Like an annual physical for our health, an annual “marriage checkup” can keep relationships healthy, according to James Cordova, Ph.D., associate professor of psychology at Clark University in Worcester, Ma.
He presented preliminary findings on his Marriage Checkup Project Saturday in Orlando, Fl., at the Association for Behavioral and Cognitive Therapies convention.
“Marital satisfaction improves for couples who have been through the Marriage Checkup and control couples aren’t improving,” he said, citing his results on 68 couples followed for six months.
The goal is to enroll 200 couples, randomly assigning them to the checkup or no checkup and assessing the results. Currently, 136 are enrolled and in various stages of follow up, he said.
“Essentially the marriage checkup is the marital health equivalent of the annual physical or the every six-month dental visit,” Cordova said.
He developed it in 1996, he said, because currently couples have access mainly to “primary prevention” — workshops geared to the newly married or those about to marry — and to “crisis” interventions such as marriage counseling when the marriage is in trouble.
There’s little available in the middle, he said, for couples mildly concerned about the health of their marriage or who want to be active in keeping their marriage healthy.
“We want to be able to catch the potentially damaging processes in a relationship before they actually do any real significant damage,” Cordova said.
Research over the past decades has uncovered predictors of marital health and deterioration, he said. Divorce has been shown more likely, for instance, among couples with poor communications and those prone to criticizing each other. But like a tiny dental cavity you can’t see, Cordova said, “so much is what is predictive of a deteriorating relationship is difficult for the couple to detect.” That’s where the checkup comes in.
The checkup includes a two-session intervention. In the first session, couples complete a battery of questions about marital health, covering a wide range of areas, Cordova said, including problem solving, communication skills, sex, conflicts over child-rearing, intimacy issues, and patterns of disagreements.
Next, the couples come in for a face-to-face assessment. “During the interview with a marital health consultant, we ask about the early phases of their marriage, how they got together, the decision to get married,” he said. The identify strengths and weaknesses.
In the study, the average age is 47 for husbands and 44 for wives; the couples have been marred on average 15 years, although some are newlyweds and others veterans of many decades of marriage.
“We watch them talk about a problem in their relationship together,” he said, noting that the conversation is videotaped — and telling when he and his colleagues evaluate it later.
Two weeks later, the couple is given a feedback report, highlighting strengths and weaknesses. “We talked about what they have self-identified as principal strengths and weaknesses,” he said. “Most people are pretty good at it.”
“We provide them with a menu of options,” Cordova said. The options may include seeing a marriage therapist, do-it-yourself measures such as reading a book on their issue or spending more time together, or a combination.
Next, the program directors follow up with a questionnaire six months later, to see how things are going. In all, the follow up will stretch to two years.
Preliminary results are promising, Cordova said. He reported on the first 68 couples followed for six months; half got the Checkup and half did not (although they will be offered it later).
Improvements are occurring in many areas, he said. Besides marital satisfaction, improvements were seen in intimacy, the degree to which each partner feels accepted and their ability to cooperate and get things done together.
Cordova expected some relapse after the improvement — similar, he says, to how people get more serious about health habits after visiting their doctor and getting advice, then sloughing off until the next checkup is near.
“For the treatment group, they are improving and maintaining at the two-week follow up and then have a little relapse at six months, but it’s still better than it was,” Cordova said.
The control group had no improvement in the areas measured, he said.
The project is funded by the National Institutes of Health’s National Institute of Child Health and Human Development. In previous research Cordova’s group did a pilot study to test the concept.
If the results hold as the study continues, Cordova hopes to package the Marriage Checkup and make it widely available. He sees it as a small and brief intervention with a big payoff. “This relatively brief intervention is resulting in significant improvements,” he said.
“For a lot of couples, life gets up and running and we stop paying attention to the health or our marriage,” Cordova said. “Often, our marriages don’t catch our attention until they start to hurt.”
Looking inward on an annual basis, he said, could help people maintain a healthy, more satisfying marriage.
As 55 percent of the couples in the project are raising children, Cordova also hopes to develop the Parenting Checkup for Couples in the future.
Cordova’s new book, The Marriage Checkup: A Program for Sustaining and Strengthening Marital Health is due out in April 2009.
Source: Association for Behavioral and Cognitive Therapies