Indicated Treatment and Prevention of Marital Deterioration in At-Risk Couples

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DESCRIPTION (provided by applicant): The project objective is to conduct a Phase II clinical trial to study the efficacy and safety of the Marriage Checkup (MC), an indicated preventive intervention for treatment-avoidant couples at-risk of marital deterioration and divorce. In addition to the suffering inherent in marital deterioration and divorce, these processes have been associated with increased risk of major depression, substance abuse, domestic violence, physical illness, poorer medical treatment adherence, and poorer child mental and physical health. Couples that become severely distressed and eventually dissolve their marriages first pass through an at-risk stage in which they experience early symptoms of marital deterioration but have not yet suffered irreversible damage. Couples in this at-risk stage are unlikely to seek treatment because they have not yet become distressed enough to see the need or because the barriers to therapy are too great. Such couples also do not seek premarital interventions because they are in established marriages. However, it is during the at-risk stage that couples may benefit most from early intervention. Intervening with couples in this at-risk stage fills a niche between the distress inoculation provided by prevention programs and the intensive treatment provided by couple therapy. There are currently no empirically established programs for intervening early in the process of relationship deterioration. The MC is the first such program. The first objective is to determine the efficacy of the MC as a means of identifying and providing early intervention with treatment-avoidant couples at-risk for marital deterioration and divorce. The objective is to demonstrate that treatment-avoidant couples at-risk of marital deterioration will be attracted to participate in the MC. The second objective is to determine the efficacy of the MC as a means of providing immediate relief from the symptoms of marital distress that may hinder effective marital health behaviors, specifically lack of intimacy, collaboration, and motivation to change. The third objective is to determine the efficacy of the MC as a means of motivating appropriate help seeking. The fourth objective is to determine the efficacy of the MC as a means of preventing marital deterioration/divorce and their sequelae. The MC should facilitate couples' efforts to improve their marital health, which in turn should arrest and reverse relationship deterioration that they would otherwise experience, as well as alleviate the known negative effects of marital distress on partners' mental, physical, and children's' health.