Clinical Trial of the Online OurRelationship Program for Veteran Couples

Access to a flexible spectrum of family-based VA mental health care for Veterans is mandated by law. Research shows that relationship distress harms Veterans' mental health, physical health, and mortality, while healthy relationships provide resilience and facilitate recovery from illness. However, there are many barriers to accessing couple and family care within VA, including system-level barriers such as insufficient access to specialty providers and couple-level barriers such as difficulty coordinating schedules and finding childcare. OurRelationship is an evidence-based, coached online intervention for couples that provides flexible, accessible, and scalable treatment to improve relationship functioning. This proposed CDA-2 project will test whether OurRelationship is effective for improving Veterans' intimate relationships and supporting their rehabilitation. This study supports the mission of the 2018-2024 Strategic Plan of the Department of Veterans Affairs by improving Veterans' relationship functioning to enhance their overall quality of life.

Inclusion Criteria: * Participants will be couples consisting of a Veteran referred from a mental health care clinic at VA San Diego Healthcare System and their spouse or romantic partner who is willing to participate * Couples must: * both speak, read, and write English * be married, living together, or in a relationship for at least 12 months * endorse clinically significant relationship distress by one or both partner's reports (i.e., \< 104.5 on the Couples Satisfaction Index-32) * have internet access sufficient to complete the online program and attend telehealth visits * be willing to have telehealth coach sessions audio-recorded Exclusion Criteria: * Couples will be excluded if either partner reports * an active substance use disorder within the past three months (i.e., 2+ on the TAPS screening tool for a single substance followed by positive diagnosis in clinical interview) * a diagnosis of a psychotic or bipolar disorder with current uncontrolled symptoms (by self-report) * a diagnosis of severe cognitive impairment or intellectual disability (by self-report) * severe physical or sexual relationship aggression during the past 12 months (i.e., 10+ on the Hurt-Insult-Threaten-Scream \[HITS\] screening tool followed by clinical interview) * current suicidal ideation or behavior determined to be high-risk according to current VA clinical assessment protocols (i.e., "yes" on any high-risk items on the Columbia Suicide Severity Rating Scale) * suicide-related hospitalizations within the past 12 months (by self-report)