November 1st, 2014

Marriage Checkup Program outlined

With the divorce rate hovering around 50 percent of all marriages in this country, the road to happy-ever-after is not always smooth. In fact, according to James V. Cordova, Ph.D., professor and chair of psychology and the director for the Center for Couples and Family Research at Clark University, couples who expect to hit a few bumps along the way can make the journey more successful in the long run.

Cordova recently completed work as the principal investigator of a one million dollar National Institute of Health grant developing the Marriage Checkup Program. His research, which he is working to disseminate through training modules and two books written for the public and for mental health professionals, “The Marriage Checkup: A Scientific Program for Sustaining and Strengthening Marital Health” and “The Marriage Checkup Practitioner’s Guide: Promoting Lifelong Relationship Health,” has produced a practical model for clinicians to quickly assess and provide feedback for relationships both healthy and distressed.

Cordova recently spoke with Catherine Robertson Souter of New England Psychologist about the Marriage Checkup and why it’s something that he feels should and will be as widespread among adults as the standard dental checkup.

 Q: First, tell us what is the Marriage Checkup Program?

 A: Well, it is intended to  basically be preventive, the relationship health equivalent of your annual physical health checkup or every-six-month dental health checkup.

As human beings, we are tuned to be mostly scanning the environment for threats and problems and it is very easy to overlook things we could be grateful for. We want to turn partners back towards each other to be able to celebrate who they are and recognize that as a foundation for healthy relationships.

What we are theorizing about clinically and what we are culling out of the research literature is that the patterns that undermine relationship health are often invisible to the couples caught in those patterns. What we want is to be able to get in there before couples start to identify themselves as distressed so we can help them to identify those themes and patterns that might be corrosive before they do any permanent damage.

When I first started doing this research, what we had available for couples was either tertiary care when the relationship starts to become distressed or relationship education for newlyweds but nothing for couples in between.

Q:  Why are checkups necessary?

 A: The hope of something like a checkup is that it can do for the population’s relationship health what the dental checkup has done for the population’s dental health. The move from strictly dental treatment to prevention happened in the Army during the 1950s partly to keep soldiers ready and able to go into the field. They were losing a lot of people to tooth decay, root canals and that sort of thing so they were experimenting with this regular checkup model. It spread into the broader community and has led to the shift where people expect now to keep most of their teeth for a majority of their lives versus prior to that when you could expect to lose most of them after a certain period of time.

The analogy is that, in the absence of some kind of regular preventive care, it seems to be predictable that a certain percent of relationships are just going to end to the same extent that it was predictable that you are just going to lose a number of your teeth. If we can set up this kind of broad-based preventive care and influence the culture in such a way that people would be going to get a marriage checkup on a regular basis, we might have that same effect on relationship health and prevent a large portion of divorces.

Q: How do you get people to buy into this?

 A: Part of what we are trying to help people to understand is that relationship health is a health system just as much as physical health, mental health or dental. If you look into the research literature it is quite clear that the quality of a person’s relationship has a fairly direct influence across all of these health systems.

When people start thinking of it in terms of health, then we already have this model in the community of how to maintain health and a checkup is part of that model. You take your teeth, your body, even your car, in for a checkup and this is what we do to take care of things that matter most deeply to us.

The other thing about it is that it is fast and it’s easy and it is not therapy. You are coming in for an assessment session and for a feedback session and get to go away and never come back.

We try to keep it positively focused on the couple’s strengths and the experience is intended to be both interesting and fun. People are more willing to do something like this because it is not in the context of a distressed relationship. And, once they have a positive experience, it will further lower the bar to additional therapy if needed.

Q:  This could have a major impact on adult life in this country and around the world. How do you envision this working? Would adults see a therapist or do this online?

 A: I think it is essential for the couple to get in front of a trained professional because one part of the presumption is that we are all blind to our blind spots.

I have thought about training anyone for whom part of their professional life is working with couples. Part of the challenge is that it has to be very brief. How do you make a meaningful and significant impact on a couple’s relationship health in a relatively brief period of time?

Q:  Where are you in the process of getting this out to the public?

 A: We did a longitudinal study on the effects of the marriage checkup, following couples for two years, and we just had that study published in the “Journal of Consulting and Clinical Psychology.” Given the positive results that we were getting out of that study, we started to disseminate the checkup through other studies. So we are doing another study at the University of Tennessee, where we are disseminating the marriage checkup into low income homes and we are just finishing up a pilot study funded by the Department of Defense for Air Force couples.

We are also doing preliminary work on a Web site designed to be a portal for clinicians and couples to set up appointments. The couple would complete a questionnaire online and find clinicians trained to do couples checkups.

Q:  How did you, as a psychologist, come to work in this field?

 A: When I was in grad school at the University of Washington, I trained with Neal Jacobson. He developed, with Andrew Christensen, Integrative Behavioral Couples Therapy, a shift from a skills-based to an acceptance-oriented approach, helping couples to recognize that if you put two complicated human beings together in something as emotionally complex as a long term relationship, you are going to get a handful of naturally occurring friction points. Successful couples’s therapy is not about helping couples to eliminate those friction points but helping them to live more gracefully with them.

Then I was on an internship studying Bill Miller’s drinker’s checkup and for me it was this serendipitous opportunity to combine these two idea of helping couples to identify patterns with a checkup model.

Then of course, coming out of a research background, before we can disseminate that, we have to develop it and see if it actually works. 

By Catherine Robertson Souter

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