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Symposia

Couples / Close Relationships

Session: From "Too Little, Too Late" to the Right Treatment at the Right Time: Toward a Stepped-Care Approach to Relationship Health

3 - (SYM 67) Adapting the Relationship Checkups for Use in the Veterans Healthcare Administration: Utilizing Community and Provider Input to Maximize Treatment Engagement

Saturday, November 18, 2023

10:30 AM – 12:00 PM PST

Location: Clallum (701), Level 7

Speaker(s)

PB

Peter Britton, Ph.D. (he/him/his)

Research Psychologist
Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System
Canadaigua, New York

Co-author(s)

DC

Dev Crasta, Ph.D. (he/him/his)

Research Psychologist
Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System
Canandaigua, New York
JF

Jennifer Funderburk, Ph.D.

Clinical Research Psychologist
Department of Veterans Affairs
Syracuse, New York
SM

Stephen Maisto, PhD

Professor Emeritus
Department of Clinical Psychology, Syracuse University; Center of Integrated Healthcare, Syracuse VA Medical Center
Syracuse, New York

Background: In the last decade, the US Department of Veterans Affairs (VA) has disseminated a range of evidence-based couple therapies in specialty behavioral health clinics. Unfortunately, these services are underutilized with low initial engagement and high rates of dropout before therapeutic effect is reached. One potential solution is to implement Relationship Checkups (RC), a brief, 2-3 session intervention that combines couple therapy skills and motivational interviewing techniques (MI). While RC has demonstrated promise improving relationships for active-duty military couples (Cordova et al., 2022), its MI components also have the potential to increase engagement with couple and family support offered in VA.

Method: We describe the process of adapting RC to veterans considering relationship services within VA’s integrated healthcare system. Initial input was sought from a regional Veteran’s Engagement Board and VA care coordinators representing family-focused programs (e.g., Intimate Partner Violence Assistance Program, Caregiver Support Program). Suggested practices were then incorporated with a pilot group of N=20 couples completing RC.

Results: Consultation with the Veteran’s Engagement Board led to the creation of a series of modular one-paragraph service descriptions to facilitate engagement in additional treatment. RC interventionists used the descriptions to provide couples with information about services that are directly relevant to couples’ concerns using eligibility guidelines provided by coordinators and the interventionists' own judgment. For the 18 couples completing the RC pilot, the most frequently recommended relationship support services were couple therapy, relationship aggression courses for the veteran, or caregiver support for the partner. In the 90 days after completing RC, these relationship support services were used by nine couples (50%; M=4.2 sessions attended).

Discussion: Using input from veterans, an acceptable and promising brief intervention was adapted to be the "first step" of a more comprehensive couples relationship treatment program. RC has potential to meet multiple needs by quickly improving relationship satisfaction and facilitating engagement in more intensive treatments. We end with a discussion of further adaptations to RC based on pilot feedback and input from VA’s suicide prevention coordinators.