Publication year
2017
Citation Title
Long-term effectiveness of treatment-as-usual couple therapy for military Veterans.
Journal Name
Behavior Therapy
Journal Volume
48
Page Numbers
847-859
DOI
10.1016/j.beth.2017.05.007
Summary
Veterans often face relationship problems that may be partially due to their military experiences (e.g., combat exposure); however, little is known about the long-term effect of couples therapy on Veterans. This study included 238 participants from 125 couples (at least one partner of each couple was a Veteran). Each participant completed questionnaires regarding relationship satisfaction, intimate partner violence (IPV), and psychological symptoms before and 18 months after couples therapy. Results indicated positive effects of couples therapy on Veterans.
Key Findings
Participants reported increased relationship satisfaction and reduced psychological symptoms and IPV 18 months after the couples therapy.
The long-term effectiveness of the couples therapy was not influenced by participants' pre-treatment characteristics (e.g., demographics, relationship satisfaction, psychological status).
Participants with IPV before the treatment reported larger improvements in relationship satisfaction 18 months after the treatment compared to participants without IPV. In addition, compared to younger participants, older participants were less likely to show reductions in psychological symptoms after the treatment.
Implications for Program Leaders
Develop relationship education workshops for military families in order to increase their marriage satisfaction
Disseminate information regarding useful resources for military couples who have relationship problems
Promote the benefits of couples therapy intervention for IPV offenders
Implications for Policy Makers
Support relationship education programs that aim to improve relationship satisfaction and reduce IPV in military families
Recommend that all military couples who are in serious relationship distress be offered couples therapy
Encourage the training of professionals who work with military families on common risk factors that may reduce marital satisfaction
Methods
Couples were recruited from two Veteran Administration Medical Centers; they were contacted by the research staff if they were suitable for couples therapy and at least one partner of each couple was a Veteran.
Each participant completed an initial questionnaire, received couples therapy, and completed a follow-up assessment approximately 18 months after the therapy. For this study, measures included demographics, relationship satisfaction, IPV, and psychological symptom.
Data were analyzed to examine the long-term effect of couples therapy on relationship satisfaction, IPV, and psychological symptoms.
Participants
Participants were 113 heterosexual couples and 12 additional individuals whose partner did not complete the study (238 individuals in total); at least one partner of each couple was a Veteran.
The average ages of the male and female participants were 50.66 years (SD = 13.77) and 47.81 years (SD = 12.77), respectively.
The majority of participants were White (72% of men and 65% of women) and Black (15% of men and 18% of women); the race/ethnicity of the remaining 13% male and 17% female participants was not reported.
The military branches that the Veterans used to serve in was not collected or reported.
Limitations
There was no control group, so the observed improvements could be due to factors other than the therapy.
Only self-report data were used in the study, so the findings could be subject to social-desirability and memory bias.
Only heterosexual couples were included in the study, so caution must be taken to generalize the results to homosexual couples.
Avenues for Future Research
Assign couples randomly to a treatment group and a control group so that the effect of couples therapy can be separated from other factors (e.g., the willingness to seek help) that may potentially lead to improved relationship satisfaction and reduced psychological symptoms
Recruit both heterosexual and homosexual couples so that the findings can be better generalized
Use both subjective (e.g., self-report) and objective (e.g., hospital records) data so that the results are more reliable
Focus
Multiple Branches
Target Population
Population Focus
Abstract
Despite the fact that veterans face increased psychological and relationship distress as a result of their service-related experiences, no study to date has explored the long-term effectiveness of couple therapy for veterans. In the present investigation, 238 individuals (113 couples and 12 additional individuals) completed assessments 18 months after termination of treatment-as-usual couple therapy at two Veteran Administration Medical Centers. From pretreatment to 18-month follow-up, couples experienced significant increases in relationship satisfaction (d = 0.59) and significant decreases in both psychological distress (d = -0.31) and presence of intimate partner violence (d = -0.47). Overall, pretreatment demographic, psychological, and relationship characteristics did not significantly moderate maintenance of gains across 18 months. However, African American individuals (d = -0.58) and individuals not reporting intimate partner violence at pretreatment (d = -0.46) experienced smaller improvements in relationship satisfaction through 18-month follow-up. Further, older participants showed smaller reductions in psychological symptoms 18 months after treatment (d = 0.16). Thus, for many veterans and their spouses, treatment-as-usual couple therapy is effective at intervening in psychological and relationship distress long-term. Moreover, the long-term effectiveness of couple therapy with veterans appears to generalize across many demographic, intrapersonal, and interpersonal factors.
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