Pilot Study of an Eight-Week Group Cognitive Behavioral Conjoint Therapy (CBCT) for PTSD Treatment Delivery with Active Duty and Veteran Couples in Community Clinic Settings

Background and Purpose: This study’s objective was to conduct a one group, pre- and post-treatment program evaluation of cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD) delivered in group format over eight weeks with active duty and veteran couples. CBCT for PTSD supports the couple working together in treatment to “shrink the PTSD” in their relationship.  CBCT) for PTSD has been offered in Veterans Health Administration and community settings with good outcomes, for active duty and veteran couples (Monson, et al., 2004; Monson et al., 2011). Research has been conducted on a 15-week format with individual couples, but this study is the first to evaluate the treatment delivered over 8 weeks with groups of couples. Based on positive anecdotal reports from similar treatment offered in VA settings, and research in active duty settings, we hypothesized that clients treated by community based clinicians would achieve similar treatment gains by reducing symptoms of PTSD and depression, and increasing quality of life and relationship satisfaction.

Methods: A total of 20 couples completed eight weeks of treatment over one year from four clinicians in two clinics. The format of CBCT was shortened from 15 to 8 weeks based on consultation with treatment developers in 2018. Couples completed pre- and post-treatment assessments online with the Quality of Life and Enjoyment Scale Short Form (QLES-SF), the Patient Health Questionnaire-9 (PHQ-9), the Couples Satisfaction Index (CSI), the Dyadic Adjustment Scale (DAS) and the PTSD Checklist-5 (PCL-5).

Results: Results are pending final follow up data collection in spring 2019. Paired samples t-tests will yield findings regarding any significant changes in key mental health and relationship measures. Anecdotally, couples reported positive aspects of group treatment that allowed them to bond with others facing similar problems and learn from each other’s experiences and successes. Further, spouses of service members and veterans were grateful to be part of the treatment recovery process instead of remaining isolated and suffering alongside their spouse. Veteran couples routinely comment about the desire to address PTSD as a couple; pending analysis will contribute to understanding of the effectiveness of couples-based treatment delivered by community-based providers.

Conclusions and Implications: The various CBCT delivery formats assessed in this pilot study – group format, shorter duration and in community rather than military/VA settings, all merit more rigorous study to understand CBCT’s full potential. Social workers trained in this modality will have another tool to use in their work with veterans and service member affected by trauma, while also supporting spouses who suffer alongside a loved one with PTSD.