The Effectiveness of Couple Therapy and Relationship Support

Official title

The Effectiveness of Couple Therapy and Relationship Support: a Randomized Controlled Trial

Overview

This randomized and controlled study investigates the effectiveness of relationship counselling and couple therapy in improving couples' relationship satisfaction and overall well-being. It compares four intervention groups both with each other and with a waitlist control group. The groups are: 1. HUS Self-Help (Mielenterveystalo.fi): Participants independently complete online self-help tasks based on couple therapy, developed by Helsinki University Hospital (HUS) Psychiatry and Väestöliitto. 2. Peloton Parisuhde (eng. Fearless Relationship) Online Course: Based on Emotionally Focused Couple Therapy (EFCT), this course by EFCT trainers Eklund-Mikola \& Pinomaa uses online lectures and exercises to help couples identify negative interaction patterns and strengthen their emotional connection. 3. Short Manualized Emotionally Focused Couple Intervention: Five face-to-face sessions with a couple therapist. 4. Face-to-Face Couple Therapy (Treatment As Usual): 1 to 10 sessions, with the therapeutic approach varying depending on the therapist's training. The study is conducted at the Relationship Counselling Unit of the City of Helsinki's Social Services in Finland, which provides counselling and family guidance under Section 26 of the Social Welfare Act to couples with children living in Helsinki. A total of 200 couples from the unit's treatment queue will be invited to participate and randomly assigned to one of the interventions or the control group, with 40 couples in each group. Participants will complete questionnaires at the beginning and end of the service, and at a 4-month follow-up. The questionnaires measure relationship satisfaction and well-being, among other things. The study also examines how individual, couple-level, and treatment-related background factors influence and mediate the effectiveness of the interventions. In addition to the questionnaires, registry data, therapist assessments, and ongoing treatment feedback collected within the unit is utilized. The results will provide new scientific insights into the effectiveness of short interventions and their suitable target groups and can be used to develop relationship counselling work both within the unit and nationally.

Interventions

• Behavioral Self-Help Program for Couples
  Self-Help Program for Couples (Mielenterveystalo.fi) developed by HUS, this online self-help program provides couples with psychoeducational content and practical exercises designed to enhance relationship well-being. Partners can complete the tasks together or individually. The materials aim to strengthen emotional connection and improve communication.
• Behavioral Peloton Parisuhde (eng Fearless Relationship) Online Course
  Based on Emotionally Focused Couple Therapy, this course by Eira Eklund-Mikola and Hanna Pinomaa uses online lectures and exercises to help couples identify negative interaction patterns and strengthen their emotional connection.
• Behavioral Manualized Short-Term EFT-Based Couple Intervention
  Manualized Short-Term EFT-Based Couple Intervention is a structured program consisting of five face-to-face sessions with a trained couple therapist. Based on Emotionally Focused Therapy (EFT), the intervention helps partners explore emotional patterns, improve communication, and strengthen their bond through guided therapeutic exercises.
• Behavioral Standard Face-to-Face Couple Therapy (Treatment as Usual)
  This intervention consists of 1 to 10 in-person sessions with a couple therapist. The therapeutic approach varies depending on the therapist's professional background and training. It reflects typical clinical practice and is not standardized, allowing for flexibility in addressing the couple's specific needs.

Primary outcome measures

• Relationship Satisfaction (Dyadic Adjustment Scale) [Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.]
• Depression severity (Patient Health Questionnaire-9) [Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.]
• Anxiety Severity (Generalized Anxiety Disorder-7) [Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.]

Secondary outcome measures (3)

• Adult Attachment (Experiences in Close Relationships - Revised [Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.]
• Reflective Functioning (Reflective Functioning Questionnaire) [Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.]
• Communication Patterns (Communication Patterns Questionnaire) [Time frame: Masured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup]

Eligibility criteria

Inclusion criteria

• Parents (couple) and blended families, and at least one of the parents is resident of Helsinki
• Couples expecting their first child. The couple is experiencing one or more of the following (1) severe relationship conflict, (2) a serious threat of separation, (3) significant challenges in forming a family or navigating a blended family relationship.
• couples eligible for treatment at the couple counselling faculty of Helsinki

Exclusion criteria

• Inadequate Finnish written language skills (the questionnaires are only available in Finnish)
• if both spouses do not complete the baseline questionnaires within the given deadline.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Supportive care

Study locations

Finland · 1 center

• Relationship Counselling — Helsinki

Identifiers

NCT: NCT07604740 · nro 20/2024

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗