Table of Contents | Previous | Next |
PART III: SYSTEMATIC AND SALIENT INTERACTIONS
The landscape of marriage programs presents providers with a variety of options when developing and implementing programs. Providers make countless choices at the inception of their program and throughout its evolution. They make these choices in the context of their own organizations and based on the realities of their clients, the ideals of their missions and communities, and their personal preferences or biases. Aspects of the environment, setting, clients and intervention may fuse together seamlessly or their intersection may present tensions that providers must balance over time. In this section we look at some of theses intersections and the tensions they present to program providers. While these intersections and their possible implications are innumerable, we focus on some of the most salient and systematic of those we observed.
PROGRAM CREATION IN CONTEXT: COMMUNITY, COLLABORATION, AND POLITICAL WILL
The interaction between an organization and its environment can create tensions characterized by bottom-up and top-down forces. Individuals and organizations may act on an environment in an attempt to order or change it, while the environment may also influence organizational decisions and priorities.
Ground-level marriage program providers play a large role in the creation of community-wide efforts. Many providers began their own programs and only then decided to sponsor or organize community-wide coalitions united around marriage as an issue. For example, a marriage provider in a public mental health facility began an initial program within her organization and then created a Community Implementation Manual to distribute to others in her community and around the country. Providers at a community counseling center offered marriage services with individual couples for years; they recently developed an institute to reach out to therapists across their area dealing with marriages and relationships. Clergy who have required premarital education for their congregants for years have organized to support community-wide education requirements for couples wishing to marry in houses of worship.
While some individual providers strive to alter their local environments through community-wide or national efforts, environments also shape the way that providers and organizations act and view the scope of their choices. For instance, providers note that what is politically and culturally feasible in one environment may not be in another. Providers regularly mentioned that people in environments with large faith communities, local and state leaders sympathetic to the marriage movement, and conservative political affiliations would be more likely to welcome marriage services and endorse them. In these environments, providers would be more likely to offer marriage services and feel like they had the support of the community. For example, after one state passed a law that reduced the marriage license fee for couples that received premarital education, the state extension system developed a curriculum to fit the parameters of the programs described by the State legislature.
In contrast, other providers saw the presence of universities, liberal political affiliations, and a lack of political will as indicators that marriage services would not be a priority or even be welcome, particularly if framed in a “marriage-only” light or promoted by the government instead of community members. While the prospects for funding were generally dubious with providers in our sample, providers who perceived environmental factors (such as unsupportive politicians) as negative had doubts that state or local funding would support or match Federal efforts to support marriage initiatives. Providers who sensed that the community would not be receptive to marriage programs talked about a need to adapt efforts to reflect a willingness to serve all romantic relationships, not just marriages.
ORGANIZATIONS AND PROGRAMMING: A MARRIAGE OF MISSIONS?
Another tension arises when marriage programming is not consistent with the mission of a potential host program. Providers of programs that do not currently offer marriage services offer a range of opinions on how marriage programming would fit within their current services. For example, social service organizations attempt to meet people where they are in their lives rather than working toward external norms. Social service providers expressed concern that programming for romantic relationships, especially programming that exclusively addressed or aimed toward marriage, would tell clients where they should be or should want to be rather than understanding where they are. For programs with large gay and lesbian populations among their clients, endorsing a marriage-only approach would endorse a relationship that might alienate clients who do not have the option to marry.
Even if clients do aspire to marriage, providers expressed concern that marriage programming may not be a priority in clients’ hierarchy of needs. Some organizations are more concerned with providing income supports or ensuring safety for families and view attention to romantic relationships as a luxury after clients’ basic needs are met. Other providers feel that investments in human capital, such as job training, are more important than marriage services. These providers feel that economic security, mental stability, and other individual services will lead to more “marriageable” individuals and subsequent married couples.
Other organizations, sometimes within the same setting or system as those that were unresponsive to marriage programming, think marriage services would fit well in their settings. Providers, often in the mental health field, who used a family systems approach saw couple relationships as an integral part of their work. Providers who believe that dynamics within a home often manifest themselves in the larger world were also likely to welcome marriage programming; these providers perceive that happy marriages lead to greater economic security and fewer external symptoms, such as spousal and child abuse. In sum, the mission and priorities of an organization within a theoretical or philosophical framework can greatly affect organizational willingness to offer marriage programs.
Variation of openness toward marriage programming between settings and systems may be a result of organizational missions and likely clientele. Variation within settings and systems is more difficult to explain. However, there are two factors that may be at work. First, funding is a large concern among providers, and the degree of concern may vary within the same setting or system. While some providers will never endorse marriage programming and others will fundraise just to offer it, many providers may be poised to offer the programming only if and when money becomes available. Providers who did not offer marriage or relationship programming but had heard of marriage initiatives often said they might offer programming if funding were available. Many social service providers with whom we spoke expressed concern over budget reductions and staff layoffs. Some saw marriage programming as an interesting yet costly program that without financial support would overwhelm staff; others saw it as a way to stay afloat in difficult budget times. Thus, funding may entice some providers on the cusp to offer marriage programming or at least explore it in their settings. Funding entities must then consider whether the impact of marriage programming will change if organizations endorse it largely as a financial, rather than philosophical, addition to services.
Second, provider attitudes and personal philosophies may also explain variation within settings and systems. A provider’s personal negative or positive experience with marriage or relationships may persuade or dissuade the provider from offering a marriage program. Furthermore, the personal lens with which providers view their clients’ relationships may also affect organizational willingness to provide marriage services. If this is the case, the importance of provider backgrounds may be a salient issue when determining how to expand marriage programs.
PROVIDER BACKGROUND, CULTURAL COMPETENCY, AND CAPACITY FOR ISSUES
|
Another key intersection, matching the capacity of the setting with the needs of the clients, can raise tensions for providers. An important aspect of the setting is the set of providers available to offer services. The background of these providers can influence their cultural competency and, in turn, ability to deal effectively with critical client issues. In our discussions with providers of marriage programs, the majority of these providers served a largely white, middle- to upper-income population in their classes. In contrast, respondents working in social service settings not currently offering marriage programs worked routinely with clients of various ethnic or racial backgrounds, were more likely to offer services in languages other than English, and were more likely to deal with a variety of family structures. In some organizations serving a variety of client types, providers differed in their experiences working with different groups. For example, one provider with whom we spoke served primarily Jewish or interfaith, engaged couples with college backgrounds in her premarital education seminars; in her organization’s other programs, such as HIV / AIDS outreach or foster care casework, providers served African-American and Hispanic clients and clients from low-income backgrounds.
The background of providers also influences the capacity of a marriage program to deal with clients with more challenging problems. Providers with mental health backgrounds are more likely to do screening for domestic violence, substance abuse, and other critical problems for couples before enrolling couples in marriage programs. However, even those within the mental health community do not routinely do these screenings for one-day or two-day programs. Providers in social service settings, even those without mental health backgrounds, tended to mention screening as a potential issue for programs, as well.
Mental health providers, due to the nature of their training, are more likely to include exploration of family of origin and its effects on future relationships in marriage or relationship training. Some providers working with low-income clients cautioned that exploration of family of origin for many clients may raise issues of childhood sexual and physical abuse and its continuation in current relationships. Providers dealing with low-income couples often mentioned a history of violence as a salient issue to address in programming and therapy; some other providers did, as well, noting that these were issues that crossed socioeconomic lines.
At the same time, the use of paraprofessionals as program providers has been appealing to some developers of programs. Paraprofessional providers would also allow programs to spread more rapidly and expansively. Some therapists remarked that they did not have many, if any, Black or Hispanic therapists in their communities. Black or Hispanic clients might feel uncomfortable sharing in a class led by a provider of a different race or ethnicity. The use of paraprofessionals from a variety of ethnic, racial, or linguistic backgrounds might make it easier to recruit people of color and non-native English speakers.
Overall, providers serving low-income families identified domestic violence, substance abuse, mental health, and critical instability in personal relationships as important issues to address; however, providers currently vary in how they address these issues. For example, in addressing domestic violence, some providers collaborate with domestic violence agencies or employ routine screening practices. Another provider said his church program handles domestic violence issues “in-house.” Still others report they have never encountered this problem with couples. As the government becomes involved in providing marriage services, some guidance to programs on how to ensure a match between clients’ needs and programs’ capacity for addressing them will be important. Ideally, programs may need to keep therapists on staff, or at minimum, develop a reliable referral mechanism.
COMPETING INTERESTS OF DOSAGE AND TIME
During implementation of their programs and future iterations, providers often experience competing pressures regarding intervention dosage. A long-term, intensive approach often conflicts with client ability or willingness to set aside time for the intervention. For example, providers cite engaged couples as unlikely to participate in long-term interventions. These couples may be preoccupied with planning weddings. Additionally, other types of couples, both married or cohabiting, would have demands on their time outside of marriage programming. Providers cite the demands of children and the inflexibility of job(s), particularly among low-income couples, as frequent barriers to participation in a variety of services, not just marriage programs. In program evaluations administered at the close of sessions, providers often hear that the classes are too long in duration. Furthermore, some providers remark that it is easier to recruit for classes that are shorter in length. One provider recalled that local clergy diverted engaged couples from her intensive program offered in conjunction with the faith community to another local provider with a shorter intervention.
Meanwhile, many providers believe the length and intensity of interventions are key predictors for long-term behavioral change. Particularly those in the mental health field tend to think that use of skills or concepts learned in the sessions will peak at the end of the program and decline over time. Some providers expressed an interest in doing booster sessions as a way to refresh couples’ skills. Additionally, even those outside of the mental health field often wanted to adhere to the level, if not wholly the material, of intervention intensity on the market. Others expressed a pressure to lengthen programs in order to provide information they considered important for couples.
The length of a program may have a dramatic effect on the group dynamics in a class, a characteristic cited as important by some providers. When providers spoke of group dynamics in marriage classes, they positively highlighted examples of bonds formed between couples over the duration of a program and cases in which couples continued to meet after a class was over.
Nonetheless, over time, the number of hours required for a program as a barrier to client participation tends to force dosage to lower levels among the programs we encountered. The most frequent change to programming that we observed, aside from provider variations in curriculum material, was a change in the length of the program. While providers often started with many sessions over a period of weeks, similar to the format of some widely known programs like PREP, many remarked that they had shortened sections of the curriculum in order to accommodate clients. Providers using widely known premarital or marriage enrichment curricula sometimes omitted whole sections or abridged others to reduce dosage. Some other providers expressed interest in adding skills or sections to their classes but chose not to because it would lengthen the dosage of the intervention, thereby discouraging clients who are already difficult to recruit.
The ramifications of low dosage in marriage interventions are not entirely clear. By default, our sample of marriage programs primarily serves middle- to upper-income couples. Based on research that indicates low-income couples endure a greater degree of stress in their daily lives, it is possible that pressures on their time would be even greater than those we examined. Moreover, even if providers use research-based curriculum, excisions or abridgements may limit the effectiveness of any given program and the possibilities to evaluate it. Finally, if the effectiveness of a program is based on a lasting bond or even comfort to share in a group setting, dosage may become one of the most salient issues for organizations to discuss when creating or sustaining a marriage program.
A WORLD OF HYBRIDS: PROVIDERS AND CURRICULAR CHOICE
Clients’ needs and providers’ backgrounds also intersect to form tensions around when, how, and why curricula should be adapted. Adaptations to curricula are largely driven by the philosophy of the provider and provider perceptions of client needs. In our sample of marriage and relationship programming, pure curricula are uncommon. Providers who do use well-known curricula on the market, such as PREP, PAIRS, and Making Marriage Work, cite specific reasons for these choices, such as religious affiliation of the clientele, a cognitive versus affective approach, or the practicality of issues that a curriculum addresses. However, the vast majority of providers attach new pieces to these curricula, remove parts, or sample sections from them to create hybrids. It was common for providers to mention adding pieces of a philosophy or technique at various points over time to make the training more broad in scope. A minority of providers, often those familiar with psychology research or evaluation methods, adheres to a pure curriculum. These providers may also follow a particular theory in therapy or social work that drives a more unified approach to marriage programming.
Many providers express a degree of ownership and satisfaction with hybrid curricula. Providers often add pieces to a curriculum because something outside of it resonates with them and their own experiences in relationships or the relationships they perceive among their clients. Even within larger settings with multiple sites that offer marriage programs, providers emphasized the uniqueness of the programs and their interest in making the curricula “their own.”
The perceived needs of clients are the other largest factor driving curriculum choice and adaptation in current marriage programs. Curriculum abridgement is largely a product of time constraints for clients, but providers make changes for other reasons, too. Some providers mentioned the unrealistic expectation that adults who did not like or do well in traditional terms in school would do homework for a relationship class; these providers do only in-class exercises. New spiritual additions may accommodate religious groups, while sessions on financial planning may address practical concerns that stress couples. Providers may reproduce general concepts in language that is more understandable to clients who have low literacy levels.
Providers may also use a set curriculum as a framework but add new activities. These additions may engage clients who do not like lecture or may be turned off by a school-like atmosphere. Providers may add additional information to account for the reality of clients’ lives, such as information about the dynamics of same-sex relationships, domestic violence, and techniques to deal with multiple-partner fertility. Attempts to recruit a wider swath of participants may sometimes necessitate additions, too. For instance, some providers suggested low-income couples are more interested in programming if it has a direct impact on their children; therefore, providers may add sections to the curriculum to make this connection.
Providers’ curricular choices and adaptations may impact the effectiveness of the programs and hold lessons for future implementation. If the effectiveness of a program is dependent upon specific intensity of instruction or the order of skill lessons, adaptations may weaken this effectiveness. Again, provider training may also play a role. While most providers make changes to curricula, it is unclear how many are familiar with adult-learning techniques. Additionally, the incorporation of multiple theoretical approaches in one program may negate the strength of any one approach. However, while adaptations may weaken the effects of research-based curriculum, they may simultaneously increase provider dedication to a marriage program.
GROUP DYNAMICS: THE EFFECTS OF SIZE AND GROUP CHARACTERISTICS
Finally, providers grapple with another set of tensions when selecting the right format in which to provide an intervention that will best meet client needs. Specifically, the size and heterogeneity of a group in a marriage program may affect the ways in which couples receive and respond to the intervention. Providers typically associate group size with the effectiveness of recruitment efforts and the capacity of a space in a given physical setting. Programs regularly deal with low client turnout for their programs, which often has an impact on group size. Providers usually have a minimum number of couples they consider necessary to offer a program and still achieve ideal group interactions. Other program providers said space, rather than turnout, was a very large determinant of their group sizes. Providers with larger classes note that they often hold programs in classroom-like spaces, which may change the ambience and program tone for couples.
Group size may also limit or expand the opportunities for different types of interventions. Small groups or one-on-one programming may allow for more intimacy among the couple(s). One provider chose to offer personalized, in-home programming for couples in order to address concerns about attrition in a long-term program and the lack of transportation in a largely rural area. Group size also affects the level of interaction in a program. Role-playing may work in very small classes, while lecture tends to be more common in large classes.
The characteristics and variation of clients in a group may affect the ways in which couples respond to the intervention, too. Programs for more homogeneous groups, such as those for engaged Catholic couples or couples embarking on a second marriage, may make couples feel more comfortable as they identify with their peers. Homogeneous groups also expand the opportunity to customize a curriculum for couples in the group. For example, for a class for women with children, a provider may add information about the effects of healthy romantic relationships on children. Providers offering services to couples with little education could tailor the curriculum to recognize lower levels of literacy.
Programs that target specific types of couples may inadvertently create a stigma for some participants. For example, a marriage program that just targets parents involved with the child welfare system would identify participants as belonging to that group. Such classes may alienate potential participants. Some providers note that dynamics in rural communities and small towns may exacerbate this stigma, thereby necessitating a different approach than that used in urban areas.
Heterogeneous groups also present unique opportunities and challenges. They may allow clients to learn more from the varying situations of their counterparts. Providers mention that engaged couples learn from couples that have been married for decades, just as long-term couples can be rejuvenated by the optimism of newlyweds. However, programs that serve heterogeneous groups must appeal to a wider array of clients in different phases of their relationships. In particular, providers of programs for heterogeneous groups that include some low-income couples may not consider issues unique to these couples, such as literacy levels, need for child care, or the inability to afford weekend retreats or transportation.
| Table of Contents | Previous | Next |