Developmental Couple Therapy for Complex Trauma: Results of a Pilot Study

This session is not available for CE credits.

Abstract
This presentation will share the results of a pilot study to examine the efficacy, process, and outcomes of Developmental Couple Therapy for Complex Trauma (DCTCT). DCTCT targets both the individual symptoms of CPTSD in partners as well as couple functioning to fill a significant gap in the mental health treatment needs for survivors and their partners. DCTCT was developed with an emphasis on remediating developmental deficits in self capacities-emotion regulation and mentalization- to directly intervene at individual level CPTSD symptoms and couple level distress. Findings with a diverse group of couples (heterosexual, LGBTQ+, BIPOC, economically disadvantaged) diagnosed with CPTSD and severe couple distress at the beginning of therapy, suggest that DCTCT is a promising treatment for CPTSD symptoms in individuals and couple distress. Fourteen couples took part in an average of 20 one hour sessions of DCTCT with the PI. This was a highly traumatized group of participants with the majority reporting high levels of cumulative CT. Couples were assessed at pre- and post-treatment for levels of CPTSD symptoms and relationship distress as well as for levels of emotion regulation and mentalizing deficits. Two couples separated before completing treatment. Of the 12 couples who completed treatment, there was high compliance with session attendance and high reported satisfaction with treatment. Paired t-test comparisons showed significant improvement in symptoms of CPTSD with an effect size of 2.07 (p.0487). There was not sufficient power to run quantitative analyses on couple satisfaction, emotion regulation and mentalizing due to the small sample size therefore, qualitative analyses were conducted using the reliable change index where clinically significant change was defined as an improvement or deterioration of one standard deviation (SD) , or a change that led to movement out of the clinical range on a measure. The majority of participants no longer met criteria for a diagnosis of CPTSD at the end of treatment. This was the case regardless of changes in couple satisfaction, in that the participants where couple satisfaction did not increase to a clinically significant level, also evidenced clinically significant improvements in CPTSD symptoms. Overall, couple satisfaction showed clinically significant increases with eight of 12 couples moving out of the clinical range ( >98) or improving more than one standard deviation (16). Clinically significant improvements were found in emotion regulation capacities (8/12). Findings regarding mentalizing capacities were inconclusive due to challenges with the reliability of the psychometric measurement. These results can be interpreted as highly promising regarding the potential benefits of DCTCT as sequelae of CT leading to CPTSD are often chronic and resistant to change.