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

Trial Summary

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 data supports the effectiveness of the OurRelationship treatment for relationship distress?

Research shows that the OurRelationship program, including its online version, can improve quality of life, work functioning, and perceived health for individuals experiencing relationship distress. Additionally, the Prevention and Relationship Enhancement Program (PREP), a component of the treatment, has been effective in improving communication skills and reducing marital distress. ^{1 2 3 4 5}

Is the OurRelationship Program safe for participants?

The OurRelationship Program and similar relationship education programs like PREP and Within My Reach have been studied for their effects on relationship skills and outcomes. Participants generally report high satisfaction and improvements in communication and relationship quality, with no significant safety concerns noted in the studies. ^{2 3 5 6 7}

How is the OurRelationship treatment different from other treatments for relationship distress?

The OurRelationship treatment is unique because it focuses on teaching couples skills like conflict resolution and communication to prevent and manage relationship distress, rather than just treating it after it occurs. It emphasizes building intimacy, commitment, and friendship, which can help protect against future crises and improve relationship satisfaction over time. ^{3 5 6 8 9}

What is the purpose of this trial?

Access to a flexible spectrum of family-based VA mental health care for Veterans is mandated by law. Research shows that relationship distress harms Veterans' mental health, physical health, and mortality, while healthy relationships provide resilience and facilitate recovery from illness. However, there are many barriers to accessing couple and family care within VA, including system-level barriers such as insufficient access to specialty providers and couple-level barriers such as difficulty coordinating schedules and finding childcare. OurRelationship is an evidence-based, coached online intervention for couples that provides flexible, accessible, and scalable treatment to improve relationship functioning. This proposed CDA-2 project will test whether OurRelationship is effective for improving Veterans' intimate relationships and supporting their rehabilitation. This study supports the mission of the 2018-2024 Strategic Plan of the Department of Veterans Affairs by improving Veterans' relationship functioning to enhance their overall quality of life.

Research Team

Kayla C. Knopp, PhD

Principal Investigator

VA San Diego Healthcare System, San Diego, CA

Eligibility Criteria

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

Couples must both speak, read, and write English

We have reliable internet for online programs and telehealth visits.

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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 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]

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]

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) 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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

The effectiveness of PREP with lower-income racial/ethnic minority couples. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

The Online OurRelationship Program for Relationally Distressed Individuals: A Pilot Randomized Controlled Trial. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

Preventing marital distress through communication and conflict management training: a 4- and 5-year follow-up. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Trajectories of relationship and individual functioning among waitlisted couples for an online relationship intervention. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Dismantling study of prevention and relationship education program: the effects of a structured communication intervention. [2013]

6. United States 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. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

The impact of the within my reach relationship training on relationship skills and outcomes for low-income individuals. [2014]

8. United States pubmed.ncbi.nlm.nih.gov

Equipping couples with the tools to cope with predictable and unpredictable crisis events: the PREP Program. [2004]

9. United States pubmed.ncbi.nlm.nih.gov

Relationship education in community settings: effectiveness with distressed and non-distressed low-income racial minority couples. [2022]