Higher Peaks in Relationship Education

by Alan J. Hawkins

The Bottom-line First: The relationship education (RE) field has experienced a lot of successes over the past 20 years, but we can’t let this obscure our view of the higher peaks beyond. We need to raise our sites and become more innovative and strategic if we are really going to move the needle on the problems we are trying to address: family instability and social poverty. RE practitioners need to think more like public health workers. Here is a strategy for raising our sites for the next 20 years. 

When I look out from my back porch, I see a beautiful view of the Wasatch Mountains, the western edge of the Rocky Mountains and the eastern edge of the Great Basin Desert. I live pretty close to the these mountains and as I look up I can see an impressive peak about 8,000 feet high. What is obscured from my view, however, because I am so close to the mountain is two sets of higher peaks beyond. If I drive west a few miles and look back, the higher peaks come into view.

There’s a metaphor here. Often, we climb one hill only to get a clearer view of higher peaks that still await us. I think this is where we are now in the relationship education field. We’ve had some great success; but we’re not yet where we need to be.

Now, it’s better to have problems resulting from success than failure, but regardless, problems are problems. I think the biggest challenge facing the relationship education (RE) field is the result of our recent successes. Over the past 20 years, we have experienced tremendous growth in the RE field, including substantial public funding for RE efforts to stretch our work to more disadvantaged, at-risk individuals and couples. By my count, we have reached about 2.2 million low-income RE participants since 2007 through these publicly-supported programs. Of course, this figure doesn’t include millions more each year reached through private and community RE efforts.

And as a RE scholar, I’m keenly tuned into the research. The quantity and quality of RE evaluation research has never been better. There have been more than 300 RE evaluation studies.[1] Another wave of rigorous evaluation studies is on the horizon. And it’s not just the quantity; in my judgment, the quality of the work is the best it has ever been. Overall, RE researchers are showing that RE works. And an emerging body of work is showing positive effects on the children of these participants. Moreover, a lot of good research now is showing it works best for the more distressed and disadvantaged people who come to our programs (see my earlier blog).

But this substantial hill that we have climbed only gives us a clearer vista of the challenges that still confront us. Even while celebrating our accomplishments, my biggest worry is our inability to really move the needle on the two mega-problems our work seeks to redress: family instability and social poverty. (Social poverty is the experience of lacking key relationships of trust and care in our lives. I blogged about that here.) Despite our successes, our efforts presently are overmatched by the need. We can help some and we should be proud of that. But from a societal perspective, our RE services are not making a big enough dent in the epidemic of loneliness and social poverty[2] and the plague of family instability.[3]

The numeric reality is that only a small percentage of people invest in these valuable RE services. Moreover, the people who generally need help the most may struggle to access these services. So, that’s why we dug into the public coffers for help to make these programs available to more disadvantaged individuals and couples.[4] Social justice seems to demand that. But it takes a lot of money to run a successful intensive program.

Yes, we have developed and implemented good programs for more at-risk groups. This has been an important, positive development in the field over the past decade. But though we are getting RE to different folks, we still have the same problem: we can’t get it to enough of them. I think it’s going to take innovation and non-traditional approaches to RE to meet the challenges ahead of reach and impact.

Maybe relationship educators should just be satisfied with the important successes we are having helping a few more individuals and couples form and sustain healthy relationships and stable marriages. No social program (e.g., Head Start, WIC) reaches all who need the service. Maybe we should hold fast to our helping professional roots. We will do our small part and hope to make a difference one small group at a time. As individual educators, I have no problem with this attitude. But I don’t think it is sufficient for the RE field as a whole. We can’t just stop our ascent and pitch our tents on the plateau of this first peak. The field needs to be a social change agent as well as a helping profession.

How are we going to move the needle? I want to present a model of how we can achieve this bigger goal moving forward. It incorporates our successful efforts but requires some substantial reprioritization and change as a field. At the heart of what I think we need to do is add to our helping profession orientation a public health mindset.

The public health field has shown that it can make measurable dents in big problems without intensive interventions; smoking cessation and teen pregnancy prevention are just two examples of how sustained public health efforts have not only helped improve individual lives but also substantially reduced a societal problem (and saved taxpayers money).[5] And I just read some things that suggest that two decades of public health efforts to attack obesity are starting to get traction.[6] Echoing the way that some couple therapists several decades ago moved upstream to provide educational programs to strengthen couple relationships, a new cadre of RE practitioners need to put on the badge of a public health worker to reach much larger numbers of people and provide the basic, preventative tools of relationship health.

We are not seeing some success in fighting obesity in our society because a lot of people are choosing to attend intensive educational programs focused on diet and exercise (although a few do so and benefit from it). Instead, public health professionals are flooding media with short, consumable, but powerful nuggets and nudges about how to be healthier, making it smart and cool to eat better, avoid empty calories, and be more active. Public health has raised consciousness and spurred a myriad of little innovations that support a healthier weight. Fit bits keep us motivated to keep moving. Young people are the most important targets of public health messages about obesity (because it is so difficult to reduce weight once it is on). And public health builds consensus to make possible public policy changes, such as reducing high-sugar, high-fat snacks in schools and placing nutrition/calorie information on packaging.

The RE field can borrow the ideas and tools of public health to serve the purpose of improving relational health in our society. Let me be more specific. I want us to start thinking in terms of an overall strategy that has 4 tiers of intervention. The third tier is where most of the work we have been doing in the RE field goes. I think we need to give priority and more energy to tier-1 and tier-2 interventions.

Priority Intervention
Tier-1 Relationship Literacy Education
• micro-messaging
• RE for youth/young adults
Tier-2 Micro-interventions
• relationship check-ups
• brief naturalistic interventions
Tier-3 Programmatic Couple Relationship Education
• moderate, prevention
• intensive, intervention• combine with booster micro-interventions
Tier-4 Clinically-delivered Education
• tailored, one-on-one counseling

 

Tier-1:  In tier-1, which I call relationship literacy intervention, I emphasize two kinds of interventions. First, we need more and more effective micro-messaging. With skilled media campaigns and similar efforts, we need to seed the culture with golden nuggets of relational literacy. We are cultural creatures; we go with the cultural flow. If we can change the culture – and there is ample evidence that public health efforts can do that – we can make measurable increases in the overall relational health of society.

The training and tools for effective intervention at this level are different from what helping professionals learn. So, we need talented people trained in social marketing to team-up with relationship scientists and practitioners to create these messages and the campaigns. Micro-messages can embed powerful ideas in our heads and hearts over time that can nudge our attitudes and behaviors for better. The field of behavioral economics has shown us the power of little nudges. More nudges, fewer programmatic interventions, I say! Moreover, we can provide these messages at earlier ages before young people start accumulating the heavy relational baggage that makes it harder and harder for them to form and sustain healthy relationships and stable marriages down the road.

Which leads me to the second element within the first tier of intervention. I’m convinced that we need to increase dramatically the number of youth and young adults who have been schooled in basic relationship literacy. If we wait until unions have already formed to try and help these couples, we are working with one hand tied behind our practitioner backs because too many young people begin these relationships haphazardly and take-on baggage that makes forming a healthy relationship and maintaining a stable marriage hard. We need to take our preventative roots more seriously and move upstream to help young people before they start forming families know what a healthy relationship is, how to achieve it, and how to avoid the pitfalls that make it harder. Over the past 50 years, couple relationship education has absorbed most of our energy. We need to flip the field so that much more of our energy is going to relationship literacy education for youth and young adults.

Tier-2: The second tier of intervention I call micro-interventions. Micro-interventions are more than a message. They are brief, 1-2 session programs focused on a specific idea or skill that can make a disproportionate difference for good. They attract more participants because you don’t have to commit a lot of time and resources to benefit from them. Two quick, illustrations:

  • Couple Check-ups: There are a couple of good, evidence-based relationship check-up interventions out there now. These are generally two sessions. In the first session, couples complete a relationship survey that can identify strengths and areas for improvement. In the second session, a trained coach reviews their survey responses and helps them identify an area for improvement. It is a way for couples to take seriously the need for regular maintenance work on their relationships.[7]
  • Naturalistic, micro-interventions: I am intrigued by an intervention that Frank Fincham has studied. In just one brief session, he teaches religious couples a technique to pray (partner-focused petitionary prayer) for their partner (to increase their outward orientation in the relationship). He has found some noteworthy positive effects from this simple, naturalistic approach.[8] There are many more innovative possibilities for these kinds of micro-interventions. And I’m sure many can be delivered digitally which will extend their reach.

Tier-3: The third tier of interventions gets us to where I think most of our energies have been: programmatic couple relationship education. These are moderate to intensive programs designed to strengthen existing relationships. They emphasize broad, generic skills and cover a lot of ground to be able to help couples with many different needs. I would differentiate between more moderate-dosage, moderately intensive programs with a strong prevention orientation (I think most premarital education curricula would go here) and heavier-dosage, more intensive intervention for distressed and at-risk couples (unmarried parents would be a prime target here). These programmatic curricula provide a needed service in our intervention portfolio. We need to continue the research to make them even more effective. And we should make many of these programs available digitally to reach those who will never come through our doors.

In addition, I think we need to look at Tier-3 CRE in a different way. Instead of designing it as a stand-alone, one-time, acute, relationship-strengthening intervention, we need to view it is as a loading dose to begin treatment for a chronic condition that needs to be sustained long term. That is, we should think about the need to strengthen relationships as a chronic challenge rather than an acute, one-time intervention. We should build into our CRE programs booster interventions, probably with Tier-2 micro-intervention strategies. I think it is asking too much of a one-time educational intervention to “cure” relationship challenges forever and ever. We need to adjust our RE theory of change model to fit what is a chronic need, not an acute problem.

Tier-4: I’ll just briefly mention the fourth tier of intervention. I call it clinically-delivered education. I include therapeutic work trying to help highly distressed couples within the circle of relationship education. That is, much of good therapy is educational, just one-on-one and more tailored. We still need this kind of help in our intervention portfolio too. And in fact, one of our RE program goals should be to help couples make the choice to get counseling easier (and earlier).

3 Supports: Finally, as part of my model, I want to outline three kinds of supports for these various kinds of interventions.

  • Public Policy: First, public policy can build in more incentives to becoming relationally literate. The prime example that exists currently are the 10 states that provide discounts on marriage licenses for engaged couples who invest in premarital education (although they have not been implemented well, but that is a story for a previous blog). I think there are other incentives that we can bake into public policy.
  • CHMIs: Second, I want to give a shout-out to the community healthy marriage initiatives out there. We need this kind of support infrastructure in all our communities to help make participation in RE mainstream. We can’t reach our goal working independently. And healthy relationships are nurtured best in communities of care. (See this previous blog about a community initiative that appears to be making a dent in the local divorce rate.) And along these lines, I want to see more states take up the policy goal of increased family stability and reduced poverty and support that work with active, formal commissions. Today, there is only one state-sponsored commission promoting and overseeing state relationship education efforts (my own state of Utah).
  • ACF HMRE. Third, I want to acknowledge the valuable role that the Administration for Children and Families has played in getting healthy marriage and relationship education services to more disadvantaged individuals and couples. However, going forward I’d like to see ACF spur more innovation and put more energy in the first two intervention tiers – relationship literacy and micro-interventions – perhaps in conjunction with funding tier-3 programmatic CRE.

Let’s appreciate but not settle for our current successes; the problem of relational health in our society is too big and too important. While we are basking in the sunlight of accumulated successes on the first peak we’ve scaled, let’s not loose site of the higher peaks beckoning us forward.

 

I would love to hear your feedback on these soft-clay ideas, so I will open up the comments feature on this blog.

 

Note: This blog is based on remarks given at a plenary session at the National Association for Relationship and Marriage Education, July 19, 2019.

 

Endnotes:

[1] For reviews of this large body of work, see: Blanchard, V. L., Hawkins, A., Baldwin, S., & Fawcett, E. (2009). Investigating the effects of marriage and relationship education on couples’ communication skills: A meta-analytic study. Journal of Family Psychology, 23, 203–214. doi:10.1037/a0015211; Fawcett, E., Hawkins, A., Blanchard, V., & Carroll, J. (2010). Do premarital education programs really work? A meta-analytic study. Family Relations, 59, 232–239. doi:10.1111.j.1741-3729.2010.00598.x; Hawkins, A., Blanchard, V., Baldwin, S., & Fawcett, E. (2008). Does marriage and relationship education work? A meta-analytic study. Journal of Consulting and Clinical Psychology, 76, 723–734. doi:10.1037.a0012584; Hawkins, A., & Erickson, S. (2015). Is couple and relationship education effective for lower income participants? A meta-analytic study. Journal of Family Psychology, 29, 59–68. doi:10.1037.fam0000045; Hawkins, A. J., Stanley, S. M., Blanchard, V. L., & Albright, M. (2012). Exploring programmatic moderators of the effectiveness of marriage and relationship education: A meta-analytic study. Behavior Therapy, 43, 77-87; Lucier‐Greer, M., & Adler‐Baeder, F. (2012). Does couple and relationship education work for individuals in stepfamilies? A meta‐analytic study. Family Relations, 61, 756–769. doi:10.1111/j.1741-3729.2012.00728.x; Pinquart, M., & Teubert, D. (2010). A meta-analytic study of couple interventions during the transition to parenthood. Family Relations, 59, 221–231. doi:10.1111/j.1741-3729.2010.00597.x; Simpson, D. M., Leonhardt, N. D., & Hawkins, A. J. (2017). Learning about love: A meta-analytic study of individually oriented relationship education programs for adolescents and emerging adults. Journal of Youth and Adolescence. doi: 10.1007/s10964-017-0725-1

[2] Halpern-Meekin, S. (2019). Social poverty. New York: New York University; Holt-Lunstad, J., Robles, T. F., & Sbarra, D. A. (2017). Advancing social connection as a public health priority in the United States. American Psychologist, 72, 517-530.

[3] Sawhill, I. V. (2014). Generation unbound: Drifting into sex and parenthood without marriage. Washington D.C.: Brookings Institution.

[4] Randles, J. M. (2017). Proposing prosperity: Marriage education policy and inequality in America. New York: Columbia University.

[5] Hornik, R. C. (2002). Public health communication: Evidence for behavior change. Mahwah, NJ: Lawrence Erlbaum Associates.

[6] For instance, see: Liping Pan, David S. Freeman, & Sohyun Park, “Changes in obesity among US children aged 2-4 years enrolled in WIC 2010-2016,” Journal of the American Medical Association, 321 (2019): 2364-2366.

[7] For instance, see: Cordova, J. (2009). The marriage checkup: A scientific program for sustaining and strengthening marital health. Lanham, MD: Jason Aronson.

[8] Cooper, A. N., May, R. W., & Fincham, F. D. (2019). Stress spillover and crossover in cople relationships: Integrating religious beliefs and prayer. Journal of Family Theory & Review, 11, 289-314. Doi:10.1111/jftr.12330

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