https://aub.ie/MilitaryREACH-Fischer2018TRIP

Fischer, M. S., Bhatia, V., Baddeley, J. L., Al‐Jabari, R., & Libet, J. (2018). Couple Therapy with Veterans: Early Improvements and Predictors of Early Dropout. Family process, 57(2), 525-538. https://doi.org/10.1111/famp.12308

By nature of military service and the exposure to combat trauma, military veterans are more likely to experience both individual mental health problems and relational problems compared to those who have not served. Despite this, veterans have higher rates of dropping out of couple therapy when compared to the general population. This study examined data from 140 heterosexual couples, in which the male partner was a veteran utilizing family services from the Veterans Affairs Medical Center, to identify factors associated with dropping out of couple therapy during the early phases and changes in relationship satisfaction. Higher rates of female partner depression were associated with dropping out of therapy during the assessment phase (i.e., the first three sessions). However, relationship satisfaction levels did increase even after only completing the assessment phase of therapy.

https://doi.org/10.1111/famp.12308

Couples
Mental health
Veterans

Multiple branches

Veteran

Spouse of service member or veteran
Veteran

Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)

Cross-Sectional Study
Quantitative Study

Fischer, Melanie S., Bhatia, Vickie, Baddeley, Jenna L., Al‐Jabari, Rawya, Libet, Julian

Family services within Veterans Affairs Medical Centers fulfill an important role in addressing relationship distress among Veterans, which is highly prevalent and comorbid with psychopathology. However, even for evidence‐based couple therapies, effectiveness is weaker compared to controlled studies, maybe because many Veteran couples drop out early and do not reach the 'active' treatment stage after the 3–4 session assessment. In order to improve outcomes, it is critical to identify couples at high risk for early dropout, and understand whether couples may benefit from the assessment as an intervention. The current study examined (a) demographics, treatment delivery mode, relationship satisfaction, and psychological symptoms as predictors of dropout during and immediately following the assessment phase, and (b) changes in relationship satisfaction during assessment. 174 couples completed questionnaires during routine intake procedures. The main analyses focused on 140 male Veterans and their female civilian partners; 36.43% dropped out during the assessment phase and 24.74% of the remaining couples immediately following the first treatment session. More severe depressive symptoms in non‐Veteran partners were associated with dropout during assessment. Relationship satisfaction improved significantly during the assessment phase for couples who did not drop out, with larger gains for non‐Veteran partners. No demographics or treatment delivery mode were associated with dropout. Although more research is needed on engaging couples at risk for early dropout and maximizing early benefits, the findings suggest that clinicians should attend to the civilian partner's and Veteran's depressive symptoms at intake and consider the assessment part of active treatment.

John Wiley & Sons

Article
REACH Publication

Ralph H. Johnson VA Medical Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSF
Ralph H. Johnson VA Medical Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, VB
Ralph H. Johnson VA Medical Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, JLB
Ralph H. Johnson VA Medical Center, RAJ
Ralph H. Johnson VA Medical Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, JL