Optimizing an Online Couples PTSD Self-Help Treatment

Cognitive-Behavioural Conjoint Therapy (CBCT) is an efficacious couples therapy that targets posttraumatic stress disorder (PTSD) and relationship satisfaction. However, there are significant barriers to accessing CBCT, including additional barrier from the COVID-19 pandemic. To increase accessibility an online, therapist-assisted couples self-help intervention was modelled after CBCT, Couple HOPES (CH). Generic couples therapy and CBCT literature suggest that initial relationship satisfaction may moderate treatment outcomes and predict dropout. Determining if preintervention relationship satisfaction moderates outcomes in CH is imperative to ascertain if it is an effective treatment alternative for couples with both high and low relationship satisfaction. The proposed study aims to examine the effects of preintervention relationship satisfaction on PTSD, relationship satisfaction and dropout in CH. The proposed project will utilize data from a larger funded trial. Military members, veterans, first responders, and healthcare workers exposed to COVID-19 with PTSD and their significant other (N = 140) will be receive access to 7 CH modules and 4 brief therapist calls. Self-report measures will be administered at pre, mid, post, and follow up. PTSD will be assessed with the PTSD Checklist for the identified patient and the PTSD Checklist Collateral version for the partner. The Couples Satisfaction Index will assess each partners' relationship satisfaction. PTSD and relationship satisfaction outcomes will be analyzed using growth curve modelling. Dropout will be analyzed with a continuous time survival analysis. These findings have clinical implications for maximizing outcomes by paring couples with the most suitable intervention based on their relationship satisfaction.