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Trauma and Stressor Related Disorders and Disasters

Couple HOPES, an online, guided self-directed intervention for PTSD and relationship enhancement: A case study presentation

(PS4-A9) Couple HOPES, an Online, Guided Self-directed Intervention for PTSD and Relationship Enhancement: A Case Study Presentation

Friday, November 18, 2022

1:30 PM – 2:30 PM EST

Location: Westside Ballroom, 5th Floor

Author(s)

Sonya Varma, M.A.

Doctoral Student
York University
Toronto, Ontario, Canada

Co-Author(s)

Skye Fitzpatrick, Ph.D.

Assistant Professor
York University
Toronto, Ontario, Canada
JI

Jennifer Ip, M.A.

Graduate Student Researcher
Ryerson University
Toronto, Ontario, Canada
KW

Kristen M. Whitfield, PhD

Masters Student
Ryerson University
Toronto, Ontario, Canada
AS

Ashley N. Siegel, Other

Student
York University
Thornhill, Ontario, Canada
EE

Elizabeth A. Earle, PhD

Research Coordinator & Lab Manager, TULiP Lab
York University
Toronto, Ontario, Canada
CS

Christina Samonas, PhD

Lab Manager and Research Assistant
Ryerson University
Toronto, Ontario, Canada
VD

Victoria L. Donkin, B.A.

Research Assistant
York University
Toronto, Ontario, Canada
AC

Alexis Collins, B.S.

Research Assistant
Ryerson University
Ajax, Ontario, Canada
JB

Julianne Bushe, None

Research Assistant
Ryerson University
Toronto, Ontario, Canada
RV

Robert Valela, Other

Research Project Manager
Ryerson University
Edmonton, Alberta, Canada
Alexander O. Crenshaw, Ph.D.

Postdoctoral Fellow
Ryerson University
Toronto, Ontario, Canada
CM

Cait Martin-Newnham, B.S., Other

Project Manager
York University
Toronto, Ontario, Canada
Lindsay Fulham, M.A.

Graduate Student
York University
Toronto, Ontario, Canada
AD

Alyssa A. Di Bartolomeo, PhD

Graduate Student
York University
Thornhill, Ontario, Canada
DM

Desiree H. Mensah, B.S.

Research Assistant
York University
Mississauga, Ontario, Canada
Meredith S. Landy, Ph.D.

Research Fellow
Ryerson University
Toronto, Ontario, Canada
Leslie Morland, Psy.D.

Professor of Psychiatry
VA San Diego Healthcare System/University of California, San Diego
La Jolla, California
Brian D. Doss, Ph.D.

Professor of Psychology
University of Miami
Miami, Florida
AW

Anne C. Wagner, Ph.D.

Adjunct Professor
Ryerson University
Toronto, Ontario, Canada
CM

Candice Monson, Ph.D.

Professor
Ryerson University
Toronto, Yukon, Canada

Posttraumatic stress disorder (PTSD) is significantly associated with intimate relationship distress, particularly among veterans and military members. Cognitive-Behavioral Conjoint Therapy for PTSD (CBCT-PTSD; Monson & Fredman, 2012) is an efficacious in-person couple intervention that improves PTSD and intimate relationship functioning simultaneously. To address barriers to its access, CBCT-PTSD was adapted into an online, guided self-directed intervention: Couple HOPES (Helping Overcome PTSD and Enhance Satisfaction). Preliminary research shows that Couple HOPES improves PTSD and relationship satisfaction for those with PTSD and their intimate partners. However, a comprehensive understanding of how a couple engages with Couple HOPES, and how this associates with objective and subjective outcomes, remains unknown. Elucidating this type of information is essential to ultimately inform user interface, intervention development, and which perspective couples may, or may not, benefit from Couple HOPES, and how they may do so. Accordingly, this study involves a case study presentation of the first couple who underwent Couple HOPES. We describe: 1) how this couple engaged with each Couple HOPES component (e.g., psychoeducational module completion pace, practice assignment frequency, coaching call content themes); and accordingly present 2) their quantitative (i.e., changes in outcome) and qualitative (i.e., feedback on their intervention impressions) intervention experiences. The adult couple comprises one individual with PTSD (Canadian veteran) and their intimate partner involved in a case series testing the feasibility, acceptability, and efficacy of Couple HOPES (Fitzpatrick et al., 2021). Regarding intervention engagement, the couple consistently completed modules weekly, practiced assignments daily – with increased effort on approaching trauma-reminders that elicited avoidance, and attended coaching calls bi-weekly, in accordance with the coaching manual. Regarding clinically significant change from pre-post intervention, both partners recovered (i.e., reliably improved and crossed diagnostic threshold) across self- and informant-ratings of PTSD and relationship satisfaction. Both partners also improved across other clinical domains (e.g., depression). At post-intervention, the couple expressed high intervention satisfaction levels, improved communication, a deeper shared understanding of PTSD, and discovered that approaching versus avoidance was essential to their healing. Although future work explicating the other couples’ experiences is needed, results suggest that couples who engage consistently with each intervention component, and who identify that approaching avoidance is essential in combating PTSD, may particularly benefit from, and enjoy, Couple HOPES.