| Literature DB >> 34783038 |
Howard J Markman1, Alan J Hawkins2, Scott M Stanley1, W Kim Halford3, Galena Rhoades1.
Abstract
This article systematically reviewed 34 rigorous evaluation studies of couple relationship education (CRE) programs from 2010 to 2019 that met the criteria for Level 1 well-established interventions. Significant advances include reaching more diverse and disadvantaged target populations with positive intervention effects on a wider range of outcomes beyond relationship quality, including physical and mental health, coparenting, and even child well-being, and evidence that high-risk couples often benefit the most. In addition, considerable progress has been made delivering effective online CRE, increasing services to individuals rather than to couples, and giving greater attention to youth and young adults to teach them principles and skills that may help them form healthy relationships. Ongoing challenges include expanding our understanding of program moderators and change mechanisms, attending to emerging everyday issues facing couples (e.g., healthy breaking ups, long-distance relationships) and gaining increased institutional support for CRE.Entities:
Keywords: couples < populations; diversity < populations; evidence-based < theory/model; intervention/technique < clinical; practice development < professional/practice issues; review of literature < research
Mesh:
Year: 2021 PMID: 34783038 PMCID: PMC9298911 DOI: 10.1111/jmft.12565
Source DB: PubMed Journal: J Marital Fam Ther ISSN: 0194-472X
Figure 1Flowchart of search and coding for CRE RCT studies 2010–2019
Efficacy and effectiveness RCT studies of couple relationship education interventions (2010–2019)
| Authors, year (overlapping sample studies) | Study design, conditions/curricula |
| Sample characteristics | Focal outcomes | Assess‐ment points |
Significant results ‐ latest assessment (effect size, if reported) T = treatment group C = control group |
|---|---|---|---|---|---|---|
| Bakhurst et al. ( |
Couple CARE in Uniform Active Control (self‐help book) | 32 couples |
Age: Men: M = 34.3; Women: M = 32.8; Married: 85% Location: Australia | Satisfaction; Stability; Communication; Aggression | Pre, Post | None |
|
Barton, Beach, Wells, et al. ( (Barton, Beach, Bryant, et al., |
Protecting Strong African American Families Active Control (book: 12 hours to a great marriage) | 346 couples |
Age: Men: M = 39.9; Women: M = 36.6; Race/Ethnicity: 100% AA Married: 63% Location: Southeast USA | Communication; Satisfaction; Confidence; Coparenting; Parental Monitoring; Youth Exposure to Interparental Conflict | Pre, 9, 17, 25 months |
T > C: satisfaction, communication, confidence, co‐parenting, parental monitoring, youth exposure to interparental conflict (Post‐intervention change in couple functioning predicted coparenting at 25 months) |
| Bodenmann et al. ( |
Couple Coping Enhancement Training‐DVD (+phone monitoring) CCET‐DVD (no phone monitoring) Wait‐list Control | 330 couples |
Age: Men = M = 41.4; Women M = 40.0 Race: 100% White Married: 71% Location: Switzerland | Dyadic Coping; Positive Communication; Negative Comm.; Conflict Resolution; Satisfaction | Pre, Post, 3, 6 months |
T1&T2 > C: dyadic coping (women), positive comm., conflict resolution (women), satisfaction (women, men T1 only) T1&T2 < C: negative comm. (women) |
| Bradley et al. ( |
Creating Healthy Relationships Program (Sound Relationship House) No‐treatment Control | 115 couples |
No demographic information provided Location: not given | Self‐reported IPV; Observed Propensity toward Violence (Contempt, Belligerence, Domineering, Anger, Defensiveness) | Pre, Post, 9, 15 months | T < C: observed propensity toward violence outcomes (men only) |
| Braithwaite & Fincham ( |
ePREP No‐treatment Control (given inert information) | 77 couples | Age: M = 19.92; Race/Ethnicity: 3% AA/10% L‐H Cohabiting: 20% Location: Florida | Satisfaction; Commitment; Communication; Psychological Aggression; Physical Assault; Depression; Anxiety | Pre, 1.5‐ months Post |
T > C: commitment (men), communication T < C: psych. aggression, phys. assault, depression |
| Braithwaite & Fincham ( |
ePREP Information‐only Control | 52 couples | Age: M = 32.36; Race/Ethnicity: 21% AA/7% L‐H Married: 100% Location: Florida | Self‐ and Partner‐reported (SR, PR) Psychological Aggression, Physical Aggression | Pre, Post, 12 months | T < C: PR physical aggression (females), SR physical aggression; PR psych. aggression (female), SR psych. aggression (male) |
|
Buzzella et al. ( |
Strengthening Same‐sex Relationships Wait‐list Control | 12 same‐sex male couples |
Age: M = 44 Race/Ethnicity: Caucasian 90%, Hispanic 5%, Asian 5%. Married: 75% Engaged: 25% Location: Boston area | Satisfaction; Confidence; Communication; Problem solving; Stress | Pre, Post, 3 months | Significance tests not reported. |
| Carlson et al. ( |
PREP Wait‐list Control | 54 couples |
Age: Men: M = 34.24; Women: M = 33.17 Race/Ethnicity: 14% AA/55% L‐H/7% Asian‐American Married: 100% Location: USA | Satisfaction | Pre, Post | T > C: satisfaction |
| Cordova et al. ( |
Marriage Checkup Wait‐list control | 215 couples |
Age: Women = 45, Men = 47 Race/Ethnicity: 93% W/3% AA/3% Asian American Married: 100% Location: Boston area | Satisfaction, Emotional Intimacy, Felt Acceptance | Pre, Post, 2, weeks, 6, 12, 12.5, 18, 24 months | T > C: intimacy ( |
| Cowan et al. ( |
Becoming a Family (couple focus) Becoming a Family (parenting focus) Low‐dose Active Control (consulting) | 113 couples |
Age: 37.5 Race/Ethnicity: 84% W/7% AA/7% Asian/2% L‐H/ Married: 100% Location: California Bay Area | Satisfaction; Communication; Parenting Style; Child Behavior Problems | Pre, Post, 5, 6, 10 years |
T1 > C: satisfaction, communication, behavior problems T2 > C: satisfaction (mothers), communication (mothers) |
| Doss et al. ( |
OurRelationship Wait‐list Control | 300 couples |
Age: M = 36.11 Race/Ethnicity: 17% AA/10% L‐H Married: 80% Location: USA | Satisfaction; Confidence; Positive/Negative Relationship Quality; Depression; Anxiety; Health; Quality of Life | Pre, Mid‐treatment, Post | T > C: satisfaction ( |
| Fallahchai et al. ( |
PREP Wait‐list Control | 76 couples |
Age: M = 32.34; Married: 100% Location: Bandar Abbas, Iran | Satisfaction; Couple Conflict | Pre, Post, 12 months |
T > C: satisfaction T < C: conflict |
| Feinberg et al. ( |
Family Foundations No‐treatment Control | 169 couples | Age: Men: M = 29.8; Women: M = 28.3; Married: 82% Location: Pennsylvania | Couple Relationship; Parenting Stress, Self‐efficacy, Depression; Coparenting; Harsh Parenting; Child Emotional Adjustment; Child Behavior Problems | Pre, 3, 6, 12 months |
T < C: parental stress ( T > C: self‐efficacy ( |
| Halford et al. ( |
Couple CARE for Parents Alternative‐treatment Control (maternal parenting program) | 71 couples |
Age: Men: M = 31; Women: M = 29 Race/Ethnicity: 90%+ W Married: 70% Location: Brisbane, Australia |
Satisfaction, Self‐regulation; (observed) Negative Communication; Parenting Stress | Pre, Post, 5, 12 months |
T < C: negative communication T > C: satisfaction, self‐regulation (women), parenting stress (women) |
| Halford et al. ( |
RELATE RELATE + Couple Care Alternative‐treatment Control (marriage book) | 182 couples |
Age: Men: M = 45, Women = 43 Married: 69% Location: Unspecified | Satisfaction; Mental Health | Pre, Post, 6, 12, 18, 30, 48 months | None |
| Jones et al. ( |
Family Foundations No‐treatment Control | 399 couples |
Age: Men: M = 31; Women: M = 29 Race/Ethnicity: 85%W Location: Pennsylvania | Positive/Negative Coparenting; Positive/Negative Parenting; Coparenting Positivity/Negativity; Depression, Anxiety; Child Behavior Problems | Pre, 10, 24 months |
T > C: pos. parenting ( T < C: neg. coparenting ( |
|
Kalinka et al. ( |
Power of Two (online) Placebo Control | 79 couples |
Age: M = 28 Race/Ethnicity: 84% W/7% L‐H/6% Bi‐racial/3% AA Married: 73%; Location: USA | Conflict Resolution; Satisfaction | Pre, 1, 2 months | T > C: satisfaction ( |
| Kröger et al. ( |
PREP‐EPL Wait‐list Control | 32 militarycouples |
Age: Mid‐ Thirties Race/Ethnicity: 100% W Married: 50% Location: Germany | Satisfaction; Conflict; Psychological Distress |
Pre, Post, 2 months (no follow‐up for controls) | T > C: satisfaction, conflict (men) |
| Loew et al. ( |
PREP (online) Alternative‐treatment Control (online birth parent visitation course) | 32 couples |
Age: M = 44.82; Race/Ethnicity: 89% W; 3% L‐H Married: 100% Location: USA | Positive Communication/Conflict Management; Negative Communication | Pre, Post | T > C: positive communication/conflict management |
| Lowenstein et al. ( |
Supporting Healthy Marriage (SHM) No‐treatment Control (8 independent samples) Curricula: Within Our Reach; For Our Families, For Our Children; Loving Couples, Loving Children; PREP‐Becoming Parents |
6,298 couples |
Age: M = 31; Race/Ethnicity: 43% L‐H/11% AA/25% W/25% Mixed‐Other; Married: 82%; Location: USA (8 independent sites) | Relationship Quality, Stability; Positive/Negative Communication; Psychological Abuse; Psychological Distress; Cooperative Co‐parenting |
Pre, 12‐months, 30 months |
T > C: (combined sies) quality ( T < C: neg. comm (women (Communication gains did not mediate outcome change; WOR program sites ‐ pattern of small treatment effects [Md = .14]) |
| McCormick et al. ( |
Supporting Healthy Marriage No‐treatment Control Curricula: Loving Couples, Loving Children; PREP‐Becoming Parents; PREP‐Within Our Reach; For Our Family, For Our Children | 97 couples | Age: Men: M = 39; Women: M = 38; Race/Ethnicity: 27% AA/26% L‐H Married: 100% Location: USA | Relationship Quality, Conflict; Daily Mood, Stress (diary reports) | Pre, 30 months | T < C: association between negative moods and conflict (for women), association between stress and conflict (for husbands). |
| Markman et al. ( |
PREP (combined university‐based & religious‐organization‐based) Alternative‐treatment Control (naturally occurring premarital services) | 193 couples |
Age: Men: M = 27; Women: M = 25; Race/Ethnicity: Women 84% C/12% L‐H, 2% Men: 87% C/10% L‐H/% Engaged couples Location: USA | Divorce; Aggression; Negative Communication (observed) | Pre, Post, 8 years (average) |
T > C: divorce among higher initial neg. comm. couples T < C: divorce among lower initial neg. comm. couples (general divorce non‐significant) |
| Moore et al. ( |
Building Strong Families (BSF) No‐treatment Control (8 independent samples) Loving Couples, Loving Children; Love's Cradle; PREP‐Becoming Parents | 5,102 couples |
Age: M = 24; Race/Ethnicity: 52% AA/20% L‐H/12% W/16% Mixed‐Other Married: 7% Cohabiting: 55% Location: USA (8 separate sites) | Relationship Happiness, Support, Stability; Conflict, Fidelity, Positive Attitudes toward Marriage; Communication; IPV; Coparenting; Parenting Behavior; Child Behavior Problems | Pre, 12, 36 months |
(combined sites) None T > C: stability (OKC site; 49% vs. 41%) (T > C: relationship quality outcomes at 12 months for most disadvantaged couples) |
| Moore et al. ( |
Parents and Children Together (PACT) No‐treatment Control (2 independent samples) Curricula: Within Our Reach; Loving Couples, Loving Children |
1,595 couples |
Age: M = 35; Race/Ethnicity: 78% L‐H/10% AA/12% Other Married: 59% Location: NYC, El Paso | Relationship Quality, Stability, Commitment; Positive/Negative Communication; IPV; Coparenting; Depression |
Pre, 12 months |
(combined sites) T > C: Stability ( T < C: neg. comm. ( |
| Petch et al. ( |
Couple CARE for Parents Alternative‐treatment Control (maternal parenting program) | 250 couples |
Age: Men: M = 31; Women: M = 29 Married: 65% Location: Australia | Satisfaction; Negative Communication; Parenting Stress; Intrusive Parenting; IPV | Pre, 4, 16, 28 months |
T < C: neg. comm. (women) T > C: satisfaction (high‐risk women) |
| Pruett et al. ( |
Supporting Father Involvement Wait‐list Control | 239 couples |
Age: Fathers M = 32; Mothers M = 29 Race/Ethnicity: 52% L‐H/34% W/8% AA Married: 49%; Romantically Involved 43% Location: California | Couple Conflict; Parenting Conflict; Parenting Quality; Parenting Stress; Harsh Parenting; Risk for Child Abuse; Child Behavior Problems | Pre, 2, 18 months |
T < C: couple conflict ( (Decline in couple conflict associated with decreases in harsh parenting, which was associated with fewer child behavior problems) |
|
Rienks et al. ( (only coded: FRAME – Couples, not men only, women only) |
Fatherhood Relationship and Marriage Education – Couples (adaptation: PREP‐Within Our Reach) No‐treatment Control | 103 couples | Age: Men: M = 36; Women: M = 31.3; Race/Ethnicity: 34% AA/22% L‐H Married: 70% Cohabiting: 30% Location: Denver, CO area | Adjustment, Satisfaction; Negative Communication.; Coping Efficacy; Anxiety, Depression; Father Involvement; Parenting Alliance | Pre, Post | T > C: father involvement (Greater parental alliance predicted greater father involvement among treatment couples) |
| Roddy et al. ( |
OurRelationship (online) Wait‐list Control | 300 couples |
Age: M = 37.4; Race/Ethnicity: 15% AA/10% L‐H Married: 80% Cohabiting: 14% Location: USA | Relationship Satisfaction | Pre, Post | T > C: satisfaction (Treatment effect not moderated by pre‐IPV) |
| Rogge et al. ( |
PREP Compassionate & Accepting Relation‐ships through Empathy (CARE) Brief relationship awareness session No‐treatment Control | 174 engaged/newly wed couples |
Age: Men: M = 29.3; Women: M = 27.9 Race/Ethnicity: 55% W/21% L‐H/11% AS/5% AA/8% Other Cohabitating: 72% Location: Unspecified | Relationship Dissolution, Satisfaction | Pre, 2, 6, 12, 24, 36 months | All Ts > C: dissolution (11% vs. 24%) |
|
Stanley et al. ( (Allen, Rhoades et al., |
PREP ‐ Strong Bonds No‐treatment control | 662 couples |
Age: Men: M = 28.5; Women: M = 27.7 Race/Ethnicity: 70% W/12% L‐H/11% AA/2% NA‐AN/7% Mixed/Other Married: 100% Location: USA | Divorce; Relationship Quality, Satisfaction; Communication; Confidence; Dedication | Pre, Post, 6, 12, 18, 24 months | T < C: divorce (8% vs. 15%) (effect stronger for minority couples) |
| Trillingsgaard et al. ( |
Marriage Checkup Wait‐list Control | 233 couples |
Age: Men: M = 39, Women: M = 37 Married: 80% Location: Denmark | Relationship Satisfaction; | Treatment: Pre, 10, 21, 34, 47, 54 weeks; Control: Pre, 10, 54 weeks | T > C: Satisfaction ( |
| Wadsworth et al. ( |
Fatherhood, Relationship, and Marriage Education (adapted: PREP Within Our Reach) No‐treatment Control | 173 couples |
Age: Men: M = 34; Women: M = 31 Race/Ethnicity: 33% W/28% AA/24% L‐H/6% AI/10% Mixed/Other Married: 67% Location: Denver, CO | Financial Worries; Problem Solving; Coping Efficacy Avoidance, Emotional Numbing, Emotional Regulation; Depression | Pre, Post |
T < C: financial worries, avoidance, numbing T > C: regulation, problem solving (women) |
| Whitton et al. ( |
Strengthening Same‐Sex Relationships Wait‐list Control | 20 same‐sex male couples |
Age: Men: M = 40; Race/Ethnicity: 83% W/10% AA/3% L‐H Married: 20% Location: Midwest USA | Satisfaction; Instability; (observed) Positive/Negative Communication; Stress; Social Support | Pre, Post, 3 months |
T > C: satisfaction ( T < C: neg. comm. ( |
| Zemp et al. ( |
Couples Coping Enhancement Training Triple‐P No‐treatment control | 150 couples |
Age: Men: M = 39.7; Women: M = 37.4 Location: Switzerland | Relationship Quality; Parenting; Child Behavior Problems | Pre, Post, 6, 12 months (analyses did not include 6, 12 months follow‐ups) | T1 > C: relationship quality (mothers) (enhanced quality associated with reduced child behavioral problems [mothers]) |