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PTSD Treatment and Couples Therapy Go Hand in Hand

New Study Finds Combined Treatment Effective

Partners of People With PTSD continued...

"By agreeing not to go to family gatherings or out to dinner, for example, because her husband is too anxious, the wife simply reinforces the idea that the symptoms can't be managed," Monson says. "They shrink their lives to manage the anxiety ... We help them reexamine such unhelpful thoughts and behaviors."

The last phase of the therapy focuses on the problematic beliefs that each partner holds and that contributes to PTSD and their relationship problems. They address issues of trust, control, emotional closeness, and physical intimacy.

At the end of the study period, the couples that had gotten therapy showed significant improvements. Their satisfaction with their relationship increased more than four times as much as the couples who were not treated.

Meanwhile, the partners with PTSD reported an average 50% reduction in the severity of their symptoms, or about three times the improvement of those on the wait list. More than three quarters of them no longer met the criteria for PTSD.

The study shows that this therapeutic approach was better than no therapy -- but it doesn't show whether the therapy the researchers have developed is more or less effective than other types of therapy.

Second Opinion

Also, an editorial published with the study points out that the people in Monson's study seemed "easier to treat" than couples who face similar problems. In general, writes editorial author Lisa M. Najavits, PhD, these couples were in highly stable and satisfying relationships, without accompanying issues such as alcoholism, drug addiction, or abusive behavior.

"Thus, the trial by Monson et al cannot be interpreted as being applicable to couples with these additional challenges, which may be the couples in greatest need of help," writes Najavits, a psychologist at the Veterans Affairs Boston Healthcare System.

Monson disagrees. She says that the study population is quite typical and that very few people were excluded from the study based on issues like substance dependence or relationship aggression.

She adds that such distress in a couple is often a motivator for change. Without such motivations, couples often maintain the status quo, making them more difficult to get into treatment.

"The fact that we found significant improvements in patients' relationship satisfaction, despite the relatively high baseline levels of satisfaction, further supports the notion that it is a powerful treatment with respect to improvements in couple functioning," Monson says.

Getting Help

Monson and Glynn, who've collaborated in the past, say that PTSD is a highly treatable disorder. If your partner has experienced trauma and exhibits PTSD symptoms, the best thing you can do is be supportive and be willing to seek help together. Glynn points to the VA's Coaching Into Care program as an excellent place to start.

"Be kind, be firm but not coercive when you discuss getting help, and be hopeful," says Glynn. "Having PTSD or living with someone who has it can be a very hard road, but there is hope."


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