Initial outcomes of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement

Abstract

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.

An uncontrolled trial of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement.

“…As Liebman et al (2020) note in their review of CBCT for PTSD, partners of those with PTSD tend to report relatively more improvements in relationship satisfaction than PTSD+ participants. This finding was true here and in the Couple HOPES case series (Fitzpatrick et al, 2021). The primary benefits from Couple HOPES may be contingent on an individual’s role in the relationship, with PTSD+ partners experiencing the greatest benefit in PTSD symptoms and their partners experiencing the greatest benefit in relationship satisfaction.…”

“…This uncontrolled pilot trial corroborates the Couple HOPES case series (Fitzpatrick et al, 2021) and provides further support for the feasibility, acceptability, and efficacy of Couple HOPES. Consistent with the primary goals of Couple HOPES, intent-to-intervene and completer results revealed significant improvements in PTSD+ partners’ self-reported PTSD symptoms and their intimate partner’s relationship satisfaction postintervention.…”

“…This study was preregistered on the Clinical Trials Registry (Clinicaltrials.gov; identifier NCT04231578), including sample size and all measures in the study. In accordance with a priori plans and prior work (Fitzpatrick et al, 2021), this article focuses on primary outcomes for both partners and secondary outcomes for PTSD+ participants. Secondary outcomes were also assessed for partners, which will be reported in a subsequent article.…”

“…The safety, acceptability, and outcomes of Couple HOPES was initially tested in a case series of 10 couples in which one partner was a military member, veteran, or first responder with probable PTSD (referred to as the PTSD+ partner; Fitzpatrick et al, 2021). Seven of 10 couples completed the program, and completers were on average “mostly” to “very” satisfied with the program.…”

Partner outcomes from an uncontrolled trial of Couple HOPES: A guided online couple intervention for posttraumatic stress disorder and relationship enhancement

“…All partners were married or common-law married. Full descriptions of participant characteristics are reported in Fitzpatrick et al (2021) and Monson et al (2022). Samples were tested for differences and did not significantly differ with regard to age, relationship length, gender, ethnicity, the presence of children, or educational attainment.…”