OurRelationship Program for Relationship Distress

(VA-OR Trial)

Overseen By Leslie A. Morland, PsyD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Substance use, Psychotic, Bipolar, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

Duration: 8 weeks

180 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test an online program called OurRelationship, designed to help Veterans improve their intimate relationships. Strong relationships can enhance mental and physical health, particularly for Veterans who face barriers to accessing couple and family care. The trial will compare couples who start the program immediately with those who wait two months. Couples experiencing significant relationship distress, who are part of the VA San Diego Healthcare System, and have internet access are well-suited for this trial. As an unphased trial, participants can contribute to research that may enhance relationship support for Veterans.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on relationship distress and does not mention medication requirements.

What prior data suggests that the OurRelationship program is safe for improving relationship functioning?

Research shows that the OurRelationship program is an online therapy based on proven methods for helping couples. Studies have found it effective in improving relationships, with no safety concerns reported. The program is mostly self-guided, allowing couples to work through it independently, which reduces the chance of side effects.

Various studies have tested the OurRelationship program, showing positive results in helping couples improve communication and satisfaction. So far, no reports of harm or negative effects have emerged from using this program, suggesting it is very safe and well-tolerated by participants.

Overall, the OurRelationship program appears to be a safe option for couples wanting to enhance their relationship skills, especially since it is entirely online and doesn't involve medication or invasive procedures. ^{1 2 3 4 5}

Why are researchers excited about this trial?

The OurRelationship program is unique because it offers an accessible, online platform specifically designed to help couples experiencing relationship distress. Unlike traditional couples therapy, which often requires in-person sessions and can be costly or difficult to schedule, this program allows couples to work through their issues at their own pace and from the comfort of their homes. Researchers are excited about this trial because it has the potential to reach a broader audience, providing support to those who might not otherwise seek help, and could offer a more flexible and cost-effective solution to relationship problems.

What evidence suggests that the OurRelationship program is effective for improving relationship distress?

Research shows that the OurRelationship program effectively improves how couples interact. It offers an eight-hour online therapy based on successful in-person couple therapies. Over ten years of government-funded research supports this program, demonstrating its ability to attract participants and help them improve their relationships. It has been especially successful for underserved couples, such as racial minorities and low-income families, who often face more relationship challenges. This evidence suggests the program can be a valuable resource for veterans and their families seeking to strengthen their relationships. Participants in this trial will either begin the OurRelationship program immediately or after a two-month delay, depending on their assigned group. ^{1 2 3 6 7}

Who Is on the Research Team?

Kayla C. Knopp, PhD

Principal Investigator

VA San Diego Healthcare System, San Diego, CA

Are You a Good Fit for This Trial?

This trial is for Veteran couples experiencing relationship distress. Eligible participants are Veterans and their partners who have been together for at least a year, speak English, and report significant relationship issues. They must have internet access and be willing to participate in online sessions. Couples with recent substance abuse, severe mental health disorders, cognitive impairments, or high-risk suicidal behavior are excluded.

Inclusion Criteria

Couples must be married, living together, or in a relationship for at least 12 months

We have reliable internet for online programs and telehealth visits.

Couples must both speak, read, and write English

Exclusion Criteria

Neither my partner nor I have been hospitalized for suicide-related reasons in the past year.

Neither my partner nor I have uncontrolled bipolar or psychotic symptoms.

Couples will be excluded if either partner reports a diagnosis of severe cognitive impairment or intellectual disability (by self-report)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Waitlist Control

Couples assigned to the Waitlist Control condition will begin the OurRelationship program following a 2-month delay after random assignment

8 weeks

Treatment

Participants receive the OurRelationship program, which includes eight hours of a self-paced online couples' program with three 20-minute telehealth coaching sessions

8 weeks

3 telehealth coaching sessions

Follow-up

Participants are monitored for relationship and individual functioning improvements, with data collected at baseline, mid-program, post-program, and a 6-month follow-up

6 months

What Are the Treatments Tested in This Trial?

Interventions

• OurRelationship

Trial Overview The 'OurRelationship' program is being tested to see if it can improve intimate relationships among Veterans by providing an evidence-based online intervention that's flexible and accessible. The study will evaluate the effectiveness of this coached program in supporting Veterans' rehabilitation and enhancing life quality.

How Is the Trial Designed?

Group I: Waitlist Control Experimental Treatment 1 Intervention

Couples assigned to the Waitlist Control condition will begin the OurRelationship program following a 2-month delay after random assignment.

Group II: Immediate Treatment Experimental Treatment 1 Intervention

Couples assigned to the Immediate Treatment condition will begin the OurRelationship program immediately following random assignment.

OurRelationship is already approved in United States for the following indications:

Approved in United States as OurRelationship Intervention (ORI) for:

• Marriage and relationship education/skills
• Marriage enhancement
• Divorce reduction
• Job and career advancement

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Published Research Related to This Trial

Couples who participated in a structured communication version of the Prevention and Relationship Education Program (PREP) showed more positive communication behaviors and fewer negative ones at the 6-month follow-up compared to those who did not receive structured communication training.

Both groups of couples experienced a decrease in negative communication patterns, but there was no significant change in overall relationship adjustment, indicating that while communication improved, it did not necessarily translate to a better overall relationship status.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dismantling study of prevention and relationship education program: the effects of a structured communication intervention. Owen, J., Manthos, M., Quirk, K.[2013]

In a study of 221 distressed couples on a waitlist for online relationship help, there was a general pattern of improvement in relationship satisfaction and individual psychological distress over six months, even without intervention.

Despite these improvements, most couples remained relationally distressed, suggesting that while some natural progress can occur, many couples still require structured interventions to achieve significant and lasting improvements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trajectories of relationship and individual functioning among waitlisted couples for an online relationship intervention. Barton, AW., Lavner, JA., Hawrilenko, MJ., et al.[2022]

The Prevention and Relationship Enhancement Program (PREP) effectively teaches couples skills like conflict resolution and communication, which help reduce marital distress and enhance relationship satisfaction.

Research indicates that PREP can lead to significant decreases in marital distress and improvements in satisfaction that last for up to four years after participation, making it a valuable preventive intervention for couples.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Equipping couples with the tools to cope with predictable and unpredictable crisis events: the PREP Program. Freedman, CM., Low, SM., Markman, HJ., et al.[2004]

The Prevention and Relationship Enhancement Program (PREP) significantly improved communication skills and relationship quality among 321 lower-income and racial/ethnic minority couples, demonstrating its effectiveness in enhancing relationship functioning.

Couples who participated in PREP in a couple format experienced better outcomes in relationship quality compared to those in a group format, suggesting that the delivery method can influence the effectiveness of relationship interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of PREP with lower-income racial/ethnic minority couples. Owen, J., Quirk, K., Bergen, C., et al.[2022]

Couples experiencing relationship distress are increasingly attending Couple and Relationship Education (CRE) programs, raising questions about the effectiveness of these programs for this specific group.

The study found that the dosage and duration of participation in CRE programs significantly influence outcomes, suggesting that tailored approaches based on distress levels and time spent in the program are essential for improving effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

It's About Time! Examining Received Dosage and Program Duration as Predictors of Change Among Non-Distressed and Distressed Married Couple and Relationship Education Participants. Bradford, AB., Drean, L., Adler-Baeder, F., et al.[2019]

The Within My Reach healthy relationships curriculum was effective for 202 low-income, at-risk individuals, showing significant improvements in knowledge, communication skills, and relationship quality immediately after training and at 6 months post-training.

Participants reported high satisfaction with the training, and there was a trend towards reduced relationship violence, suggesting that community collaboration can enhance the effectiveness of relationship programs for at-risk populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of the within my reach relationship training on relationship skills and outcomes for low-income individuals. Antle, B., Sar, B., Christensen, D., et al.[2014]

The Prevention and Relationship Enhancement Program (PREP) significantly improved communication skills among couples, leading to higher positive and lower negative communication levels at the 5-year follow-up.

Couples who participated in PREP also reported lower levels of marital violence compared to those in the control group, highlighting the program's effectiveness in promoting healthier relationships.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preventing marital distress through communication and conflict management training: a 4- and 5-year follow-up. Markman, HJ., Renick, MJ., Floyd, FJ., et al.[2019]

In a study of 362 low-income African American and Hispanic couples, distressed couples showed significant improvements in relationship functioning, including dedication and communication, after participating in couple relationship education (CRE) programs.

Couples in a group format experienced greater gains in positive communication compared to those in a single-couple format, highlighting the potential benefits of group dynamics in CRE interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Relationship education in community settings: effectiveness with distressed and non-distressed low-income racial minority couples. Quirk, K., Strokoff, J., Owen, JJ., et al.[2022]

The web-based relationship intervention for individuals (OR-I) showed significant improvements in quality of life, work functioning, and perceived health among participants compared to a waitlist control group, indicating its efficacy in enhancing individual well-being.

While OR-I did not lead to significant improvements in relationship functioning or symptoms of depression and anxiety, it maintained benefits in quality of life and perceived health over a short-term follow-up, suggesting it could be a valuable option for those unable to engage in traditional couple therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Online OurRelationship Program for Relationally Distressed Individuals: A Pilot Randomized Controlled Trial. Nowlan, KM., Roddy, MK., Doss, BD.[2020]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4804631/

Effects on Relationship and Individual Functioning This study tests the efficacy of the OurRelationship (OR) program, an eight-hour online program adapted from an empirically-based, in-person couple therapy.

2. ourrelationship.com ourrelationship.com/evidence/

Evidence The OurRelationship programs are proven to be effective and are backed by more than a decade of federally funded research and results.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5786273/

The Online OurRelationship Program for Relationally ... The present pilot study examined the efficacy of a fully web-based relationship intervention for individuals (OR-I).

4. researchgate.net researchgate.net/publication/330546613_Effectiveness_of_the_Online_OurRelationship_program_for_underserved_couples

(PDF) Effectiveness of the Online OurRelationship Program ... The OurRelationship program is a brief web-based program with demonstrated efficacy in attracting, retaining, and improving relationship functioning.

5. psycnet.apa.org psycnet.apa.org/record/2019-02989-001

Effectiveness of the online OurRelationship program for ... Underserved couples (e.g., racial minorities or low-income populations) are at higher risk for relationship distress and dissolution.

6. clinicaltrials.gov clinicaltrials.gov/study/NCT02806635

Study Details | NCT02806635 | Web-based Programs to ... The OurRelationship program is based on Integrative Behavioral Couple Therapy and encourages couples to select, understand, and solve a relationship problem.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT04588012

A Pilot Study of OurRelationship.dk, a Web-based Self-help ... The OurRelationship program, a web-based, primarily self-help program for couples developed in the US, has previously shown medium to large effects sizes on ...