This study is testing a program called Get Better Together, a relationship education program designed to help military couples effectively navigate life stressors as a team. The goal is to find out if attending Get Better Together improves mental health and relationship skills, and reduces problems like alcohol misuse, aggression, and suicide risk. Couples who join the study will be randomly placed into one of two groups. One group will attend Get Better Together at a weekend retreat. The other group will continue their usual activities and later receive access to an online relationship education program. All participants will complete surveys before the retreat and again 2, 4, and 6 months later.
Couple is in a committed romantic relationship of at least six months
At least one partner is a military Service member on active duty
Both partners are age 18 or older
Couple has not previously attended a relationship enrichment retreat or workshop together (e.g., CREDO, Strong Bonds, BSRT). This does not include couples therapy or pre-marital counseling.
One or both partners decline to provide informed consent
Required command endorsement for retreat attendance is not received (for Service members E-6 and below)
Couple is unable or unwilling to attend any of the scheduled retreats during the study period
Parallel
Get Better Together (GBT)
BehavioralGet Better Together is a couple-based, primary prevention program designed to reduce risk for suicidal thoughts and behaviors, problematic alcohol use, and intimate partner violence by addressing two transdiagnostic drivers: emotion dysregulation and relationship conflict. The intervention is an adaptation of the empirically supported Prevention and Relationship Enhancement Program (PREP), modified in collaboration with military stakeholders to meet the unique cultural and contextual needs of military couples. The GBT curriculum includes approximately 10 hours of structured content presented using didactic instruction, video demonstrations, group discussions, and guided couple exercises. Skills focus on interpersonal emotion regulation (e.g., emotion identification, acceptance, reappraisal, and problem solving) and evidence-based communication strategies (e.g., structured communication strategies, conflict de-escalation).
Suicide Cognitions
Assessed using the Suicide Cognition Scale-Revised (SCS-R), a 16-item validated self-report measure capturing cognitive risk factors for suicidal behavior. Scores range from 0 to 64, with higher scores reflect greater risk.
Alcohol Misuse
Measured using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), a 3-item measure designed to identify hazardous drinking. Scores range from 0 to 12, with higher scores reflect greater likelihood of drinking affecting one's health and safety.
Intimate Partner Violence
Measured using the Revised Conflict Tactics Scale-Short Form (CTS2S), a 20-item measure assessing multiple types of relationship abuse. Dichotomous scores will indicate the presence of any form of abuse. Dichotomous subscale scores will indicate the presence of assault, injury, psychological aggression, or sexual coercion.
Emotion Dysregulation
Measured using the Difficulties in Emotion Regulation Scale - 18 Item (DERS-18), which assesses six dimensions of emotion dysregulation: awareness, clarity, nonacceptance, impulse, goals, and strategies. Total scores range from 18 to 90, with higher scores indicating more severe difficulties regulating one's emotions.
Relationship Conflict
Evaluated using the Ineffective Arguing Inventory (IAI), an 8-item scale measuring perceived patterns of unresolved conflict and communication breakdown in romantic relationships. Total scores range from 8 to 40, with higher scores indicating a higher degree of ineffective communication.
Interpersonal Emotion Regulation with Romantic Partner
Measured using the Dyadic Coping Inventory (DCI), an 37-item self-report measure assessing how couples communicate stress and cope together (supportive, delegated, negative, and joint coping). Total scores range from 37 to 185, with higher scores indicated higher levels of dyadic coping.
Relationship Functioning
Assessed using the Revised Dyadic Adjustment Scale (RDAS), a 14-item self-report measure evaluating relationship functioning across three domains: Dyadic Consensus, Dyadic Satisfaction, and Dyadic Cohesion. Items assess agreement on relationship issues, frequency of shared activities, and satisfaction with the relationship. Total scores range from 0 to 69, with higher scores indicating greater relationship satisfaction.
Military Readiness (active-duty participants only)
Measured using items adapted from the 2017 Workplace and Equal Opportunity Survey of Active Duty Members (Office of People Analytics, 2018), a DoD standardized survey tool. Items assess key indicators of readiness, including self intent to remain in the military. Items use Likert-type scales appropriate to each domain (e.g., "Very poorly prepared" to "Very well prepared"). The items are designed to be used independently rather than as a single composite scale.
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Henry M. Jackson Foundation for the Advancement of Military Medicine
Lead sponsor
Uniformed Services University of the Health Sciences
Collaborator
