Improvements in closeness, communication, and psychological distress mediate effects of couple therapy for veterans.

Doss, Brian D.; Mitchell, Alexandra; Georgia, Emily J.; Biesen, Judith N.; Rowe, Lorelei Simpson

doi:10.1037/a0038541

Cited by 24 publications

(37 citation statements)

References 43 publications

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“…MH visits were reduced following complete courses of couple therapy among higher initial utilizers of physical and mental health services. The findings regarding reductions in MH services are consistent with previous results from this sample indicating that reductions in relationship distress are associated with subsequent improvements in MH (Doss et al., ). There are several reasons why couple therapy may also lead to reductions in PH visits, particularly among those with higher initial levels of service utilization.…”

Section: Discussionsupporting

confidence: 90%

“…Proc., Vol. 56, September, 2017 MADSEN, TOMFOHR-MADSEN & DOSS / 629 reductions in relationship distress are associated with subsequent improvements in MH (Doss et al, 2015). There are several reasons why couple therapy may also lead to reductions in PH visits, particularly among those with higher initial levels of service utilization.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, individual therapy has diminished effectiveness for a number of disorders in the presence of co‐occurring relationship discord (for reviews, see Baucom, Belus, Adelman, Fischer, & Paprocki, ; Baucom et al., ). In our own study of veterans in treatment‐as‐usual couple therapy, improvements in psychological distress among men mediated the effect of treatment on subsequent relationship satisfaction (Doss, Mitchell, Georgia, Biesen, & Rowe, ). In summary, relationship problems are associated cross‐sectionally and longitudinally with individual mental health problems and greater use of mental health services; therefore, couple therapy may reduce mental health visits by alleviating individual distress.…”

Section: Study Overviewmentioning

confidence: 92%

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The Impact of Couple Therapy on Service Utilization among Military Veterans: The Moderating Roles of Pretreatment Service Utilization and Premature Termination

2016

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Couple therapy reduces relational and individual distress and may affect utilization of other health services, particularly among higher service utilizers. Although average decreases in service utilization are predicted among recipients of couple therapy, low utilizers of services may appropriately increase use. The relationship between couple therapy and service utilization was examined among a sample of 179 U.S. military veterans who received treatment in Veterans Affairs (VA) specialty couple therapy clinics. Consistent with hypotheses, overall mental and physical health visits decreased from the 12 months preceding couple therapy to the 12 months following treatment. Moderator analyses showed that decreases were greatest among individuals who were rated by their therapist as having completed a full course of couple therapy, suggesting that change was attributable to intervention. Pretreatment service utilization also moderated observed change-higher utilizers' use of services decreased substantially, whereas lower utilizers' slightly increased. Cost analyses revealed that the estimated per person mean cost in our sample decreased by $930.33 in the year following compared to the year prior to couple therapy, as per 2008 VA cost data. As service utilization data were only available for one partner and only for 1 year posttherapy, the true magnitude of this effect may be underestimated. Our findings are relevant to policy makers as they demonstrate that couple therapy reduces average service utilization and associated costs and addresses calls for analyses of cost effectiveness of systemic interventions.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Study Overviewmentioning

confidence: 92%

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The Impact of Couple Therapy on Service Utilization among Military Veterans: The Moderating Roles of Pretreatment Service Utilization and Premature Termination

2016

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“…Social exchange and social learning theories (e.g., Jacobson & Margolin, 1979) assign great significance to interpersonal communication as a generative force in relationships, of course, and preventive interventions target behavior change as a key mechanism for improving relationships. Finding consistent support for this idea has proven difficult, however, and existing evidence supports the idea that dyadic processes are a relatively stable, trait-like characteristic of the dyadic system that partners create—processes that deteriorate principally when relationship distress becomes overt and unavoidable, and only then becoming amenable to change (e.g., Doss, Mitchell, Georgia, Biesen, & Rowe, 2015). Our findings build on this idea and suggest that communication operates less as an unmoderated generative force and more as a risk-activated amplifier of other experiences that couples undergo, notably when those experiences are significantly different than before.…”

Section: Discussionmentioning

confidence: 99%

Communication moderates effects of residential mobility on relationship quality among ethnically diverse couples.

Nguyen¹,

Williamson²,

Karney³

et al. 2017

Journal of Family Psychology

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Although interpersonal communication is a defining feature of committed relationships, the quality of couple communication has not proven to be a straightforward cause of relationship quality. At the same time, emerging models argue that external circumstances likely combine with communication to generate changes in relationship quality. We integrate these two ideas by proposing that communication does exert effects on changes in relationship quality, but primarily when couples encounter challenging situations that require an adaptive response. In the present study we examine residential moves to different neighborhoods as one such adaptive challenge. We conducted a longitudinal study of 414 newlywed couples to examine whether observed communication moderates the effect of moving to higher or lower-income neighborhoods on changes in relationship quality. Results indicate that communication exerts no main effects on relationship quality. Consistent with the proposed model, however, wives who displayed less positive, less effective, and more negative behaviors experienced greater decreases in relationship quality, but only when couples moved to substantially higher-income neighborhoods. Because communication may not affect relationship quality until couples encounter qualitatively new demands, strengthening relationships may pivot less on improving communication skills and more on ensuring that couples’ circumstances do not overwhelm the skills that they already possess.

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“…Research on BCT for distressed couples without AUDs has focused on several putative MOBC, including increases in positive behaviors (Doss et al, 2005), communication and problem solving, and decreases in negative communication (Baucom et al, 2011; Doss et al, 2005; Halford et al, 1993; Iverson and Baucom, 1990; Sayers et al, 1991; Sevier et al, 2008), increased positive cognitions about the partner (Halford et al, 1993), increased positive affect (Doss et al, 2005; Doss et al, 2014; Halford et al, 1993), and greater emotional acceptance (Doss et al, 2005; South et al, 2010). Research has examined change in these putative mechanisms from baseline to post treatment, as well as associations between pre-post changes in these mechanisms and post-treatment relationship satisfaction.…”

Section: Alcohol Behavioral Couple Therapy: Active Ingredients and Mementioning

confidence: 99%

Active Ingredients of Treatment and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later

Magill

Kiluk

McCrady

et al. 2015

Alcohol Clin Exp Res

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Background The current review revisits the article entitled: Active Ingredients of Behavioral Treatments for Alcohol Use Disorders (AUDs) published in Alcoholism: Clinical and Experimental Research. This work summarized proceedings from a 2004 Symposium of the same name that was held at the Annual Meeting of the Research Society on Alcoholism (RSA). A decade has passed, which provides occasion for an evaluation of progress. In 2014, an RSA symposium titled Active Treatment Ingredients and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later did just that. Overview The current review revisits state-of-the-art research on the three treatments examined 10 years ago: Cognitive Behavioral Therapy (CBT), Alcohol Behavior Couples Therapy (ABCT), and Twelve Step Facilitation (TSF). Because of its empirically-validated effectiveness and robust research agenda on the study of process-outcome, Motivational Interviewing (MI) has been selected as the fourth treatment modality to be discussed. For each of these four treatments, the reviewers provide a critical assessment of current theory and research with a special emphasis on key recommendations for the future. Conclusions Noteworthy progress has been made in identifying AITs and MOBCs in these four behavioral interventions for alcohol and other drug use disorders. Not only have we established some of the mechanisms through which these evidence-based treatments work, but we have also uncovered some of the limitations in our existing frameworks and methods. Further progress in this area will require a broader view with respect to conceptual frameworks, analytic methods, and measurement instrumentation.

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Improvements in closeness, communication, and psychological distress mediate effects of couple therapy for veterans.

Cited by 24 publications

References 43 publications

The Impact of Couple Therapy on Service Utilization among Military Veterans: The Moderating Roles of Pretreatment Service Utilization and Premature Termination

The Impact of Couple Therapy on Service Utilization among Military Veterans: The Moderating Roles of Pretreatment Service Utilization and Premature Termination

Communication moderates effects of residential mobility on relationship quality among ethnically diverse couples.

Active Ingredients of Treatment and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later

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