Motivational Interviewing as an Intervention for At‐risk Couples

Thirty-one couples participated in a pilot, motivational interviewing, intervention for at-risk couples called the Marriage Checkup (MC).The MC consisted of thorough relationship assessment and individualized feedback.It attracted substantial numbers of at-risk couples who were not otherwise seeking treatment.Partners' marital satisfaction improved signijkantly from pre-to postcheckup and remained improved at 1-month follow up.Partners were no longer sign$icantly direrent from a nondistressed comparison group following intervention.Although not addressing the eficacy of the MC, this study supports its viability as an indicated preventive intervention with couples at-risk for severe marital distress by addressing its attractiveness, tolerability, and safety.Severe and chronic marital distress takes a dramatic toll on the health, welfare, and quality of life of distressed partners and their children.It has been estimated that at any one time, approximately 20% of all marriages are experiencing some significant level of distress (Beach, Arias, & O'Leary, 1987) and that between 40% and 50% of first marriages can be expected to end in divorce (U. S. Bureau of the Census, 1992).In addition, the risk of having a major depressive episode has been estimated to be 25 times higher for both men and women in discordant marriages (Weissman, 1987).Chronic marital distress has been reported to be the most frequent precipitant to depression in women (Paykel et al., 1969), has been associated with poor treatment response (Rounsaville, Weisman, Prusoff, & Herceg-Baron, 1979), and has been implicated in depressive relapse (Hooley & Teasdale, 1989).In addition, many individuals seeking marital therapy report high levels of substance abuse (Halford & Osgarby, 1993), and chronic marital distress has been reported to frequently precipitate problem drinking (Maisto, O'Farrell, Connors, McKay, & Pelcovits, 1988).Maritally distressed couples are at greater risk for marital violence with its substantial physical and mental health risks, particularly to women and children (Holtzworth-Munroe, Smutzler, Bates, & Sandin, 1997).Marital discord has also been shown to directly affect the immune system of individuals (Newton, Kiecolt-Glaser, Glaser, & Malarkey, 1995) and to affect adherence to medical treatment regimens (Schmaling & Sher, 1997).Furthermore, research has demonstrated significant effects on the children of distressed couples, including poorer school performance, more behavioral problems, and a greater incidence of physical illness (Cherlin, Furstenberg, Chase-Lansdale, & Kiernan, 1991; Emery, 1988).In short, there is good evidence to support the argument that preventing severe and chronic marital distress and deterioration may have a positive effect on a range of psychological, behavioral, and physical disorders.Unfortunately, most interventions for marital distress have traditionally been limited to marital therapy (although for an example of premarital distress prevention see Gordon & Durana, 1999).As a result, professional help has typically been available only after relationships have significantly deteriorated and, even ~~ ~