Worried About us: Evaluating an Intervention for Relationship-Based Anxiety.

Although romantic relationships are commonly a source of pleasure and comfort, for some individuals they can be a source of persistent anxiety. The aim of the current investigation was to explore the construct of relationship-based anxiety and to evaluate the effectiveness of a brief couple-based psychoeducational session for this issue. Common behavioral patterns and cognitive tendencies seen among individuals with relationship-based anxiety were examined, including excessive reassurance-seeking, self-silencing, and partner accommodation. In the current investigation, a single psychoeducational session was developed to address these maladaptive interactive patterns of behavior specifically. The session was administered to a sample of 21 couples and was found to decrease levels of reassurance-seeking and self-silencing significantly among individuals with relationship anxiety, and to decrease levels of maladaptive accommodation behaviors significantly in their partners.

Rejection Sensitivity, Perceived Power, and HIV Risk in the Relationships of Low-Income Urban Women.

The psychological processes associated with HIV infection in long-term relationships differ from those operative in casual sexual encounters, and relatively little research has considered the aspects of personality applicable in the ongoing heterosexual relationships in which women are at greatest risk. Sensitivity to rejection has been linked with efforts to prevent rejection at a cost to the self and, therefore, may be relevant to the health risks that many women incur in relationships. We examined the association of rejection sensitivity with women's sexual risk behavior in a sample of women at heightened risk for HIV exposure. Women in long-term heterosexual relationships (N = 159) were recruited for study participation in the hospital emergency room serving a low-income neighborhood in New York City, in 2001-2003. Rejection sensitivity and known HIV risk factors were assessed using verbally administered questionnaires. Rejection sensitivity was associated with lower perceived relationship power and, in turn, more frequent unprotected sex with a partner perceived to be at risk for HIV. These results held when controlling for other HIV risk factors including partner violence, economic dependence, and substance use. Understanding the association of rejection concerns with lower perceived personal power in relationships may be important for HIV prevention.

Couple-based interventions for psychopathology: a renewed direction for the field.

This article provides a rationale and empirical support for providing couple-based interventions when one partner in a relationship is experiencing individual psychopathology. Several investigations indicate that relationship distress and psychopathology are associated and reciprocally influence each other, such that the existence of relationship distress predicts the development of subsequent psychopathology and vice versa. Furthermore, findings indicate that for several disorders, individual psychotherapy is less effective if the client is in a distressed relationship. Finally, even within happy relationships, partners often inadvertently behave in ways that maintain or exacerbate symptoms for the other individual. Thus, within both satisfied and distressed relationships, including the partner in a couple-based intervention provides an opportunity to use the partner and the relationship as a resource rather than a stressor for an individual experiencing some form of psychological distress. The authors propose that a promising approach to including the partner in treatment involves (a) integrating intervention principles from empirically supported interventions for individual therapy for specific disorders with (b) knowledge of how to employ relationships to promote individual and dyadic change. Based on this logic, the article includes several examples to demonstrate how couple-based interventions can be focused on a specific type of psychopathology, including encouraging empirical findings for these interventions. The article concludes with recommendations for how clinicians and researchers can adapt their knowledge of couple therapy to assist couples in which one partner is experiencing notable psychological distress or diagnosable psychopathology.

Treating obsessive-compulsive disorder in intimate relationships: a pilot study of couple-based cognitive-behavior therapy.

Although cognitive-behavioral therapy (CBT) involving exposure and response prevention (ERP) is an established treatment for obsessive-compulsive disorder (OCD), not all patients respond optimally, and some show relapse upon discontinuation. Research suggests that for OCD patients in close relationships, targeting relationship dynamics enhances the effects of CBT. In the present study, we developed and pilot tested a 16-session couple-based CBT program for patients with OCD and their romantic partners. This program included (a) partner-assisted ERP, (b) techniques targeting maladaptive relationship patterns focal to OCD (e.g., symptom accommodation), and (c) techniques targeting non OCD-related relationship stressors. OCD, related symptoms, and relationship functioning were assessed at baseline, immediately following treatment (posttest), and at 6- and 12-month follow-up. At posttest, substantial improvements in OCD symptoms, relationship functioning, and depression were observed. Improvements in OCD symptoms were maintained up to 1year. Results are compared to findings from studies of individual CBT for OCD and discussed in terms of the importance of addressing interpersonal processes that maintain OCD symptoms.

Enhancing exposure and response prevention for OCD: a couple-based approach.

The effectiveness of individual therapy by exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) is well established, yet not all patients respond well, and some show relapse on discontinuation. This article begins by providing an overview of the personal and interpersonal experiences of OCD, focusing on interpersonal processes that maintain OCD symptoms and interfere with ERP. The study then describes a couple-based treatment program that the authors have developed to enhance ERP for individuals with OCD who are in long-term relationships. This program involves psychoeducation, partner-assisted exposure therapy, couple-based interventions aimed at changing maladaptive relationship patterns regarding OCD (i.e., symptom accommodation), and general couple therapy. Three case examples are presented to illustrate the couple-based techniques used in this treatment program.

Let me check that for you: symptom accommodation in romantic partners of adults with Obsessive-Compulsive Disorder.

Obsessive Compulsive Disorder (OCD) is typically considered from the perspective of the individual, yet symptoms often occur within an interpersonal context. Family members often engage in accommodation, assisting patients with rituals in order to alleviate anxiety, prevent conflict, or "help out" with time-consuming compulsive behaviors. Prior research has primarily examined accommodation in parents of children with OCD or in adult caregiver relationships, where caregivers can include various family members (e.g., parents, romantic partners). The current study examined accommodation behaviors in romantic partners of adults with OCD. As part of a treatment study, 20 couples were assessed for accommodation behaviors, OCD symptoms, and relationship functioning before and after 16-sessions of cognitive-behavioral treatment. Accommodation was associated with the patient's OCD symptoms at pre-treatment, and negatively associated with the partners', but not the patients', self-reported relationship satisfaction. Post-treatment partner accommodation was also associated with poorer response to treatment. The implications of these findings are discussed within an interpersonal framework, and the benefits of including partners in the treatment of OCD are described.