A Needs Assessment to Evaluate Implementing a Relationship Enhancement Intervention for Couples at a Community Mental Health Clinic

Background: Divorce's harmful effects on individuals, families, and communities is a well-known concern. Dissatisfying relationships, even without divorce, are a significant source of stress and can contribute to increased morbidity and mortality. Relationship interventions reduce stress and improve relationship satisfaction in stressed and nondistressed couples, but most do not seek treatment. Barriers to treatment include the availability of trained providers, cost, time, and stigma. Group programs can be an effective strategy for overcoming treatment barriers. Local Problem: A community mental health clinic offers no relationship interventions other than traditional couples therapy. This project aimed to conduct a needs assessment to provide recommendations for implementing a group relationship enhancement program for couples at the community mental health clinic. Methods: The Kaizen model-driven needs assessment used electronic health record data extraction, a survey, and a discussion group to evaluate the current nature and effectiveness of relationship interventions at the community mental health clinic. A literature search and content expert recommendations informed the educational PowerPoint and intervention proposal presented to clinic partners. A post-presentation survey gathered outcome measures to evaluate the proposal's acceptability, appropriateness, and feasibility. Results: Most couples requesting services at the community mental health clinic did not receive treatment. Provider availability largely contributed to the inaccessibility of services. All clinic partners agreed that the proposal to implement an adapted version of Mindfulness-Based Relationship Enhancement (MBRE), an evidence-based relationship enhancement group program that captures nondistressed couples, was acceptable, appropriate, and feasible. Conclusion: Project results reveal a gap in services available to nondistressed couples at a community mental health clinic. Implementing evidence-based group programs at community mental health clinics may address barriers to treatment, including lack of providers and cost.