Relationship-focused group therapy (RFGT) to mitigate marital instability and neuropsychophysiological dysregulation

This article describes an innovative model of couples therapy designed to mitigate marital instability. The authors suggest that combining ongoing couples therapy with a separate relationship-focused group for each partner favorably impacts each person's neuropsychophysiological regulation and their ability to participate in a stable intimate marriage. The neurobiology of attachment theory is seen as providing understanding of the affect regulation issues operational in many couple relationships. The safe and secure attachments worked out in the relationship-focused group therapy are seen as improving neuropsychophysiological integration and regulation.     

Control of the Mind Edited by Seymour M. Farber and Roger H. L. Wilson

Abstract

This article describes an innovative model of couples therapy designed to mitigate marital instability. The authors suggest that combining ongoing couples therapy with a separate relationship-focused group for each partner favorably impacts each person’s neuropsychophysiological regulation and their ability to participate in a stable intimate marriage.

The neurobiology of attachment theory is seen as providing understanding of the affect regulation issues operational in many couple relationships. The safe and secure attachments worked out in the relationship-focused group therapy are seen as improving neuropsychophysiological integration and regulation.     

The Treatment of Violence and Victimization in Intimate Relationships

This essay presents an analysis of violence in intimate life that draws on multiple theoretical perspectives. These include but are not limited to feminist theory, object relations theory, systems theory, narrative and social constructionist theory, and neurobiology. It is argued that it is possible to be effective in ending violence and abuse through a modified couples treatment format that addresses relationship issues, individual trauma, and biological vulnerability while simultaneously taking a clear, moral position that violence, abuse, and inequality are intolerable in any form.     

Maintenance of Gains in Relationship and Individual Functioning Following the Online OurRelationship Program

In the United States, more than 40% of marriages end in divorce and more than one third of intact marriages are distressed. Unfortunately, only a minority of couples seek couple therapy to improve their relationships. Online interventions, with their increased reach and reduced costs, offer the potential to improve relationships nationwide. The online OurRelationship program has been shown in previous nationwide studies to improve relationship and individual functioning. The present study examined whether initial gains in the OurRelationship program were maintained in the following year and whether the extent of maintenance varied across important demographic and individual factors. In this study, 151 distressed heterosexual couples (302 individuals) who were randomized to the OurRelationship program were assessed 3 and 12 months following the intervention. Initial gains in relationship satisfaction, relationship confidence, and negative relationship quality were maintained through 12 months; positive relationship quality significantly improved over follow-up. Furthermore, couples maintained their initial gains in depressive symptoms, perceived health, work functioning, and quality of life; anxious symptoms continued to significantly decrease over follow-up. Finally, there was no evidence that historically underserved groups—racial/ethnic minorities, lower income couples, or rural couples—experienced greater deterioration. In fact, Hispanic couples reported continued improvement in relationship confidence and negative relationship quality in the 12 months following the program. The ability of the OurRelationship program—an 8-hour, primarily self-help program—to create long-lasting improvements in distressed relationships indicates it may have the potential to improve the lives of distressed couples on a broad scale.     

Participant Perceptions of Relationship Education Programs Adapted for Same-Sex Couples

Mixed methods data were collected from 57 couples who participated in the Strengthening Same Sex Relationships (SSSR) Programs, relationship education programs adapted for same-sex couples. Quantitative and qualitative data yielded key themes, including high program satisfaction, appreciation that the program was designed specifically for same-sex couples, and requests for more detailed content addressing same-sex couples' unique needs. Participants expressed preferences for specialized programs for male or female same-sex couples. Women strongly preferred female sexual minority program leaders; men valued leader competency over match in gender or sexual orientation. Results can inform efforts to provide culturally sensitive relationship education to same-sex couples.     

Non-Violent Communication and Marital Relationship: Efficacy of ‘Emotion-Focused Couples’ Communication Program Among Filipino Couples

Non-Violent Communication (NVC), developed by Dr. Marshall B. Rosenberg, fosters intra- and interpersonal relationship through empathetic and compassionate communication. It has been used and proven effective in a variety of settings like schools, health care centers, jails, and in restorative and rehabilitative institutions. However, the use of NVC in the field of marital relationship is found to be relatively few. The present study aimed at investigating the efficacy of the intervention program, Emotion-Focused Couples’ Communication Program (EFCCP) in a Filipino setting. EFCCP which is an intervention program developed by the researchers based on the constructs of NVC has already been proven to be effective in a previous study involving couples in an Indian setting. This present study was undertaken to investigate the efficacy of the program’s shortened version in the Filipino setting and to test whether the program is culturally suited for Filipino married couples. Relational Communication Scale and Locke–Wallace Marital Adjustment Test were used to measure the level of communication and marital satisfaction among the couples. The EFCCP-Shortened Version was administered to a group of 12 couples for a period of 3 weeks, and the results revealed a significant difference in the level of couples’ communication and marital satisfaction among the participants. These results provided ample indications to the efficacy of the EFCCP-Shortened Version in enhancing communication and enriching marriage quality among couples across diverse settings.     

A Randomized Controlled Trial of Coach Contact During a Brief Online Intervention for Distressed Couples

The negative impacts of relationship distress on the couple, the family, and the individual are well‐known. However, couples are often unable to access effective treatments to combat these effects—including many couples who might be at highest risk for relationship distress. Online self‐help interventions decrease the barriers to treatment and provide couples with high quality, research‐based programs they can do on their own. Using a combined multiple baseline and randomized design, the present study investigated the effectiveness of the Brief OurRelationship.com (Brief‐OR) program with and without staff support in improving relationship distress and individual functioning. Results indicated the program produced significant gains in several areas of relationship functioning; however, these gains were smaller in magnitude than those observed in Full‐OR. Furthermore, effects of Brief‐OR were not sustained over follow‐up. Comparisons between couples randomized to Brief‐OR with and without contact with a staff coach indicated that coach contact significantly reduced program noncompletion and improved program effects. Limitations and future directions are discussed.     

Conflict management: A premarital training program in mutual problem solving

Abstract

The purpose of this study was to evaluate the effectiveness of a structured educational program designed to train premarital couples in communication and mutual problem-solving skills. Twenty-six couples participated in an eight-week, 24-hour problem-solving training program, while 28 similar couples participated in an eight-week, 24-hour relationship discussion group. Results indicated that the problem-solving group, as compared to the relationship-discussion group, showed a significant increase in communication and mutual problem-solving skills. Discussion focused on the benefits for premarital couples of learning effective problemsolving procedures as well as the need for follow-up assessments of both behavioral skill level and relationship satisfaction and adjustment.     

The efficacy of the Triple P-Positive Parenting Program in improving parenting and child behavior: a comparison with two other treatment conditions

The aim of this randomized controlled trial was to evaluate the efficacy of an evidence-based parenting program (the Triple P-Positive Parenting Program), intending to improve parenting skills and children's well-being. Parents participating in a Group Triple P program (n=50 couples) were compared with parents of a non-treated control group (n=50 couples) and parents participating in a marital distress prevention program (couples coping enhancement training (CCET)) (n=50 couples). The two major goals of this study were (a) to evaluate the efficacy of Triple P compared with the two other treatment conditions over a time-span of 1 year and (b) to answer the question whether this program that was developed in Australia is culturally accepted by Swiss parents. Results revealed that Triple P was effective with Swiss families. Mothers of the Triple P group showed significant improvements in parenting, parenting self-esteem, and a decrease in stressors related to parenting. Women trained in Triple P also reported significantly lower rates of child's misbehavior than women of the two other conditions. However, in men only a few significant results were found. Positive effects of the relationship training (CCET) were somewhat lower than those for the Triple P. These findings are further discussed.     

Who Benefits from Couple Relationship Education? Findings from the Largest German CRE Study

In evaluation studies on couple relationship enhancement (CRE) programs, researchers are encouraged to also investigate which couples benefit from program participation. The authors qualified 104 university students to offer an evidence-based CRE program. Up to a 15-month follow-up, the participating couples (N = 234) reported a significant decrease in unsolved relationship conflicts. A 2-day-long intensive training led to better results compared with a weekly format regarding dropouts. Couples with lower pretest satisfaction ratings reported significant improvements over time, whereas couples with initial higher ratings reported no change or a deterioration. Further predictors were identified. The findings should be taken into account in future research.     

Treating survivors of the World Trade Center terrorist attacks of September 11, 2001

As part of an established traumatic stress research and treatment program located in New York City, we experienced the September 11, 2001, terrorist attacks on the World Trade Center first as New Yorkers, but also as professionals with an interest in both treating the survivors and furthering scientific knowledge regarding the neurobiology and treatment of traumatic stress. This paper gives vignettes of calls to our program and the treatment of World Trade Center terrorist attack survivors.     

Improving Young Male Couples’ Sexual and Relationship Health in the 2GETHER Program: Intervention Techniques,Environments of Care,and Societal Considerations

Young male couples are at high risk for acquiring human immunodeficiency virus (HIV). However, few HIV prevention programs meet the needs of young male couples that express an interest in how to maintain healthy relationships. As such, we developed 2GETHER, a couple-based program that integrates HIV risk reduction and sexual health information into a relationship education program specific to young male couples. 2GETHER was guided by cognitive-behavioral theories of HIV risk reduction and relationship functioning and was informed by a social–ecological perspective to address factors within and outside the couple that can impact sexual and relationship health. As a micro-level intervention, 2GETHER intervenes directly with couples via psychoeducation and cognitive-behavioral strategies to change couples’ communication patterns, sexual health behaviors, and relationship satisfaction. Successful implementation of 2GETHER requires mezzo-level interventions that create an affirming environment of care for sexual minority individuals and facilitators who are culturally competent in working with young male couples. Although macro-level interventions to change societal acceptance of and policies germane to sexual minority couples are beyond the scope of 2GETHER, we discuss how clinicians can advocate for systemic changes to improve sexual minority couples’ health, and how 2GETHER addresses the impact of such macro-level factors on the couple’s relationship. Our experience developing and testing 2GETHER indicates that HIV prevention programs for young male couples should reflect the unique contexts shaping sexual minority individuals’ relationships and lives, and that programs should intervene within and across multiple levels when possible to improve health for sexual minority men.     

At-Risk Marriages after Compulsory Premarital Testing and Counseling for β-Thalassemia and Sickle Cell Disease in Saudi Arabia, 2005–2006

Results from a screening program for sickle cell disease and β-thalassemia suggest about 90% of couples in Saudi Arabia at risk of having affected children still decide to marry. This study determined the rate of at-risk marriages and identified several factors that may prevent at risk couples from marrying. The marriage status of 934 at-risk couples was determined from original screening program records in the Ministry of Health. Of 934 couples, 824 married (88.2%) and 110 (11.8%) did not. A case–controlled study was conducted on 104 couples who did not marry (cases) and 478 couples who did marry (controls) in order to assess relationships between various cultural and social factors and marriage decisions. In the case-controled study, 28.8% of couples (30/104) who did not marry (cases) knew their disease or carrier status before screening compared to 18% (86/478) of those who married (controls). Reasons couples gave for proceeding with marriage included: wedding plans could not be canceled, and fear of social stigma. Couples who did not marry reported being influenced by prior knowledge of their disease or carrier status and whether they or family members were affected. Approximately half of the cases and controls (n = 270, 46.4%) thought it best to undergo screening before proceeding with the engagement and wedding plans. Most couples received no advice to participate in genetic counseling services. Marriage decisions for the small number who received genetic counseling (n = 168, 27.6%) did not differ significantly from those that received no counseling. Recommendations are made for improving the effectiveness of this screening program.     

Couples’ Communication as a Predictor of Marital Satisfaction Among Selected Filipino Couples

This study investigated the relation between couples’ communication and marital satisfaction and the possible predictive influence of communication on the marital satisfaction among selected couples of Quezon City, Metro Manila, Philippines. The study was conducted among 82 married couples, and the results showed a significantly positive relationship between couples’ communication and marital satisfaction. Relational Communication Scale and Primary Communication Inventory were used to measure the couples’ communication, while Dyadic Adjustment Scale and Locke–Wallace Marital Adjustment Test were used to measure the marital satisfaction among the couples. A regression analysis of the data significantly showed that 90.4% of variance in marital satisfaction can be accounted for by couples’ communication. The results carry clear and meaningful implications for the role of couples’ communication in building and maintaining happy and satisfying marital relationship. This correlational and predictive study was undertaken to explore the need as well as the scope of a couples’ communication program for enhancing marital satisfaction.     

The effects of interpersonal skills training on sex-role identity of premarital dating partners

The purpose of the present study was to assess the effects of a problem-solving skills training program on sex-role identity. It was hypothesized that individuals in a problem-solving skills training program would show greater movement toward androgyny relative to a control group. Twenty-six premarital couples were assigned to a problem-solving skills training program and 29 couples served as a contact control group. An analysis of covariance was performed on the Bem Scale masculine and feminine scores to test the effects of group and sex. Results indicated that the experimental group, as compared to the control group, was significantly higher on femininity following treatment. Discussion centered on the implications of being able to change sex-role identity as well as the need to further explore means of facilitating the development of androgyny in adults.     

Heteronormative Relationship Education for Same‐Gender Couples

In recent years, same‐gender group‐based relationship education has emerged as a viable intervention to prevent relationship distress among same‐gender couples. However, many of these programs are conducted in metropolitan areas and lack the ability to reach rural populations. The current study sought to investigate whether two wide‐reaching web‐based heteronormative relationship education programs could positively impact same‐gender relationships. In a sample of 49 same‐gender couples, heteronormative relationship education had small (Cohen's d = 0.16–0.39) but reliably positive effects on key areas of relationship functioning and perceived stress relative to a waitlist control group. Additionally, when same‐gender couples were matched with different‐gender individuals with similar baseline characteristics, no reliable differences between the two groups emerged even though the program effects were sometimes half as large for same‐gender couples. Finally, same‐gender participants were as satisfied with the program as the matched different‐gender individuals. Though the results of the present study indicate that heteronormative relationship education can be helpful for same‐gender couples, additional tailoring should be undertaken to ensure that same‐gender couples experience as much benefit as possible. Estimates from the current study could be used in future studies to detect what might be small‐sized differences.     

Group training in communication skills for couples: A preliminary report

Abstract

This article reports on the initial development and evaluation of a group skill-training program for couples. The program, entitled the Communication Skills Workshop (CSW), aims at improving communication and problem-solving skills within the context of relationships. The orientation of the CSW is preventive and educational in that it (a) serves couples prior to the onset of serious relationship discord, and (b) focuses on the learning of general communication skills and problem-solving strategies rather than the amelioration of specific relationship conflicts.     

A Component Analysis of Marriage Enrichment: Information and Treatment Modality

Two primary components were identified in marriage enrichment programs: information about marital life (or none) and discussion among married couples (or none). Student couples (N = 36) volunteered for a marriage enrichment program and were assigned to one of four conditions: (1) assessment only, (2) information only (received by couples), (3) an unstructured discussion group, and (4) a structured group with both information and group discussion. Information had little apparent effect on couples, but discussion in groups improved couples' marriage satisfaction and their sexual and intellectual intimacy throughout the study relative to couples not receiving group discussion. Improvement was thought to be due to the group discussion heightening couples' attention to how they use their time as a couple.     

Greater emotional arousal predicts poorer long-term memory of communication skills in couples

Many studies have examined the importance of learning skills in behaviorally based couple interventions but none have examined predictors of long-term memory for skills. Associations between emotional arousal and long-term recall of communication skills delivered to couples during a behaviorally based relationship distress prevention program were examined in a sample of 49 German couples. Fundamental frequency (f(0)), a vocal measure of encoded emotional arousal, was measured during pre-treatment couple conflict. Higher levels of f(0) were linked to fewer skills remembered 11 years after completing the program, and women remembered more skills than men. Implications of results for behaviorally based couple interventions are discussed.     

Relationship Education for Military Couples: A Pilot Randomized Controlled Trial of the Effects of Couple CARE in Uniform

Military life can place excess strain on couple relationships. The Couple CARE relationship education program was tailored to address the challenges of military couples. Thirty-two Australian military couples participated in a pilot feasibility study assessing the Couple CARE in Uniform adaptation against an active control. Relationship satisfaction and communication improved in both conditions, with no significant difference between the conditions. Couples' high relationship satisfaction on presentation, paired with modest statistical power, might have contributed to the null results. However, Couple CARE in Uniform had significantly higher consumer satisfaction than the comparison condition, suggesting it is a program worthy of further evaluation.