As an individual recovers from posttraumatic stress disorder (PTSD), his or her partner often confronts significant caregiver burden and psychological distress.
A new study discovers that participation in disorder-specific couples therapy resulted in decreased PTSD symptom severity and increased patient relationship satisfaction, compared with couples who were placed on a wait list for therapy.
The study is discussed in the Journal of the American Medical Association (JAMA).
Experts all agree that there are well-documented associations between PTSD and intimate relationship problems, including relationship distress and aggression.
“Although currently available individual psychotherapies for PTSD produce overall improvements in psychosocial functioning, these improvements are not specifically found in intimate relationship functioning.
“Moreover, it has been shown that even when patients receive state-of-the-art individual psychotherapy for the disorder, negative interpersonal relations predict worse treatment outcomes,” study authors said.
In the study, Candice M. Monson, Ph.D., and colleagues examined the effect of a cognitive-behavioral conjoint therapy (CBCT) for PTSD, designed to treat PTSD and its symptoms and enhance intimate relationships in couples.
Researchers conducted the randomized controlled trial from 2008 to 2012, and included heterosexual and same-sex couples (n = 40 couples; n = 80 individuals) in which one partner met criteria for PTSD.
Symptoms of PTSD, co-existing conditions, and relationship satisfaction were collected by assessors at the beginning of the study, at mid treatment (median [midpoint], 8 weeks after baseline), and at post-treatment (median, 16 weeks after baseline).
An uncontrolled 3-month follow-up was also completed. Couples were randomly assigned to take part in the 15-session cognitive-behavioral conjoint therapy for PTSD protocol immediately (n = 20) or were placed on a wait list for the therapy (n = 20).
Researchers studied if the intervention helped reduce PTSD symptom severity (as a primary outcome); and if intimate relationship satisfaction, patient- and partner-rated PTSD symptoms, and co-existing symptoms were also improved (secondary outcomes).
The researchers found that PTSD symptom severity and patients’ intimate relationship satisfaction were significantly more improved in couple therapy than in the wait-list condition.
Additionally, PTSD symptom severity decreased almost 3 times more in CBCT from pretreatment to post-treatment compared with the wait list; and patient-reported relationship satisfaction increased more than 4 times more in CBCT compared with the wait list.
The secondary outcomes of depression, general anxiety, and anger expression symptoms also improved more in CBCT relative to the wait list. Treatment effects were maintained at three-month follow-up.
“This randomized controlled trial provides evidence for the efficacy of a couple therapy for the treatment of PTSD and comorbid symptoms, as well as enhancements in intimate relationship satisfaction,” said researchers.
Notably, improvements occurred in a sample of couples in which the patients varied with regard to sex, type of trauma experienced, and sexual orientation.
Researchers discovered the treatment outcomes for PTSD and related symptoms were comparable with or better than effects found for individual psychotherapies for PTSD.
In addition, patients reported enhancements in relationship satisfaction consistent with or better than prior trials of couple therapy with distressed couples and stronger than those found for interventions designed to enhance relationship functioning in nondistressed couples, report the authors.
In summary, researchers believe cognitive-behavioral conjoint therapy can be an effective strategy to address individual and relational dimensions of traumatization. The therapy technique may be of benefit to individuals with PTSD who have stable relationships, and partners willing to engage in treatment with them.