Communal Coping as a Change Process in Couple-Focused Interventions for Health Problems

Abstract

Communal coping—a process in which romantic partners view a problem or stressor as "ours" rather than "yours" or "mine" and engage in collaborative problem solving to address it —has emerged as an important predictor of health and treatment outcomes. This study investigated communal coping as a theoretically derived and empirically supported intervention target within two couple-focused interventions for health problems: Family Systems Therapy for problematic alcohol use and Family Consultation for health-compromised smoking. With a combined sample of 56 couples (37 alcohol, 21 smoking), this study investigated within-session changes in communal coping—indexed via observable, communal coping behaviors and first-person plural pronoun use (we-talk)—prior to and following therapist implementation of specific solution-focused therapy techniques that aimed to promote communal coping in the couples during a target therapy session. Teams of trained raters observed the target therapy sessions and made independent ratings of couple communal coping behaviors and therapist adherence. Pronoun measures for each partner were obtained via computerized text analysis from transcripts of partners' speech during the target therapy sessions. Both patients and spouses showed increases in communal coping behavior and we-talk from a "baseline" problem-focused therapy block to the "active" solution-focused therapy block. In addition, exploratory analyses revealed that several couple and therapist characteristics, as well as specific solution-focused techniques were associated with within-session changes in communal coping. Findings from this study identify communal coping as a client change process and solution-focused therapy techniques as a therapist change process within the two interventions, and demonstrate successful engagement of communal coping as a therapeutic target.