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Sexual Minority couples, those who identify as lesbian, gay, bisexual, trans, queer or other (LGBTQ), have voiced a desire for LGBTQ-affirmative couple interventions, and researchers have suggested theoretical adaptations to address this need. However, to date no LGBTQ-affirmative adaptations of general couple interventions have been developed and assessed. The present study assessed the feasibility, acceptability, and effectiveness of an LGBTQ-affirmative adaptation of a preventive, two-session relationship intervention, The Relationship Checkup (RC). In this pilot study, adaptations were made based on recommendations from existing literature, consultation with experts in the field, and conversations with LGBTQ-identified individuals. Data from eighteen couples who completed the intervention suggest that the LGBTQ-RC is feasible and acceptable to participants. Results indicate that the LGBTQ-RC improved both individual and relationship well-being and was viewed by participants as LGBTQ-affirmative. These findings support the effectiveness of utilizing an affirmative stance and addressing LGBTQ-specific issues in couple interventions. [ABSTRACT FROM AUTHOR]

The association between relationship functioning and depressive symptoms is well established. This study examined the effects of the Marriage Checkup, a brief two-session Assessment and Feedback relationship intervention, on depressive symptoms. Two hundred and nine married couples participated in the Marriage Checkup and were randomized into Treatment (N = 108) and Waitlist-Control Conditions (N = 101). Compared to the control condition, intervention participants reported significant improvements in depressive symptoms (d = 0.55), with an even greater effect for those who were reporting more severe baseline depression symptoms (d = 0.67). These outcomes are comparable to those within long-term individual psychotherapy, couple therapy, and pharmacology trials, making this the briefest intervention to date to demonstrate significant improvements in depressive symptoms. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

In this study, we examined mediators of a brief couples intervention. Intimate safety, acceptance, and activation were examined in 2 roles: their contribution to marital satisfaction gains in the first 2 weeks after treatment (contemporaneous effects), and how early changes in the mediators influenced longer term changes in marital satisfaction over 2 years of follow-up (lagged effects). Married couples (N = 215) were randomized to either an intervention group or a wait-list control group and followed for 2 years. Latent change-score models were used to examine contemporaneous and time-lagged mediation. A booster intervention in the 2nd year was used for a replication study. Changes in intimate safety and acceptance were uniquely associated with contemporaneous treatment effects on relationship satisfaction in Year 1, but only acceptance was uniquely associated with contemporaneous effects in Year 2. With respect to lagged effects, early changes in acceptance partially mediated later changes in marital satisfaction in Year 1, whereas the same effect for intimate safety was marginally significant. These lagged paths were moderate in size and indirect effects were small. No lagged effects were significant in Year 2. Change in activation was not significant as either a contemporaneous or a lagged predictor of change in relationship satisfaction. We found moderate support for acceptance and more limited support for intimate safety as mediators of short- and long-term treatment response, suggesting that these processes play an important role in sustaining marital health. [ABSTRACT FROM AUTHOR]

Introduction: Close relationship problems play a key role in many contemporary theories of suicide. However, the potential of relationship support in suicide prevention is understudied. This study explores the feasibility, safety, acceptability, and promise of utilizing the 3‐session Relationship Checkup (RC) in veterans with mental health and romantic relationship concerns. Methods: We conducted a single‐arm pilot of telehealth RC in veterans with a positive mental health screen and their romantic partners. Couples completed baseline and post‐treatment assessments of study outcomes. Results: Feasibility analyses showed we were able to recruit an elevated‐risk sample (30% history of attempts or interrupted attempts), take them through the service (90% treatment completion), and had minimal harm events (no suicidal behavior, no physical harm in arguments). Multimethod acceptability analyses suggested high satisfaction with the program, though some desired more intensive services. Couples reported improvements in relationship functioning, emotional intimacy, thwarted belongingness, depression, and posttraumatic stress. Perceived burdensomeness only improved for identified patients and drinking did not change for either partner. Conclusion: The RC is a feasible, safe, and acceptable strategy for providing relationship support to couples at elevated risk. Although further randomized trials are needed, RC shows promise to reduce relationship‐level and individual‐level suicide risk factors. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the efficacy of the marriage checkup, as adapted to integrated primary care settings and active-duty military couples, for improving relationship health and depressive symptoms. Method: Married couples (N = 244, Mage = 32.4, 67.6% Caucasian) in which at least one member was active-duty Air Force were recruited from bases across the U.S. via online advertisement, emails sent from medical clinics to enrolled beneficiaries, social media posts, and flyers, and randomly assigned to active treatment or waitlist control. Treatment and control couples were linked in pairs sequentially and pairs completed nine sets of questionnaires at baseline, 1-, and 6-month posttreatment. Outcome measures included the Couples Satisfaction Index, Intimate Safety Questionnaire, Responsive Attention Scale, Partner Compassion Scale, Communication Skills Test, and the Center for Epidemiologic Studies Depression Scale. Results: A three-level multilevel model indicated, after adjustment for multiple comparisons, treatment couples experienced statistically significant small-to-moderate improvements compared to the control group (Cohen's d from 0.21 to 0.55) at 1 month that were sustained at 6 months for relationship satisfaction, responsive attention, compassion toward their partners, communication skills, intimate safety, and depressive symptoms. Conclusions: A longitudinal randomized control trial of the MC supports the hypothesis that the MC significantly improves relationship satisfaction, intimacy, communication, partner compassion, responsive attention, and depressive symptoms. Implications for theory, treatment, and dissemination are discussed. What is the public health significance of this article?: Poor marital relationship quality is positively associated with a multitude of negative health outcomes. Effective tertiary couple therapies exist but are underutilized and have limited reach into the population. We adapted a brief prevention and early intervention relationship health protocol for use with military couples in integrated primary care. The marriage checkup attracted couples across the continuum of relationship health and significantly improved relationship quality compared to a control condition. Brief preventative interventions lower barriers to care, prevent health deterioration, and effectively improve relationship health functioning. [ABSTRACT FROM AUTHOR]

Same-gender couples face unique sexual minority stressors that significantly impact individual and relationship health. This impact may be even greater among same-gender couples living in regions where there are pervasive social and legal biases that affect the lesbian, gay, bisexual, transgender, queer and/or questioning, intersex, asexual, two-spirit (LGBTQIA2S+) community (e.g., south central Appalachia). Brief relationship interventions, like the relationship checkup, are effective at improving relationship health and can be widely disseminated due to the brief and flexible nature of the program. Yet, this program was developed for different-gender couples and, as a result, may lack specific intervention for the unique stressors of same-gender couples. While many skills delivered in relationship interventions, including the relationship checkup, are applicable to all couples, untailored interventions for same-gender couples may result in less impactful outcomes. The present study examined whether the relationship checkup, in its original, unadapted format, is as effective for same-gender couples as it is for different-gender couples. Using a subsample from the larger relationship checkup study (N = 656 couples), the present sample included 64 committed couples (same-gender = 32; different-gender = 32). We used propensity score matching to match different-gender participants to the same-gender participants based on racial minority status, poverty status, marital status, and parenting status. Results revealed that same-gender couples presented similarly to different-gender couples on baseline relationship functioning and changed similarly on all relationship functioning outcomes through 1-month postintervention. Same-gender couples also reported similar degrees of satisfaction with and perceived helpfulness of the relationship checkup. The relationship checkup appears to be equally effective and acceptable for same-gender and different-gender couples. [ABSTRACT FROM AUTHOR]

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. (PsycInfo Database Record (c) 2020 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Introduction: There are substantial health disparities in Appalachia partially due to the poor access and utilization of health care. Social support, especially in Appalachia, is consistently linked to the utilization of available health care. The present study aims to identify how on aspect of social support, relationship functioning, are associated with health care utilization for couples in Southern Appalachian.Method: Individual and couple data (N = 147, individuals; n = 76, couples) were collected from participants interested in a brief couple interventions. Individuals and Dyadic Path analyses were conducted in Mplus using methods to account for the dependence in the data.Results: Relational aggression was the only marital factor linked to health care utilization in multivariate analyses while constructive communication was only linked to health care utilization in bivariate correlations, r = .24, p < .05. Dyadic results indicate that men's health care utilization may benefit from partner's relational aggression while women's utilization may be negatively influenced by her own self-reported relational aggression.Discussion: An individual's social context must be considered in order to completely understand barriers to health care utilization. Further, the inclusion of couple/dyadic level interventions should be considered in order to improve health care utilization in the Appalachian region and similarly rural regions. (PsycInfo Database Record (c) 2020 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

The overall objective of this study was to pilot the Marriage Checkup (MC), a brief intervention for enhancing marital resiliency tailored to a military population, for use by internal behavioral health consultants (IBHCs) working in an integrated primary care clinic. The MC was revised to fit into the fast-paced environment of primary care (e.g., streamlined to fit within three 30-min appointments), and military-relevant material was added to the content. IBHCs working in primary care were then trained to offer the intervention. Thirty participants were enrolled in the study and completed a relationship checkup and one-month follow-up questionnaires. Analysis of post-test and one-month follow-up data showed statistically significant improvements in participants' marital health compared to pre-treatment. The MC intervention appeared to be well received by both couples and IBHCs. [ABSTRACT FROM AUTHOR]

Relationship conflict and lack of partner support are risk factors for perinatal mood and anxiety disorders. An intervention to strengthen couples' relationships before birth may reduce relationship risk factors for perinatal mood and anxiety disorders, though no research has explored this to date. The aims of this Stage 1 open-series non-experimental proof of concept study were to adapt the 'Marriage Checkup', an evidence-based intervention for relationship distress, as a preventative intervention for perinatal mood and anxiety disorders and to assess its feasibility and acceptability. Pregnant women receiving care at a university-based obstetric practice, and their partners, were recruited. Ten couples participated in the Before Baby Relationship Checkup, a personalized relationship health service offered in the obstetric clinic. Quantitative and qualitative data gathered suggests the intervention is feasible to implement in an obstetric setting, and acceptable to perinatal couples. Specific adaptations to the Marriage Checkup for perinatal couples are warranted and further testing is needed to evaluate efficacy. [ABSTRACT FROM AUTHOR]

Understanding how partners' perceptions of their relationships predict couple distress and treatment outcomes can inform relationship interventions, because consensus on pretreatment relationship concerns has previously been related to better treatment outcomes. However, whether consensus specifically about relationship concerns is beneficial, or whether consensus more generally (e.g., about couples' strengths) is also related to distress and treatment outcomes, is unknown. Therefore, to replicate and extend previous findings, the present study examined how 740 couples' consensus regarding their relationship strengths and concerns was associated with their relationship distress and satisfaction from pre- to postintervention after completing the Relationship Checkup (an adaptation of the Marriage Checkup). Couples who presented with greater initial consensus on relationship concerns were less likely to be clinically distressed pre- and postintervention. Broadly, there were similar significant gains in relationship satisfaction from pre- to postintervention regardless of couples' initial level of consensus on concerns. However, when distress was modeled categorically, couples with lower initial consensus on concerns showed greater improvement in distress levels than did those with higher consensus. There were no associations between partners' consensus on strengths and their distress or satisfaction pre- or postintervention. Results indicate that a brief integrative relationship intervention can decrease relationship distress, even for couples that present with very different opinions about their relationship concerns. Implications of brief and acceptance-based models in couple education and therapy are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the efficacy of the Marriage Checkup (MC) for improving relationship health and intimacy. Method: Cohabiting married couples (N = 215, Mage women = 44.5 years, men = 47 years, 93.1% Caucasian) recruited from a northeastern U.S. metropolitan area through print and electronic media were randomly assigned to MC treatment or wait-list control. Treatment but not control couples participated in assessment and feedback visits, at the beginning of the study and again 1 year later. All couples completed 9 sets of questionnaires over 2 years. Outcome measures included the Quality of Marriage Index, the Global Distress subscale of the Marital Satisfaction Inventory-Revised, the Intimate Safety Questionnaire, and the Relational Acceptance Questionnaire. Results: A latent growth curve model indicated significant between-group differences in intimacy at every measurement point after baseline (d ranged from .20 to .55, Md = .37), significant between-group differences in women's felt acceptance for every measurement point after baseline (d ranged from . 17 to .47, Md = .34), significant between-group differences in men's felt acceptance through the 1-year 2-week follow-up (d across follow-up ranged from .11 to .40, Md = .25), and significant between-group differences in relationship distress through 1-year 6-month follow-up (d across follow-up ranged from .11 to .39, Md = .23). Conclusions: Longitudinal analysis of the MC supports the hypothesis that the MC significantly improves intimacy, acceptance, and satisfaction. Implications for dissemination are discussed. [ABSTRACT FROM AUTHOR]