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Newsletter | South Central MIRECC

Summer 2018, Volume 20, Issue 4 - In this Issue

2018 VA Operational Plan
2018 Grant Writing Scholars Evaluation Results
2018 TRIPS Awardees

Research to Practice: Incorporating Emotion-Regulation Skills in Couple- and Family-based PTSD Treatment
Recent Publications
Pilot Study Research Program Applications Due October 1
Implementation, Design and Analysis Support Available for Affiliates

Research to Practice: Incorporating Emotion-Regulation Skills in Couple- and Family-based PTSD Treatment

Summary by Sonora Hudson, MA

A 2017 review by VA researchers explored the value of incorporating emotion-regulation skills in couple- and family-based treatment for posttraumatic stress disorder (PTSD). Authors of the well-organized article, by Deborah A. Perlick, Frederick J. Sautter and Julia J. Becker-Cretu, et al., are/were affiliated with the VISN 2 South MIRECC at the James J. Peters Medical Center (Bronx, NY), the South Central MIRECC, the Southeast Louisiana Veterans Health Care System, the Washington, D.C. VA Medical Center, and the Office of Patient Care Services.

The authors begin building their case for including emotion-regulation skills in couple- and family-based PTSD treatment by reviewing evidence of the important role that emotion dysregulation has on symptom severity of PTSD, as well as interpersonal and marital difficulties of Veterans and their family members. The authors suggest emotion-regulation skills should be incorporated into family-based interventions for PTSD to address both of these clinical concerns conjointly.

They trace the evolution of couple- and family-based interventions for PTSD, briefly reviewing preliminary evidence of couples work with PTSD, especially with Veterans, and then discussing the stronger research base for interventions that include both emotion-regulation and interpersonal skills. They then focus on two specific couples interventions for Veterans with PTSD that deal explicitly with emotion regulation.

One, structured approach therapy (SAT), involves a single therapist with a single couple and between-session practice. It emphasizes disclosure but not intense exposure and first educates the couple about trauma and the way it affects processing of emotions crucial for maintaining intimate relationships. The couple then learns skills to identify, label and communicate about avoidance of trauma-related stimuli, along with emotion-regulation skills to help them activate positive emotions and engage in couple soothing and empathic mutual support to increase distress tolerance. This is followed by six disclosure-based exposure sessions encouraging the Veteran to discuss trauma-related memories and emotions with his/her partner. A recent randomized clinical trial showed that all Veterans randomly assigned to SAT had significantly greater reductions in PTSD symptoms than those randomly assigned to PTSD family education. Moreover, gains were still present at the 3-month follow-up, with 52% of the SAT Veterans no longer meeting Diagnostic & Statistical Manual, Fourth Edition, Text Revision criteria for PTSD.

The other intervention, multi-family group for military couples with trauma (MFG-MC), involves three phases. It begins with two sessions in which clinicians meet with each couple to evaluate problems and define treatment goals, followed by two sessions of education about post-deployment strains and mental health sequelae to a group of Veterans and their partners. The third phase involves twice-monthly MCG meetings for six months, focusing on problem solving, emotion regulation and communication while receiving social support. An open-trial pilot study found MFG-MC effective in reducing Veterans’ PTSD, and a randomized controlled trial was ongoing at time of publication.

The authors conclude that incorporating PTSD treatment within a couples and family context may be effective in reducing PTSD symptoms while simultaneously enhancing the ability to support Veteran recovery. Despite promising early research, further work that continues to explore the role of emotion-regulation skills in the context of family-based PTSD treatment is needed.

This article may be accessed at

Citation: Perlick, D. A., Sautter, F. J., Becker-Cretu, J. J., Schultz, D., Grier, S.C. Libin, A.V., . . . Glynn, S. M. (2017). The incorporation of emotion-regulation skills into couple- and family-based treatments for post-traumatic stress disorder. Military Medical Research, 4, 21.


Last updated: December 15, 2020