Couple HOPES (Helping Overcome PTSD and Enhance Satisfaction) is a guided, online couple intervention adapted from Cognitive-Behavioral Conjoint Therapy for posttraumatic stress disorder (PTSD). It was created to overcome a range of barriers to accessing evidence-based treatments for PTSD and the intimate relationship problems associated with it. This manuscript describes initial outcomes of the intervention in a series of 10 couples. Participants were military, veteran and first responders with probable PTSD and their intimate partners. Couples completed the program and measurements of PTSD, relationship satisfaction, and secondary outcomes at pre-, mid-, and post-intervention. Mean satisfaction for the program was high and it was completed by seven of ten couples. Participants with PTSD evidenced significant and large pre- to post-intervention effect size improvements in PTSD symptoms ( g = 0.80) and perceived health ( g = 1.13). They also exhibited non-significant but medium effect size pre- to post-intervention improvements in quality of life ( g = 0.62), and depression ( g = 0.53), and small effect size pre- to post-intervention improvements in argumentativeness ( g = 0.43), anger ( g = 0.31), and anxiety ( g = 0.31). Partners reported significant and moderate pre- to post-intervention effect size improvements in relationship satisfaction (g = 0.68 ), and medium but not significant effect size improvements in accommodation of PTSD ( g = 0.56). Results provide initial support for the feasibility, acceptability, and efficacy of Couple HOPES for improving PTSD and relationship satisfaction. However, more testing in larger samples, including with randomized controlled designs, is needed.
The present study used a newly developed simplified coding system, the Therapist Demand and Support Code, to examine specific therapist behaviors in the context of a previously conducted training trial on Deliberate Practice (DP). The parent trial randomized trainees to a DP workshop or its Traditional, more didactic counterpart (Westra et al., 2020). In both groups, trainees were taught to use Support, rather than Demand, for managing ambivalence and resistance, with the DP group having more feedback and practice. In this study, 68 trainees interviewed both an ambivalent community volunteer and an ambivalent simulator 4 month post workshop. The DP group was found to exhibit significantly fewer Demand behaviors than the Traditional group, with the latter also being significantly quicker to use Demand in the interviews. Moreover, the simulator evoked significantly greater Demand from therapists, regardless of the Training group, suggesting the simulators were more resistant. Although therapist use of Support was equal for community volunteers across training groups, Traditional workshop trainees decreased Support when interviewing the more resistant simulators, whereas DP trainees increased their Support with this same group. This is consistent with findings that DP trainees were more appropriately responsive, making fewer Demands following interviewee counterchange talk and using more Support at these times. These results provide some initial validation of the simplified therapist behavior coding system and offer further evidence for the benefits of DP workshop training for managing resistance. Clinical Impact StatementQuestion: This study examines how receiving deliberate practice training impacts therapist levels of support with real people and simulators. Findings: Clinicians should consider evaluating future continuing education workshops for their compliance with deliberate practice training. Meaning: Training should integrate the use of both simulators and real people in explicitly testing training impact because the difficulty of simulators can be increased to promote consistency in clinical skill application. Next Steps: Future training and research should explicitly evaluate the impact of deliberate practice and consider developing less complex process coding systems for easier adaptation to a training context.
workshops, the dominant model of postgraduate training, are not systematically tested and in fact are limited for improving therapist performance. This is because they typically focus more on knowledge than skill (e.g., Davis et al., 1999;Owen et al., 2016;Taylor & Neimeyer, 2017). Workshops on motivational interviewing are one of the few areas where therapist learning has been studied versus assumed (MI;Miller & Rollnick, 2002). MI workshops tend to involve relatively higher amounts of practice, and reviews of 2-day workshops indicate that they have large effects on self-reported skills and modest effects on observer-rated skills pre-to post-work-
Novel interventions that overcome limited access to empirically supported psychotherapies for posttraumatic stress disorder (PTSD) are sorely needed. Couple helping overcome PTSD and enhance relationships (HOPES), a guided, online couple intervention drawing from cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson, 2012), was designed to decrease PTSD symptoms and improve relationship satisfaction. The present study is the first uncontrolled trial of 17 couples in which one partner was a military member, veteran, or first responder and had probable PTSD (PTSD+ partner) based on self-report assessment. Intent-to-intervene analyses revealed significant improvements from pre-to postintervention in PTSD+ partners' self-reported PTSD symptoms (g = .72), as well as their intimate partner's relationship satisfaction (g = .34) and behavioral accommodation of PTSD symptoms (g = .84). There were also significant improvements in PTSD+ partners' depression (g = .43) and perceived relationship arguments (g = .62). There were similar results found in the completer sample. There were no adverse events and high satisfaction with the intervention in those who completed the evaluation. These findings provide additional initial data on the safety, feasibility, and efficacy of Couple HOPES. The similarities of intent-to-intervene and completer results, as well as the need for randomized controlled trial designs to test Couple HOPES, are discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.