Brian D. Doss

• Ph.D.
• University of Miami

The aim of this study was to pilot an adapted version of an online relationships program with residents in treatment for alcohol and other drugs (AOD). The OurRelationship (OR) Program, which is based on Integrative Behavioral Couples Therapy, was piloted in a group-based format to determine whether residents' participation in the program would res...

Not surprisingly, incarceration's extreme separation and stress have significant negative effects on romantic relationships. Unfortunately, few programs have been developed to improve jailed individuals' romantic relationship with their non‐incarcerated partner. The present study investigated the effectiveness of the individual version of the digit...

Little is known about the individual factors that potentiate communication conflict in romantic relationships. This study examined the main and interactive effects of two types of emotion regulation in 1240 couples enrolled in an online relationship intervention. Results revealed that higher levels of actors' communication conflict were associated...

In couples with a partner with posttraumatic stress disorder (PTSD), accommodation refers to changes in the intimate partner’s (i.e., partner without PTSD) behavior that seeks to avoid or alleviate the PTSD+ partner’s (i.e., partner with PTSD) mental health-related distress. While research shows negative outcomes associated with accommodation for t...

Sexual intimacy, characterized as the experience between individuals of sharing general affection and sexual activity with one another within the Personal Assessment of Intimacy in Relationships inventory, is positively related to relationship satisfaction and stability. However, many studies of couple therapy have shown that it only results in sma...

Online programs that reduce relationship distress fill a critical need; however, their scalability is limited by their reliance on coach calls. To determine the effectiveness of the online OurRelationship program with varying levels of coach support, we conducted a comparative effectiveness trial with 740 low-income couples in the United States. Co...

Low-income couples experience increased stress and declines in relationship quality during the perinatal period. They also encounter many barriers to accessing relationship services. Using a subsample of low-income perinatal couples (n = 180) from two randomized controlled trials, the current study examined the impact of online relationship interve...

Research surrounding pornography and its impact on individual and relationship functioning is a frequent and ongoing debate in the current literature. However, recent meta-analyses and aggregated studies suggest that relationship distress is associated with higher levels of general pornography use. This may be a reason why a significant number of m...

While most psychosocial and behavioral digital health interventions have been designed to be consumed by an individual, intervening at the level of a dyad – two interdependent individuals – can more comprehensively address the needs of both individuals and their relationship. The clinical utility of the dyadic digital health intervention approach,...

Posttraumatic stress disorder (PTSD) is associated with significant individual and relationship impairment for people with PTSD and their romantic partners. Conjoint treatments, such as cognitive behavioral conjoint therapy for PTSD (CBCT), are designed to address individual and relationship factors, yet significant barriers impede accessing in‐per...

The focus of this special section is impact studies that were conducted as part of the Administration for Children and Families' Healthy Marriage and Responsible Fatherhood initiative. This initiative has led to more than 2 million people receiving relationship education and fatherhood programs across the United States over the last two decades. Co...

Low-income couples are at an increased risk for relationship instability and divorce, which can have residual impacts on coparenting between the two partners. Growing evidence suggests that brief online relationship education programs can be an effective tool for alleviating relationship distress among low-income couples. However, findings remain m...

Despite an established link between personality traits and relationship outcomes, few studies have examined whether personality impacts outcomes of couple interventions. Given the growing popularity of online relationship services, we examined whether five-factor model personality traits moderated change in relationship satisfaction, relationship c...

Novel interventions that overcome limited access to empirically supported psychotherapies for posttraumatic stress disorder (PTSD) are sorely needed. Couple helping overcome PTSD and enhance relationships (HOPES), a guided, online couple intervention drawing from cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson, 2012), was designed to...

The current article presents a review of the published research from 2010 to 2019 on the treatment of couple relationship distress; 37 studies met all criteria for inclusion. Behavioral Couple Therapy, Cognitive Behavioral Couple Therapy, Emotionally Focused Therapy, and Integrative Behavioral Couple Therapy meet criteria as “well‐established” appr...

Military-related stressors place veterans at increased risk of intimate relationship problems, which are detrimental to physical health, mental health, and well-being. Couple and family interventions for veterans are effective, and veteran access to family-based care is mandated by law. However, many veteran couples experience barriers to accessing...

Decades of research have documented the apparent health benefits of marriage, but the dynamics of how health may change across the transition to marriage are not fully understood. In two studies, we compared being unmarried or married on several indices of mental and physical health. In Study 1, we used a national sample of 1,078 individuals in dif...

BACKGROUND In-person relationship education classes funded by the federal government tend to experience relatively high attrition rates and have only limited effects on relationships. In contrast, low-income couples tend to report meaningful gains from online relationship education when provided with individualized coach contact. However, little is...

Background In-person relationship education classes funded by the federal government tend to experience relatively high attrition rates and have only a limited effect on relationships. In contrast, low-income couples tend to report meaningful gains from web-based relationship education when provided with individualized coach contact. However, littl...

Low-income couples are at increased risk for relationship instability and divorce. In response, online relationship education programs such as ePREP and OurRelationship have been developed to more easily reach this population. A previous trial indicated that these programs promote relationship functioning (Doss et al., 2020) and individual well-bei...

To inform research and practice with distressed couples, the current study was designed to examine patterns of change among distressed, help-seeking couples prior to receiving an intervention. Data from this study originate from 221 couples assigned to the waitlist control condition of a randomized controlled trial for couples seeking online help f...

The COVID-19 pandemic has highlighted the significant and varied losses that couples can experience during times of global and regional disasters and crises. What factors determine how couples navigate their close relationships during times of loss? In this paper, we elaborate and extend on one of the most influential frameworks in relationship sci...

Couple HOPES (Helping Overcome PTSD and Enhance Satisfaction) is a guided, online couple intervention adapted from Cognitive-Behavioral Conjoint Therapy for posttraumatic stress disorder (PTSD). It was created to overcome a range of barriers to accessing evidence-based treatments for PTSD and the intimate relationship problems associated with it. T...

The logistical, financial, and attitudinal barriers to in-person treatments for relationship distress become even more formidable during periods of social isolation and physical separation. Digital couple interventions are a way to overcome these barriers to work with distressed couples in a remote, asynchronous fashion. We present the OurRelations...

Background: Couple HOPES (Helping Overcome PTSD and Enhance Satisfaction) was created to help overcome a range of barriers to accessing psychotherapy for posttraumatic stress disorder (PTSD) and commonly associated intimate relationship problems. Objective: Couple HOPES is a guided, online self-help intervention adapted from Cognitive-Behavioural C...

Low-income couples tend to face more external stressors and report less stable romantic relationships compared to higher income couples. A recent nationwide randomized controlled trial of the web-based OurRelationship and ePREP programs was conducted with a sample of 742 lower income couples within 200% of the federal poverty line to help improve r...

Divorce or separation concerns have typically been identified as a common reason why couples seek treatment for their relationship. However, to our knowledge, no study has investigated the breakup process in a help-seeking sample. Using a low-income sample of individuals who broke up with their partner during a large randomized controlled trial inv...

Web-based relationship programs are effective in improving low-income couples' relationship functioning. However, little is known about: (a) whether parenting couples presenting for relationship help also have difficulties in coparenting and parenting, (b) whether relationship-focused programs can improve these two domains, and (c) whether program...

With so many promising digital therapeutics for anxiety and obsessive‐compulsive (OC) spectrum problems, there is an urgent need to consider how evolving regulatory oversight of digital therapeutics is poised to shift how these tools are developed, evaluated, reimbursed, and delivered. In this commentary, we discuss both opportunities and potential...

Due to various barriers, most relationally distressed couples do not seek couple therapy. With the COVID‐19 pandemic, many of these barriers are further exacerbated, while the need for relationship services has increased. To increase the reach of couple therapy both during and after the pandemic, we propose a stepped‐care model that utilises techno...

Objective: Web-based relationship interventions have been shown to improve relationship functioning for low-income couples, with gains maintained up through 12 months (Doss et al., 2020; Roddy et al., 2020). However, little is known about mechanisms of improvements and maintenance for these programs. Method: A sample of 742 low-income couples (Mage...

Using a sample of 134 distressed, different-sex couples, this study investigated the effects of Integrative Behavioral Couple Therapy and Traditional Behavioral Couple Therapy on sexual dissatisfaction and sexual frequency both during treatment and in the five years following treatment. Therapy effects depended on treatment type, gender, and whethe...

Objective: Military couples need and desire relationship interventions. Online interventions improve access; however, their effectiveness within the military population is untested. Using a subsample from a larger randomized controlled trial of OurRelationship and ePREP online relationship programs for low-income couples, this study examined basel...

Experimental tests of the association between relationship functioning and physical health are limited. Although associations are hypothesized to be partially mediated through improved psychological functioning, tests are mostly limited to lab‐based studies. The present study evaluated relational and psychological mediators of change in perceived h...

Objectives: This study updated existing meta-analyses of couple therapy that typically do not include multiple treatment modalities, various research designs, long-term outcomes, or recent studies. Eligibility Criteria: Studies published in English that reported relationship satisfaction or other outcomes of couple therapy were included; over 70%...

In recent years, same-gender group-based relationship education has emerged as a viable intervention to prevent relationship distress among same-gender couples. However, many of these programs are conducted in metropolitan areas and lack the ability to reach rural populations. The current study sought to investigate whether two wide-reaching web-ba...

Given the increasing utilization of online recruitment and delivery for prevention programming, the current study was designed to examine the ways in which recruitment and eligibility factors affect the resulting size and composition of participants in an online intervention. Study hypotheses were tested from a sample of 2512 low-income individuals...

Objective: Although low-income couples experience greater relationship challenges, they have limited access to effective relationship interventions. Furthermore, most previous efforts to improve low-income couples' relationships have yielded very small effects (Hawkins & Erickson, 2015). In an effort to overcome these limitations, this study inves...

Initial evidence suggests that gains in relationship functioning from brief, web-based programs are maintained through one year following the intervention; however, whether these results generalize to a low-income sample is unclear. Furthermore, previous research from in-person couple therapy suggests there may be different shapes of maintenance sl...

Relationship distress is a pervasive problem in the USA that disproportionally impacts couples with low-income levels. The goal of the present study was to evaluate the effectiveness of two online relationship interventions, OurRelationship and ePREP, both of which were supported by a paraprofessional coach, in improving mental health and physical...

The transition to parenthood has been identified as a significant relationship stressor. Many couples report declines in relationship satisfaction and difficulty with individual stress and co-parenting—problems that have been associated with both child temperament as well as emotional and behavioral problems. Several parenting and relationship inte...

Compared to higher-income couples, low-income couples experience higher rates of relationship disruption, including divorce and breakup of cohabiting relationships. In recognition of this disparity in relationship outcomes, relationship interventions have increasingly been targeted at this population. However, these interventions have had limited i...

Although online and app-based relationship interventions have been developed to promote relationship well-being, they require a computer, tablet, or smartphone and a high-speed data connection. Instead, text messaging may be a more cost-effective form of delivery. In the current study, 461 participants from three universities, who were mostly femal...

The current study sought to examine immediate and long-term consequences of college sexual assault (C-SA) among women with no prior sexual assault history. While much is known regarding the short-term negative impact of C-SA, the current study examines whether C-SA is associated with immediate academic and psychosocial consequences as well as long-...

Objective To assess program completion of the online OurRelationship program with varying levels of paraprofessional support in an effort to further examine the role of coach support in self‐help couple interventions. Background Although the OurRelationship program for distressed couples has been found to statistically improve relationship and ind...

Internet delivery of couple interventions is becoming increasingly popular; however, little is known about mechanisms of change during these interventions. One online, self-help relationship intervention-the OurRelationship program-has been shown to improve relationship satisfaction (Doss et al., 2016) during the intervention and to maintain gains...

Many children never receive treatment for their mental health symptoms-and those that do often receive it only after years of delay. Given that relationship and parenting conflict is an identified mechanism of child mental health symptoms, reducing distress in the parents' romantic relationship may help reduce this unmet need. In the current study,...

Rationale: Relationship dissatisfaction has been linked with worse health outcomes in many patient populations, though the mechanism(s) underlying this effect are unclear. Among patients with chronic fatigue syndrome (CFS) and their partners, there is evidence for a bi-directional association between poorer relationship satisfaction and the severi...

While the efficacy of couple therapy has been repeatedly demonstrated, most distressed couples do not seek treatment. To improve reach and overcome barriers to therapy, Integrative Behavioral Couple Therapy (IBCT) was translated into a web-based program, OurRelationship (OR). While both IBCT and OR have been shown to improve relationship and indivi...

Recently-developed online interventions for relationship distress show promising results; however, the degree to which paraprofessionals need to be involved with web-based interventions for relationship distress remains unclear. The present study sought to determine if varying levels of coach contact moderated gains during the online OurRelationshi...

Underserved couples (e.g., racial minorities or low-income populations) are at higher risk for relationship distress and dissolution. Although there have been large-scale efforts to improve relationships for underserved couples, these programs have resulted in high attrition and minimal effectiveness. The OurRelationship program is a brief web-base...

This article describes recent developments in online interventions for distressed couples, with a focus on an adaptation of an online program to address the needs of couples in which one partner has Generalized Anxiety Disorder (GAD). This program, OurRelationship.com, is based on Integrative Behavioral Couple Therapy, an empirically supported trea...

Couples are increasingly utilizing newly developed online adaptations of couple therapy; however, different presenting problems could drive couples to seek either online or in‐person services. This study compared the presenting problems of 151 couples seeking an online couple intervention for relationship distress (OurRelationship) with responses f...

In the United States, more than 40% of marriages end in divorce and more than one third of intact marriages are distressed. Unfortunately, only a minority of couples seek couple therapy to improve their relationships. Online interventions, with their increased reach and reduced costs, offer the potential to improve relationships nationwide. The onl...

This special issue presents a collection of reports that highlight recent advances in methods and measurement and also shed light on the complexity of family psychology. The importance of theory in guiding solid family science is evident throughout these reports. The reports include guides for researchers who incorporate direct observation into the...

Technological advances provide tremendous opportunities for couple and family interventions to overcome logistical, financial, and stigma-related barriers to treatment access. Given technology’s ability to facilitate, augment, or at times even substitute for face-to-face interventions, it is important to consider the appropriate role of different t...

Rates of child and adult sexual assault (SA) among women are staggering and place women at risk for intra- and interpersonal difficulties. However, the independent contributions of child and adult SA or the mechanisms of this risk are unknown. This study’s goal was to examine the indirect effects of child and adult SA on women’s own and partner’s r...

Relationship distress has deleterious effects on mental health, physical health, and quality of life. Although many couples report relationship distress, one barrier to seeking services is that one member of a couple may be too busy or refuse to participate. Relationship interventions offered to individuals have shown promising efficacy, but, as mo...

Despite the fact that veterans face increased psychological and relationship distress as a result of their service-related experiences, no study to date has explored long-term effectiveness of couple therapy for veterans. In the present investigation, 238 individuals (113 couples and 12 additional individuals) completed assessments 18 months after...

In-person conjoint treatments for relationship distress are effective at increasing relationship satisfaction, and newly developed online programs are showing promising results. However, couples reporting even low levels intimate partner violence (IPV) are traditionally excluded from these interventions. To improve the availability of couple-based...

The negative impacts of relationship distress on the couple, the family, and the individual are well-known. However, couples are often unable to access effective treatments to combat these effects-including many couples who might be at highest risk for relationship distress. Online self-help interventions decrease the barriers to treatment and prov...

Couple therapy reduces relational and individual distress and may affect utilization of other health services, particularly among higher service utilizers. Although average decreases in service utilization are predicted among recipients of couple therapy, low utilizers of services may appropriately increase use. The relationship between couple ther...

Evidence-based treatment of couples began with the provision of behavioral couple therapy, emphasizing positive behavioral exchange and communication skills training to clinically distressed couples. The theoretical models of couple therapy expanded to incorporate cognitive interventions in Cognitive-Behavioral Couple Therapy, and then acceptance-b...

Integrative Behavioral Couple Therapy (IBCT), developed by Drs. Andrew Christensen and Neil Jacobson, builds off the tradition of behavioral couple therapy by including acceptance strategies as key components of treatment. Results from a large randomized clinical trial of IBCT indicate that it yields large and significant gains in relationship sati...

Integrative Behavioral Couple Therapy (IBCT) is based in part on traditional behavioral couple therapy but expands both the conceptualization of couple distress and of intervention. The efficacy of IBCT has been supported in three clinical trials, including one with five year follow-up. Additionally, the effectiveness of IBCT in the real world has...

The birth of the first baby - often referred to as the transition to parenthood (TTP) - is both a time of great joy and great stress for new parents. Although the literature is mixed, the preponderance of evidence suggests that the TTP has a negative effect on relationship functioning for most couples. However, as children age, the relationship fun...

Objective: Within the United States, one third of married couples are distressed and almost half of first marriages (and more than half of unmarried cohabiting relationships) end in divorce/separation. Additionally, relationship distress has been linked to mental and physical health problems in partners and their children. Although couple therapy...

Feedback to therapists based on systematic monitoring of individual therapy progress reliably enhances therapy outcome. An implicit assumption of therapy progress feedback is that clients unlikely to benefit from therapy can be detected early enough in the course of therapy for corrective action to be taken. To explore the possibility of using feed...

Objective: Empirically based couple therapy results in significant improvements in relationship satisfaction for the average couple; however, further research is needed to identify mediators that lead to change and to ensure that improvements in mediators predict subsequent-not just concurrent-relationship satisfaction. In addition, given that muc...

Although there are a number of highly efficacious in-person treatments designed to ameliorate relationship distress, only a small proportion of distressed couples seek out in-person treatment. Recently developed internet-based interventions based on these in-person treatments are a promising way to circumvent common barriers to in-person treatment...

Purpose: The purpose of this paper is to test the utility of regulatory focus theory principles in a real-world setting; specifically, Internet hosted text advertisements. Effect of compatibility of the ad text with the regulatory focus of the consumer was examined. Design/methodology/approach: Advertisements were created using Google AdWords. D...

Objective: Building on earlier work examining predictors of short- and moderate-term treatment response, demographic, intrapersonal, communication, and interpersonal variables were examined as predictors of clinically significant outcomes 5 years after couples completed 1 of 2 behaviorally based couple therapies. Method: One hundred and thirty-f...

The transition to parenthood has been repeatedly identified as a stressful period, with couples reporting difficulties in domains of individual, coparenting, and relationship functioning. Moreover, these difficulties have been shown to impact children's development. To buffer against these difficulties, numerous effective parenting, couple, and com...

Observed positive and negative spouse behavior during sessions of Traditional (TBCT) and Integrative Behavioral Couples Therapy (IBCT) were compared for couples with successful outcomes and their unsuccessful counterparts. One hundred and thirty-four married chronically and seriously distressed couples (on average in their forties and 80% Caucasian...

This study investigated the impact of couples' agreement regarding relationship problems at therapy intake on subsequent treatment engagement and success. One hundred and 47 couples seeking marital therapy at one of two Veteran Administration Medical Centers completed questionnaires assessing relationship satisfaction and were asked to indicate the...

To examine the current and potential future impact of formal and informal resources to enhance romantic relationships, 1,160 individuals were surveyed. When asked about resources previously used, participants reported that numerous forms of relationship help, including talking to a friend/coworker/family member, an individual therapist, and reading...

Couple therapy-across a number of different theoretical approaches-has been shown to be an effective treatment for a variety of individual and relationship difficulties. Moreover, recent studies have demonstrated that the effects of several approaches last at least 2-5 years after the end of treatment. However, couple therapy has a critical limitat...

Despite the numerous challenges facing U.S. veterans and their relationships, there have been no examinations of the effectiveness of couple therapy for relationship distress provided to veterans. In the present study, 177 couples presenting for couple therapy at two Veteran Administration Medical Centers completed assessments of relationship satis...

Both the prevalence and adverse impact of infidelity argue for the importance of disseminating evidence-based interventions for couples struggling with this highly disruptive event. We describe an integrative approach for promoting recovery from infidelity drawing on empirically supported treatments for couple distress as well as empirical literatu...

To examine changes in observed communication after therapy termination in distressed couples from a randomized clinical trial. A total of 134 distressed couples were randomly assigned to either traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979) or integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998). Video...

Previous studies of couple therapy have conceptualized change as a gradual process. However, there is growing evidence that, for many clients, the majority of gains in other treatment modalities are often achieved between just 2 sessions. Isolating the frequency, nature, and predictors of these sudden gains (SGs) in couple therapy can add to a grow...

Premature termination (PT) has been identified as widespread in individual, family, and couple therapy. Unfortunately, research on PT utilizes numerous definitions of PT without providing guidance on which definition may be most clinically useful. The current study investigated seven definitions of PT (three based on therapist ratings and four base...

Couples presenting for treatment of relationship distress often experience additional problems, including individual psychopathology and intimate partner violence (IPV). Both issues are associated with current and future poor relationship functioning in nontreatment samples, but relatively little is understood about their association with initial p...

Integrative Behavioral Couple Therapy (IBCT) posits that emotional reactions to a partner's behavior can be as important to the relationship as the behavior itself. This study examined whether acceptance (a) is distinct from relationship sentiment, (b) mediates the link between a partner's behavioral frequency and own relationship satisfaction, and...

Although previous research has demonstrated increased relationship distress and separation for cohabiting couples, little is known about specific problems cohabiting individuals encounter in comparison to dating and married individuals. This study examines open-ended reports of 1,252 individuals' (220 dating, 231 cohabiting, and 801 married) relati...

Although second marriages are more likely to end in divorce than first marriages, and thus represent an important target for intervention, there have been no detailed examinations of the use of premarital education in second marriages. Using random-digit dialing methods, 398 individuals currently in a second marriage and 1,342 individuals currently...

This longitudinal study examined the effect of the birth of the 1st child on relationship functioning using data from 218 couples (436 individuals) over the course of the first 8 years of marriage. Compared with prebirth levels and trajectories, parents showed sudden deterioration following birth on observed and self-reported measures of positive a...

This study explored the relations between eating, weight, and shape (EWS) concerns and romantic relationships in college women and their partners. Eighty-eight heterosexual couples (176 individuals) completed two assessments spaced two months apart. Results indicated that neither women's relationship functioning nor perceptions of their partners' d...