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8-12-2016 Relationship science and interventions: Where we are and where we are going Kieran T. Sullivan Santa Clara University, [email protected]

Erika E. Lawrence

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Recommended Citation Sullivan, K.T. & Lawrence, E.E. (2016). Relationship science and interventions: Where we are and where we are going. In K.T. Sullivan and E.E. Lawrence (Eds) The Oxford Handbook of Relationship Science and Couple Interventions. Oxford Press.

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This Book Chapter is brought to you for free and open access by the College of Arts & Sciences at Scholar Commons. It has been accepted for inclusion in Psychology by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. CHAPTER Relationship Science and Couple Interventions: 18 Where We Are and Where We Are Going

Kieran T. Sullivan and Erika Lawrence

Abstract

Relationship distress and divorce often have profound effects on couples and their children. Relationship science has long sought to prevent and alleviate relationship distress; this chapter is a summary of many important recent developments in the field. Ongoing challenges in studying and assisting intimate relationships are also discussed.

Key Words: long-term relationship, , couple intervention, marriage, relationship distress, divorce, distressed marriage, marital distress

The purpose of this book is to describe and inre­ relational processes and efforts to base the descrip­ grate cutting edge research in the basic and applied tion of such processes on empirical evidence mark a study of relationship development, maintenance, substantial move forward for the field. Experts call and dysfunction. We hope you, the reader, will gain for continued improvement, particularly in devel­ a sense of the critical importance of srudying rela­ oping greater precision in the conceptualization of tionship functioning, the current state of the field relational processes, which will facilitate meaning­ of relationship science, and what top research sci­ ful inquiry into rhe causes of couple dysfunction, entists view as the crucial next steps to understand­ encourage innovation in applied research, and result ing intimate relationships in all their complexity in in better empirical data on which to base policy order to effectively assist couples who experience decisions (Beach et al., Chapter 2). A focus on the distress and dysfunction. In this final chapter, we dissemination of current definitions and assessment summarize the key developments and future chal­ instruments and related training across counrries lenges for relationship scientists and practitioners and settings is also needed to maximize the poten­ described in this book. tial of the new, more precise definitions (Foran et al., Chapter 3). Summary of Key Developments in Couple Research and Interventions Causes and Con·elates ofCouple Defining and Classifying Couple Dysfunction Dysfunction Perhaps the most innovative and leading edge Perhaps the most fundamental contribution for of recent relationship research is the integration of scientists and practitioners has been the develop­ genetics and epigenetics. Al1 emerging body of work ment of reliable and precise standard definitions of provides compelling evidence that understanding key relational processes to guide assessment, diag­ molecular generics and epigenetic processes that nosis, and research, which have taken place in the affect gene expression and activity is essential for context of the recent DSM and !CD revisions. 'l11e understanding relationship functioning and out­ increased focus of these classifications systems on comes. Furthermore, examining the interactions

259 among genetics, epigenetics, and key family pro­ factors for mental illnesses and relationship pro­ cesses will assist in the development of more cesses (Whisman & Robustelli, Chapter 6). precise models that will better capture the transac­ Research on the associarion between sexual tio nal processes between family and genetic faccors functioning and relationship functioning remains (Beach, Brody, & Kogan, Chapter 4) and how these limited. Basic research on sexual functi oning and processes affect individual health and well-being. relationships is scarce and there are currently no Recent rapid improvements in the technology for randomized clinical trials of sex therapy, in part genotyping has spurred on research in this area and due ro the medicalization of sexual dysfunction. the continued development ofs uch technology, and C linical researchers have argued for a psychobioso­ associated reduced costs, is expected co encourage cial approach to treatment and cognitive-behavioral the inclusion of genetic and epigenetic variables in therapy for sexual dysfunction has been developed couple and family research. and implemented in recent years. McCarthy and Several other key areas of research into couple Wald (Chapter 7) call for an empirical study of dysfunction that are described in this book are the models of sexual functioning and its association associations between physical and mental health with relationships functioning, as well as effi cacy and relationships, the connections between sex­ trials for sex therapy. ual and relationship functioning, and the effects Rega rding partner aggression, recent research has of parmer aggression and infidelity. Decades of highlighted the importance of psychological aggres­ research on health and couple functioning have sion and its relationship co physical aggression. provid ed abundant evidence of the strong link fndeed, evidence from treatment research indicates between physical health and relationship satisfac­ that reducing psychological aggression is the key to tion. Recent research has elucidated the complex­ reducing physical aggression. There are a number of ity of the relations between physical health and treatments that have been shown to reduce partner relationship processes, which is best conceptual­ aggression, such as behavioral couple therapy, treat­ ized as a reciprocal, longitudinal feedback loop, ment for substance dependence, and couple therapy wherein relationship factors influence health designed to specifically treat partner aggression, as processes and health issues influence relation­ well as individual services for men and women fol­ ship processes. Longitudinal designs that include lowed by dyadic interventions. Ir remains critical multiple assessments of couple functioning­ for practitioners to identify couples who can ben­ from prediagnosis through recovery- are needed efit from dyadic interventions, particularly because in o rder ro understand the complexity of the there is litrle evidence that mandated individual relatio nship between health and relationship services fo r males arc effective (Salis & O 'Leary, functio ning (Piecqnski et al. , C hapter 5). Such C hapter 8). research will help practitioners maximize the Recent research o n infidelity indicates that atti­ effectiveness of interventions before, during, and tudes about infidelity, marital satisfaction, and sexual after illness, and to attenuate couple expectations satisfaction are important predictors of engaging in regarding relationship functioning throughout infidelity. These findings have important treatment this process. implications and suggest optimal targets when help­ Research on relationship factors and men tal ing couples understand why the extramarital infi­ health has examined the complexity of associa­ delity occurred and helping couples prevent fu ture rions between psychopathology and relationship occurrences. The good news regarding treatment is functioning by controlling for third variables (e.g., that though it is difficult, there is evidence that sug­ personali ty variables) and employing twin studies gests that it can be successful; empirically validated to test whether genetic and/or shared environment treatment approaches include the forgiveness-based selection effects ca n account for these associations. approach developed by Gordon and colleagues Research in this field has also expanded to include (H owell, G ilberr, & Gordon, C hapter 9), behav­ mental disorders that have not been examined pre­ ioral couple therapy, integrarive behavioral couple viously (e.g., binge eating disorder), and to iden­ therapy, and emotionally focused couple therapy tify speci fi c aspects of relationship functioning (see also C hapter 13). that contribute to the development and mainte­ nance of psychopathology, such as expressed emo­ Assessment, Design, and Data Analysis tion and perceived criticism. Future research is A series of recommendations for best prac­ needed to explore interactions between other risk tices in the assessment of couple distress have been

260 I RE LAT I ONS HIP SCI ENCE AND COU P LE I NTE RVENTI ONS developed based on empirical findings regarding Yi, Chapter 16). When working with stigmatized or couple distress (Balderrama-Durbin, Fisserte, & marginalized groups, such as lesbian, gay, bisexual, Snyder, Chapter 10). Key elements ofoptimal assess­ and transgender (LGBT ) couples, couples with low ment include an initial screening of couple and indi­ socioeconomic status (SES), or couples who belong vidual functioning, a tailored in-depth assessment to a disadvantaged minority group, it is critical to based on the couple and the psychometric charac­ address the unique challenges faced by these couples teristics of each assessment technique, and assessing (Mitchell, Chapter 17). communication, aggression, substance use, affective Another challenge to actualizing the promise of disorders, and emotional or physical involvement ESTs is dissemination to practitioners. The APA, with someone other than the relationship partner. among other organizations, is attempting to meet Multiple assessment methods (e.g., self-reports and this challenge by developing specific processes for partner reports, interviews, behavioral observations) establishing treatment guidelines based on empiri­ should be used whenever possible and the assess­ cal fi ndings and clinical experiences (Sexton & ment of couple distress should be ongoing. LaFollette, Chapter 12). There are also exciting The ubiquity and ongoing rapid development of new approaches to intervening with couples, such information technology have dramatically improved as the Marriage Checkup and web-based programs our ability to design and analyze research on couple such as Power of Two and Our Relationship, that dysfunction. Relationship researchers are now eval­ show promise for improving our efforts to prevent uating and improving measurements using Item and treat couple distress (Fleming & Cordova, Response Theory (e.g.,' relationship satisfaction, Chapter 15). Funk, Rogge, & Ronald, 2007). There are many new options for collecting data in more naturalistic Suggestions for Moving the Field Forward settings, such as the use of mobile devices to assess Our first recommendation for the field is to actu­ in-the-moment behaviors, feel ings, and thoughts, alize the promise ofempil'icalo/ sttppol'ted tl'eatments. direct observation outside the laboratory using Researchers have already taken steps to address the voice- and video-streaming (e.g., Skype), and pas­ challenge of dissemination of efficacious interven­ sive monitoring for collecting naturalistic behavior tions. An excellent model is the training ofVeteran's samples that requires little or no effort on the part of Administration therapists to implement Integrative participants. Automated coding programs based on Behavioral Couple Therapy (IBCT) to assist veter­ acoustic speech features and video are being devel­ ans who are suffering from posttraumatic stress dis­ oped and show great promise for coding behavior order (PTSD ). Evidence indicates that IBCT is an in a fraction of the rime it currently takes. Finally, effective treatment fo r PTSD, especially fo r those new statistical techniques, such as multilevel model­ suffering from comorbid couple distress (Monson, ing and actor-partner interdependence models, are Macdonald, Fredman, Schumm, & Taft, 2014). allowing researchers to analyze the ongoing mutual This is a great example of how researchers and gov­ influence of intimate partners (Atkins & Baucom, ernment can work together to get interventions out Chapter 11). and assess their effectiveness in community settings. Our second recommendation is to expand the sys­ Treating Couple Dysfunction and Distress tem for specialization in couple andfo mio/ psychology. There are a number of empirically validated Couple distress is the most common complaint of approaches to treating (Benson & Christensen, those who seek therapy, bur most couples do not Chapter 13) and preventing couple distress (H alford, receive empirically supported treatments and/or do Perch, & Bate, Chapter 14) that have the potential not work with a trained couple therapist. Ineffective to increase the effectiveness of couple interventions. couple therapy is costly for those who receive it and Two challenges, however, limit actualizing their contribute to the myth that couple therapy is largely potencial in clinical settings. The first is the lack of ineffective. Stanton and Welsh's (2011) seminal text research on treating diverse couples (e.g., people of on Specialty Competencies in Couple and Famio/ color, gay and lesbian couples). Adcfitional research Psychology "provides a comprehensive explanation that focuses on whether empirically supported of the competencies involved in the specialty and treatments (ESTs) are effective for couples from illustrates how complexity, reciprocity, interdepen­ diverse cultural backgrounds and whether cultural dence, adaptation, and self-organization are impor­ adaptations of ESTs do, in fact, improve outcomes tant aspects of rhe epistemology of a couples and for diverse groups is sorely needed (Sevier, Brew, & family approach." Indeed, the American Board

SULLiVAN, LAWRENCE 261 of Couple and Family Psychology, which admin­ family psychology encompasses a broad orienta­ isters the examinations that allow professionals tion to human behavior that occurs in the context to become Board Certified as Couple and Family of relationships as well as larger macrosystemic Psychologists, evaluates individuals based on this set dynamics (Stanton & Welsh, 2011). Research of competencies. These certification processes and clearly demonstrates that the couple and family established, operationalized competencies are the context is bidirectionally related to individual adult key to determining which professionals are truly and child well-being. Assessing the effectiveness of qualified to provide couple or and integrated care, for example, relationship and health will allow potential clients to make better informed outcomes when family interventions are merged decisions about where to seek couple therapy. with pri mary health care, or when interventions for Third, we call for efforts to clearly establish the physical aggression are merged with public health cost effectiveness ofcouple interventions. Government efforts, is critical for optimizing outcomes and research and fu nding emphasize the need for cost­ minimizing cost. effective interventions; thus there has been great interest in fu nding for the prevention of marital References distress through implementation of empirically sup­ Funk, j. L., Rogge, & Ronald D. (2007). Testing the ruler with ported premarital education programs. Mal

RELATI ONSHI P SCIENCE AND COUPLE INTERVENTIONS