Theses and Dissertations

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Date of Award

1-1-2026

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Psychology (PsyD)

First Advisor

Emily Georgia

Keywords

couples therapy; low-income couples; online intervention; relationship distress

Abstract

Relationship distress is prevalent and associated with significant psychological and physical health risks, yet many couples face barriers to accessing therapy, such as cost, limited availability, and stigma. The OurRelationship program is an empirically supported online relationship intervention that helps couples identify and address their most pressing relationship concerns. Although the program has demonstrated robust overall effects, less is known about whether treatment outcomes vary as a function of couples’ presenting problems. The present dissertation examined whether the type and quantity of couples’ presenting problems, identified within this program as “core issues,” moderated treatment outcomes (e.g., problem severity, relationship satisfaction, psychological distress) and program completion in the OurRelationship program. Data was drawn from 201 racially and ethnically diverse (27% non-White; 13% Hispanic or Latino) low-income couples (N = 402 individuals) enrolled in the OurRelationship program. Couples were primarily in different-gender (92%), married or engaged relationships (74%), with children (70%), and in their early thirties (M = 32.83 yrs, SD = 7.34). Qualitative coding demonstrated that the most frequently reported presenting concern was Communication (51%); 73% of couples selected one core issue. Three-level hierarchical linear models demonstrated significant pre-post improvement across all outcomes, including reductions in core issue intensity (γ = −0.63, SE = 0.22, p = .004, d = 0.38) and psychological distress (γ = −1.64, SE = 0.46, p < .001, d = 0.28), and increases in relationship satisfaction (γ = 1.72, SE = 0.43, p < .001, d = 0.32). Remarkably, neither core issue type nor quantity moderated change in any outcome. Attrition analyses showed that 80% of couples completed the program; the quantity of core issues was not associated with attrition, χ²(1) = 0.21, p = .64, OR = 1.12, 95% CI [0.60, 2.28]. These results suggest that the OurRelationship program may be a broadly applicable intervention, with no evidence of differential treatment effects by core issue presentation. More broadly, these findings highlight the potential for scalable online interventions to expand access to effective relationship care for couples facing structural and financial barriers to treatment.

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