Effectiveness of emotionally focused couple therapy in a multidisciplinary Veterans Health Care setting

Abstract: Emotionally Focused Couple Therapy (EFCT) is an empirically validated treatment for relationship distress with well-established efficacy. However, there is an increased need to understand its effectiveness and applicability in real-life clinical environments, including hospital and training clinics, and across varying therapist training backgrounds. Our clinical training program in a multidisciplinary US Veterans Affairs (VA) hospital follows a standardized protocol of Sue Johnson's externship in EFCT (ICEEFT 2023; Johnson 2019). Healthcare professional trainees complete a 6-month EFCT didactic and experiential series while delivering EFCT to veterans and their partners. We utilized dyadic analyses to evaluate (a) changes in relationship satisfaction and (b) moderating factors, such as therapist training background, treatment modality, and length of treatment, and (c) demographic characteristics, including age, race/ethnicity, combat status, and service-rated disability associated with changes in relationship satisfaction. The sample consisted of 79 diverse couples (n = 158) that completed a mean of 16 sessions. Reliable change indices (RCI) showed 18.9% and 40.4% of individuals significantly improved in relationship satisfaction from pre- to posttreatment on the Dyadic Adjustment Scale and Couples Satisfaction Index, respectively. Results were robust across telehealth/face-to-face modality, session count, or therapist training background and demographic characteristics. These findings suggest that EFCT is a therapeutic intervention teachable in a multidisciplinary training setting and remains effective in improving relationship satisfaction for the veterans and their partners. The present study is the largest to date to examine the effectiveness of EFCT for veterans and their partners in a VA training hospital.