More than 2 million people in the U.S. have taken federally funded relationship education or fatherhood classes in the past 20 years at a cost of over $1 billion. But early studies raised questions about the value of such programs, paid for as part of the Administration for Children and Families’ “Healthy Marriage & Responsible Fatherhood Initiative.”
Early findings on the effectiveness of relationship programs were tepid at best.
But the view is shifting as the programs have evolved from earlier renditions. A special section in the journal Family Process recently looked at a variety of programs funded from 2015-2020 through the lens of rigorous studies to gauge their effectiveness.
Some clearly show some value, said Galena K. Rhoades, a research professor of psychology at the University of Denver who edited the section and who directs a relationship education program for low-income women called MotherWise.
Based on previous bad reviews of healthy relationship programs, many people are “up in arms about how much the government is spending,” Rhoades told the Deseret News, noting previous programs and those today are not the same.
She said the last round of funding for what are often community-based programs to foster healthy relationships for low-income individuals, couples and families included money to conduct randomized controlled studies. Researchers were able to compare benefits or deficits to those in the programs to that of similar folks who didn’t participate. Often, the studies showed positive impact. A few of them were previously published online.
In the introduction to the special section, Rhoades, Brian D. Doss of the University of Miami and Ryan G. Carlson of the University of South Carolina wrote: “Beyond demonstrating the impact of these community-based programs, we hope that this special section further encourages family scientists, program developers and those in the community who have the opportunity to implement evidence-based programs to work together, learning from one another to effectively support families.”
Relationship and fatherhood programs are typically short term, lasting just weeks. One study called them “brief, targeted interventions.” Relationship classes generally have components like communication skills, conflict management, how conflict arises and sometimes concepts such as how family background, individual characteristics and trauma can pressure relationships.
“I think that collection of studies — including a meta-analysis that I did — shines a brighter light on the value of these federally funded relationship education studies,” said Alan J. Hawkins, a professor in Brigham Young University’s School of Family Life. “Compared to the first wave of studies that showed limited and very small or no significant effects of these programs on couple relationships, this last wave of studies is showing stronger — but still modest — effects, as well as broadening the effects to individual mental health and some other important outcomes.”
Hawkins said early disappointing findings regarding the programs “were not a big surprise,” given those developing programs faced a “steep learning curve.” With what he calls “solid testing of well-implemented programs by good instructors,” Hawkins said, “I am heartened that we are seeing more promising results now.”
The studies, he added, are “tracking improved implementation of effective programs.”
Unexpected benefits
Some of the findings were surprising. In a review, Rhoades’ program, MotherWise, was found to reduce preterm birth. “To see that a social program like this can have an impact on a hard health outcome — that’s pretty incredible,” she said.
MotherWise serves women with very low incomes. “They have high needs in terms of community resources. Many of them don’t have stable housing. They may have a place to sleep, but it’s not their own home. About a quarter of them have had some domestic violence in the last year. If there’s a selection effect, it’s that we reach a population who has kind of fallen through the cracks in other systems,” said Rhoades.
While some of the women receive government benefits, many others are eligible but haven’t figured out how to enroll. Some have experienced a lot of trauma “and have tried to get mental health support therapy counseling and just can’t wade through the community mental health center system to get that support,” she said.
The program is for women who are pregnant or postpartum, not couples, but if one person in a relationship learns new skills, the effect ripples. So if a woman learns skills to manage conflict, in turn reducing stress, it’s not really surprising that this leads to healthier pregnancies and reduces preterm birth. The finding is especially hopeful, Rhoades said, because “it’s such a critical time, and maternal health in the United States is pretty abysmal to begin with. So there’s a lot of room for improvement.”
Rhoades said the special section is partly an update “on where we are with that controversy around whether these programs work and whether they’re worth it from a taxpayer’s perspective.”
“But the other part is how we link these programs to maternal health and the impact that they can have in realms that we haven’t typically considered, thinking about health outcomes, thinking about setting babies up for the brightest future they can have by being born at the right time.”
MotherWise also has a strong focus on a model Rhoades and colleague Scott Stanley call “deciding vs. sliding.” It’s better not to drift into relationships or related decisions, she said. “We’re just going to do better if we make clear decisions.”
A collection of evidence
The featured studies also include a review led by Hawkins of 32 government-funded couple relationship education programs. That review found “small but significant effects for couple relationship quality, relationship skills, mental health and co-parenting.” The researchers didn’t find significant effects for relationship stability, parenting and child well-being, though supplemental analysis showed larger impact there.
The researchers said administration-funded programs can support both concerns about the initiative and hopes for it. And while noting that critics could find fuel for their concerns, they wrote that “we see positive signs for these programs, however, in our finding that programs that began later in the ACF policy initiative had stronger outcomes than did the earliest programs.”
The study said the Administration for Children and Families made efforts over the past 15 years to share best practices and what was learned from early programs. As more is learned and more best practices identified, the authors said they should be shared “generously and quickly” among programs.
Different ways to build healthy relationships
The special section shows a wide range in terms of what healthy relationship programs or education can include. For teens, healthy relationship classes might be taught in middle school or high school. There are programs like MotherWise for people who may or may not be in a relationship. Some people in different programs may not be in a safe relationship and need support around making good decisions about who they’re in a relationship with and how to communicate “even long before you’re at the stage of walking down the aisle,” Rhoades said.
One program targets co-parents, who may or may not be in a romantic relationship. “It may be that your co-parenting fatherhood program is dad co-parenting with his mother, and she’s coming to the program,” Rhoades said. “And they need to be able to communicate and work well together to be able to raise a child. It may be dad and his sister or friend or someone else. It may be dad and the mother of his child, but they’re not in a romantic relationship any longer. There’s just this much wider range of what these programs cover from where we started 20 years ago, which was offering programs to a man and a woman in a committed relationship.”
A number of programs were studied, not necessarily in the same way, and often the findings were hopeful. For example:
- Examination of a pair of online programs called OurRelationship and ePREP found that two-thirds of participants completed the program and more than 95% said the programs helped them.
The reviewers said, “This study contributes to a rapidly expanding field of research showing that online interventions can serve a central role in delivering effective services to low-income couples. These brief, targeted interventions can improve relationship functioning in a way that is scalable.”
- Of a youth education program where high school students were randomly assigned the usual class or a healthy relationship class taught by outside facilitators, evaluators said students were highly engaged and gave the program high marks, but the study found no statistically significant impacts on healthy relationship skills, attitudes and behaviors after three and nine months.
Still, 85% of the participants said they could “better describe what makes a relationship healthy, use new skills in their relationships, felt confident in using the skills presented in the program and knew more about what constitutes a good relationship.”
More than 4 out of 5 said the class raised their expectations for relationships.
Asked how much the class helped, nearly 40% said “a lot;” fewer than 5% didn’t find the class helpful. Within a year, more than a quarter of those in the class said they’d ended an emotionally unhealthy relationship, 18% had ended a physically unhealthy or abusive relationship, and 47% had ended a relationship that was “just not working.”
- A study of a relationship program for economically vulnerable couples using the Within Our Reach curriculum found those in the program showed “statistically significant improvement over the six-month study period on emotional regulation and coping with challenges and stress as a couple, compared to those on a waiting list for the program. The improvement in individual distress and relationship adjustments was not statistically significant.”
- In the couples-based fatherhood intervention TRUE Dads, low-income fathers and co-parenting partners do six three-hour workshops and fathers have the option of a two-week employment program. The study showed a year later the dads had fewer depression symptoms, less destructive communication and domestic violence, and more employment. Indirect effects were improvements in their children’s behavior problems and more economic self-sufficiency.
- Reviews of the ELEVATE and Couples Connecting Mindfully relationship programs both showed couples made significant gains in their relationship skills and in family harmony compared to the control group. ELEVATE had “measurable impact” on mental health and sleep quality. Both evidence-based programs could help a broad population of couples, the study said.