Couple Treatment for Posttraumatic Stress Disorder

Abstract

Posttraumatic stress disorder (PTSD) affects not only the people suffering from the disorder but also those surrounding them. PTSD is one of the mental health difficulties most strongly associated with relationship distress (Whisman et al. 2000); it has a strong association with a range of family problems, including mental health difficulties in partners and children (Monson et al. 2009; Renshaw et al. 2011; Taft et al. 2011). PTSD can elicit responses from friends and family that are well-meaning but may maintain the symptoms of PTSD, such as helping the individual with PTSD avoid reminders of the trauma, which may over time erode these relationships and place increased burden on family members, leading to negative mental health outcomes (Caska and Renshaw 2011). These accommodative behaviors may also reinforce avoidance associated with PTSD (Figley 1989). Consistent with research documenting that negative social interactions in the wake of trauma are among the most robust risk factors for PTSD (e.g., see Wagner et al. under review for a review), negative family interactions have been linked to poorer individual cognitive-behavioral therapy outcomes (Monson et al. 2005; Tarrier et al. 1999). Moreover, individual evidence-based treatments for PTSD do not consistently improve relational functioning (e.g., Galovski et al. 2005; Monson et al. 2012a, b, c; Lunney and Schnurr 2007). Consequently, there have been efforts to develop and test dyadic treatments that improve relational functioning and PTSD and, in some cases, also improve the health and well-being of partners. The current chapter describes different ways to conceptualize couple treatment in the case of PTSD and reviews the efficacy of these interventions.