Implementation of Strength at Home for Military Couples

April 27, 2022 updated by: Casey Taft, Boston VA Research Institute, Inc.

Strength at Home Couples Program to Prevent Military Partner Violence

The Strength at Home Couples program is designed to enhance intimate relationships and prevent intimate partner violence (IPV) among service members and their partners in light of the unique stressors and experiences of this population.

Study Overview

Detailed Description

A Hybrid Type-I Implementation-effectiveness research design will allow the research team, comprising investigators with expertise in treatment development, efficacy and effectiveness research, and implementation science, to simultaneously investigate the effectiveness of SAH-C in a military population while identifying any barriers to implementation that would need to be addressed before SAH-C could be successfully implemented on a larger scale.

SAH-C derives from a unique fusion of interventions for trauma and IPA, integrating elements of cognitive processing therapy for PTSD,39 couples therapy for PTSD,40 and a cognitive behavioral intervention for IPA.41 SAH-C consists of 10 two-hour weekly sessions, co-led by two therapists. This was the minimum length deemed necessary to incorporate components addressing the proposed IPA mechanisms and is consistent with the briefest IPA interventions.42 During each session, couples are provided assignments to practice skills together and to assist with the consolidation of material. A group couples format is used because group cohesion among clients appears to be associated with IPA prevention.43 Group interventions also use less time and resources than individual-based interventions.

Study Type

Interventional

Enrollment (Actual)

150

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Washington
      • Tacoma, Washington, United States, 98431
        • Joint Base Lewis McChord

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Couples must be in an intimate relationship
  • Must be over the age of 18
  • Both members of the couple report no occurrence of physical IPA in the past 3 months and no severe aggression in the past 12
  • At least one member reports at or below a score of 100 on the Dyadic Adjustment Scale
  • Both members must provide research consent

Exclusion Criteria:

  • Will be excluded on the basis of reading difficulties that preclude valid completion of the assessment instruments

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: PREVENTION
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: SINGLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Active Treatment
The intervention includes components from empirically validated interventions for intimate relationship difficulties and PTSD. This includes core themes of trust, self-esteem, power and control, conflict-management skills, and communication skills training.
See arm description.
ACTIVE_COMPARATOR: Supportive Treatment
Broadly based on the principles and techniques of client centered (Rogerian) therapy, and the fundamental principles and practices for experiential group psychotherapy as specified by Yalom. The group also draws upon the work of Murphy's Supportive Therapy protocol specifically for group intervention with domestic abuse perpetrators.
See arm description.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Domestic Violence Prevention - Revised Conflict Tactics Scale (CTS2)
Time Frame: Intake/Pre-Treatment
Changes of physical and psychological IPV as evidenced by change in CTS2 responses. Each item response option ranges in value from 0-7 with 0 being the minimum value and 7 being the maximum value. Scale is a 78-item measure with higher scores meaning greater conflict.
Intake/Pre-Treatment
Domestic Violence Prevention - Change in CTS2
Time Frame: Post-treatment (after 10 weeks of class)
Changes of physical and psychological IPV as evidenced by change in CTS2 responses. Each item response option ranges in value from 0-7 with 0 being the minimum value and 7 being the maximum value. Scale is a 78-item measure with higher scores meaning greater conflict.
Post-treatment (after 10 weeks of class)
Domestic Violence Prevention - Change in CTS2
Time Frame: 3-month post-group follow-up (3-months after last class)
Changes of physical and psychological IPV as evidenced by change in CTS2 responses. Each item response option ranges in value from 0-7 with 0 being the minimum value and 7 being the maximum value. Scale is a 78-item measure with higher scores meaning greater conflict.
3-month post-group follow-up (3-months after last class)
Relationship Satisfaction: Dyadic Adjustment Scale
Time Frame: Intake/Pre-Treatment
Changes in relationship satisfaction as evidenced by answers to the Dyadic Adjustment Scale. Items 1-15 options: Always Agree, Almost Always Agree, Occasionally Disagree, Frequently Disagree, Almost Always Disagree, Always Disagree. Item 16-22: All the Time, Most of the Time, More Often than Not, Rarely, Never. Item 23: Every day, Almost Every Day, Occasionally, Rarely, Never. Item 24: All of them, Most of them, Some of them, Very few of them, None of them. Items 25-28: Never, Less than once a month, Once or twice a month, Once or twice a week, Once a day, More often. Items 29-30: Yes/No. Item 31: Extremely Unhappy, Fairly Unhappy, A Little Unhappy, Happy, Very Happy, Extremely Happy, Perfect. Item 32: six statements in which the participant picks the statement that best describes how they feel about the future of their relationship. Overall score ranges from 0 to 151; higher scores indicating a more positive adjustment and lower level of distress within relationship.
Intake/Pre-Treatment
Change in Relationship Satisfaction: Dyadic Adjustment Scale
Time Frame: Post-treatment (after 10 weeks of class)
Changes in relationship satisfaction as evidenced by answers to the Dyadic Adjustment Scale. Items 1-15 options: Always Agree, Almost Always Agree, Occasionally Disagree, Frequently Disagree, Almost Always Disagree, Always Disagree. Item 16-22: All the Time, Most of the Time, More Often than Not, Rarely, Never. Item 23: Every day, Almost Every Day, Occasionally, Rarely, Never. Item 24: All of them, Most of them, Some of them, Very few of them, None of them. Items 25-28: Never, Less than once a month, Once or twice a month, Once or twice a week, Once a day, More often. Items 29-30: Yes/No. Item 31: Extremely Unhappy, Fairly Unhappy, A Little Unhappy, Happy, Very Happy, Extremely Happy, Perfect. Item 32: six statements in which the participant picks the statement that best describes how they feel about the future of their relationship. Overall score ranges from 0 to 151; higher scores indicating a more positive adjustment and lower level of distress within relationship.
Post-treatment (after 10 weeks of class)
Change in Relationship Satisfaction: Dyadic Adjustment Scale
Time Frame: 3-month post-group follow-up (3-months after last class)
Changes in relationship satisfaction as evidenced by answers to the Dyadic Adjustment Scale. Items 1-15 options: Always Agree, Almost Always Agree, Occasionally Disagree, Frequently Disagree, Almost Always Disagree, Always Disagree. Item 16-22: All the Time, Most of the Time, More Often than Not, Rarely, Never. Item 23: Every day, Almost Every Day, Occasionally, Rarely, Never. Item 24: All of them, Most of them, Some of them, Very few of them, None of them. Items 25-28: Never, Less than once a month, Once or twice a month, Once or twice a week, Once a day, More often. Items 29-30: Yes/No. Item 31: Extremely Unhappy, Fairly Unhappy, A Little Unhappy, Happy, Very Happy, Extremely Happy, Perfect. Item 32: six statements in which the participant picks the statement that best describes how they feel about the future of their relationship. Overall score ranges from 0 to 151; higher scores indicating a more positive adjustment and lower level of distress within relationship.
3-month post-group follow-up (3-months after last class)
Domestic Violence Prevention - Multidimensional Measure of Emotional Abuse (MMEA)
Time Frame: Intake/Pre-Treatment
Changes of physical and psychological IPV as evidenced by changes in MMEA scores. MMEA is a 28-item measurement tool with scale responses ranging from 0 to 7 where higher scores indicate greater emotional abuse.
Intake/Pre-Treatment
Domestic Violence Prevention - Change in MMEA
Time Frame: Post-treatment (after 10 weeks of class)
Changes of physical and psychological IPV as evidenced by changes in MMEA scores. MMEA is a 28-item measurement tool with scale responses ranging from 0 to 7 where higher scores indicate greater emotional abuse.
Post-treatment (after 10 weeks of class)
Domestic Violence Prevention - Change in MMEA
Time Frame: 3-month post-group follow-up (3-months after last class)
Changes of physical and psychological IPV as evidenced by changes in MMEA scores. MMEA is a 28-item measurement tool with scale responses ranging from 0 to 7 where higher scores indicate greater emotional abuse.
3-month post-group follow-up (3-months after last class)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Suicidal Ideation
Time Frame: Intake/Pre-Treatment
Changes in suicidal ideation through the suicidality measure asking about suicidal thoughts (the four response options include: I do not have thoughts, Sometimes I have thoughts, Most of the time I have thoughts, and I always have thoughts), suicide attempts (response is a fill in the blank), wish to live/die (the three response options include I have a moderate to strong wish to live/die, I have a weak wish to live/die, and I have no wish to live/die), and belongingness (some items will be reverse scored and the 7-point Likert scale includes 1[Not at all true for me], 2, 3, 4 [Somewhat true for me], 5, 6, 7 [Very true for me]). Lower scores indicate less suicidal ideation.
Intake/Pre-Treatment
Suicidal Ideation
Time Frame: Post-treatment (after 10 weeks of class)
Changes in suicidal ideation through the suicidality measure asking about suicidal thoughts (the four response options include: I do not have thoughts, Sometimes I have thoughts, Most of the time I have thoughts, and I always have thoughts), suicide attempts (response is a fill in the blank), wish to live/die (the three response options include I have a moderate to strong wish to live/die, I have a weak wish to live/die, and I have no wish to live/die), and belongingness (some items will be reverse scored and the 7-point Likert scale includes 1[Not at all true for me], 2, 3, 4 [Somewhat true for me], 5, 6, 7 [Very true for me]). Lower scores indicate less suicidal ideation.
Post-treatment (after 10 weeks of class)
Suicidal Ideation
Time Frame: 3-month post-group follow-up (3-months after last class)
Changes in suicidal ideation through the suicidality measure asking about suicidal thoughts (the four response options include: I do not have thoughts, Sometimes I have thoughts, Most of the time I have thoughts, and I always have thoughts), suicide attempts (response is a fill in the blank), wish to live/die (the three response options include I have a moderate to strong wish to live/die, I have a weak wish to live/die, and I have no wish to live/die), and belongingness (some items will be reverse scored and the 7-point Likert scale includes 1[Not at all true for me], 2, 3, 4 [Somewhat true for me], 5, 6, 7 [Very true for me]). Lower scores indicate less suicidal ideation.
3-month post-group follow-up (3-months after last class)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

September 1, 2015

Primary Completion (ACTUAL)

September 30, 2021

Study Completion (ACTUAL)

September 30, 2021

Study Registration Dates

First Submitted

January 26, 2018

First Submitted That Met QC Criteria

August 17, 2020

First Posted (ACTUAL)

August 19, 2020

Study Record Updates

Last Update Posted (ACTUAL)

April 28, 2022

Last Update Submitted That Met QC Criteria

April 27, 2022

Last Verified

April 1, 2022

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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