An Initial Examination of Couple Therapy for PTSD Outcomes Among Black/African American Adults: Findings from an Uncontrolled Trial with Military Dyads

Steffany J Fredman¹, Alyssa A Gamaldo², August I C Jenkins^{3

4}, Yunying Le⁵, Jacqueline A Mogle², Candice M Monson⁶, Charlene E Gamaldo⁷, Roland J Thorpe Jr⁸, Brittany N Hall-Clark⁹, Tabatha H Blount⁹, Brooke A Fina⁹, Orfeu M Buxton¹⁰, Christopher G Engeland^{10

11}, Galena K Rhoades⁵, Scott M Stanley⁵, Alexandra Macdonald¹², Katherine A Dondanville⁹, Daniel J Taylor¹³, Kristi E Pruiksma⁹, Brett T Litz^{14

15}, Stacey Young-McCaughan^{9

16}, Jeffrey S Yarvis¹⁷, Terence M Keane^{15

18}, Alan L Peterson^{9

16

19}; Consortium to Alleviate PTSD

Affiliations

¹ Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA.
² Department of Psychology, Clemson University, Clemson, SC 29634, USA.
³ Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA.
⁴ Department of Human Development and Family Science, Auburn University, Auburn, AL 36849, USA.
⁵ Department of Psychology, University of Denver, Denver, CO 80210, USA.
⁶ Department of Psychology, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada.
⁷ Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
⁸ Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21202, USA.
⁹ Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
¹⁰ Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA.
¹¹ Ross and Carole Nese College of Nursing, The Pennsylvania State University, University Park, PA 16802, USA.
¹² Department of Psychology, The Citadel, Military College of South Carolina, Charleston, SC 29409, USA.
¹³ Department of Psychology, University of Arizona, Tucson, AZ 85721, USA.
¹⁴ Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA 02130, USA.
¹⁵ Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA.
¹⁶ Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA.
¹⁷ Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Cavazos, TX 76543, USA.
¹⁸ Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA.
¹⁹ Department of Psychology, The University of Texas at San Antonio, San Antonio, TX 78249, USA.

PMID: 40282158
PMCID: PMC12023970
DOI: 10.3390/bs15040537

An Initial Examination of Couple Therapy for PTSD Outcomes Among Black/African American Adults: Findings from an Uncontrolled Trial with Military Dyads

Steffany J Fredman et al. Behav Sci (Basel). 2025.

. 2025 Apr 16;15(4):537.

doi: 10.3390/bs15040537.

Authors

Affiliations

¹ Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA.
² Department of Psychology, Clemson University, Clemson, SC 29634, USA.
³ Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA.
⁴ Department of Human Development and Family Science, Auburn University, Auburn, AL 36849, USA.
⁵ Department of Psychology, University of Denver, Denver, CO 80210, USA.
⁶ Department of Psychology, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada.
⁷ Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
⁸ Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21202, USA.
⁹ Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
¹⁰ Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA.
¹¹ Ross and Carole Nese College of Nursing, The Pennsylvania State University, University Park, PA 16802, USA.
¹² Department of Psychology, The Citadel, Military College of South Carolina, Charleston, SC 29409, USA.
¹³ Department of Psychology, University of Arizona, Tucson, AZ 85721, USA.
¹⁴ Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA 02130, USA.
¹⁵ Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA.
¹⁶ Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA.
¹⁷ Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Cavazos, TX 76543, USA.
¹⁸ Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA.
¹⁹ Department of Psychology, The University of Texas at San Antonio, San Antonio, TX 78249, USA.

PMID: 40282158
PMCID: PMC12023970
DOI: 10.3390/bs15040537

Abstract

Black/African American individuals experience high rates of posttraumatic stress disorder (PTSD), which is frequently chronic and undertreated in this population. Intimate relationships are a salient resource for Black/African American adults' psychological well-being. To help advance health equity, this study serves as an initial, proof-of-concept investigation of patient outcomes among Black/African American adults who received a disorder-specific couple therapy for PTSD. Participants were a subsample of seven Black/African American adults (mean age = 40.56 years, SD = 10.18; 85.7% male) who participated in an uncontrolled trial of an abbreviated, intensive, multi-couple group version of cognitive-behavioral conjoint therapy for PTSD with 24 military dyads. Treatment was delivered over 2 days in a weekend retreat format. Assessments were administered at baseline, 1 month post-retreat, and 3 months post-retreat. There were large and significant decreases in patients' PTSD symptoms based on clinicians' and patients' ratings (ds -1.37 and -1.36, respectively) by the 3-month follow-up relative to baseline. There were also large and significant decreases in patients' depressive, anxiety, and anger symptoms (ds -1.39 to -1.93) and a large, marginally significant decrease in patients' insomnia (d = -0.85; p = 0.083). Patients reported a medium, non-significant increase in relationship satisfaction (d = 0.68; p = 0.146) and a large, marginally significant increase in joint dyadic coping (d = 0.90; p = 0.069). Findings offer preliminary evidence that treating PTSD within a couple context is a relevant strategy to reduce PTSD and comorbid symptoms among partnered Black/African American adults and a promising approach to enhance relationships.

Keywords: African American; Black; PTSD; couple therapy; couples; military; posttraumatic stress disorder; retreat; treatment; veteran.

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Conflict of interest statement

Steffany J. Fredman and Candice M. Monson receive royalties from Guilford Press for their published treatment manual on cognitive-behavioral conjoint therapy for PTSD and payment for providing workshops on couple therapy for PTSD. No other authors have conflicts of interest to declare. The views expressed herein are solely those of the authors and do not reflect an endorsement by or the official policy or position of the U.S. Army, the Department of Defense, the Department of Veterans Affairs, or the U.S. Government. The sponsors had no role in the design, execution, interpretation, or writing of the study.

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An Initial Examination of Couple Therapy for PTSD Outcomes Among Black/African American Adults: Findings from an Uncontrolled Trial with Military Dyads

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An Initial Examination of Couple Therapy for PTSD Outcomes Among Black/African American Adults: Findings from an Uncontrolled Trial with Military Dyads

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