Can Relationship Checkups Work?

By Jennifer Griffith

The Bottom-line First: Checkups are a good way to identify health issues before they become bigger problems. Could relationship checkups work the same way as a dental checkup? A recent study found that brief relationship checkups with feedback to couples can strengthen their relationships, even when the feedback is given impersonally by a computer-generated report. Read more.

“It’s time for your annual checkup!” This announcement comes as no surprise to children whose mothers takes them in for regular checkups with a primary care physician. And your spouse’s reminder to schedule that dentist appointment for a checkup isn’t nagging, it’s a sign of caring about your health. We have come to expect checkups, not because it means that we think something is wrong with us, but so we can maximize our chances for remaining healthy. Visiting the doctor is not always about being sick. It is also about prevention, catching something early to limit negative repercussions.

Why don’t we feel this way about mental and relationship help “doctors”? Relationship therapists bemoan that couples wait years for a problem to fester and then confront a crisis before seeking out help.[1] And for that matter, relationship educators – specialists in prevention – know that many of their program participants are already in distress when they start coming to their programs.[2] The idea of relationship checkups may be new, but the principle is much the same as a child’s annual doctor’s appointment or a parent’s semi-annual dentist checkup. A checkup with a relationship professional to follow-up on past treatments, to prevent further symptoms, to learn new skills, to deal with new challenges, or just to express commitment and gain peace of mind makes as much sense as a dental checkup.

But can relationship checkups even work? Researchers from Aarhus University sought to determine this very thing in their article: “Checking up on Couples – A Meta-Analysis of the Effect of Assessment and Feedback on Marital Functioning and Individual Mental Health in Couples.”[3] These researchers found 12 rigorous evaluation studies (randomized controlled trials comprising more than 1,000 couples) previously done on the effectiveness of relationship checkups. They combined the results of the 12 studies to get an overall picture of how effective relationship checkups are. A relationship checkup typically consists of two sessions. The first involves filling out an assessment questionnaire with many questions about the relationship. Both partners complete the assessment. In a second session, they receive individualized and couple feedback from a therapist or from a computer-generated report. Some checkups are done in person with a facilitator and some are done online. The purpose of this study was not only to determine the general effectiveness of relationship checkups, but also to determine if effects were stronger when a therapist provided feedback to the couple rather than a computer. In addition, the researchers explored whether current relationship satisfaction affected the results. Here is a summary of their results:

  • Moderate Success. Researchers found that couples who took relationship checkups reported modestly higher relationship quality than control-group couples who did not take the checkup (d = .23). This was so even at 6-month follow-up assessments. These effects are nearly as strong as the effects seen in more intensive, face-to-face relationship education programs.[4]
  • Computer-Generated Reports Work Too. There was little difference between relationship checkups for those couples who had therapist-guided feedback compared to those couples who had computer-generated-feedback reports. Checkups were effective regardless of how couples received feedback.
  • Couple Distress Was Not a Moderator. Effects of relationship checkups were positive whether couples identified as happy or distressed before the intervention.

These are encouraging results with important implications for couple and relationship education:

  • Reaching a Larger Population. Because of the less-intrusive and less time-intensive nature of relationship checkups, compared to therapy and relationship education, relationship checkups have a greater chance of reaching a larger number of couples that otherwise may not choose to seek out more intensive forms of relationship help.
  • Checkups as Boosters. Due to the accessibility of relationship checkups, relationship educators running traditional RE programs could follow-up annually with relationship checkups for couples who complete their programs. This kind of “booster shot” might sustain intervention effects longer.
  • Checkups as Recruiters. Relationship educators should also consider informing couples who take relationship checkups about traditional face-to-face programs that can help couples develop their relationship skills and work on issues before they become bigger problems. Relationship checkups may be an effective recruitment technique for traditional relationship education.

Relationship checkups appear to be another useful intervention tool in the relationship educator’s tool belt. As a field, we should be increasing our use of this valuable tool. Educators interested in reading a more in-depth treatment of relationship checkups should read James Córdova’s The Marriage Checkup.[5]


[1] Lebow, J. L., Chambers, A. L., Christensen, A., & Johnson, S. M. (2012).  Research on the treatment of couple distress.  Journal of Marital and Family Therapy, 38, 145-168.

[2] Bradford, A., Hawkins, A. J., & Acker, J. (2015). If we build it, they will come: Exploring policy and practice implications of public support for couple and relationship education for lower income and relationally distressed couples. Family Process, 54, 639-654.

[3] Fentz, H. N. and Trillingsgaard, T. (2017). Checking up on couples—A meta-analysis of the effect of assessment and feedback on marital functioning and individual mental health in couples. Journal of Marital and Family Therapy, 43, 31–50. doi: 10.1111/jmft.12185

[4] Blanchard, V., 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.; Fawcett, E., Hawkins, A., Blanchard, V., & Carroll, J. (2010). Do premarital education programs really work? A meta-analytic study. Family Relations, 59, 232–239; Hawkins, A., & Erickson, S. (2014). Is couple and relationship education effective for lower income participants? A meta-analytic study. Journal of Family Psychology, 29, 59-68; 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; 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; Pinquart, M., & Teubert, D. (2010). A meta-analytic study of couple interventions during the transition to parenthood. Family Relations, 59, 221–231.

[5] Córdova, J. (2009). The Marriage Checkup: A scientific program for sustaining and strengthennig marital health. Lanham, MD: Jason Aronson.