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Therapy is an effective form of treatment for couple distress; yet, research shows that 20%-60% of couples terminate treatment prematurely. Predictors of couple retention in therapy and research are unclear, particularly for couples from marginalized populations, which has important implications for the quality and generalizability of research results, and the benefits derived from therapy are limited when participants are not retained. The purpose of this study (N = 1310) was to identify couple-level

Interventions for couples that can be flexibly delivered (e.g., home) are gaining traction in the field of couple therapy, particularly for underserved couples who experience barriers to accessing traditional methods of care. However, questions remain regarding what types of couples prefer the home over traditional clinic settings and whether there are differences in treatment effectiveness in the home versus a clinic setting. The present study sought to address these gaps in the literature. Using a secondary data analysis approach, data from 339 couples who participated in a brief, relationship intervention were examined. Couples were able to select where they wanted to participate (i.e., their home or a local clinic). Logistic regression analyses revealed that parents were significantly more likely to choose to participate in the intervention at their home relative to nonparents. No differences in intervention setting emerged as a function of marital status, racial/ethnic minority status, or poverty status. Three 2-level multilevel models indicated that, at baseline, couples presented with similar attitudes toward relationship help seeking and relationship satisfaction across settings as well as established a similar alliance with the facilitator at 1 month after the intervention. Additionally, a series of 3-level multilevel models found that rates of change did not significantly differ between groups on attitudes toward relationship help seeking and relationship satisfaction across the intervention. Thus, despite the potential chaos of the home, home settings appear to be an equally effective delivery setting relative to traditional settings for this brief relationship intervention and may be particularly useful for reaching parents.

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Romantic relationship distress leads to decreased satisfaction and dissolution. While therapy is effective for helping distressed couples, it is often inaccessible due to cost, time, and childcare barriers. Churches are often able to offer lower-cost services and provide childcare. In partnership with a network of local churches, university staff trained lay leaders to deliver an evidence-based relationship education program and collected data from 97 couples to evaluate pre-to post-workshop changes in couple functioning. Multilevel modeling was used to examine changes from pre-to post-workshop and thematic analysis was used to analyze open-ended feedback responses. Results showed improvements in communication, relationship satisfaction, commitment, and intimacy safety, with the largest effect found for communication. Participants also reported improved communication skills were one of the most beneficial parts of the program. Through the partnership with a university, churches can offer and rigorously evaluate evidence-based programs to strengthen couple relationships in their communities.