Couple Communication & Support
When a patient is diagnosed with a serious illness, both the patient and their partner often experience difficult emotions, such as worry, fear, and sadness. Illness can also cause changes in couples' relationships due to disruptions in usual work and family roles and responsibilities. Research indicates that couples who are able to talk openly and effectively about illness-related challenges feel closer to each other, are able to provide more support for one another, and successfully navigate the challenges as a team. However, couples often find it difficult to discuss illness-related concerns with one another.
The focus of our research is twofold:
- To better understand how couples communicate about illness-related issues, and to identify specific patterns of communication that are associated with patient, partner, and couple adjustment.
- To develop, test, and disseminate couple-based interventions to improve psychological and relationship adjustment among couples coping with serious illness.
Couple-based Interventions for Advanced Cancer
The purpose of this study is to evaluate whether couple-based programs are helpful for patients with cancer and their spouses/partners. Patients are eligible to participate if they are married or in a committed relationship and have one of the following diagnoses: Stage 4 breast, lung, GI, or GU cancer, Stage 3B lung cancer, or Stage 3 pancreatic cancer. We are testing whether a six session program delivered by videoconference is helpful at improving emotional and relationship health for cancer patients and their partners. Couples are randomized to one of two interventions: (a) Couple Communication and Support which provides couples with skills in supporting each other and communicating about issues and concerns related to cancer, or (b) Living Healthy Together which provides couples with information and resources on topics relevant to maintaining their health during cancer treatment (such as sleep, nutrition, and exercise).
This study is funded by the National Cancer Institute.
Disclosure Among Patients with GI Cancer and Their Spouses
This study examined patterns of disclosure about cancer-related concerns between patients with GI cancer and their spouses, and associations between disclosure and patient adjustment, spouse adjustment, and relationship functioning. Findings indicated that patients and spouses reported moderately high levels of disclosure and low levels of holding back. Among patients and spouses, low levels of disclosure and high levels of holding back were associated with poorer relationship functioning. High levels of holding back were associated with increased psychological distress for both patients and spouses. There were no indications that patient or spouse disclosure was harmful for the other person.
This study was funded by the American Cancer Society.
Partner-Assisted Emotional Disclosure for GI Cancer
In this study, we trained patients in communication skills for sharing illness-related thoughts and feelings with their spouses/partners, and we trained partners in skills for listening in a supportive manner. The intervention was delivered in four face-to-face sessions. We found that couples who received the intervention reported improvements in their relationship satisfaction and intimacy. Couples in which the patient initially reported high levels of holding back from expressing their cancer-related thoughts and feelings showed the most improvements.
This study was funded by the National Cancer Institute.
Videoconference Couple Communication Skills Training for Advanced GI Cancer
To better meet the needs of couples who often have difficulty attending in-person sessions (due to time, distance, and/or the patient's medical condition), we offered a six-session communication skills training intervention via videoconference. In this study, we trained both patients and partners in skills to share their cancer-related thoughts and feelings and listen supportively to each other. We also trained them in skills for joint decision making around medical issues. Findings from this small pilot study indicated that the videoconference format was feasible and acceptable, and that the intervention led to improvements in couples' relationship satisfaction.
This study was funded by the American Cancer Society.
Intimacy Enhancement Interventions
We have been collaborating with Dr. Jennifer Reese at Fox Chase Cancer Center who developed a couple-based intimacy enhancement intervention for patients with breast and colorectal cancer and their partners. The four-session intervention is delivered by telephone and teaches couples skills to cope with the changes cancer has caused to their physical intimacy. The intervention includes education about the impact of cancer on sexual functioning, behavioral skills such as sensate focus exercises, and cognitive strategies to cope with negative thoughts about cancer-related challenges. Several studies have show that couples participating in this intervention report improvements in sexual and psychosocial outcomes.
Read the study: Colorectal Cancer
These studies were funded by the American Cancer Society and the National Cancer Institute.
Couple Communication in Cancer: A Multi-method Examination
This is a longitudinal study using multiple methods of examining how couples communication about cancer, and the impact of their communication patterns on their adjustment over time. 368 cancer patients and their partners participated in this study and completed the following activities:
- Self-report measures of communication and relationship and psychological adjustment at the start of the study and every three months for one year.
- Ecological Momentary Assessment (EMA): Twice-daily reports of communication and relationship and psychological adjustment for two weeks using a smartphone app developed for the study.
- A 15-minute conversation about a cancer-related topic of their choosing. This was videotaped and coded for communication behaviors and fundamental frequency (a measure of vocally encoded emotion).
Data analyses are ongoing. Initial findings include the following:
Read attachment study findings
Read fundamental frequency study findings
This study was funded by the National Cancer Institute.