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A randomized trial of brief couple therapy for PTSD and relationship satisfaction

APA Citation:

Morland, L. A., Knopp, K. C., Khalifian, C. E., Macdonald, A., Grubbs, K. M., Mackintosh, M…Monson, C. M. (2022). A randomized trial of brief couple therapy for PTSD and relationship satisfaction. Journal of Consulting and Clinical Psychology, 90(5), 392-404. https://doi.org/10.1037/ccp0000731

Abstract Created by REACH:

Cognitive behavioral conjoint therapy (CBCT) is commonly employed to treat various presenting problems, including posttraumatic stress disorder (PTSD), relationship dissatisfaction, and functional impairment (e.g., difficulty with intimate relationships, work tasks), when working with both partners in a couple. Using a randomized controlled trial, this study examined whether a brief version of CBCT (bCBCT) produced greater reductions in PTSD symptoms across in-person and virtual modalities than family PTSD education sessions. 137 dyads (i.e., Veterans and partners) self-reported on their relationship satisfaction and Veterans’ functional impairment at 5 time points (i.e., before, during, immediately following, 3 months after treatment, and 6 months after treatment). Overall, Veterans experienced greater decreases in PTSD symptoms in both modalities of bCBCT than in family PTSD education sessions, and the symptom reduction was generally maintained across the follow-up periods.

Focus:

Couples
Mental health
Trauma
Veterans

Branch of Service:

Multiple branches

Military Affiliation:

Veteran

Subject Affiliation:

Veteran
Spouse of service member or veteran

Population:

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)

Methodology:

Longitudinal Study
Quantitative Study

Authors:

Morland, Leslie A., Knopp, Kayla C., Khalifian, Chandra E., Macdonald, Alexandra, Grubbs, Kathleen M., Mackintosh, Margaret-Anne, Becker-Cretu, Julia J., Sautter, Frederic J., Buzzella, Brian A., Wrape, Elizabeth R., Glassman, Lisa H., Webster, Katelyn, Sohn, Min Ji, Glynn, Shirley M., Acierno, Ron, Monson, Candice M.

Abstract:

OBJECTIVE: This three-arm randomized trial tested a brief version of cognitive-behavioral conjoint therapy (bCBCT) delivered in two modalities compared to couples' psychoeducation in a sample of U.S. veterans with posttraumatic stress disorder (PTSD) and their intimate partners. METHOD: Couples were randomized to receive (a) in-person, office-based bCBCT (OB-bCBCT), (b) bCBCT delivered via home-based telehealth (HB-bCBCT), or (c) an in-person psychoeducation comparison condition (PTSD family education [OB-PFE]). Primary outcomes were clinician-assessed PTSD severity (Clinician Administered PTSD Scale), self-reported psychosocial functioning (Brief Inventory of Psychosocial Functioning), and relationship satisfaction (Couples Satisfaction Index) at posttreatment and through 6-month follow-up. RESULTS: PTSD symptoms significantly decreased by posttreatment with all three treatments, but compared to PFE, PTSD symptoms declined significantly more for veterans in OB-bCBCT (between-group d = 0.59 [0.17, 1.01]) and HB-bCBCT (between-group d = 0.76 [0.33, 1.19]) treatments. There were no significant differences between OB-bCBCT and HB-bCBCT. Psychosocial functioning and relationship satisfaction showed significant small to moderate improvements, with no differences between treatments. All changes were maintained through 6-month follow-up. CONCLUSIONS: A briefer, more scalable version of CBCT showed sustained effectiveness relative to an active control for improving PTSD symptoms when delivered in-person or via telehealth. Both bCBCT and couples' psychoeducation improved psychosocial and relational outcomes. These results could have a major impact on PTSD treatment delivery within large systems of care where access to brief, evidence-based PTSD treatments incorporating family members are needed.

Publisher/Sponsoring Organization:

American Psychological Association

Publication Type:

Article
REACH Publication
Featured Research

Author Affiliation:

VA San Diego Healthcare System, LAM
VA San Diego Healthcare System, KCK
VA San Diego Healthcare System, CEK
VA San Diego Healthcare System, KMG
VA San Diego Healthcare System, BAB
VA San Diego Healthcare System, ERW
VA San Diego Healthcare System, LHG
VA San Diego Healthcare System, KW
VA San Diego Healthcare System, MJS
Department of Psychiatry, University of California, San Diego, LAM
Department of Psychiatry, University of California, San Diego, KCK
Department of Psychiatry, University of California, San Diego, CEK
Department of Psychiatry, University of California, San Diego, KMG
Department of Psychiatry, University of California, San Diego, BAB
Department of Psychiatry, University of California, San Diego, ERW
Department of Psychiatry, University of California, San Diego, LHG
Department of Psychology, The Citadel, Military College of South Carolina, AM
National Center for PTSD—Dissemination and Training Division, VA Palo Alto Healthcare System, MM
Department of Psychiatry & Behavioral Sciences, Tulane University School of Medicine, JJBC
Southeast Louisiana Veterans Healthcare System, JJBC
Southeast Louisiana Veterans Healthcare System, FJS
VA Greater Los Angeles Healthcare System, SMG
Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, SMG
Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, RA
Department of Psychology, Ryerson University, CMM

Keywords:

couples therapy, PTSD, relationship satisfaction, cognitive behavioral therapy

View Research Summary:

REACH Publication Type:

Research Summary

Sponsors:

Award Number 1I01RX002093-01 from the
Rehabilitation Research and Development Service of the VA Office of Research and Development

REACH Newsletter:

  October 2022

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