Behavioral Health » Providers » Deployment » Relationships

Frequently Asked Questions About Relationships

Q: Why are relationships important?

A: Having good relationships with others is important for overall well- being. Relationship problems negatively impact our physical and emotional health, as well as the functioning of others around us. Here are some important facts:

  • People who are in romantic relationships tend to be happier than those who are single. 1
  • Difficulties getting along with a boss or coworkers can impact work performance.
  • Couples who are experiencing marital problems tend to be less nurturing and their children are more likely to exhibit behavioral and emotional problems.2
  • Having regular healthy social contact can be a buffer for depression.
  • Important relationships can be good sources of support for both positive and negative things that occur in your life.
  • Distressed couples experience a number of negative emotions such as anger and jealousy, or psychiatric problems such as depression and anxiety. 2
  • Marital problems may lead to substance abuse. 2

Q: How do you identify a relationship problem?

A: Relationships can be difficult from time to time. People disappoint one another, say and do hurtful things, and can be hard to get along with. Identifying a problem in your relationship while it is occurring can be complicated because relationship dissatisfaction is experienced differently by those involved in the relationship. It goes without saying that certain actions, like violating a law or a code of honor generally upsets most people. Infidelity is an example of a violation of an intimate relationship that is to overcome.

Many individuals can easily work through minor differences, but sometimes a series of minor issues can build up over time and become a relationship issue. For example, if a coworker inadvertently makes a joke that embarrasses you, an apology might be a sufficient resolution. But, if embarrassing jokes persist, a different intervention may be called for. Not addressing seemingly small, but chronic issues can lead to angry outbursts that seriously damage or destroy relationships.

How's your relationship? Test the strength of your romantic relationship by taking this online quiz.

Interpersonal abuse, be it physical, sexual, or emotional, is a relationship destroyer. This type of abuse is never justified. Domestic abuse can happen to anyone, regardless of age, economic status, race and/or educational background. Domestic violence happens to men and to same-sex partners, but most often involves men abusing their female partners.3 Get the facts and learn more about domestic abuse.

The Domestic Violence Screening Quiz may help you determine if domestic abuse is occurring in your relationship.

Q: Are relationship problems considered mental disorders?

A: According to the Diagnostic and Statistical Manual of Mental Disorders- 4th Edition, a number of Relational Problems are classified as stressors that may be the focus of clinical attention, but are not classified as mental disorders. The term "Relational Problem" is used to identify and explain patterns of interaction between or among members of a relational unit that are associated with clinically significant impairment in functioning. 4

Examples include:

  • Parent-Child Relational Problem
  • Partner Relational Problem
  • Sibling Relational Problem

When people experience a psychiatric disorder they often exhibit symptoms or behaviors that have a negative impact on their relationships. For instance, service members suffering from Posttraumatic Stress Disorder may be quick to anger with family members. People living with a mood disorders may be pessimistic or irritable, which can be difficult for other people to be around. Substance abuse can affect relationships, when individuals become argumentative with friends and family while intoxicated, or fail to follow through with responsibilities at home or work because of a hangover or poor memory.

Q: How common are relationship problems?

A: Work-related conflicts, disagreements with neighbors, school officials, friends, etc. are inevitable. In fact, it is virtually impossible to go through life without having some form of conflict in at least one of your relationships.

Marital problems are common in today's society and cause distress for couples and the people who are close to them.2 The lifetime prevalence of divorce ranges from 40-50%. More

Women experience significantly more partner violence than men do. According to the National Violence against Women Survey 25% of surveyed women, compared with 8% of surveyed men, said they were raped and/or physically assaulted by a current or former spouse, cohabiting partner, or date in their lifetime.5 More

In 2001, there were more than 18,000 incidents of spousal abuse reported to the Department of Defense's Family Advocacy Program. Learn more about domestic violence in the military.

Q: What treatments are helpful for relationship problems?

A: Several different types of psychotherapy are effective for treating marital problems. According to the American Psychological Associations, Division 12, Society of Clinical Psychology,6 behavioral marital therapy is a well established treatment for marital discorder.7, 8 This treatment involves teaching communication and problem-solving skills, and helping couples use more positive behaviors with each other.2

Several other treatments also appear effective for treating marital problems:

  • Emotionally focused couples therapy for moderately distressed couples works on helping partners understand their own and each other's negative emotional and behavioral responses and helps develop more constructive behavior toward each other that can fulfill their needs.9, 10 
  • Insight-oriented marital therapy tries to facilitate insight for each partner into his or her own personality and behavior, as well as into the dynamics of the relationship. It also aims to develop new interactions that more directly and positively meet each partner's expressed needs. 11, 12

Family therapy may be helpful when problems impact the entire family, such as divorce. Many families experience ups and downs, and most families are able to cope without getting professional help. However, if problems are impacting your families' ability to function, it may be time to get help. More

Research seem to agree that cognitive behavioral therapy for male batterers can be somewhat effective for reducing domestic violence.13 Sometimes batterers are court mandated to attend treatment, which can occur in individual or group formats.

Depending upon the nature of a work-related conflict, commanders, supervisors, and/or human resources staff may be able to intervene and help resolve work-related issues. If a psychiatric disorder, such as depression or substance abuse develops, as a result of relationship problems, treatment is available.

Medications may be used to treat psychiatric disorders that negatively impact relationship, but are not prescribed otherwise. Since drug treatments vary depending upon the disorder type, and since not all medications work the same for all people, it is recommended that you talk to your provider about a treatment plan that is best for you.

Q: How do I locate specialists or support groups for relationship problems?

A: You can contact any of the following organizations, which have referral capabilities:

Q: Do I have to see a specialist in order to get help?

A: There are a number of steps you can take on your own to improve your relationships. Check out the self-help tools offered on this web portal, which include skill training handouts, relationship tips, and book recommendations. Marital enrichment and relationship workshops may be helpful resources. Remember, not all help needs to come from mental health professionals. Sometimes family, friends, or clergy can be sources of support.

Your primary care manager or (PCM) may be able to prescribe an appropriate medication for treatment if you develop psychiatric symptoms. If your PCM believes it is necessary to seek specialty care, they will be able to assist you to that next level of care.

Q: Is relationship therapy a covered TRICARE benefit?

A: When a primary behavioral health problem is a diagnosed mental disorder, e.g., depression or an anxiety disorder, treatment in support of the diagnosed mental disorder may be covered. Marriage and/or relationship therapy is not a covered TRICARE benefit as the primary focus of treatment. TRICARE beneficiaries are eligible for eight behavioral health care visits per year without a referral or pre-authorization for covered behavioral health services. Active duty military personnel always need a referral for care outside a military treatment facility. More

References:

1Kamp Dush, C.M. (2005).Consequences of relationship status and quality for subjective well-being.Journal of Social and Personal Relationships, 22, 5, 607-627.

2Epstein, N. B., Baucom, D. H., & LaTaillade, J. L. (in press).Marital problems. In J.E. Fisher & W. O'Donohue (Eds.), Practice Guidelines for Evidence Based Psychotherapy. New York: Kluwer Academic.

3Mayo Clinic (2005). Domestic violence toward women: Recognize the patterns and seek help. Accessed 3/24/06.

4American Psychiatric Association (2000).Diagnostic and Statistical manual of Mental Disorders Fourth Edition, Text Revision.Washington, DC: American Psychiatric Association.

5Tjaden, P., & Thoennes, N., (1998). Prevalence, Incidence, and Consequences of Violence Against Women: Findings From the National Violence Against Women Survey. National Institute of Justice Centers for Disease Control and Prevention. Accessed 3/24/06.

6Chambless, D. L., Baker, M. J. Baucom, D. H., Beutler, L. E., Calhoun, K.S. Crits-Christoph, P., Daiuto, A. et al. (1998). Update on the Empirically Validated Therapies II. The Clinical Psychologist, 51, 1, 3-16.

7Azrin, N. H., Bersalel, A., Bechtel, R., Michalicek, A., Mancera, M., Carroll, D., Shuford, D., & Cox, J. (1980). Comparison of reciprocity and discussion-type counseling for marital problems. American Journal of Family Therapy, 8, 21-28.

8Jacobson, N. S., & Follette, W. C. (1985).Clinical significance of improvement resulting from two behavioral marital therapy components. Behavior Therapy, 16, 249-262.

9James, P.S. (1991). Effects of a communication training component added to an emotionally focused couples therapy. Journal of Marital and Family Therapy, 17, 263-275.

10Johnson, S. M., & Greenberg, L. S. (1985). Differential effects of experiential and problem-solving interventions in resolving marital conflict. Journal of Consulting and Clinical Psychology, 53, 175-184.

11Snyder, D.K., & Wills, R.M. (1989). Behavioral versus insight-oriented marital therapy: Effects on individual and interspousal functioning. Journal of Consulting and Clinical Psychology, 57, 39-46.

12Snyder, D.K., Wills, R.M., & Grady-Fletcher, A. (1991). Long-term effectiveness of behavioral versus insight-oriented marital therapy: A 4-year follow-up study. Journal of Consulting and Clinical Psychology, 59, 138-141.

13Babcock, J. C., Green, C. E., & Robie, C. (2004). Does batterers' treatment work? A meta-analytic review of domestic violence treatment. Clinical Psychology Review,  23, 8 , 1023-1053.

TRICARE policy for reimbursement requires that services must be medically necessary for a diagnosed psychological disorder. The disorder must be one referenced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and must be of a severity not only to cause the patient distress but also to interfere with the patient's usual activities.