Buffering the Effects of Stress on Health through Relationship Education: The Important Role of Improving Relationship Confidence

by Alan J. Hawkins

The Bottom-line First: Relationship education programs that help couples disconnect stresses in their lives, like financial hardship, from their relationships build confidence in the future of their relationship. In turn, this improves their reports of physical health.

I just finished reading a study that brings together two issues that I’ve been focused on lately. One issue is how relationship education (RE) can buffer stresses so that they don’t tear at our relationship as much. I blogged about this recently here and even mentioned it in the recent book review I did here. The other issue I’ve been thinking a lot about is the importance of relationship hope or confidence as an intervention target in RE. I blogged about that a while ago here.

In this study,[1] researchers studied the effects of the PROSAFF program (Protecting Strong African American Families) on 346 rural, lower income, African American couples (about 2/3 married) who were randomly assigned to the PROSAFF program or a control group. (The control group received a book about marriage at the end of the study.) First, the researchers looked just at the control group couples to see how common stresses such as financial hardship affected marital processes and health. Here is what they found:

  • Stress –> Relationship Outcomes.  Financial hardship was associated with (negative) changes in relationship communication, satisfaction, and relationship confidence.
  • Relationship Outcomes –> Health.  Furthermore, these (negative) changes in relationship communication, satisfaction, and confidence were, in turn, associated with reports of poorer health about 8 months later.

No surprises yet, although further clever analyses suggested that the effect on health primarily came through the effect of financial hardship on relationship confidence rather than communication or satisfaction. But here’s the best part. Next, the researchers tested whether these same findings were evident in the group that participated in the PROSAFF program. In theory, the principles learned and skills gained in this RE program would buffer the effects of stress on the participants’ relationship processess, so the stress would not have as negative an effect on health. How did theory match up to reality?

  • Buffering Effect.  Very well, thank you. They found that greater levels of financial hardship were not associated with declines in relationship confidence for the PROSAFF group. And financial hardship no longer was connected to poorer health through relationship confidence.

Apparently, the emphasis in the PROSAFF curriculum on increasing a sense of confidence in the long-term prospects of the relationship was able to buffer common stressors, like financial hardship, from wearing away a sense of confidence in the relationship, and this helped to improve reports of physical health.

I think there are some valuable implications of these findings for RE:

  • Foster Awareness of the Effects of Stress on Relationships.  First, as many programs try to do, it is important to help RE couples understand how everyday stress can spill over into relationships. Couples can learn to disconnect the external stress from the relationship so that it is less harmful to the couple relationship. While some have argued that RE programs for more distressed, lower income couples are not helpful because they do not relieve the external stresses they experience that are at the root of their relationship difficulties (see my blog about that here), this study suggests that lower income couples can learn to disconnect that stress from relationship problems and increase their confidence in the future of their relationship.
  • Target Relationship Hope/Confidence.  Second, this study suggests that instead of targeting a sense of relationship satisfaction directly, RE curricula will do better to target couples’ sense of relationship hope, to help them develop a greater sense of confidence in their abilities to weather the inevitable stresses and keep their relationships strong. A direct target on increasing satisfaction may inadvertently focus couples on the wrong things. As the authors argue, “ideals of self-fulfillment and self-satisfaction in marriage tend to undermine, rather than bolster, fundamental constructs and practices needed for healthy, stable marriages” (p. 195).
  • Health Benefits of RE.  Finally, this study shows that you can see the indirect benefits of RE on physical health as well as relational and emotional health. Given the personal and public costs of poor health, this benefit is something we an all applaud.



[1] Barton, A. W., Beach, S. R. H., Bryant, C. M., Lavner, J. A., & Brody, G. H. (2018). Stress spillover, African Americans’ couple and health outcomes, and the stress-buffering effect of family-centered prevention. Journal of Family Psychology, 32, 186-196.