PREP in the Military
With PREP, Inc. curricula it all starts with PREVENTION.
All curricula produced and disseminated by PREP, whether for couples or the individual servicemember, have a prevention focus. They are not meant as therapy or counseling, but as relationship education efforts delivered by any of several means. However, this distinction is less about whether or not those being served are low risk, higher risk, or already have significant difficulties in their relationships and more about how they are recruited. There is more below on this important point.
The entire foundation of PREP and all the adaptations of PREP curricula are based on the goal of prevention. Howard Markman is the founder of program, and his interests go back to the mid-1970s when a burgeoning field of research on couples (by him, John Gottman, and many others) was identifying risks for marital distress and divorce. Markman’s original goal was to develop a program that could prevent marital distress and divorce. By the late 1970s and into the early 1980s, he was joined in this body of research and prevention effort by others such as Frank Floyd and Scott Stanley.
Just how much was prevention baked into PREP from its inception?
Befitting the early motivation, PREP originally stood for the Premarital Relationship Enhancement Program. Markman, Floyd, and Stanley have all published now classic publications on the use of premarital education to strengthen marriages.
Over the years, PREP moved to a wider focus on couples, including married couples, unmarried couples, couples planning marriage, as well as an increasing focus on relationship education for individuals. The acronym has remained but with a new underlying title of “The Prevention and Relationship Education Program.” This name pays homage to our roots in prevention and our focus on an educational model for helping both individuals and couples in their most important relationships. Read more about PREVENTION and decisions about who you serve, here.
What is the research behind the PREP Approach as it pertains to the military?
Overall, there are very few rigorous studies on relationship education interventions in the military. However, in one of the most rigorous studies in the history of field of relationship education (using a randomized controlled trial: RCT), chaplain-led PREP training cut the risk of divorce for Army couples nearly in half at two years after the training. In the history of research on relationship education effectiveness, it is rare to see a strong divorce reduction effect.*
This divorce-reduction finding is of obvious importance in its own right, but may take on possible added meaning given the efforts in the U.S. military to reduce risks for suicide. Although it is impossible (or nearly so) for any randomized study to be large enough to study the actual outcome of suicide (because it occurs at such low frequencies), divorce is one of the strongest risk factors for suicide, particularly for men.
Another line of research from this study follows from the findings of many studies showing that couples who cohabit prior to marriage or having mutual plans to marry are at increased risk for marital distress and divorce. (for more on this line of research, check here).
The Army couples in this study with this history of moving in together before marriage or mutual plans to marry showed the same risk as has been found in many other, non-military samples. However, this association between cohabitation history and marital outcomes was broken or neutralized for those couples assigned to the PREP group in the randomized controlled trial. In fact, for the couples in the PREP group, there was no longer any added risk associated with premarital cohabitation history. In contrast, those in the control group who had lived together prior to marital commitment developing showed over-time declines in relationship satisfaction, increases in conflict, and were more likely to divorce.
There are numerous published reports based on this randomized study of PREP, including here, here, and here. There are also scores of published studies based on the same data set about military couples, stress, PTSD, and relationship dynamics among spouses in military marriages, such as here, here, here, and here.
This randomized trial in the U.S. Army is particularly valuable as it was a community-based trial of services as provided by chaplains in their typical contexts. The evaluation was conducted by a research team comprised of scholars from the University of Denver and the University of Colorado-Denver and was funded by the National Institutes of Health (NIH: National Institute of Child Health and Human Development). Because of the level of rigor and extensive follow-up, this study was one of the most expensive studies in the history of the field of relationship education. Such studies do not happen often, as they take a high level of investment and commitment from a system, providers, participants, funders, and evaluators.
Fortunately, there are scores of studies of outcomes related to PREP and adaptations of it from sources all over the world, and we believe the body of studies bears strongly on effectiveness that may be anticipated with military populations. This is because the overwhelming amount of research on relationship education has been conducted on mostly younger couples who have economic constraints and relatively high levels of stress, which are characteristics shared by many who serve in the U.S. military.
Are there independent research studies of PREP and PREP derivatives?
The large RCT described above was conducted by a group of scholars that included Scott Stanley and Howard Markman, who are the two primary forces behind PREP (which was founded by Howard Markman). Their body of work is consistent with the decades long commitment that they and their colleagues have to the scientist-practitioner model, where knowledge gained from both university-based research and real-world practice is combined to produce advances in the field.
This reasonably raises the question as to independence between the creation of interventions like PREP and tests of those interventions. Fortunately, we can say this without equivocation: There have been more studies on PREP and its derivatives by more researchers on more continents than any other relationship education approach that has ever existed. You can see a current list of these evaluations here and a slide deck with a sampling of findings here, as well as a slide deck describing studies with findings related to intimate partner violence and PREP curricula, here.
Which came first, PREP curricula or the research basis on relationships and marriage?
The research basis for PREP came first. It was originally created decades ago with knowledge of existing research on intimate relationships. Over time, the development and refinement of PREP has gone hand in hand with research by many scholars. Basic science studies ranging in focus on communication, conflict, commitment, support, stress, and specific relationship dynamics associated with military service have been considered as PREP and PREP curricula are developed and revised over many years. PREP-based curricula are deeply research informed and evidence-based.
A longstanding relationship with the U.S. military
Note: What we describe here is a brief history of our involvement with the U.S. military. Nothing described here should be taken as any past or present endorsement of PREP by any of the parties or entities mentioned. Furthermore, there are other notable events and turning points but these are highlights of how things have unfolded on this journey.
PREP’s history with the U.S. military began in 1990 when William (Bill) Coffin contacted Howard Markman to inquire about the possibility of getting Navy personnel trained to deliver PREP. Bill Coffin has long been a deep consumer of all things research about marriage and prevention, and he has worked as a prevention specialist at the Headquarters of the Navy Family Support Program.
Coffin became aware, through a prevention-focused newsletter, that the researchers at the University of Denver were testing a program to prevent marital distress and divorce. He arranged to look at the version of PREP that existed at the time, and then arranged to meeting with Howard Markman in the Fall of 1989 at a conference in D.C.
Coffin had contacted Markman because he wanted to explore the possibility of getting U.S. Navy Chaplains and family service center personnel trained in PREP so they could add PREP to their tools in serving military families. As a result, the first two trainings in PREP for any group outside of a research context were conducted in 1990 for the U.S. Navy by Howard Markman, Scott Stanley, and Susan Blumberg. One of the chaplains originally trained in 1990 from the U.S. Navy was Steve Smith. Smith went on to be a great advocate for the use of PREP and PREP skills in the Navy. Thus began a decades long effort to help those who serve, with team at PREP training chaplains, chaplains’ assistants, mental health providers, social workers, prevention specialists, those working in family advocacy, and other types of providers throughout the U.S. military.
Over the ensuing 10 years, Stanley and Markman had trained scores of chaplains in the U.S. Navy. Stanley personally traveled to many U.S. Navy bases and Marine installations training chaplains through those years. Markman and Stanley conducted numerous trainings at installations as far flung as London, Damn Neck, Coronado, and Yokosuka.
By the mid-1990s, both the Air Force and the Army were seeking trainings for their personnel in how to deliver PREP to military couples. Also by the mid-1990s, there had been several trainings for large groups of prevention specialists of the U.S. Air Force. There were many trainings for Air Force chaplains, as well, including in Denver, at Lakenheath, UK, and Maxwell Air Force Base.
As the 1990s went along, the U.S. Army chaplains became more interested in being trained in PREP, including active duty, national guard, and reserve components. Army chaplain Jonathan McGraw and colleagues were doing innovative work to strengthen couples at Schofield Barracks on Oahu. Markman joined Ch. McGraw there in 1999 to get chaplains and other members of the team trained in PREP. This effort was called Building Strong and Ready Families (BSRF) which came to the notice of leadership in the Army chaplain corps. The efforts in the Army grew steadily to where, by the turn of the century (2000), the Army chief of chaplains office desired to fund an evaluation of these services provided by chaplains as they were upgrading the consistency and centrality of their efforts to strengthen Army couples relationships. Army chaplain Glen Bloomstrom was leading in these efforts to systematize and expand programming to bring such training to Army couples, worldwide.
Owing to the leadership of chaplains such as Bloomstrom and McGraw, a large sample (but not randomized) evaluation was planned and ready to begin by August, 2001. This study was conducted by SAIC through a subcontract to PREP, Inc., to be conducted by Stanley, Markman and their associate, Christopher Saiz. The events of 9-11-2001 greatly curtailed those plans. In fact, the very first installation to begin contributing data for this study was the home of the first major combat unit sent to Afghanistan. Though greatly diminished by 9-11, this study was published and became the pilot study for the large, NIH funded trial Stanley, Markman, Allen, and Rhoades were to go on to conduct—the fully randomized controlled trial mentioned earlier. That rigorous study came about because of the interest and leadership of the U.S. Army chaplain corps and the persistent efforts of chaplains Glen Bloomstrom, Ronald Thomas, and Pete Frederich. That RCT essentially began at the time of the Army’s big push in developing the Strong Bonds program.
Over the years, the team at PREP (including Markman and Stanley, along with Natalie Jenkins, Lawrence Ramos, Jeff Erlacher, Miranda Egger, and many others) have had the privilege of training thousands of providers in the various branches of service in the PREP curricula for couples, along with other curricula based on the PREP Approach (Got Your Back, Within My Reach, etc.). The entire team at PREP continues to this day to work with all the service branches of the U.S. military. PREP’s lead in customer relations at PREP (Maggie Corcoran) knows who is doing what around the world to reach service members and their families with tools from PREP.
Serving those who serve military service members and families is now one part of many other efforts to disseminate PREP curricula across and U.S. and worldwide, including to community service agencies, government programs, mental health providers, and religious institutions. But these worldwide efforts in dissemination all began with a call from the U.S. Navy.
* The brief findings described here are from research papers and a project that was supported by the Eunice Kennedy Shriver National Institute Of Child Health & Human Development of the National Institutes of Health under Award Number R01HD048780. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
In the video below, Dr. Howard J. Markman, a John Evans Distinguished Professor of Psychology at the University of Denver and the Co-Director of the Center for Marital and Family Studies, and PREP founder, shares an oral history of PREP in the Military.
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If you teach military couples...
Are you conducting either virtual or in-person trainings events with servicemembers and their partners? Engage your couples more fully with PREP 8.0 curriculum. Continually refined to include the latest research while maintaining all of the core themes of the PREP Approach. Designed to build on the existing strengths of the couple, PREP 8.0 adds critical life and relationship skills that will help create safer, more stable couple relationships, and by extension, better environments for their children. Available in Spanish
Helping couples outside of the classroom
ePREP is a self-paced, on-demand program that teaches couples PREP’s prevention and resiliency skills and strategies. Installations are using ePREP to reinforce the PREP skills that have been taught to couples in a class allowing them to use this self paced program when and where they want to. ePREP is also being used to reach those who can’t attend a couples event. Special military pricing is available.
If you teach a group of individual servicemembers regardless of their relationship status
Got Your Back (GYB) curriculum builds Prevention and Resiliency skills by teaching self-awareness and mindful choices emphasizing relationship skills. GYB also focuses on workable practical skills that improve the chances of success in attaining goals in all relationships whether with command, fellow servicemembers, friends, family and romantic interests.
Helping individual servicemembers outside of the classroom
Got Your Back Online is an on-demand, self-paced program that promotes strong prevention and resiliency skills. A great resource to provide to individual servicemembers who have attended a class and need repetition in order to master the PREP prevention and resiliency skills. This is also a powerful way to reach the non-attendee.
More for individuals
Among other aspects of healthy relationships, Within My Reach engages attendees in a discussion about how adult relationships affect other areas of life. Whether it’s a bad relationship or marriage, a divorce/split-up, or a pattern of unstable relationships — all these difficulties can hurt children and affect their opportunities in life. Available in Spanish