID: 35266773 DOI: 10.1037/fam0000976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Novel interventions that overcome limited access to empirically supported psychotherapies for posttraumatic stress disorder (PTSD) are sorely needed. Couple helping overcome PTSD and enhance relationships (HOPES), a guided, online couple intervention drawing from cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson, 2012), was designed to decrease PTSD symptoms and improve relationship satisfaction. The present study is the first uncontrolled trial of 17 couples in which one partner was a military member, veteran, or first responder and had probable PTSD (PTSD + partner) based on self-report assessment. Intent-to-intervene analyses revealed significant improvements from pre- to postintervention in PTSD + partners' self-reported PTSD symptoms (g = .72), as well as their intimate partner's relationship satisfaction (g = .34) and behavioral accommodation of PTSD symptoms (g = .84). There were also significant improvements in PTSD + partners' depression (g = .43) and perceived relationship arguments (g = .62). There were similar results found in the completer sample. There were no adverse events and high satisfaction with the intervention in those who completed the evaluation. These findings provide additional initial data on the safety, feasibility, and efficacy of Couple HOPES. The similarities of intent-to-intervene and completer results, as well as the need for randomized controlled trial designs to test Couple HOPES, are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Fitzpatrick S, Wagner AC, Crenshaw AO, Varma S, Whitfield KM, Valela R, Di Bartolomeo AA, Fulham L, Martin-Newnham C, Mensah DH, Collins A, Landy MS, Morland L, Doss BD, Monson CM. Initial outcomes of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement. Internet Interv 2021; 25:100423. [PMID: 34401382 PMCID: PMC8350611 DOI: 10.1016/j.invent.2021.100423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/30/2022] Open
Abstract
Couple HOPES (Helping Overcome PTSD and Enhance Satisfaction) is a guided, online couple intervention adapted from Cognitive-Behavioral Conjoint Therapy for posttraumatic stress disorder (PTSD). It was created to overcome a range of barriers to accessing evidence-based treatments for PTSD and the intimate relationship problems associated with it. This manuscript describes initial outcomes of the intervention in a series of 10 couples. Participants were military, veteran and first responders with probable PTSD and their intimate partners. Couples completed the program and measurements of PTSD, relationship satisfaction, and secondary outcomes at pre-, mid-, and post-intervention. Mean satisfaction for the program was high and it was completed by seven of ten couples. Participants with PTSD evidenced significant and large pre- to post-intervention effect size improvements in PTSD symptoms (g = 0.80) and perceived health (g = 1.13). They also exhibited non-significant but medium effect size pre- to post-intervention improvements in quality of life (g = 0.62), and depression (g = 0.53), and small effect size pre- to post-intervention improvements in argumentativeness (g = 0.43), anger (g = 0.31), and anxiety (g = 0.31). Partners reported significant and moderate pre- to post-intervention effect size improvements in relationship satisfaction (g = 0.68), and medium but not significant effect size improvements in accommodation of PTSD (g = 0.56). Results provide initial support for the feasibility, acceptability, and efficacy of Couple HOPES for improving PTSD and relationship satisfaction. However, more testing in larger samples, including with randomized controlled designs, is needed.
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Affiliation(s)
- Skye Fitzpatrick
- Department of Psychology, York University, 4700 Keele St., Toronto, ON M3J 1P3, Canada,Corresponding author at: Department of Psychology, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3, Canada.
| | - Anne C. Wagner
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON M5B 2K3, Canada,Remedy, 703 Bloor St. W, #201, Toronto, ON M6G 1L5, Canada
| | - Alexander O. Crenshaw
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON M5B 2K3, Canada
| | - Sonya Varma
- Department of Psychology, York University, 4700 Keele St., Toronto, ON M3J 1P3, Canada
| | - Kristen M. Whitfield
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON M5B 2K3, Canada
| | - Robert Valela
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON M5B 2K3, Canada
| | | | - Lindsay Fulham
- Department of Psychology, York University, 4700 Keele St., Toronto, ON M3J 1P3, Canada
| | - Cait Martin-Newnham
- Department of Psychology, York University, 4700 Keele St., Toronto, ON M3J 1P3, Canada
| | - Desiree H. Mensah
- Department of Psychology, York University, 4700 Keele St., Toronto, ON M3J 1P3, Canada
| | - Alexis Collins
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON M5B 2K3, Canada
| | - Meredith S.H. Landy
- Remedy, 703 Bloor St. W, #201, Toronto, ON M6G 1L5, Canada,MindBeacon, 175 Bloor St. E., Toronto, ON M4W 358, Canada
| | - Leslie Morland
- VA San Diego Healthcare System, San Diego, CA, USA and University of California San Diego, La Jolla, 3350 La Jolla Village Dr., San Diego, CA 92161, United States of America
| | - Brian D. Doss
- University of Miami, 1320 S Dixie Hwy, Coral Gables, FL, 33146, United States of America
| | - Candice M. Monson
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON M5B 2K3, Canada
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