Relationship functioning and psychopathology are strongly associated with one another. In this article we provide a selective review of the literature on relationship discord and the presence, incidence and individual-based treatment of psychiatric disorders. We then present a model for conceptualizing couple-based interventions with couples in which one partner has a psychiatric disorder, distinguishing between partner-assisted interventions, disorder-specific interventions and couple therapy interventions. Finally, we provide examples of how to employ these interventions with several psychiatric disorders (obsessivecompulsive disorder, anorexia nervosa and depression) and selectively review the efficacy of couple-based interventions in the treatment of psychopathology.Practitioner points • Relationship distress and psychopathology are associated. • In many instances individual therapy for psychopathology is less effective when the couple is distressed. • Couple-based interventions have the capacity to alleviate individual psychopathology and improve relationship functioning.

This article provides a rationale and empirical support for providing couple-based interventions when one partner in a relationship is experiencing individual psychopathology. Several investigations indicate that relationship distress and psychopathology are associated and reciprocally influence each other, such that the existence of relationship distress predicts the development of subsequent psychopathology and vice versa. Furthermore, findings indicate that for several disorders, individual psychotherapy is less effective if the client is in a distressed relationship. Finally, even within happy relationships, partners often inadvertently behave in ways that maintain or exacerbate symptoms for the other individual. Thus, within both satisfied and distressed relationships, including the partner in a couple-based intervention provides an opportunity to use the partner and the relationship as a resource rather than a stressor for an individual experiencing some form of psychological distress. The authors propose that a promising approach to including the partner in treatment involves (a) integrating intervention principles from empirically supported interventions for individual therapy for specific disorders with (b) knowledge of how to employ relationships to promote individual and dyadic change. Based on this logic, the article includes several examples to demonstrate how couple-based interventions can be focused on a specific type of psychopathology, including encouraging empirical findings for these interventions. The article concludes with recommendations for how clinicians and researchers can adapt their knowledge of couple therapy to assist couples in which one partner is experiencing notable psychological distress or diagnosable psychopathology.

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A nationwide collaborative research netviiork has been developed by the Association of Psychology Training Clinics (APTC) to carry out research with the potential to improve services provided in training clinic settings. Six APTC member clinics participated in this inaugural study. In addition to demonstrating that the APTC research network can recruit clients for participation in multisite research and randomize enrolled participants to conditions effectively across the network, findings from this study also conürihute to our growing understanding of the problem of premature termination within psychology training clinics. More specifically, the results conñrm earlier single-site reports in the literature that a high rate of premature termination is a common problem within psychology training clinics (multisite M = 69.4%) and that the most typical client outcome at the end of treatment is no reliable change in symptomatic distress. Findings indicate that clients' pretreatment expectations of treatment duration are positively correlated with the number of treatment sessions subsequently attended and are pi:Edictive of clients' symptom severity at termination. However, expectancy education was not associated with a reduction in premature termination. Notably, there is a positive correlation between prior treatment exposure and cuirent, prospective treatment expectations. Implications for training and policy are discussed with future directions for research suggested.

The effectiveness of individual therapy by exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) is well established, yet not all patients respond well, and some show relapse on discontinuation. This article begins by providing an overview of the personal and interpersonal experiences of OCD, focusing on interpersonal processes that maintain OCD symptoms and interfere with ERP. The study then describes a couple-based treatment program that the authors have developed to enhance ERP for individuals with OCD who are in long-term relationships. This program involves psychoeducation, partner-assisted exposure therapy, couple-based interventions aimed at changing maladaptive relationship patterns regarding OCD (i.e., symptom accommodation), and general couple therapy. Three case examples are presented to illustrate the couple-based techniques used in this treatment program.