Relationship Educator Experiences of Couple Improvement and Group Dynamics in Relationship Education With Low-Income Couples

Abstract

Relationship education (RE) interventions improve relationship quality and distress; yet, little is known about the origins of positive gains derived from RE. Couples identified benefits from the group format of RE; however, the perspective of facilitators is neglected. Therefore, the current investigation included two focus groups (N = 9) with RE facilitators from one federal RE program for low-income couples. Five themes emerged from the phenomenological analysis including (a) therapeutic factors of groups, (b) participant attributes, (c) stress, (d) insight/awareness, and (e) program attributes. Applications of RE facilitator experiences, specifically group factors observed, may inform RE facilitator training, intervention, and implementation.

Keywords

relationship education group dynamics low-income couples

Meta-analyses demonstrate relationship education (RE) is a viable intervention to improve couple communication and marital quality (Blanchard, Hawkins, Baldwin, & Fawcett, 2009; Hawkins, Blanchard, Baldwin, & Fawcett, 2008). Further, federally funded RE programs seek to provide service to historically underserved populations (i.e., low-income couples) and improve relationship stability. However, little is known about the precise mechanisms of change or why RE interventions are effective (Hawkins, Stanley, Blanchard, & Albright, 2012). Initial studies suggest that augmentation of positive and affectionate behaviors, as well as the reduction of negative communication and conflict behaviors, are related to post-RE improvements for couple relationship quality (Rauer et al., 2014). Yet Rauer and colleagues implied the need for further research to determine programmatic elements that may impact RE outcomes.

Additionally, research suggests the group format and facilitator dynamics influence participant outcomes (Bradford, Adler-Baeder, Ketring, & Smith, 2012; Higginbotham & Myler, 2010; Owen, Antle, & Barbee, 2013; Quirk, Strokoff, Owen, France, & Bergen, 2014); yet, few studies have explored RE group dynamics from the perspective of the RE facilitator (e.g., Reck, Higginbotham, Skogrand, & Davis, 2012). Moreover, the perspective of relationship educators that facilitate such groups may provide a unique perspective to the observable changes that occur during RE programs. The dearth of literature for the perspective of RE group facilitators is problematic in that critical information regarding facilitator experiences may provide implications for RE groups overall. Therefore, this study seeks to understand the unique perspectives and experiences of RE facilitators as they directly observe the dynamics of psychoeducational groups for couples with low income.

RE

RE is a psychoeducational intervention that follows a manualized curriculum. RE is often taught in a group setting and employs a mixture of lectures, discussion, videos, interactive exercises, and homework led by facilitators. Facilitators (or relationship educators) are often selected as representative of the local community and serve as realistic role models for healthy relationships (Ooms & Wilson, 2004). RE programs provide couples with knowledge and skills needed to have healthy and happy relationships. Thus, RE is an efficacious and cost-effective intervention to improve relationship satisfaction and decrease individual levels of distress with low-income couples (Carlson, Barden, Daire, & Greene, 2014; Carlson, Daire, & Bai, 2014).

Most of the RE literature emphasizes participant factors as outcomes and moderators of change (such as levels of distress, income, relationship stability, or satisfaction) and not factors within the control of the educational provider. In one phenomenological investigation of federal RE initiatives, participants reported two major programmatic factors that contributed to positive outcomes: (a) program incentives and structure that allow for attendance and focused effort to positive communication (i.e., childcare, transportation assistance, provision of meals, flexible scheduling, and a safe environment) and (b) normalization of relationship challenges within the group by other couples who helped to reduce personalization of problems and blame within the relationship (Randles, 2014). Thus, RE participants noted structural elements of the training and the internal workings of the group (i.e., universality) that affected the couple relationship and outcomes. Yet no studies have explored the potential of other therapeutic group factors as contributors to change.

In addition, participants’ ratings of their alliance with their RE facilitator predicted positive changes in couple communication and relationship satisfaction (Ketring et al., 2017; Owen, Rhoades, Stanley, & Markman, 2011). The RE facilitator–client alliance seems to play a role in benefits derived from RE. However, facilitator alliance effects are small and ignore group relationships and dynamics in the change process. The group format for RE intervention provided greater gains for couple’s positive communication than individual-couple formats (Quirk et al., 2014). Therefore, the group structure also contributes significantly to RE outcomes and how change occurs. In summary, group dynamics and the facilitator relationship play important roles in the RE participant’s experience and reported change. Yet only the client’s perspective of group dynamics are explored which results in a rather general perspective. In order to gain a deeper understanding of RE group dynamics as a potential contributor to change, the researchers explored group facilitator insights for such dynamics, a perspective not yet studied in spite of their proximity and connection with the RE participant’s group experience.

Facilitation of RE

RE is not group therapy. In fact, Bradford, Hawkins, and Acker (2015) cautioned facilitators to not allow the traditionally psychoeducational format to become therapy. However, specific nontherapy group skills are needed by facilitators in order to address the unique needs of the population. In fact, the authors suggested (a) additional training for nontherapist RE facilitators for group and (b) additional training for therapists who become RE facilitators in order to maintain instruction as psychoeducation and skills training only. As a result, both RE facilitators who have therapy backgrounds and those who do not are asked to expand their skill sets which may be potentially challenging.

Facilitator quality (e.g., facilitation ability) is a strong contributor to improvements in couple functioning (Bradford et al., 2012; Higginbotham & Myler, 2010). In addition, matching participant–facilitator gender has been shown to predict ratings of facilitator quality (Bradford et al., 2012) and alliance (Ketring et al., 2017). Other facilitator factors that significantly predict individual and couple change include education match and match in relationship status (Bradford et al., 2012). In summary, literature supports the importance of the relationship between participant and facilitator; yet, no studies have explored the RE facilitator perspective, the participant–facilitator relationship, nor group factors observed during RE intervention. Therefore, investigation of the therapeutic components of a group format inclusive of the facilitator’s role is warranted, given (a) the strength of RE outcomes from a group versus individual format (Quirk et al., 2014), (b) the role that facilitator factors play in group dynamics and participant outcomes (Bradford et al., 2012; Higginbotham & Myler, 2010; Ketring et al., 2017; Owen et al., 2011, 2013; Quirk et al., 2014), and (c) RE participant identification of perceived benefit from group factors (Randles, 2014) such as the normalization of relationship issues. Thus, the current study sought to examine relationship educator observations and perceptions for participant improvement and group dynamics.

Therapeutic Group Factors

According to Yalom and Leszcz (2005), there are 11 primary factors that facilitate therapeutic change among participants in group therapy. These factors include (a) instillation of hope, (b) universality, (c) imparting information, (d) altruism, (e) recapitulation of the primary family group, (f) development of socializing techniques, (g) imitative behavior, (h) interpersonal learning, (i) group cohesiveness, (j) catharsis, and (k) existential factors. The therapeutic group factors originated from therapy groups, therefore, less is known about curative factors in psychoeducational groups. Moreover, RE observations and perceptions of group dynamics within the RE setting informed the second research question of interest to the current study.

Shechtman, Bar-El, and Hadar (1997) found no differences in the therapeutic factors between psychoeducational and growth groups for adolescents. Although psychoeducational groups (such as RE) differ from group therapy, in preliminary studies, RE participants endorsed the significance of therapeutic group factors that parallel Yalom’s factors (i.e., Quirk et al., 2014; Randles, 2014). Although group RE literature is focused on the participant perspective, group facilitators play an important role in the development of a therapeutic environment where group factors are experienced (Kivlighan & Tarrant, 2001). Moreover, RE facilitators observe couple- and group-level interactions which may reveal aspects of change not yet explored in the literature. Therefore, exploration of the perspectives and experiences of RE facilitators is imperative to improve awareness for group dynamics and specific group factors that may contribute to participant change.

Method

The researchers conducted a phenomenological study to investigate the meaning and essence (Moustakas, 1994) of the lived experiences of the participants. Participants in the current study included relationship educators who conducted RE groups in affiliation with one federally funded RE program for couples with low income. Focus groups allowed participants to explore their perceptions and thinking (Krueger & Casey, 2015) about group dynamics and contributions to changes reported by RE participants. The researchers completed a narrative analysis to ascertain common themes among the responses of the participants (Creswell, 2007).

Research Design

The university institutional review board reviewed and approved all aspects of this study for research with human subjects. The researchers offered two focus groups that included group interviews between 60 and 90 min in length and utilization of open, purposive, and structured questions (Frey & Fontana, 1993). Focus groups are useful to provide opinions and insights through focused discussion with participants who share a common factor (Krueger & Casey, 2015)—in this case, individuals who share the experience of RE facilitation at one federally funded program for couples with low income. The researchers sought to recruit between five and eight participants per focus group, the ideal focus group size (Krueger & Casey, 2015). One of the researchers conducted both interviews on location in the same physical space where all educators had previously led RE interventions for couples, a familiar and natural environment for participants. The group moderator audio recorded the focus group discussion for subsequent transcription.

The researchers determined the group interview format was the most appropriate design to allow for interaction between facilitators and collaboration between respondents (Frey & Fontana, 1993). Many of the relationship educator participants previously cofacilitated RE groups with one another. Therefore, some level of comfort and familiarity was assumed. Also, the researchers chose the group format to parallel the group structure of the workshops the respondents previously led. Finally, the second author, a skilled moderator led the focus groups to reduce the influence of dominant members, engage participants, and maintain the purpose of the group.

The research questions guiding this study included (1) What did the relationship educators observe and experience concerning participant improvement? (2) What group dynamics did the relationship educators observe when they facilitated couple and RE? In part, the current study relied on the facilitator’s subjective experiences and perceptions of participating couples change observed over time. More specifically, participants were asked the following questions when they did not naturally emerge during the discussion:

Questions related to participant improvement and characteristics of the couples: Thinking back on couples who seem to make progress or receive benefit, what do you notice as different about them? What types of behaviors did you observe that led you to believe that their relationship was different? Were there any differences you could note about them in retrospect at the very beginning of the group? How do you perceive couple motivation as influencing change?

Questions related to group and program dynamics: From your perspective, what group processes contribute to participant change? What role do you believe group cohesion had on couple outcomes or benefits from RE participation? What role do you believe your relationship with the participant had on couple outcomes or benefits from RE participation? What role do you believe normalization of couple conflict and stressors had on couple outcomes or benefits from RE participation? What role do you believe programmatic supports (e.g., gift cards, meals, childcare, and family support services) had on couple outcomes or benefits from RE participation?

Procedures

Criterion sampling employed in this study required that potential participants (a) provided RE services to low-income couples through employment as a relationship educator at the university-based implementation site and (b) delivered at least one 12-hr RE workshop using the Prevention and Relationship Enhancement Program (PREP) curriculum (Stanley, Markman, Jenkins, & Blumberg, 2008). Prior to the facilitation of a workshop, facilitators from this specific program (a) completed at least 24 hr of training in the curriculum, (b) shadowed at least 12 hr of program facilitation, and (c) presented the curriculum independently to program staff. Additionally, program administration conducted intermittent facilitator observations to monitor and promote fidelity to the curriculum. The PREP curriculum is widely used in practice and is highly researched. It is also included on the Substance Abuse and Mental Health Services Administration registry of evidence-based practices.

The researchers contacted potential participants via e-mail to provide information about the study and the opportunity to enroll. The researchers invited a total of 27 potential respondents to include all educators affiliated with the federally funded RE projects for the past 5 years based on employment records. Two facilitators responded that they no longer lived in the immediate area and were therefore unavailable to participate. One e-mail returned as undeliverable to the address on file. Overall, a total of nine respondents expressed interest in involvement in the study, a 38% (9 of the 24 possible) response rate. All of the interested participants were also current and active facilitators in an ongoing RE project at the site. Most of the identified participants worked other jobs aside from their RE role. Therefore, the researchers planned the focus groups to occur during a lunch hour to accommodate participant schedules and to select a convenient time for the focus group. As an incentive for participation, the researchers provided participants a US$5 gift card and lunch. Krueger and Casey (2015) suggest provision of food or snacks to promote conversation between group members.

Participants

In total, two males and seven females chose to participate in the focus groups. Respondents completed a brief demographic form and provided informed consent prior to participation. The majority of participants (i.e., four educators or 45%) identified as Black, two as White, three as “Other” including two individuals who identified as Puerto Rican and one as biracial. Over half (67%) identified ethnically as Hispanic, similar to the demographic composition of couples who participated at this RE program site. The mean age of relationship educators was 33.87 and most identified educational attainment at the master’s degree level (67%). The average number of workshops delivered was 22.6 groups across an average of 3.1 years of experience as a relationship educator.

Positionality Statement

The researchers hold advanced degrees in counseling and experience as group facilitators. Additionally, the researchers discussed potential biases that may have emerged during analysis of the data. The first author had administrative experience at the agency where the current study took place and experience in cofacilitation of RE groups. She was a female and had previous experience with research that examined RE services with this population. Because the first author had prior experience with the participants in the focus group, the second author conducted the focus groups.

The second author was a female with an educational background in marriage and family therapy. She also had clinical experiences with couples and families from low-socioeconomic backgrounds. The second author moderated the focus groups and initiated transcription of the data. During the facilitation of the group, she noted common answers provided and discussed these notes with the first author. Bracketing in qualitative research is described as the process by which qualitative researchers identify and suspend their previous experiences or theories in order to analyze participants’ experiences with an open mind (Tufford & Newman, 2012). Before analyzing the data, the coinvestigator bracketed her experiences by identifying that her background as a counselor and her experiences as a group facilitator may have influenced how she interacted with the group facilitator participants. To counter these experiences, the second author asked questions specifically relevant to the research questions rather than the researcher’s personal curiosity. Although the first author did not attend the focus groups, she and the second author analyzed the data collaboratively to increase the validity of the themes gathered.

Trustworthiness

The research team discussed potential biases that would affect the collection or analysis of the data. The investigators then bracketed their biases and experiences in attempt to increase awareness of any preconceived opinions of the phenomenon (Creswell, 2007). Next, verbatim interview transcripts supplemented the trustworthiness of the data (Miles & Huberman, 1994). The first researcher removed participant identifiers to ensure confidentiality of responses for participants who were currently employed by the project associated with the current investigation. Immediately following the focus group, the moderator journaled a reflection of her experience and the main themes she identified for subsequent analysis. The researchers sent focus group transcripts to focus group members as a way of checking the transcribed content (Creswell, 2007). The first author then participated in the review of deidentified data. Finally, the third researcher served as an external auditor. The auditor had familiarity with qualitative analysis and reviewed the transcriptions and coding for accuracy.

Data Collection and Analysis

The investigators collected data in two focus groups with four and five participants in each group, a sufficient size given the desired level of RE facilitation expertise for the sample to explore the topic of focus (Krueger & Casey, 2015). The focus group sessions lasted between 60 and 90 min. The researcher audio recorded group interviews, transcribed the data, and provided a deidentified version of the transcript to the research team. Each investigator individually coded the transcriptions. The coding process followed the constant comparative method (Glaser & Strauss, 1967). The researchers independently categorized responses to each question into groups and constantly compared responses for similarities and differences of importance until themes emerged. Then, the researchers examined frequency, specificity, emotion, and extensiveness (Krueger & Casey, 2015) of the categorized comments. The researchers arrived at consensus of codes and themes after they compared and synthesized the individually created themes. Data analysis included (a) description of researcher experiences with RE groups and other experiences relevant to the phenomenon under investigation, (b) verification of the validity of the transcripts through member checking, (c) an iterative individual and collective review of the transcript to identify significant statements and codes, (d) combination of individual researcher codes and identification of significant codes relevant to the research question, and (e) definition and chunking the codes into agreed upon themes common to the experiences of most participants (Creswell, 2013; Moustakas, 1994; Patton, 2002). See Table 1 for a list of synthesized codes and themes.

Table 1.

Synthesized Table of Codes and Themes.

Themes	Codes	Definitions
Therapeutic factors of groups	Safe environment group/interpersonal learning output	The contributions of the group to creating a safe environment for sharing or disclosure
	Sharing/imparting information	The willingness of group members to share their experiences and the impact that sharing has on group dynamics
	Normalization/universality	Normalization of experiences due to other group members sharing common experiences
	Cultural impact	The impact of cultural variables (i.e., language, ethnicity) and the influence of diversity on the group experience
	Motivation/engagement learning from others/interpersonal learning	The ability of a couple to learn from the experiences of other individuals in the group, including the educator
	Encouragement/altruism	How other group members or educators can support couples by encouraging them
	Accountability/imitative behavior or existential factors	Participants having a sense of responsibility to their other group members and/or the educator
	Cohesion/cohesiveness	Overall factors contributing to relationships amongst couples within the group
	Cohesion-social supports/development of socializing techniques	The relationships and friendships formed through interactions in the group
Participant attributes	Motivation/engagement comparisons	Characteristics of engaged and disengaged couples
	Body language-intimacy	Nonverbal expression of levels of engagement in the group
	Motivation/engagement hope/instillation of hope	How hope or a lack of hope affects a couple’s level of engagement
	Motivation/engagement openness to experience	The ability of participants to be open to new experiences and be involved in the group
	Motivation/engagement effort leads to change	The idea that the amount of effort a participant puts into their experience outside of the workshop will impact the amount they receive
Stress	Distressed couples	Characteristics of couples that present in higher levels of distress
Stress	Contextual stress	Contextual stressors that contribute to a couple’s level of engagement in group
Insight/awareness	New perspective/corrective experience or catharsis or self-understanding or interpersonal learning input	“Aha” moments in group that lead to insight or awareness
	Applicability of information	How the information relates to other areas of life and relationships
	Applicability of information—future generations	How information relates to impact of future generations/long-term benefit
Program attributes	Safe environment educator	The contributions of the educator to creating a safe environment for participants through the relationship, self-disclosure, and overall interactions with participants
	Program support	Services and incentives offered to participants through the program
	Cofacilitation benefits	Benefits of having two facilitators leading the groups
	Value of experience	The participant statements of appreciation of the program and services provided

Results

Data analysis resulted in the identification of five themes reflective of the relationship educator’s experiences. The themes were (a) therapeutic factors of groups, (b) participant attributes, (c) stress, (d) insight/awareness, and (e) program attributes. The researchers derived each of these themes from a list of 24 codes (see Table 1) that emerged from the original transcript of the focus groups. These themes incorporated the facilitators’ common experiences with factors perceived as contributors to change observed among couples who participated in federal RE programs.

Therapeutic Factors of Groups

The therapeutic factors of groups theme related to the specific dynamics within the groups that facilitators identified as contributing to change for RE program participants. Therapeutic factors of groups included the following nine meaning units or codes: (a) safe environment group—the group contributed to the creation of a safe environment for sharing, (b) sharing—group members were willing to share their experiences with others, thus influencing group dynamics, (c) normalization—group members shared common experiences, (d) cultural impact—diversity and cultural variables influenced the group experience, (e) motivation/engagement-learning from others—group members learned from others in the group, (f) encouragement—group members or educators supported couples through statements of encouragement for successes and challenges reported, (g) accountability—couples reported a sense of responsibility to the group members and the educators for application of skills and effort in their relationship, (h) cohesion—couples in the group demonstrated a connection and caring relationships with other couples in the group, and (i) social supports—the couples reported relationships that extended beyond the group time formed through group interactions.

The respondents in this study reported that the overall group experience contributed greatly to change within the RE program participants. That is, the more safety that RE program participants felt, the more motivated and willing to share they appeared to be. It may seem intuitive that increased safety would contribute to disclosure and engagement; however, past research narrowly focused on alliance between facilitator–client and did not address alliance between group members as a whole. RE program participants reported learning a lot from one another. For example, Participant 1 stated:

I think…the universality of it—identifying with other couples issues and realizing that you’re not alone, that what’s in your relationship could be normal, that others have gone through it or are going through it—that helps you normalize and that I’m sure eventually helps hope better.

Participant 6: I think once [couples] come and realize that they’re not the only ones going through things…it kind of brings down all the barriers…[couples] may feel isolated but when they hear all the people, they’re like we’re going exactly through the same thing so they know it’s not just their problem, it’s [a] problem that all couples go through wherever they come from or whatever their belief may be….

Additionally, Participants 4 and 5 reported group cohesion and the friendships formed within the RE group as key factors that appeared to increase social support and group engagement. Group cohesion as a contributor to RE outcomes is a novel idea that may warrant further investigation.

Participant 4: By the time that they’re at the end, they don’t want to separate, they’re like we all live in…[the same neighborhood] so maybe I could…[babysit] this night…. So feeling close enough and getting to know the people well enough to possibly trust them to be able to let them watch their kids…in the long run…affects the couple positively…having time to work on their relationship and having more support…being able to connect on that level I think does encourage them to feel that they can accomplish some of the things they have as goals for their relationship because they feel like “ok well we know we have this support here even if it’s not terribly intimate it’s still…another piece of our support group.”

Moreover, participants reported culture as a significant influence on the group experience. The facilitators identified benefits from diversity such as exposure to alternative points or view.

Participant 4:…they’re broadening their horizons and just sitting in a group of people who are different from them. So like its typical…that my group, my inner circle is pretty homogenous and so sitting in a group full of people who have different thoughts and opinions, backgrounds…. I think [couples] can be exposed to things for the first time.

Yet the facilitators noted that diverse groups appeared to take more time to build relationships with one another and did not appear as cohesive as the culturally homogenous groups. The RE facilitators expressed that similarities in language and ethnicity appeared to have an impact on the level of engagement of RE participants with one another and the overall group atmosphere.

Participant 1: There’s definitely a difference in the tone of the Spanish workshops than the English speaking…. I can see them being very prideful and wanting to show you if there’s that relationship or you might speak more directly with folks that you have a relationship with especially with the Hispanic groups cause that interactions different. You might be more like “we’ll see you next week right? You’ll be here, you better be on time!” so there’s that other layer of accountability.

Participant Attributes

The participant attributes theme encompassed characteristics of the RE participants observed by facilitators within the group and associated with couples’ change. Facilitators noted varied levels of a couple’s motivation for change as evidenced by (a) an openness to share or practice skills in the group, (b) discussion of their efforts for application of homework or skills outside of group, (c) participant verbalizations of hope or lack of hope that their relationship could improve, and (d) the group effect of couples with different levels of motivation. Participant attributes for motivation are exemplified in the examples below:

Participant 5: So if you have a high level of motivation you might take the workbook and do some of the activities and make the time to share with your partner. Whereas if the motivation is not there, you’re less likely to do the extra pieces that fill in the space between three hours every week.

Participant 2: I guess the motivation of the couple helps in the group dynamic. You know, I think even if you have one or two motivated couples bring the other couples into it also.

Participant 5: for confidence building like seeing another couples be able to apply a skill and be successful in it, I could see how that—how that could be motivating for me and my partner to try it next week.

Some specific attributes included body language of an individual or couple that facilitators interpreted as their level of hope, effort, and openness to experience. However, the facilitators clarified that although disengaged individuals may present as less expressive in group, overall one’s level of engagement may not be solely determined by his or her outward participation or level of expression in group. To illustrate this point, Participant 5 reported “…because some of the quietest couples in the workshop say that they’re so thankful and so grateful and say that they’ve gotten so much.” Thus, suggesting that the level of involvement outside of session—how a couple applies what is learned in session—may be just as important as what happens during sessions. Similarly, hope for the relationship to improve may be integral to motivation and behavior within the RE group. Related, Participant 1 added that often couples who share a religious or spiritual affiliation seem to also have more hope and receptivity to new strategies for their relationship. “I have noticed that a lot of couples that have expressed as hopeful or more positive about their circumstance; a lot of them…are affiliated with some spirituality or religion.” Thus, personal values, spirituality, or religiosity may be additional areas of consideration for their association to RE outcomes.

Stressors

The participants in this study identified stressors as another factor in RE participant engagement and change in the group. The two meaning units included in this theme are (a) distressed couples—characteristics of couples who presented with high levels of observable distress and (b) contextual stress—environmental stressors that contributed to a couple’s level of motivation and engagement in group. In addition to the influence of positive factors perceived as associated with change in couples, it seemed that barriers existed and how couples overcame barriers may contribute to their success in the group experience. The facilitators provided RE groups to couples with low income, the target population of federal RE programs. Couples with low income are more likely to face contextual stressors (Karney & Bradbury, 2005) that may affect their ability to fully engage in the group process. Specifically, contextual stressors identified by focus group participants included financial stressors due to limited income, transportation concerns, and barriers to childcare.

Participant 4: Sometimes couples don’t even have the ability to connect because they’re so stressed out, they can’t focus on these higher level things when their basic needs aren’t met.

Participant 6: Sometimes you can see a lot of tension with couples with they come in, you can tell, you know they may have just been arguing in the car or they have that look “I’m only here because they made me come”…

The RE program included in this investigation provided case management (e.g., brief individual-couple support, referrals to other social service providers), childcare services, meals, transportation support, and gift cards to participants as investments in their time and to help address some of the contextual barriers to enrollment and engagement. Moreover, relationship educators reported that these contextual factors may effect a couple’s level of engagement as highly stressed couples may not be fully engaged as they have more pressing concerns than their relationship.

Insight/Awareness

The insight/awareness theme communicates how RE program participants appear to be impacted through specific content and skill instruction or moments in the group process that facilitated insight. This theme included the following meaning units: (a) new perspective—“aha” moments in group that led to insight, (b) applicability of information—information conveyed in the workshop related to other aspects of participants’ lives, and (c) applicability of information-future generations—the perceived long-term benefit of the information learned in the workshops. Specifically, participants reported to facilitators the influential nature of some of the PREP curriculum content including the speaker–listener activity, stress and relaxation content, and the discussion on fun.

Participant 6 stated:

I think [the topics covered in RE groups] are universal skills so they don’t just apply to couples, they apply to if you communicate with your boss, when you communicate with your mom, when you communicate with your siblings…

Furthermore, participants identified interpersonal learning that occurred as they listened to the experiences of the others in the group. Participants identified benefit from a new perspective or alternative viewpoint that challenged their own thoughts/approach.

Participant 6: so it’s not that you’re really looking for…the answer to resolve the problem but it’s more “I want to hear what people have to say about this” and had we not had the group dynamic…that person could have never explored into other options.

Program Attributes

The final theme that emerged from the data was that of program attributes. Participants reported program-specific factors that supported engagement, motivation, and change within-group members. The meaning units included in this theme are (a) safe environment-educator—educator contributions to the creation of a safe environment for participants through self-disclosure, relationships (i.e., alliance), and overall interactions with participants; (b) cofacilitation benefits—benefits of two group facilitators per group; (c) program support—incentives and services offered to participants throughout the program; and (d) value of experience—participant statements of appreciation for program services.

Participant 8: I want to emphasize, it’s not that low-income families, they don’t care about marriage communication and family but first things first. So when you provide what I need first, now I can feel ok, now I can dive in…we provide something that at least for 4 Saturdays or 4 Thursdays they can say “Okay, I have food, they can eat, now we can talk.”

Participant 7: I think for a lot of couples, this is the first time that they are able to be together, spending time together, having their child being taken care of by someone that they trust,…and just having that additional support makes it so much easier for them to attend the workshop, to finish the workshop, I think incentives are huge in helping couples succeed and complete the whole workshop.

Participant 3: it’s worked because there was that sort of established trust where they’ve felt comfortable you know going deeper um than they otherwise might have with the tools and I think in that way just encouraging them to open up with the because they feel safe.

Discussion

The themes identified in this analysis of RE facilitator experiences were (a) therapeutic factors of groups, (b) participant attributes, (c) stress, (d) insight/awareness, and (e) program attributes. Each theme presents a unique perspective consistent with prior findings related to the experiences of RE facilitators who work with low-income couples enrolled in a RE program. Likewise, each theme presents opportunities for recommended training, implementation, and consideration by RE practitioners. Additionally, the findings reveal several new areas as potential contributors to RE change that warrant further investigation including (a) group member cohesion and group members as new sources of social support; (b) cultural diversity or homogeneity within the group; (c) couple motivation and hope for relationship success; (d) spirituality, religiosity, or personal values for family; and (e) the influence of contextual stressors to engagement and couple effort for change.

Therapeutic Factors of Groups

Group formats of RE yield significantly greater participant outcomes when compared to an individual-couple format (Quirk et al., 2014). Therefore, the group dynamic may influence or contribute to the benefits derived by RE participants. Groups have inherent therapeutic factors yet these remain unexplored in the literature. Distinctions between group therapy and psychoeducational intervention are clear (Bradford, Hawkins, & Acker, 2015). However, the facilitators in this study directly endorsed 9 of the 11 original therapeutic factors of groups (Yalom & Leszcz, 2005) with exception of catharsis, recapitulation of the primary family group, and instillation of hope. Facilitator reports of the observed normalization and universality of couple challenges indirectly inferred that installation of hope may occur for some couples. Similarly, facilitator descriptions of distressed couples often included the couple’s level of hope for change. Further, it is significant that catharsis and the family group/recapitulation factors were missing because it suggests that the psychoeducational group may be less emotionally intense than other group situations and therefore perhaps less able to directly address certain needs of couples with more troubling issues.

Markman and Ritchie (2015) suggested personalization of RE delivery to address common issues identified by participants through screening. Moreover, appropriate referrals for distressed couples are essential to maintain fidelity to curriculum content and differentiate RE from therapy (Markman & Ritchie, 2015). The absence of certain curative factors also highlights differences from group therapy, including that the leader/member relationship may be less emotionally charged and that transference reactions are minimally recognized in this setting.

In addition to support for most of Yalom’s therapeutic factors, the facilitators in this study identified one additional therapeutic group factor—culture. Facilitators identified differences in group dynamics for situations where a shared language or culture existed. The program examined in the current study offered half of the RE workshops in Spanish. Consequently, some facilitators associated greater cohesion, engagement, and involvement of the participants in the Spanish-language groups (e.g., depth of sharing in group discussions, social support inside, and outside of group). This finding parallels prior findings that participant–facilitator match in education, relationship status, and gender improve couple outcomes (Bradford et al., 2012). Yet the importance of culture to group dynamics supports the idea of that group member demographic match is an influential factor to RE group outcomes.

Moreover, in a review of Hispanic RE participant experiences, Daire and colleagues noted culturally influenced themes such as sharing information acquired in the group with their family members who did not attend (Daire et al., 2012). Culture is therefore an important consideration for facilitator training to build alliance and rapport. Further, culture match or diversity, especially among Hispanic groups, warrants further investigation to ascertain the degree of influence to group curative factors such as cohesion as well as for RE outcomes.

Participant Attributes

The participant attributes theme underscored the importance of participant motivation for growth and change. The facilitators reported that often observable behaviors related to personal disclosure and group participation were associated with couple reports of perceived improvement. Similarly, couple expectations and engagement with the material contributed to RE outcomes. Extant literature within adult learning research indicates that student motivation and prior experience influence the acquisition of new information (Ambrose, Bridges, DiPietro, Lovette, & Norman, 2010; Barkley, 2010; Bligh, 2000). This literature parallels the findings of the current study that support the importance of couple motivation for outcomes. Individuals learn and apply information in different ways according to their level of motivation to do so and context for learning to occur. Additionally, building from a client’s level of motivation for action is an important factor in the transtheoretical model and stages of change in therapeutic intervention (Prochaska & DiClemente, 1984). Perhaps, due to the skills focus of the RE curricula, participants’ readiness for action in application of the tools taught may be necessary for a behavioral change to occur. However, some studies suggest that tool usage is unrelated to RE participant reported improvement (Carlson, Guttierrez, Daire, & Hall, 2014).

Overall, per the facilitators’ report of their experience, motivation also seemed to be influenced by a couple’s level of hope. Facilitators identified that some couples appeared more hopeful and that this was often related to a stated value for family, oftentimes connected to their personal spirituality/religious affiliation. In fact, it seemed that RE workshops provided a unique secular experience to connect individuals with a common high value for family. This is congruent with the historical foundation of RE in premarital counseling programs often offered through churches (Ooms & Wilson, 2004). Moreover, prior research found that spirituality and hope related to greater marital satisfaction as a source of family resilience among families with aging parents (Murphy, Nalbone, Wetchler, & Edwards, 2015). Yet hope, personal values, and spiritual/religious affiliation are unaddressed in the RE outcome literature. Therefore, the concepts of hope, motivation, values, and spirituality may be significant considerations for future research studies. Individual motivation, engagement, and learning may also be influenced by other sources of stress experienced by couples with low income.

Stressors

Individuals with low-income experience a myriad of contextual stressors that can exacerbate stress including relationship stress (Karney & Bradbury, 2005; Maisel & Karney, 2012). Limited social support and resources contribute to relationship challenges, lower relationship satisfaction, and more mental health problems (Maisel & Karney, 2012). The RE facilitators noted that stressors reported by participants (e.g., financial stress, parenting stress, and work stress) contributed to the levels of engagement in the workshop. Further, they noted that even highly distressed couples attended and engaged with the material. Although initially intended as prevention for nondistressed couples, RE contributes to greater gains in relationship functioning for distressed couples (Carlson, Rappleyea, Daire, Harris, & Liu, 2017; Quirk et al., 2014). Facilitators identified distressed couples through couple statements such as “this is the last resort” and nonverbal behaviors that indicated tension or distance between members of the couple.

Additionally, in discussion of distressed couples, several facilitators mentioned those with an attitude of “my spouse dragged me here” where one partner may present unequal effort/interest. Relationship effort and strategies are associated with relationship satisfaction (Wilson, Charker, Lizzio, Halford, & Kimlin, 2005). The facilitators noted that level of distress influenced engagement either positively (e.g., “motivated because they are looking for some kind of breath of fresh air”) or negatively (e.g., “…they feel hopeless.”). Yet stressors shared by facilitators emphasize the value of several implementation and program attributes.

Program Attributes

Facilitators noted that a benefit of the program that supported couples’ focus on the relationship included attributes such as incentives and overall structure. This idea echoes Randles’s (2014) findings from interviews with RE participants. Programming for low-income couples could benefit from consideration for the holistic and hierarchical needs of participants to support attention, effort, and engagement with relational issues. For the facilitator, this includes their personal contributions to development of a safe environment for participants through group relationships, appropriate self-disclosure, and overall interactions conveying genuine care and regard for participants. The facilitators identified times where they needed to manage group discussion to maintain emotional safety. Management of group safety included monitoring depth of sharing, validating feelings shared, providing alternative viewpoints when discussion would take a negative turn, modeling the type of healthy communication skills taught, or self-disclosure to help normalize the learning process. Each of these ideas is consistent with prior findings for the role of alliance to participant outcomes; yet, they add a new perspective to the facilitator–client relationship worth noting.

Insight/Awareness

Finally, facilitators reported benefit from the practical nature of the information conveyed. They attribute comprehension and engagement with the tools and material to the practicality and accessibility of information provided. Participants related information to other relationships, areas of life, and connected implications of healthy communication to future generations. They noted group discussion or activities which provoked thought, created new awareness and realizations. However, the degree to which participant disclosure and interpersonal learning are observed within RE groups is unknown. Therefore, this serves as an important consideration for future studies to observe group dynamics including disclosure to examine the relationship as a potential mechanism of change.

Limitations

One limitation of the study is the positionality of the researchers. As identified in the positionality statement, both the researchers have professional backgrounds in RE and group counseling. This background in counseling and knowledge of group dynamics could have influenced the selection of themes found in the data. A second limitation is that most of the focus group participants (55.6%) possessed educational training in counseling, which may have influenced how the participants viewed the effect of the group process on couples’ progress in the program. However, there was consistency in responses from focus group participants who had backgrounds in counseling and those who did not. This consistency in responses suggests that the dynamics the participants observed as relationship educators are commonly observed rather than specific to individuals with a counseling background. Finally, the relatively small sample size may be another limitation; however, the researchers chose to focus inquiry at one RE program site, which inherently limited the number of focus group members available.

Future research should seek to identify potential similarities and differences between relationship educators’ and couples’ perceptions of curative factors in a RE program. Additionally, as this study focused on the factors from the facilitator’s perspective, future research may seek to account for couple’s views on curative factors in the group experience that may not be observable by the relationship educators. This information would help expand the knowledge on curative factors in RE and may help RE programs better serve couples. Finally, the themes in relationship educators’ experiences which emerged reveal areas for additional analysis and research including the influence of group dynamics and culture to RE outcomes.

Conclusion

Overall, RE facilitator experiences related to (a) therapeutic factors of groups, (b) participant attributes, (c) stress, (d) insight/awareness, and (e) program attributes. Implications for future RE facilitator training and program implementation coordinators include (a) assessing couple motivation, stress, and related supports needed; (b) discussing expectations of potential participants; (c) connecting RE material to other relationships/aspects of life; (d) considering culture in forming/facilitating RE groups; and (e) basic skills training for lay-educators on group dynamics. Further examination of each of these areas with respects to RE implementation and intervention is needed.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Naomi J. Wheeler

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