Couple relationship education content: What we have and what we are missing

Abstract

Couple relationship education (CRE) has decades of research showing mixed results for participants. Various competing frameworks for CRE content have emerged in the development of the field, yet content has not been systematically investigated. Through an inductive content analysis of 15 different CRE programs, this study explored content themes and categories that are common across programs. Analysis found four themes throughout the programs: interactional skills, the self in the relationship, partner bonding, and relationship motivations. Categories for each theme were identified and are presented and discussed. Findings validate the primacy of teaching interactional skills within CRE including consistency in topics (e.g., communication training, conflict management). Other themes were also common (e.g., self in the relationship), though their categories were more diverse (e.g., self‐care, expectations, personality). Several factors that have emerged as more significant in relationship theory and research were not well‐represented in the content analysis (e.g., socioecological contexts, systemic patterns).

Couple relationship education (CRE) programs have been an important part of relationship science and community intervention for many years and are a valuable method of disseminating research findings to the public. Programs encourage relationship enhancement and enrichment and can help improve relationship outcomes, resulting in decreased breakup or divorce and a reduced likelihood of intimate partner violence (Markman et al., 2022). Attending CRE is correlated with couples having positive attitudes toward and more willingness to seek out professional services (e.g., couple therapy) in the future (Williamson et al., 2018). Further, recent research on CRE identifies improvements in physical and mental health, co‐parenting, and child well‐being (Markman et al., 2022).

Much research has been conducted on best practices for CRE programs. Stanley et al.'s (2020) review outlined current best practices in areas such as format, dose, approach, training of educators, recruitment, overcoming barriers, etc. Each area contributes to robust programs that can reach the greatest number of people with the greatest effectiveness and long‐term benefits. However, many programs teach different areas of content, though the majority teach some form of communication skills (e.g., listening and problem‐solving; Stanley et al., 2020). Within the field of relationship science, much progress has been made in determining what makes relationships satisfying and stable (Karney & Bradbury, 2020), yet it remains uncertain how much CRE programs have kept pace with our increased understanding. Integrating new knowledge may help couples learn and apply aspects of healthy relationships that could help improve relationship outcomes. As content can determine much of what couples learn from CRE programs, understanding what programs teach is an essential part of refining current and future programs. As a result of research on the effectiveness of CRE, calls for new directions have arisen (see Hawkins et al., 2004; Markman et al., 2022; Stanley et al., 2020), which begs for greater understanding of what the content of program curricula currently looks like and whether the calls have been heeded. Through qualitative inductive content analysis, this study aims to determine what common and unique concepts and strategies are taught in a variety of CRE programs.

LITERATURE REVIEW

Although CRE has made several strides in the last decade including improved scope of empirical analyses, more access through online education, and expanding its reach to racial and ethnic minorities, lower‐income couples, and LGBTQ+ couples (Markman et al., 2022; Stanley et al., 2020), the ongoing mixed results present real dilemmas for understanding and improving the field. Markman et al. (2022) outline several areas needing further attention: mechanisms and moderators of change, continued efforts to reach lower‐income couples, more online CRE, briefer interventions, and missed content, among others. Regarding content—the focus of this study—they proposed three core areas of current emphasis: managing negative emotions, enhancing positive connections, and strengthening commitment. They further propose a need to incorporate additional areas (e.g., breakups and long‐distance relationships). Nevertheless, a closer examination of competing frameworks of content that have developed in CRE is important to explore.

Competing frameworks in the development of CRE

Most CRE programs consistently focus on communication skills and processes (Stanley et al., 2020) largely rooted in the cognitive behavioral and social learning theory perspectives that have been at the heart of curricula for decades (Markman et al., 2022). The earliest manifestations of this involved communication skills training around clear speaking and active listening—popularized by PREP's “speaker‐listener technique” (Markman et al., 2010) and other variations. Karney and Bradbury (2020), now believe, however, that the focus on communication may have been misguided: “contrary to predictions of behavioral models of marriage, negative communication between spouses can be difficult to change, does not necessarily lead to more satisfying relationships when it is changed, and does not always predict distress in the first place” (p. 100). Other scholars disagree and feel that intervention research tells a different story and suggest the focus on communication is merited and is highly regarded by CRE participants (e.g., Markman et al., 2022; Stanley et al., 2020).

Though communication training is common, other competing frameworks have also been proposed and implemented. These frameworks were often, though not always, promoted in contrast to the predominant focus on communication training. Gottman et al.'s (1998) early criticisms of the active listening model (speaker‐listener skills) in favor of an affect regulation approach emphasized greater attention to the management of the emotional climate of a relationship through “repair attempts” (efforts to restore the relationship to positive sentiment by behaviors such as apologizing, taking breaks, and accepting influence). Despite their critiques, both approaches developed in similar ways: PREP's focus on preventing four destructive communication patterns (escalation, invalidation, withdrawal, and negative interpretation) had similarities to Gottman's prevention of “the four horsemen of the apocalypse” (criticism, defensiveness, contempt, and stonewalling) and Gottman's integration of the Rapoport model of communication integrated speaker‐listener skills like those found in PREP (Gottman & Gottman, 2017; Markman et al., 2010). The key here is that both still emphasize communication, but now with greater attention toward regulating the emotional climate of the relationship.

Additional concepts gained further prominence in CRE's development. PREP's growing promotion of relationship commitment (Markman et al., 2010) was later added as a pillar, alongside trust, to Gottman's sound relationship house theory (Gottman & Gottman, 2017). Commitment has been a notable feature in relationship science for its role in predicting relationship stability (Stanley et al., 2020) and purportedly has achieved greater prominence across different programs (Markman et al., 2022). Alongside these developments, positive connection through friendship, play, and rituals gained greater centrality in these and other programs (Markman et al., 2022). Similarly, some programs promoted an even deeper focus on emotional bonding by teaching emotional literacy, emotional attunement, and attachment bonding (e.g., Kennedy et al., 2019).

An additional behavioral approach (Halford et al., 2004) that took issue with teaching couples a predetermined set of relationship skills instead promoted relationship self‐regulation, or simply, self‐change. Other developments emphasized self‐care, mindfulness, and wellbeing (McGill et al., 2021). These updates may represent a diverse but growing belief in the difficulty for partners and couples to alter relational patterns without paying attention to self‐guided change, wellbeing, and personal development.

Further, Rogge et al. (2013) found that a simple relationship awareness intervention (watching relationship‐focused movies together, discussing the themes, and imagining their application in their relationship) performed similarly to two communication‐based programs in lowering rates of dissolution 3 years later. Moreover, one communication program showed slower declines in hostile conflict and the other showed faster declines in positive communication than the relationship awareness intervention, suggesting that perhaps only emphasizing the technical aspects of relationship functioning sensitizes couples to deficits in their relationship, thus discouraging their efforts. These findings conflict with other findings which indicate the effectiveness of communication training (see Hawkins et al., 2022; Markman et al., 2022).

Additional adaptations have grown more particularly out of the work on human flourishing and virtue. Fowers (2000) criticized the cultural prominence of individualism, which arguably leads couples to overemphasize personal happiness at the cost of relationship obligations. He suggested that a focus on communication and satisfaction promotes individualism and instead encourages the development of relationship virtues (courage, generosity, forgiveness, loyalty, sacrifice, justice, honesty, etc.). When investigated, CRE research has detected larger shifts in flourishing than satisfaction (Halford et al., 2021), though it remains to be seen how prominent teaching flourishing is in CRE content. Additionally, some have promoted a community‐based model of marriage including relational supports to the couple as well as paying it forward, which has seen some infusion in current curricula (e.g., ELEVATE, McGill et al., 2021).

Finally, a larger critique of current content addresses the socioecological context in which couples reside. This focus gained its greatest momentum when communication‐based programs were not as effective as hoped for in government‐funded efforts. Carlson et al. (2020) discussed the importance of expanding CRE content for ethnically and racially diverse couples because most CRE programs have been created by and for White, middle‐class, educated, nonminority groups. Although some relevant contextual issues have found greater presence in curricula, further work is needed to fully imagine how content could be adapted to better meet the needs of diverse, low‐income, and at‐risk couples (Markman et al., 2022). Some content developments address more fragile marital relationships including blended or stepfamilies (Lucier‐Greer & Adler‐Baeder, 2012), give greater attention to life events and transitions (Halford et al., 2008), and emphasize how couples can better communicate about stress through dyadic coping (Halford & Bodenmann, 2013). Other programming draws from family systems and ecological approach which addresses co‐parenting, relationship quality, family of origin, individual wellbeing, and child development in the context of social stressors and supports (Cowan & Cowan, 2019).

Current study

Despite the wide array of competing approaches and opinions, a systematic evaluation of the content of programs has never been conducted. It is, therefore, unknown what CRE content actually looks like thematically. Research from 20 years ago suggested three core areas that relationship education programs focus on: relationship skills, awareness/knowledge/attitudes, and motivations/virtues (Hawkins et al., 2004). Markman et al. (2022) now propose three core areas in CRE: negative emotion, positive connection, and commitment. In each case, however, these purported themes came from a cursory review of CRE programs and do not represent an empirical evaluation of the content of programs nor do they provide a granular investigation of the elements of larger content themes. Although the primary emphasis in current programs seems to maintain a preeminent dependence on the cognitive behavioral and social learning theory perspectives (Markman et al., 2022), many of the competing frameworks in the CRE literature have taken certain developments of relationship science into account. It remains unclear, however, how much current programming has integrated these advancements into their content. This study aims to examine the current state of content in CRE programming so that the field can more adequately evaluate what might be missing, and what future content changes may be necessary.

METHOD

The purpose of this content analysis was to discover what couple relationship education programs teach. In doing so, we followed Mayring's (2000) approach to inductive content analysis which includes three steps: (1) determine the material to be analyzed, (2) narrow content down to categories, and (3) establish themes. Inductive content analysis allows for categories and themes to be drawn directly from the data instead of from pre‐conceived categories and themes from other literature or research (Cho & Lee, 2014). Following step one of Mayring's (2000) approach, this analysis obtained curriculum from 23 different CRE programs. Programs were found through Google and Google Scholar searches, Smart Marriages “Directory of Programs,” and through contacts with CRE experts. The instructional and/or curriculum materials for all programs were purchased, generously donated by authors, and/or found online for free.

Programs were included if they had peer‐reviewed research in order to focus on programs discussed in the literature that most CRE researchers are aware of—though some programs which did not have completed research were not necessarily excluded. Further, the authors were only able to include programs they had access to. Programs were excluded if they did not have training or manuals for facilitators because these programs are less likely to be adopted by educators aiming to impact relationships, have less history in relationship science, and are rarely researched. Although online courses are becoming more common (Spencer & Anderson, 2021), they were not included as they did not represent programming educators typically purchase and implement, nor do they represent the last 50 years of relationship education that this study seeks to evaluate. Further, other relationship‐centered self‐help programs including books, articles, and websites are beyond the scope of this study.

From the 23 initial programs identified, this inclusion and exclusion criteria narrowed the focus of this research down to 15 programs. Table 1 shows the programs included in this study, listed authors, whether the programs had peer‐reviewed research articles, and the intended dosage of each program. Though dosage differences are not evaluated as part of the analysis, it is worth noting that intended dosage impacts the amount of content each program can teach to participants (e.g., a 12 hour program can go through much more content than a 4 hour program).

TABLE 1.

Programs included in analysis.

CRE program	Authors	Peer‐reviewed research	Intended dosage
Couple Communication	Sherod Miller, Phyllis Miller, Elam Nunnally, and Daniel Wackman	Yes	11 sessions (hours not listed)
Couple LINKS	John Van Epp	Yes	5 lessons (~10 h)
Couple CARE	W. Kim Halford	Yes	6 units (~12 h)
Couples Connecting Mindfully	Julianne McGill, Scott Ketring, and Francesca Adler‐Baeder	Yes	6 sessions (9–12 h)
Couples Coping Enhancement Training	Guy Bodenmann and S. D. Shantinath	Yes	5 modules (hours not listed)
ELEVATE	Ted G Futris, Francesca Adler‐Baeder, Scott Ketring, and Thomas Smith	Yes	7 principles (8–12 h)
Hold Me Tight	Sue Johnson	Yes	8 sessions (16–24 h)
PAIRS	Lori H. Gordon	Yes	3 sessions (~9 h)
PREP	Scott M. Stanley, Howard J. Markman, Natalie H. Jenkins, Jeff Erlacher, Miranda Eggar, and Lawrence Ramos	Yes	12 modules (12+ h)
PREPARE/ENRICH	David Olson, Amy Olson, and Peter Larson	Yes	Flexible (depends on couple)
Relationship Enhancement: A Program for Couples	Robert F. Scuka, William J. Nordling, Bernard G. Guerney, Jr	Yes	10 topics (14–20 h)
Safe Conversations: The Toolbox for Couples	Harville Hendrix and Helen LaKelly Hunt	No	6 sessions (~6 h)
Seven Principles for Making Marriage Work	John Gottman, Julie Gottman, and Nan Silver	No	12 lessons (6–24 h)
SYMBIS	Les and Leslie Parrott	No	7 sessions (4–8 h)
The Marriage Garden	H. Wallace Goddard and James P. Marshall	No	6 lessons (hours not listed)

Once the programs were obtained, a team of 12 university graduate and undergraduate research assistants was recruited to review the programs and summarize their content. For each module within each program, one assistant identified what content was to be taught, including key concepts, skills, abilities, and attributes as well as definitions for these concepts, skills, abilities, and attributes. Different sections or modules of each program were analyzed individually as some CRE programs contain material across many topics. These summaries were later reviewed by the first, second, and third author for quality to control for differences in research assistants. Secondary summaries were conducted for programs and sections that were missing details from the initial summary process.

Following this gathering and narrowing of program content, the first author met with three graduate‐level research assistants, none of whom had participated in the data collection, and instructed them on the open coding inductive method to be used for analysis. Through open coding, the large amount of data can be narrowed down to common categories (Crowley & Delfico, 1996) which meets the goal of this content analysis. The three assistants then individually read the summarized data to determine labels for emergent categories (step two; Mayring, 2000) discussed across programs and were instructed not to communicate with each other about what they found.

Upon individually identifying labels, the three assistants met in a group with the first author to discuss their individual categories and category labels. Together, they then compared results and categories with one another to find the most consistent and accurate category labels across the CRE programs (e.g., “love exchange” is listed below as a content category though one assistant initially labeled it as “love bank,” another as “need fulfillment,” and the third as “expression of love”). Combining categories allowed the assistants and author to decide on categories that were logical to all four individuals and were more succinct than the original labels.

Upon deciding on the combined category labels, the three assistants went through a list of all the categories found and determined categories that connected to one another. These connected categories then became the coherent, common themes (step three; Mayring, 2000). Finally, theme titles were decided on to encompass the categories and connections between categories. These titles were discussed by the analysts and authors until an agreement was reached as to the best way to summarize the categories within each theme. Category labels and theme titles were later defined or operationalized by the first and second authors.

Trustworthiness

Although specific measures of trustworthiness are not universally given for qualitative analysis, this study utilized methods to ensure trustworthiness of the results throughout the research process. The use of multiple research assistants throughout the data analysis process allowed individuals to cross‐check their analysis with others and, together, determine categories and themes. The use of multiple assistants addresses the need for credibility of data (Cho & Lee, 2014). Further, the researchers engaged in reflexivity by openly discussing their own biases and previous experiences with relationship education programming (Cho & Lee, 2014).

One of our notable biases is the belief that CRE should expand to include additional areas beyond skill‐building such as flourishing, virtues, community support, socioecological context, systemic patterns, and individual functioning. Overall, we see CRE as something to be expanded to be theoretically rich and to encompass diverse groups and individuals. The main way that this bias was managed was by having non‐author assistants participate in the bulk of the data analysis. This allowed the categories and themes to emerge without undue author influence. The assistants had minimal experience with CRE programming, though all had varying educational experience within family and relationship sciences. All analysts and authors have studied Marriage and Family Therapy and were either current masters‐ or doctoral‐level students or professors within Human Development and Family Science departments.

RESULTS

The results of this study suggest that CRE programs focus on four main thematic content areas including interactional skills, the self in the relationship, partner bonding, and relationship motivations. Each section below outlines each theme and includes categorical descriptions of material taught within various programs, though not all programs with content in each category are included in the narrative. Tables 2, 3, 4, 5 detail all programs included within each theme and category. Although there may be some overlap between categories across different themes (e.g., emotions are discussed both in conflict management in theme one and in emotional intelligence in theme two), the themes that emerged from our analysis convey the main context we found those categories presented in the content (e.g., emotional regulation in the heat of conflict versus general emotional awareness and self‐regulation). Distinctions between these categories are best understood as they relate to the theme they fall under in our analysis (Braun & Clarke, 2006).

TABLE 2.

Interactional skills.

CRE program	Conflict management	Communication	Problem solving	Dyadic coping
Couple Communication	X	X	X
Couple LINKS	X
Couple CARE	X	X
Couples Connecting Mindfully	X	X
Couples Coping Enhancement Training	X	X	X	X
ELEVATE	X	X
Hold Me Tight	X	X
The Marriage Garden	X	X
PAIRS	X	X
PREP	X	X
PREPARE/ENRICH	X	X		X
Relationship Enhancement: A Program for Couples	X	X
Safe Conversations: The Toolbox for Couples		X
Seven principles for making marriage work	X	X	X
SYMBIS	X	X
Totals	14	14	3	2

TABLE 3.

Self in the relationship.

CRE program	Expectations	Emotional intelligence	Family of origin	Personality	Mindfulness	Self‐care	Personal strengths	Stress management	Vulnerability
Couple Communication						X
Couple LINKS	X
Couple CARE	X
Couples Connecting Mindfully					X
Couples Coping Enhancement Training								X
ELEVATE		X			X	X			X
Hold Me Tight	X
The Marriage Garden							X
PAIRS	X	X
PREP	X		X	X				X
PREPARE/ENRICH			X	X			X
Relationship Enhancement: A Program for Couples		X							X
Safe Conversations: The Toolbox for Couples			X
Seven Principles for Making Marriage Work		X
SYMBIS	X		X	X
Totals	6	4	4	3	2	2	2	2	2

TABLE 4.

Partner bonding.

CRE program	Love exchange	Sexual intimacy	Fun and friendship	Rituals	Community involvement
Couple Communication
Couple LINKS	X	X
Couple CARE	X	X
Couples Connecting Mindfully		X
Couples Coping Enhancement Training
ELEVATE		X			X
Hold Me Tight		X		X
The Marriage Garden	X		X	X	X
PAIRS	X
PREP	X		X
PREPARE/ENRICH
Relationship Enhancement: A Program for Couples
Safe Conversations: The Toolbox for Couples	X		X
Seven Principles for Making Marriage Work	X		X	X
SYMBIS	X	X
Totals	8	6	4	3	2

TABLE 5.

Relationship motivations.

CRE program	Commitment	Positive regard	Trust	Forgiveness
Couple Communication	X
Couple LINKS	X		X
Couple CARE
Couples Connecting Mindfully			X
Couples Coping Enhancement Training
ELEVATE	X		X
Hold Me Tight		X		X
The Marriage Garden	X	X		X
PAIRS
PREP	X	X
PREPARE/ENRICH	X
Relationship Enhancement: A Program for Couples
Safe Conversations: The Toolbox for Couples		X
Seven Principles for Making Marriage Work		X
SYMBIS
Totals	6	5	3	2

Theme one: Interactional skills

All 15 programs analyzed contained various interactional skills. Interactional skills describe how couples converse when dealing with arising relationship issues. Categories within this theme include conflict management, communication, problem‐solving, and dyadic coping (see Table 2).

Conflict management, ways that couples notice and respond to conflict behaviorally and emotionally, included different elements in 14 programs. PREP teaches about communication danger signs and time‐outs. PAIRS teaches constructive conflict, emotional stages of conflicts, and time‐outs. Couple LINKS discusses managing resentment toward one's partner. Couples Connecting Mindfully teaches conflict patterns, self‐regulation, and time‐outs. ELEVATE discusses navigating emotions during conflict, body responses to conflict threats, and compromise. Hold Me Tight teaches de‐escalation techniques for current, past, and future arguments.

Communication skills, tools, and abilities were also taught in 14 programs. Couple CARE teaches about identifying one's own communication patterns and self‐disclosure. Seven Principles for Making Marriage Work discusses Gottman's Four Horseman, body language, and repair. Safe Conversations: The Toolbox for Couples describes the importance of respecting partner's boundaries during communication, taking turns during discussions, using I‐statements, paraphrasing, and mirroring. Couples Communication teaches communication styles and the awareness wheel. Relationship Enhancement: A Program for Couples describes empathetic listening skills. PREP and Couples Coping Enhancement Training both teach versions of the Speaker‐Listener Technique.

Problem‐solving, defined as overcoming disagreements in the relationship, was evident in three programs. Seven Principles for Making Marriage Work discussed compromise and processing grievances as ways to solve solvable problems. Couples Coping Enhancement Training discusses focusing on facts and solutions, perspective‐taking, communicating needs, willingness to compromise, and justice and fairness, and provides steps for efficiency. Finally, dyadic coping was included in PREPARE/ENRICH and Couples Coping Enhancement Training, both describing how couples can cope with life stressors together. Overall, interactional skills were discussed in each program, verifying the primacy of skills‐based training within current CRE programming.

Theme two: Self in the relationship

All 15 programs also incorporated programming on the self in the relationship, in this case defined as fixed or flexible elements an individual brings to the relationship. Categories include expectations, emotional intelligence, family of origin, personality, self‐care, mindfulness, personal strengths, stress management, and vulnerability (see Table 3).

Expectations, discussed in six different programs, included instruction in various areas of understanding and managing expectations. Hold Me Tight emphasizes identifying reasonable expectations to create a secure attachment with one's partner. SYMBIS discusses expectations in multiple contexts, including what individuals can and cannot expect from partners regarding change, rules and roles, and dependence on partner. Couple CARE's first lesson is on expectations and includes information on how expectations can come from previous relationships. Couple LINKS discusses how expectations shape the way that we rely on each other within relationships.

Emotional intelligence training is included in Seven Principles for Making Marriage Work, PAIRS, ELEVATE, and Relationship Enhancement: A Program for Couples. Training includes information on how couples can regulate emotions, manage emotionally charged interactions, how the brain governs emotional responses, how body language influences the ways that others interpret emotions, etc. Family of origin was discussed in four separate programs. PREPARE/ENRICH discusses family maps across dimensions of separateness/togetherness, stability/change, disconnection/connection, and flexibility/inflexibility. Safe Conversations: The Toolbox for Couples examines how childhood plays a role in relationships and what individuals look for in relationships. SYMBIS discusses how familial patterns impact division of household labor and how in‐law relationships can impact the couple's bond. PREP discusses how events from family of origin can impact current relationship experiences.

A number of categories within this theme were included in only 2–3 programs. Personality included a personality assessment in PREP, SYMBIS, and PREPARE/ENRICH, allowing couples to see how their personality tendencies compare with their partner's. Self‐care, including elements on caring for individual physical and mental health as a way to reduce individual and relational stress, was included in Couple's Coping Enhancement Training and ELEVATE. Mindfulness, in Couples Connecting Mindfully and ELEVATE, described mindfulness techniques including deep breathing exercises, staying present in the moment, and mindful noticing of mind and body experiences. Personal strengths in The Marriage Garden and PREPARE/ENRICH discussed cultivating personal strengths (physical, mental, and emotional) to improve relationship outcomes as well as the importance of knowing and integrating one's own strengths and one's partner's strengths. Individual stress management was included in PREP and Couple's Coping Enhancement Training and included instruction on managing stress through understanding where stress comes from and learning to control responses. Vulnerability, in ELEVATE and Relationship Enhancement: A Program for Couples, included information on being open with one's partner. Additional potential categories were only present in one program each, including gender (SYMBIS), self‐awareness (SYMBIS), spirituality (SYMBIS), intentionality (The Marriage Garden), and differentiation (Couple CARE).

Theme three: Partner bonding

Eleven programs instructed couples on different elements of partner bonding, defined as actions partners do or activities they participate in to contribute to the closeness or connection in their relationship. Categories include love exchange, sexual intimacy, rituals, fun and friendship, and community involvement (see Table 4).

Love exchanges are actions partners do to express feelings of love in the relationship and was included in eight different programs. PAIRS describes it as a love bank where one deposits positive words, gifts, time, etc. into to support the other person and express love. SYMBIS explains love styles and learning to give and receive love across different styles, especially when partner styles do not match. Couples LINKS describes need fulfillment and being reliable to one's partner. Seven Principles for Making Marriage Work includes an emphasis on the emotional bank account and both partners contributing consistently.

Sexual intimacy was included in six programs. Couple CARE encouraged exploration around ideas about sex including debunking myths, assessing communication about sex, and managing differences in sexual desires. Hold Me Tight describes different types of sex and ways to achieve connective sex. Couples Connecting Mindfully describes different types of touch and how sexual touch can be improved. Fun and friendship, included in PREP, The Marriage Garden, Seven Principles for Making Marriage Work, and Safe Conversations: The Toolbox for Couples, includes instruction in how having fun as a couple can bring pleasuree and happiness as well as the importance of making time for fun.

Rituals, consistent events that foster belonging and connection, were included in Hold Me Tight, Seven Principles for Making Marriage Work, and The Marriage Garden. Community involvement as a way for couples to connect to each other in caring for others was included in ELEVATE and The Marriage Garden. Attachment (Hold Me Tight), quality time (ELEVATE), shared meaning (Seven Principles for Making Marriage Work), and teamwork (Seven Principles for Making Marriage Work) were content topics that fit within this theme, though each was only included in one program, so none became common content categories.

Theme four: Relationship motivations

Ten CRE programs contained instruction on relationship motivations. Motivations are defined here as driving factors that encourage positive behaviors which contribute to the longevity of a relationship. Categories within this theme include commitment, positive regard for partner, trust, and forgiveness (see Table 5).

Commitment, the most frequently used category within this theme, was taught in six separate programs. Couple Communication describes commitment as a choice that is supported by other actions. Couple LINKS explains commitment in the context of a larger Relationship Attachment Model. ELEVATE describes commitment as a choice which requires consistent effort and helps to maintain a healthy relationship. The Marriage Garden also teaches commitment as a choice as well as an investment for the future of the relationship. PREP includes an entire lesson on commitment and includes instruction on different types of commitment (dedication and constraint).

Positive regard, consistently striving to see one's partner and relationship as good and worthwhile, was included in five different programs. Hold Me Tight encourages avoiding seeing a partner as “the bad guy” and seeing your partner as an equal. Seven Principles for Making Marriage Work describes the importance of developing fondness and admiration for a partner. Safe Conversations: The Toolbox for Couples uses positive regard in tandem with talking to one's partner and expressing compliments to the partner.

Trust, confidence in a partner's reliability, is evident in Couple LINKS and ELEVATE. Both describe ways to intentionally build trust with one's partner. Forgiveness, releasing a feeling of resentment toward one's partner, was present in Hold Me Tight and The Marriage Garden. Several additional potential categories (resilience in SYMBIS, healing in Hold Me Tight, positivity in The Marriage Garden, fairness in Couples Coping Enhancement Training, and relationship vision in PREP) were only present in one program each and, though notable, did not meet criteria to be categories within this theme.

DISCUSSION

CRE programs teach a wide variety of different topics to help individuals and couples in their partnered relationships. In many ways, the results of this study confirm the general areas that have been predicted by others (Hawkins et al., 2004; Markman et al., 2022; Stanley et al., 2020), but has also provided greater nuance to the story and more precision about the meaning of the content. Through inductive content analysis, interactional skills (e.g., communication and conflict management) were identified as the most common theme across the 15 different programs, validating what many other scholars have indicated (Hawkins et al., 2004; Markman et al., 2022; Stanley et al., 2020).

The predominant focus on communication skills in CRE content ought to be critically evaluated, especially in light of Karney and Bradbury's (2020) critique citing results from the last decade of marital research which challenge its role in relationship development, outcomes, and interventions. Although CRE research yields mixed results, Stanley et al. (2020) believe the focus on communication skills is still merited especially since participants find these topics to be helpful. Regardless, eliminating the central feature of relationship education that participants report being quite beneficial is a risk. Therefore, more research that empirically investigates communication training specifically in CRE will be needed, including greater precision about different types of skills training and their effectiveness.

When CRE scholars teach interactional skills, a greater repertoire of those capacities may also be considered and tempered against the realities and complexities of other relationship dynamics, including the depth of processes behind the outward behaviors such as internal dynamics, systemic patterns, and external circumstances. For instance, the science of relationships has led to new considerations about what promotes healthy stable relationships (e.g., commitment, trust, self‐regulation, attachment, friendship, etc.). Attempts to integrate these ideas are found throughout CRE programs as represented by the other themes found in this study: the self in the relationship, partner bonding, and relationship motivations.

Consistent with a long‐held view in relationship science that individual characteristics influence dyadic interactions and relationship outcomes (Karney & Bradbury, 1995), the next most common theme, the self in the relationship, was also included in all 15 programs. It is, therefore, surprising that this variable has not been clearly captured by previous discussions of CRE content (Hawkins et al., 2004; Markman et al., 2022). The content in this theme was spread between nine different categories, with programs including information on up to four different categories, suggesting perhaps a lack of consensus on those individual attributes which are most important to address. Understanding how individual expectations, mental and emotional health, personality, family of origin, etc. can contribute to relationship outcomes is essential for relationships that often include individuals who are very different from one another. As the field has expanded to better understand how individual well‐being can contribute to relationship quality, and vice versa (McGill et al., 2021), the continued expansion of programs into this area is essential. Nevertheless, there should be caution in suggesting that CRE should primarily focus on individual context or functioning as this could reinforce individualistic notions of relationship functioning that undermine a focus on primary relationship patterns couples are dealing with (Doherty, 2013). Therefore, in our view, CRE programming should carefully connect self‐focused material to relationship patterns.

Partner bonding, the third most common theme, describes ways for couples to connect with one another through shared activities. Consistent with Markman et al.'s (2022) prediction that programming focuses on enhancing positive connections, this element was found in 11 different CRE programs. Gottman and Gottman (2017) have often studied the importance of friendship as foundational to relationship health and Doherty (2013) has emphasized rituals of connection as essential to helping couples maintain their long‐term connection. The second most frequent category in this theme, sexual intimacy, was potentially not included in enough programs given the research on its impact on relationship satisfaction (Schoenfeld et al., 2017). The positive impact time together can have on relationship satisfaction (Flood & Genadek, 2016), suggests partner bonding is an important foundational factor to relationship health in long‐term partnerships that we believe should be given continued emphasis in CRE programming.

The final theme, relationship motivations, has been outlined as an important element of CRE programs across multiple decades (see Hawkins et al., 2004; Stanley et al., 2020), and categories were included in most programs analyzed. Extensive research on commitment in relationships validates the importance of a focus on this category indicating that multiple types of commitment often act as the glue that holds relationships together when things are rocky or difficult (see Stanley et al., 2010). Research on other virtues (e.g., forgiveness and sacrifice) as well as “relationship flourishing” highlights the importance of these areas for couples to maintain healthy relationships (see Fincham & Beach, 2010). Though it was suggested by Hawkins et al. (2004) that relationship motivations are an essential cornerstone of CRE content, this theme was not widely represented in most programs. It may be that programs instead emphasize skill‐building due to the often visible changes that can be implemented while increasing or changing motivations may be more difficult to facilitate or observe (Schramm et al., 2017).

What we are still missing

Though CRE programming has expanded throughout the years to include multiple content areas beyond interactional skills, there are still unaccounted for content categories and themes that participants could benefit from. Though a few programs do talk about individual contextual factors such as family of origin, even a mention of societal context, socioeconomic status, racial and/or ethnic diversity, sexual orientation, gender identity, etc. was so rare that these important context pieces did not become categories or themes within this analysis. CRE experts have called for expansion into these areas for over a decade (Bradbury & Lavner, 2012; Carlson et al., 2020; Markman et al., 2022; Perez et al., 2013). These researchers and others have discussed the importance of creating or adapting programs that attune to the unique needs and challenging conditions of diverse groups. Additional research on what these groups would find to be beneficial along with careful integration of current research findings on couple processes is an important part of this movement.

Prevention science has long discussed the benefits and potential detriments of cultural adaptation. In adapting to cultures, prevention scientists suggest the need for understanding and addressing core values, norms, beliefs, and other aspects of a group's worldview and current circumstances while maintaining effectiveness of adapted programs (Castro et al., 2004; Kumpfer et al., 2002). Further, adaptations are sometimes based on assumptions or perceptions of a community rather than empirically based understandings (Kumpfer et al., 2002), which calls for more community‐based research and collaboration (Castro et al., 2004). A recent update to the FRAME (a framework to characterize and understand modifications made to interventions) suggests considering and reporting not only what was modified, why it was modified, and who participated in modification, but integrating when the modification occurred, whether adaptations were planned, impacts of modifications on fidelity or core elements, as well as expansion of reasons for modifications (Wiltsey Stirman et al., 2019). As prevention science suggests, program adaptation should be intentional at all stages and studied to determine effectiveness.

Although our findings call for more specific considerations of diversity within the content, CRE over the past decade has made great strides in reaching many diverse groups including lower‐income couples, racially and ethnically diverse couples, military couples, LGBTQ+ couples, and stepfamilies (Markman et al., 2022). These programs have both made alterations to existing programs and created unique programming for couples and families across diverse socioecological contexts. Rainbow CoupleCARE, an adaptation of CoupleCARE for same‐sex couples, includes minority stress‐related topics, discussions on nonmonogamy, and changes vignettes and images to same‐sex couples (Pepping et al., 2020). Another program adapted for African American rural families gave information on contextual factors these families and couples experience such as racism, finances, and extended family, and removed barriers for participation through in‐home education, childcare, free meals, and monetary rewards (Barton et al., 2018). Huang (2005) suggested that adapting Western CRE programs to Eastern cultures will require a greater focus on children and family as couples are often more likely to attend parenting‐based over couples‐based programs while a study on CRE among Latino populations suggests that added elements on gender and machismo would benefit these populations (Perez et al., 2013). It is probable that programs beyond the 15 examined in this review represent these important adaptations and others, but these curricula are sometimes missing in the literature. Additional expansion and research are essential to understand how sociocultural attunement can or cannot impact effectiveness of current or new CRE programs.

Recent discussions on CRE for relationally distressed couples have involved considerations from the couple therapy field (Markman & Ritchie, 2015); however, there remains a theoretical divide between CRE and couple therapy (excluding behaviorally oriented couple therapies), particularly as it relates to its theoretical roots in the field of systemic family therapy. A content analysis of 275 studies from the top two journals of couple and family therapy (Family Process and Journal of Marital and Family Therapy) was evaluated from 2010 to 2015 finding that the most common conceptual framework in family therapy scholarship was systems theory, followed by attachment theory (Chen et al., 2017). Although CRE programs using attachment theory, like Hold Me Tight, have grown, we found a near‐complete lack of systems theory in CRE content. Two of the most well‐researched interventions in couple therapy (Integrative Behavioral Couple Therapy and Emotionally Focused Couple Therapy; Doss et al., 2022) at a minimum integrate interactional patterns (e.g., pursue‐withdraw) derived from systems theory. The lack of empirical research on and application of systems theory in the couple relationship education field may be due to several factors including the theoretical divides between systemic family therapists and psychologists who are often the primary empirical investigators of intimate relationships, as well as the empirical and computational complexity needed to investigate systemic processes.

These ideas are not to suggest that current content is unimportant but, rather, that expansion into socioecological contextual factors and systems theory is the next potential stage within the field of relationship education. As such, variability in programming is currently and will continue to be important given the differences from couple to couple based on the individuals and the contexts within which they reside.

Limitations

This study analyzed 15 different CRE programs though there are dozens upon dozens of programs that individuals and couples can participate in. It is possible that other programs not included in this study (including self‐led and online programs) represent the important movement toward unique programming for diverse couples and individuals, so it is worth acknowledging that there are efforts being made to contemporize CRE programming which may not have been included in this study. Though scope is a limitation of the research, the 15 programs included were intentionally selected based on the aforementioned inclusion and exclusion criteria. It is likely these programs are consumed more often than others and that many government‐funded outreach projects have drawn from the programs analyzed due to their prestige within the field. Another limitation is within our methods. As described, summaries for each program were created by only one research assistant for each program. Having multiple assistants create summaries and then comparing them to one another could have provided more robust summaries. Nevertheless, multiple authors cross‐checked the summaries against the program content before proceeding with the content analysis.

As with all research, certain biases are included due to our various values and research questions. Each author and assistant is part of Human Development and Family Science programs, and, as such, each has a vested interest in helping couples and families. We acknowledge the ways that our lived experiences have shaped this research, research analysis, and the presentation of the research in this manuscript.

Griffes, S. E. , Hardy, N. R. , Gregson, T. J. , Brosi, M. W. , & Gardner, B. (2024). Couple relationship education content: What we have and what we are missing. Family Process, 63(4), 1790–1806. 10.1111/famp.13043

DATA AVAILABILITY STATEMENT

Materials and analysis code for this study are available by emailing the corresponding author.