Why It Might Be Time for a Relationship Checkup

Couples in long-term relationships may go for years or even decades without giving serious thought to whether the relationship is surviving the test of time. As long as things are going reasonably well, they may not be terribly motivated to want to dig deeper.

However, failing to take that clearheaded look at your relationship may be a big mistake. According to a newly published study on military couples by Wright State University’s Jeffrey Cigrang and colleagues (2022), “romantic relationships may require regular health maintenance, to arrest and reverse an otherwise natural vulnerability to health decline over time.” Although active-duty military couples face unusual stresses associated with combat deployments, all couples are at risk of suffering from erosion or “a natural decay process.”

Why You Need a Relationship Checkup

Developed with married couples, the type of relationship checkup used by the Wright State research team is technically referred to as the “Marriage Checkup” or “MC.” For ease of comparison, this term will be used here, although it seems reasonable that the same method would apply to any couple in a relationship in which both partners are committed over the long haul.

In the initial formulation of the MC, it is conceived of as both an assessment and an intervention. This is where the MC differs from a physical checkup. Simply by having a professional ask questions of the couple, both individually and together, some cracks in the relationship can begin to be repaired. A medical professional may put a bandage on a scratch that they discover during a routine physical, but they would stop short of any formal treatment.

In MC, as Cigrang et al. discussed, after completing standard relationship health instruments, the couple meets with a clinician, who begins to address deeper concerns the couple may have and starts to work on repairs.

One key underlying assumption of the MC is that, without the prompts provided by the clinician’s questioning, couples tend to use blinders to the flaws in the relationship that constitute its key vulnerabilities. You can think of this as comparable to a physical health issue such as a skin rash that you’d rather not look at too closely because it both scares you and makes you feel a little disgusted.

In a relationship, partners may stay away from their own sore spots because these tap into their sense of vulnerability or what the Wright State authors refer to as “accumulated unrepaired hurts.” These beginning signs of trouble may disappear on their own, but, like the skin rash, it's equally likely that they will only become more serious without proper attention.

The Basics of the Relationship Checkup

Turning now to the MC's actual components, based on previous studies, Cigrang and his coauthors developed a variation that they believed would be particularly useful for military couples. Stationed around the U.S. at five Air Force bases, the study's 211 participants in the intervention component were compared across six months with a matched group of 209 in the waitlist control condition. The study had a high completion rate of 85 percent, considerably above the 50-80 percent normally observed in veteran populations (as noted by the authors).

Although the basic elements of the MC intervention were the same as in studies of community-based couples, the adaptation for the military couples took account of the unique stresses faced by this population.

What’s important about this approach is that it rests on the assumption that one size does not fit all when it comes to interventions with couples. The military couples are a special case due to the hardships of their lives, but other couples also face stress, albeit of a different nature. Couples in which one partner serves as a caregiver might provide one example, but many others probably come to mind. Think about what stresses you and your partner now face, and then imagine what might need to be added to any kind of standard couples intervention.

Keep this background in mind as you now read about the measures included in CIgrang et al.’s MC:

Strengths and Concerns in the Relationship

The Wright State researchers developed a variant of the MC checkup that would apply to military couples and included a questionnaire assessing 33 strengths and 48 concerns. Unfortunately, this scale isn’t published or available online, but as a guide, try coming up with as many possible items in each category in your relationship. You may have as a strength the fact that both of you share similar values, but as a concern that your budget is being stretched by a steep rise in the cost of living.

Responsive Attention Scale

How does your partner respond to your “bids” for attention? Sample items on this 12-item scale include “I receive a warm welcome from my partner when we meet at the end of the day” and “my partner is present and attentive when we eat together.”

Partner Compassion Scale

What is the primary way you and your partner show compassion for each other? Sample items from this nine-item measure include “when my partner sees that I am hurting, he/she tries to comfort me,” and “even when we disagree, my partner can put him/herself in my shoes.”

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Communication Skills Test

Tapping into how well partners are able to communicate with each other, this 10-item scale asks questions such as, “When discussing issues, I summarize what my partner says in order to make sure I understand him/her.”

Intimacy Safety Questionnaire

Looking at that component of vulnerability in the relationship, this 28-item measure includes feelings of emotional safety, sexual safety, safety disagreeing, safety being yourself, and safety in public. Two sample items are, “I feel comfortable telling my partner when I feel sad,” and, “when I am with my partner, I feel safe and comfortable.”

In addition to these assessment scales of various relationship features, partners completed a standard depression screening measure and an overall satisfaction index with the relationship.

The intervention itself consisted of three sessions with a clinician who (1) reviews the couple’s relationship history, (2) addresses each partner’s primary concern, and (3) provides feedback and develops strategies for addressing the couple’s concerns collaboratively. Thus, the intervention was relatively brief and focused on the concerns that couples raised about their relationship. Behavioral methods also ensured that the intervention provided concrete suggestions that couples could follow independently.

As the authors predicted, this variant of MC produced significant positive effects on relationship health, effects that were most pronounced for couples starting out with the shakiest satisfaction scores. The control group condition, rather than showing no effects over six months while they were on the waiting list, actually showed a slight drop in scores, that “natural decay process” of deterioration over time.

Furthermore, although the treatment couples maintained higher scores across the six months, they too showed a dip in the various health measures. As the authors concluded, these findings support the checkup model as a way to “arrest and reverse” that deterioration.

How to Put the Relationship Checkup to Work

Questionnaires alone can’t stem the downward trend of a relationship on the deterioration course. However, those frequent check-ins can help you and your partner figure out when it’s time to seek help. There can be benefits of just taking the time to answer questions similar to those used in the Cigrang et al. study, or even just accounting for your relationship strengths and concerns. However, if you begin to detect the early signs of a problem, the Air Force study suggests that you seek attention from a professional. Returning to the analogy of a skin rash, chances are that you'll need to take action if it doesn’t get better on its own.

To sum up, the authors point out that from a public health perspective, if medical personnel conducted routine relationship checkups with their patients, this could be just as valuable to health as standard assessments of blood pressure and heart rate. In the meantime, learning to test yourself and your partner with a simple check-in could be just what you need to maintain your relationship’s vitality over time.

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