Preventive Education: Distinctives and Directions

This is the best of times and the worst of times for prevention education; we have more resources than ever before but more issues. In this article we focus on how we see these issues and the trends in the field from which these issues emerge. To set the context for discussing these issues, we will provide an overview of the field of preventive education in the context of public policy issues on marriage, provide an overview of trends in prevention programs that have a cognitive-behavioral therapy (CBT) emphasis, focusing on our work with the Prevention and Relationship Education Program (PREP), and then we will identify and discuss the critical issues that we see in the prevention field. Throughout the article we will integrate theory, research, and clinical illustrations. Keywords: marriage; prevention; programs; education; directions Millions of Americans experience marital distress, conflict, and divorce each year. Current estimates are that 45% to 50% of first marriages and as many as 65% of second marriages will end in divorce (Raley & Bumpass, 2003). Evidence has accumulated that marital distress and family fragmentation are associated with a broad spectrum of risks for adults and children, including problems with mental health and individual adjustment, child behavior, physical health, and economic success and stability (Booth & Amato, 2001; Coie et al., 1993; Doherty et al., 2002; Fincham, 2003; Forthofer, Markman, Cox, Stanley, & Kessler, 1996; Halford & Bouma, 1997; Kiecolt-Glaser et al., 1993; McLanahan & Sandefur, 1996). Yet, the desire for a satisfying and lasting marriage is one of the most universal and strongly held values among Americans (Millward, 1990; Waite & Gallagher, 2000). In fact, most persons in the United States desire to marry and do eventually marry (Whitehead & Popenoe, 2002). A recent review by Waite and Gallagher (2000) has documented a growing and robust literature on the positive effects of stable and satisfied marriages on mental, physical, and family health and the personal, financial, and social costs of relationship instability. Indeed, although it is recognized that children can flourish in a variety of familial contexts, they are most likely to thrive in homes where they are being raised by biological or adoptive parents who have healthy marriages (e.g., Acs & Nelson, 2003). Hence, there is growing recognition among researchers and policy makers that this entity that most people desire in their lives-marriage-has important social consequences. Although the vast majority of program development and research has been on heterosexual relationships, because the available research (Julien, Arellando, & Turgeon, 1997) suggests that relationship issues are universal, the prevention literature in terms of themes and content seems to apply to same-sex committed relationships as well. The social benefits of a long-term, healthy marriage provide part of the foundation for various efforts that are under way at federal and state government levels to enact policies and programs that might help couples who choose marriage to have healthy marriages (Horn, 2003; Parke & Ooms, 2002). In particular, there is a strong emphasis on preventive education that helps partners make good choices about mates in the first place and teaches partners in early stages of relationships (transition to marriage, transition to parenthood) skills to keep a happy relationship happy (for a review of prevention for couples, see Markman, Stanley, & Kline, 2003). We and our colleagues have contributed at high levels to national discussions about how to define and measure "healthy marriage," focusing on what we call safety theory, with healthy marriages having three essential types of safety: (1) emotional safety as reflected in day-to-day communication patterns, support, and closeness; (2) safety in terms of a secure commitment; and (3) safety in terms of freedom from fear, intimidation, or aggression (Stanley, 2007; Stanley, Markman, & Whitton, 2002). …