When It Comes to Relationship Education, Dosage Matters

Based on the premise that poverty is linked to family instability, the federal government has funded healthy marriage and relationship education programs since 2006 as a component of welfare reform. These programs, like the one that I run in the South Bronx, teach relationship skills to low-income couples with children, specifically how to deal with and recover from conflict, how to co-parent effectively, and how to speak and listen (two of the most difficult things any of us ever have to do). 

While it is commonsense for all of us to try to improve our ability to communicate, policy analysts appropriately ask questions about whether such programs are effective: is there much interest in learning these skills; are relationship skills teachable; do these skills improve the quality and stability of couples’ relationships; and do these skills have an impact on the second-generation, i.e. their children? 

Psychologist Alan Hawkins recently summarized the results of over 50 studies at AEI (and here on this blog), concluding that although this intervention shows promise, the story is quite nuanced, as is often the case with new social policies. As a three-time federal grantee, allow me to describe my personal experience with this effort.

In the first tranche of funding under the Bush administration, the government differentiated between three types of programs: relationship education for married couples, relationship education for unmarried couples, and fatherhood programs for non-custodial fathers. My program involved married couples and participated in the large, multi-site Supporting Healthy Marriage (SHM) study conducted by MDRC, a think tank that studies poverty. Although many social commentators claim that these evaluations are “disappointing,” the SHM study of 6,300 couples provided clear evidence for a “modest” impact after one year on relationship quality, relationship satisfaction, reduction in conflict, positive communication, and marital stability. Since the study design required the inclusion of couples who never attended any workshops, the impact would be better characterized as “moderate” when analyses are limited to couples who had an undiluted intervention. 

From my experience, what was impressive in this initial effort was the degree of interest in relationship education among low-income married couples in the Bronx (where only one out of three is married), and the high level of participation. We made a special effort to include men in the conversations, and the workshops were fun, social events—a rare evening away from the children—with lots of joking around, even though the topics were quite serious.

In contrast to the program for married couples, the Building Strong Families (BSF) study conducted by Mathematica evaluated 5,100 unmarried couples in that first wave (my site did not participate in BSF). Here, there was no impact in either improvement in relationship quality or stability. While critics cite this study as proof that marriage promotion programs are wasteful, a closer analysis reveals that the majority of couples included in their analyses did not attend relationship education workshops: 45% of couples in the study did not attend a single workshop, and 83% did not receive a sufficient dosage of relationship education (in contrast to the SHM study, where only 25% did not receive a sufficient dosage). Interestingly, at the one site that had good attendance, there was an impact of relationship education on relationship quality, romantic involvement, co-parenting, and father involvement after one year. The fact that there is a clear impact when attendance is good demonstrates that unmarried couples as well as married couples can benefit from relationship education when there is a sufficient dosage, i.e. at least 24 hours of programming. 

To say that an intervention “failed the litmus test” (as Nicholas Kristof did) when many people did not get the intervention is like saying that exercise doesn’t make us healthy if we do not go to the gym. All that the BSF research study showed was that many couples were not interested in participating in the program (which was due to the low level of financial incentives they were given). I suspect the same would be true if the government offered people free gym memberships; many people would not go. But the ones who did go would benefit, which is why this government-made investment is worthwhile—and why dosage matters.

In the second round of funding under the Obama administration, we were allowed to open up our program to unmarried couples, and consequently, we had a huge influx of couples interested in our services (1,000 couples over 20 months). Even though the majority of these couples had children out of wedlock, their level of interest indicates that they were still interested in improving their relationships. We don’t advocate for our couples to get married (unlike certain faith-based organizations) or for distressed couples to stay together, but we do believe that learning relationship skills is important regardless of the level of relationship commitment. Interestingly, at our site, nearly two-thirds of all participating couples had non-custodial children with other partners. In my opinion, it no longer makes sense to make a hard-and-fast distinction between relationship education and fatherhood programs. That’s because in low-income communities, blended families are the rule, not the exception. 

During this time, we participated in yet another national evaluation study conducted by Mathematica: Parents and Children Together or PACT. My site recruited the majority of couples in the PACT study and again delivered a high dose of services. Consequently, this study demonstrated the strongest impacts yet on a range of relationship quality variables, including commitment, marital stability, co-parenting (our site only), and reduction in destructive conflict. My site also found a very significant impact on employment and earnings. Our approach to employment is not to simply offer supplemental employment services that are split off from the relationship workshops. Instead, we weave in the importance of meeting one’s financial responsibilities throughout the relationship education curriculum. Financial responsibility is an integral component of our program model and philosophy and needs to be addressed as much as other relationship topics.

In the ongoing, third round of funding, we have already evaluated 867 couples at baseline and the six-month follow-up, again with a high dosage of workshops. We are finding changes in relationship satisfaction, improvements in relationship hope, and reductions in relationship distress. But in addition to these relationship outcomes, we are also finding significant improvements in emotional intelligence (so-called “EQ”) and higher scores on tests of relationship knowledge. We are in the process of conducting regression analyses to determine which factors, including dosage and marital status, account for these impacts. Dr. Hawkins’ review would suggest that couples with higher levels of distress show the biggest impacts, but I believe this might be an artifact of what is called a “ceiling effect,” that non-distressed couples do not have as much room for improvement.

So, what have we learned from these multi-site and local studies? The cumulative profile of findings would appear to demonstrate that when delivered at a sufficiently high dosage, relationship skills can be taught and do improve the quality of relationships, especially reducing conflict. In addition, relationship education may increase marital stability, at least among married couples. Finally, although one of the major aims of relationship education programs is to find second-generation impacts on children, no study has demonstrated such an effect. In my opinion, impacts on children are very difficult to study since no single measure of child well-being is applicable to children of such a wide range of ages and developmental stages. Nonetheless, I have observed that benefits accrue to children in more stable homes with less conflict and greater financial stability. If parents are happier with each other, how can it not benefit their children as well?

Scott Wetzler, PhD. is a clinical psychologist and Vice Chairman and Professor in the Department of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine and Montefiore Medical Center. He is also the author of Living with the Passive-Aggressive Man.