Improvements in depressive symptoms following a brief relationship intervention

In the United States, 21 million adults are diagnosed with depression. Couple therapy effectively treats depression, however, couples encounter access barriers. The Relationship Checkup is an assessment and feedback intervention delivered in participants\u27 homes. The current study examines changes in relationship satisfaction and depressive symptoms, and moderators and mechanisms of change in a community sample (N = 85 couples). Changes in depressive symptoms and satisfaction, and the association between changes in satisfaction and depressive symptoms were examined with multilevel modeling. Depressive symptoms (Cohen\u27s d = 0.36) and satisfaction (d = 1.43) improved from baseline to 1-month follow-up, with greater declines in depression (d = 0.44) for those with more severe symptoms. Increases in satisfaction were associated with decreases in depressive symptoms (d = 0.23), and decreases in depressive symptoms were associated with increases in satisfaction (d = 0.33). Individuals with depression and relationship distress may be well served by this intervention. © 2023 The Authors. Journal of Marital and Family Therapy published by Wiley Periodicals LLC on behalf of American Association for Marriage and Family Therapy

Is pregnancy a teachable moment for smoking cessation among US Latino expectant fathers? A pilot study

Pregnancy may be a time when US Latino expectant fathers consider quitting smoking. A ‘teachable moment’ is theorized to increase motivation to change a behavior through increased risk perceptions, emotional responses, and changes in self-image

The Co-occurrence of Daily Smoking, Binge Drinking and IPV Among Latino Expectant Fathers

Many Latino men have multiple risk factors that predispose them to chronic disease morbidity and mortality, yet few have examined patterns in this population. We describe the co-occurrence of daily smoking, binge drinking, and intimate partner violence (IPV) behaviors among Latino expectant fathers and examine factors associated with the co-occurrence of these behaviors. We conducted a secondary analysis of baseline data from the Parejas Trial, a randomized controlled trial testing a culturally tailored couples-based smoking cessation intervention. We used Kruskal-Wallis test statistics to explore the relationship of the co-occurring behavior and demographic and cultural factors. All participants smoked as was a requirement of being in the trial, but only 39% smoked daily. Forty three percent of the participants engaged in one behavior, 32% engaged in two behaviors, and 5% engaged in three behaviors, with binge drinking being the most common co-occurring behavior. In the bivariate analysis, higher stress (p = 0.01) and having more children (p = 0.003) were found to be positively significantly associated with the number of behaviors. Helping Latino expectant fathers manage with their stress may serve as tailoring points for future interventions to reduce risk behaviors

Dyadic latent profile analyses and multilevel modeling to examine differential response to couple relationship education

There are mixed evaluations of couple relationship education indicating that these types of interventions may be more or less effective depending on the couple type and demographic differences. However, this ambiguity requires more investigation with advanced statistical analyses that use a person-centered approach such as mixture modeling. We tested this hypothesis with a sample of different-sex couples (N = 455 couples) who participated in a brief in-home couple intervention. We used dyadic latent profile analysis to determine possible relationship health typologies (RHTs) of presenting couples and multilevel models to examine differential intervention effectiveness between these RHTs. Results indicated there were 3 RHT: Partners Below Average with Wife Much Lower RHT (18%), Partners Below Average with Men Slightly Lower RHT (26%), and Partner Both Above Average RHT, (56%). RHTs did not differ by demographics. Below Average and Wife Lower RHTs responded the best to the brief couple intervention. In sum, we find that a brief intervention that targets the specific concerns of the couples may improve outcomes for multiple RHT

Examining the role of therapeutic alliance and split alliance on couples’ relationship satisfaction following a brief couple intervention

The therapeutic alliance is considered to be one of the most important elements in successful individual therapy and many types of couple, marital, and family therapy. The alliance involves a bond that is developed through investment, mutual agreement, and collaboration on tasks and goals. While substantial evidence exists that the therapeutic alliance plays an important role in multiple aspects of therapy outcomes for individuals, far less empirical attention has been given to the alliance in couple therapy. A primary reason for the dearth of research on alliance within a couples context is the complexity of measuring multiple alliances that interact systemically. The present study sought to examine if a facilitator’s perceived alliance is predictive of the couple’s alliance, and how differences in alliance scores between individuals may impact relationship satisfaction at 1-month follow-up. These questions were examined using data from a brief, two-session intervention for couples, known as the “Relationship Checkup.” Using structural equation modeling, we found that facilitator report of alliance positively predicted both men and women’s report of alliance with the facilitator. Results also indicated that couples who were split on the strength of the alliance had worse outcomes at 1-month follow-up, and split alliance between wives and the facilitator indicated worse outcome for men at 1-month follow-up. Overall, these data suggest that the alliance is an important element for successful brief interventions for couples

Accepted for the Council:

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Your place or mine?: examining the accessibility and efficacy of a brief, home-based, couple intervention

Interventions for couples that can be flexibly delivered (e.g., home) are gaining traction in the field of couple therapy, particularly for underserved couples who experience barriers to accessing traditional methods of care. However, questions remain regarding what types of couples prefer the home over traditional clinic settings and whether there are differences in treatment effectiveness in the home versus a clinic setting. The present study sought to address these gaps in the literature. Using a secondary data analysis approach, data from 339 couples who participated in a brief, relationship intervention were examined. Couples were able to select where they wanted to participate (i.e., their home or a local clinic). Logistic regression analyses revealed that parents were significantly more likely to choose to participate in the intervention at their home relative to nonparents. No differences in intervention setting emerged as a function of marital status, racial/ethnic minority status, or poverty status. Three 2-level multilevel models indicated that, at baseline, couples presented with similar attitudes toward relationship help seeking and relationship satisfaction across settings as well as established a similar alliance with the facilitator at 1 month after the intervention. Additionally, a series of 3-level multilevel models found that rates of change did not significantly differ between groups on attitudes toward relationship help seeking and relationship satisfaction across the intervention. Thus, despite the potential chaos of the home, home settings appear to be an equally effective delivery setting relative to traditional settings for this brief relationship intervention and may be particularly useful for reaching parents

Couple variables predicting retention in a brief intervention and research

Therapy is an effective form of treatment for couple distress; yet, research shows that 20%–60% of couples terminate treatment prematurely. Predictors of couple retention in therapy and research are unclear, particularly for couples from marginalized populations, which has important implications for the quality and generalizability of research results, and the benefits derived from therapy are limited when participants are not retained. The purpose of this study (N = 1310) was to identify couple-level variables that predict (1) retention in a brief, two-session couple intervention (The Relationship Checkup) delivered as a home visitation program and (2) retention in research participation at 1- and 6-month follow-up. Hypotheses were tested using a two-level multi-level model. Couples are significantly less likely to be retained in the brief intervention if (1) at least one partner identifies as Asian, Pacific Islander, or Native American, (2) at least one partner identifies as Hispanic/Latinx, or (3) both partners report mental or emotional health as a concern in their relationship. Couples are significantly less likely to be retained in research if (1) at least one partner identifies as Asian, Pacific Islander, or Native American (1 month only), (2) at least one partner identifies as Hispanic/Latinx (1 and 6 months), (3) if either partner reports clinically significant relationship distress at baseline (1 and 6 months), or (4) if either partner reports relationship aggression at baseline (6 months only). These findings are discussed with relevance to clinicians and researchers to recruit and retain more diverse and marginalized participants in couple interventions and follow-up research

An Implementation study of relationship checkups as home visitations for low-income at-risk couples

Couples with the greatest need for relationship health maintenance and intervention are often least able to afford and access it; therefore, accessible, affordable, effective, and brief interventions are needed to improve relationship health for those who need it most. Consequently, this paper examined whether a brief relationship intervention could be effectively implemented with a low-income, underserved population. All enrolled participants (N = 1,312) received the Relationship Checkup, which consists of an assessment and a feedback session delivered in their homes or at a local clinic at their request. Measures assessed relationship satisfaction, communication, psychological and physical aggression, and intimacy at baseline and 1-month follow-up, and program and relationship satisfaction at 6-month follow-up. All participants reported significant improvements on all outcomes with small effect sizes. However, moderation analyses suggested that distressed couples reported significantly larger effects across the board. Overall, participants reported that they were highly satisfied with the intervention both immediately after its delivery and 6 months later. Findings provide preliminary support for the effectiveness of this brief checkup and point to the utility of offering these kinds of low-cost brief interventions in flexible formats for those who might have the most difficulty accessing them