Does premarital education decrease or increase couples' later help-seeking?

Interventions intended to prevent relationship distress are expected to enhance relationship satisfaction and, in turn, reduce the need for later couples counseling. We test this prediction against an alternative possibility: participation in preventive interventions may operate as a gateway for later help-seeking, paradoxically increasing receipt of later couples counseling. A cross-sectional study of 2,126 married individuals examined whether participation in premarital education covaried inversely or directly with couples counseling. Consistent with the gateway hypothesis, receiving premarital education covaried with an increased likelihood of receiving couples counseling. The association between receipt of premarital education and pursuit of couples counseling was moderated by demographic indicators, with the association being stronger for African Americans and for individuals with lower incomes and less formal education. Encouraging the use of premarital interventions may increase the use of therapeutic interventions later in the relationship, especially among high-risk populations.