The current study uses descriptive data from a sample of Veterans and their partners (N ϭ 97 opposite-sex couples) presenting to a Veterans Affairs Medical Center. The purpose of this investigation was to examine (a) the problems couples face before seeking treatment, (b) how long it took couples to seek treatment, and (c) what attempts couples made to improve their relationship before couples therapy. We also examined how these treatment initiation factors were related to relationship distress and expectations for therapy. Results suggest the relationship problems that precede Veteran couples seeking treatment are varied (e.g., stressors outside of relationship, communication problems, and lack of trust) and agreement between partners on type of relationship problem is not predictive of relationship satisfaction, perception of relationship problem severity, nor expectations for therapy. Partners tend to wait ϳ4 -7 years before pursuing couples therapy to resolve relational concerns. The length of time partners wait to pursue therapy is positively associated with optimistic expectations for therapy. In addition, before treatment initiation, partners tend to make multiple attempts to improve their relationship (M ϭ 1.79 attempts for men; M ϭ 2.40 attempts for women), and the number of unique attempts made to improve the relationship is associated with greater distress and more negative perceptions of relationship problem severity. Findings have implications for identifying Veteran couples who may be more or less receptive to intervention and informing the development of a stepped-care approach for couples treatment referral and planning.

Existing couple therapies are generally effective for reducing romantic relationship distress and divorce, but therapy outcomes remain poor for many. Outcomes can be improved through greater understanding of session‐by‐session therapeutic processes, particularly in real‐world treatment settings. Modern couple therapy models commonly emphasize the importance of emotional experiences as key change processes, yet few empirical studies have tested the merits of this focus. The present study addresses this limitation by examining trajectories of subjective emotions and their association with change in a key relationship outcome, relationship satisfaction, among military veterans and their partners at a VA Medical Center. Partners rated their relationship satisfaction prior to couple therapy sessions and subjective emotions immediately after sessions. Consistent with hypotheses, both hard (e.g., anger) and soft (e.g., sadness) negative emotions decreased significantly over the course of therapy. Those couples with greater decreases in hard negative, but not soft negative, emotions showed significantly more improvement in relationship satisfaction. Positive emotions did not significantly change across couples in general, but those couples whose positive emotions did increase also showed more improvement in relationship satisfaction. These results suggest change in subjective emotions may be one process underlying improvement in couple therapy and lend empirical support to the emphasis on emotion‐based change processes underlying acceptance‐based and emotion‐focused couple therapies.