Publication year
2012
Citation Title
Couple therapy for military veterans: Overall effectiveness and predictors of response
Journal Name
Behavior Therapy
Journal Volume
43
Issue Number
1
Page Numbers
216-227
DOI
doi.org/10.1016/j.beth.2011.06.006
Summary
Data from 177 couples who attended therapy at two Veteran medical centers were used to examine the effectiveness of couple’s therapy on relationship satisfaction. The influence of demographic, relational, and psychological characteristics was also explored. Results indicated that therapy effectively increased relationship satisfaction and only race was found to influence this relationship.
Key Findings
Although 62% of couples terminated therapy early, those who continued the course of therapy showed gains in relationship satisfaction.
Couples who indicated higher levels of distress at the onset of therapy experienced more gains in relationship satisfaction compare to couples who were considered non-distressed.
Black participants showed significantly more gains in relationship satisfaction over the course of therapy compared to White participants.
Implications for Program Leaders
Provide education to military couples to enhance positive communication skills to help couples effectively cope with relationship issues
Disseminate information regarding which programs and services support Service members and their families
Provide training for civilian service providers who work with military members regarding the unique challenges military members face
Implications for Policy Makers
Promote reintegration programs for Service members and their partners that focus on the couple relationship and positive ajustment once a Service member returns
Continue to provide support for programs and services specifically aimed at helping Service members and their families
Encourage collaboration among military and civilian service providers to help meet the needs of the military couples and families they serve
Methods
Couples presenting at two Veterans Affairs Medical Centers between June 2004 and November 2007 were recruited to participate in the study.
Participates completed an initial battery of intake questions regarding demographics, psychological symptoms, and relationship issues.
Couples also completed weekly questionnaires that addressed relationship satisfaction and these scores were used to examine the effectivess of therapy.
Participants
A total of 177 heterosexual couples (354 individuals) participated, resulting in a response rate of 82%.
The majority of participants were married (85%), White (70% of men, 68% of women), and middle-aged with a mean age of 49.8 years for men and 46.5 years for women.
Seventy-six percent of women and 61% of men scored within the distressed range for relationship satisfaction.
Limitations
The two Veteran clinics utilized different treatment approaches, which makes it difficult to make comparisons between the two clinics.
Veteran couples in the current study were older so results may not be generalizable to Veterans who are younger and served in OIF/OEF.
Without a control group, it is difficult to understand how much influence couple's therapy had on relationship satisfaction.
Avenues for Future Research
Examine why couples terminate therapy prematurely and explore ways to reduce the rate of premature termination
Investigate how different treatment approaches influence the rate of therapy's effectiveness on couple’s relationship satisfaction
Explore how demographic characteristics, such as race and gender, influence therapy outcomes for military couples
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Abstract
Despite the numerous challenges facing U.S. veterans and their relationships, there have been no examinations of the effectiveness of couple therapy for relationship distress provided to veterans. In the present study, 177 couples presenting for couple therapy at two Veteran Administration Medical Centers completed assessments of relationship satisfaction prior to therapy and weekly during therapy. Results revealed that the average couple showed significant gains in relationship satisfaction during treatment (d = 0.44 for men; d = 0.47 for women); gains were larger for couples beginning therapy in the distressed range (d = 0.61 for men; d = 0.58 for women) than for couples in the nondistressed range (d = 0.19 for men; d = 0.22 for women). Rates of premature termination were high, with 19% of couples completing fewer than three sessions and 62% rated as not completing a “full course” of therapy. Benchmarking analyses demonstrated that the average gains were larger than would be expected from natural remission and similar to previous effectiveness trials; however, average gains were smaller than those observed in couple therapy efficacy trials. Relationship, psychological, and demographic characteristics were generally unrelated to the amount of change in therapy after controlling for initial satisfaction. However, African American couples showed significantly larger gains than Caucasian, non-Hispanic couples. Thus, though yielding smaller effects than those shown in efficacy trials, the impact of couple therapy for veterans’ relationship problems appears to generalize across various demographic, psychological, and relationship characteristics.
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