The Impact of Chronic Health Conditions as an Underlying Challenge on Couple’s Wellbeing

  • Megan R. Story
  • Benjamin Finlayson
  • Lauren Creger
  • Elise Bunce
Original Paper


Chronic health conditions affect over 100 million Americans (Cano and Leonard in J Clin Psychol 62(11):1409–1418, 2006). Many clinicians are not integrating chronic physical health symptoms into psychotherapy. There is a complexity of issues that arise within the context of chronic health conditions. Making more need for couple and family therapists, whose primary focus is on a systemic family perspective, to understand how chronic health conditions are impacting family systems when they present for therapy (Canavarro and Dattilio in Contemp Fam Ther 33:87–90, 2011; Poleshuck et al. in Prof Psychol 41(4):312–318, 2010). The correlation of chronic health conditions on marriages and relationships has received limited attention in clinical research. This secondary data analysis examines the differences in overall well-being and psychological distress of individuals and couples seeking therapy who report a presence of chronic health conditions. Original research on the relationship between chronic health conditions and well-being, as measured by comparison of means, will be presented. Few studies investigate how chronic health conditions, when not the primary reason for seeking therapy, influence wellbeing and distress upon entering therapy. This study included 2742 participants from a clinical sample of individuals and couple seeking therapy in a family therapy clinic at a university training clinic. Independent t-tests, as well as ANOVA, were run to compare well-being and psychological distress of individuals and couples in the sample. Results showed significant differences in both overall wellbeing and psychological distress for both individuals who reported chronic illness for themselves, or their partners, than those that reported no chronic illness. There were also significant differences between groups on both well-being and psychological distress [F (2, 2706) = 47.55, p = .00, F (2, 2697) = 54.59, p = .00]. This results showed significant differences in well-being when no member of the couple has chronic health conditions, one member, or both members, with both members decreasing wellbeing significantly. This study demonstrates that chronic health conditions impact both the individual diagnosed, their partners, and is especially impactful if both members of a couple are diagnosed with chronic health conditions. Study limitations and clinical implications are also discussed.


Chronic health conditions Couples’ wellbeing Clinical sample Chronic illness Psychological distress Marriage and family therapy 


Compliance with Ethical Standards

Conflict of interest

All the authors declare no conflict of interest in this project. There is no funding received or other involvement that would create a conflict of interest.


  1. Aamar, R. O., Lamson, A. L., & Smith, D. (2015). Qualitative trends in biopsychosocial-spiritual treatment for underserved patients with type 2 diabetes. Contemporary Family Therapy: An International Journal, 37(1), 33–44. Scholar
  2. Altschuler, J. (2015). Whose illness is it anyway? On facing illness as a couple. Journal of Family Therapy, 37, 119–133. Scholar
  3. Badr, H., Acitelli, L. K., & Carmack Taylor, C. L. (2007). Does couple identity mediate the stress experienced by caregiving spouses. Psychology and Health, 22(2), 211–229. Scholar
  4. Boss, P., & Couden, B. A. (2002). Ambiguous loss from chronic physical illness: Clinical interventions with individuals, couples, and families. Journal of Clinical Psychology, 58(11), 1351–1360. Scholar
  5. Boswell, D. L., White, J. K., Sims, W. D., Harrist, R. S., & Romans, J. S. C. (2013). Reliability and validity of the outcome questionnaire-45.2. Psychological Reports, 113(1), 1–5. Scholar
  6. Campbell, T. L., & Patterson, J. M. (1995). The effectiveness of family interventions in the treatment of physical illness. Journal of Marital and Family Therapy, 21(4), 545–583. Scholar
  7. Canavarro, M. C., & Dattilio, F. M. (2011). Family therapy and medical issues. Contemporary Family Therapy: An International Journal, 33, 87–90. Scholar
  8. Cannon, C. A., & Cavanaugh, J. C. (1998). Chronic illness in the context of marriage: A systems perspective of stress and coping in chronic obstructive pulmonary disease. Families, Systems & Health, 16(4), 401–418. Scholar
  9. Cano, A., & Leonard, M. (2006). Integrative behavioral couple therapy for chronic health condition: Promoting behavior change and emotional acceptance. Journal of Clinical Psychology, 62(11), 1409–1418. Scholar
  10. Checton, M. G., Greene, K., Magsamen-Conrad, K., & Venetis, M. K. (2012). Patients’ and partners’ perspectives of chronic illness and its management. Families, Systems, & Health, 30(2), 114–129. Scholar
  11. Kuijer, R. G., Buunk, B. P., de Jong, G. M., Ybema, J. F., & Sanderman, R. (2004). Effects of a brief intervention program for patients with cancer and their partners on feelings of inequity, relationship quality and psychological distress. Psycho-Oncology, 13(5), 1099–1611. Scholar
  12. Lal, A., & Bartle-Haring, S. (2011). Relationship among differentiation of self, relationship satisfaction, partner support, and depression in patients with chronic lung disease and their partners. Journal of Marital and Family Therapy, 37(2), 169–181. Scholar
  13. Lambert, M. J., Burlingame, G. M., Umphress, V., Hansen, N. B., Vermeersch, D. A., Clouse, G. C., & Yanchar, S. C. (1996). The reliability and validity of the outcome questionnaire. Clinical Psychology & Psychotherapy, 3(4), 249–258.CrossRefGoogle Scholar
  14. Lister, Z., Fox, C., & Wilson, C. (2013). Couples and diabetes: A 30-year narrative review of dyadic relational research. Contemporary Family Therapy: An International Journal, 35(4), 613–638. Scholar
  15. Lynch, L., Waite, R., & Davey, M. P. (2013). Adverse childhood experiences and diabetes in adulthood: Support for a collaborative approach to primary care. Contemporary Family Therapy: An International Journal, 35(4), 639–655. Scholar
  16. Martire, L. M., Lustig, A. P., Schulz, R., Miller, G. E., & Helgeson, V. S. (2004). Is it beneficial to involve a family member? A meta-analysis of psychosocial interventions for chronic illness. Health Psychology, 23(6), 599–611. Scholar
  17. McDaniel, S. H., Doherty, W. J., & Hepworth, J. (2014). Medical family therapy and integrated care (2nd edn.). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  18. OQ®-45.2. (2016). Retrieved Nov 18, 2016, from
  19. Patterson, J. M., & Garwick, A. W. (1994). Levels of meaning in family stress theory. Family Process, 33(3), 287–304. Scholar
  20. Poleshuck, E. L., Gamble, S. A., Cort, N., Cerrito, B., Rosario-McCabe, L. A., Hoffman-King, D., & Giles, D. E. (2010). Interpersonal psychotherapy for co-occurring depression and chronic health condition. Professional Psychology: Research & Practice, 41(4), 312–318. Scholar
  21. Polenick, C. A., Martire, L. M., Hemphill, R. C., & Stephens, M. A. P. (2015). Effects of change in arthritis severity on spouse well-being: The moderating role of relationship closeness. Journal of Family Psychology, 29(3), 331–338. Scholar
  22. Prelow, H. M., Weaver, S. R., Swenson, R. R., & Bowman, M. A. (2005). A preliminary investigation of the validity and reliability of the brief-symptom inventory-18 in economically disadvantaged Latina American mothers. Journal of Community Psychology, 33(2), 139–155. Scholar
  23. Rafferty, K. A., Billig, A. K., & Mosack, K. E. (2015). Spirituality, religion, and health: The role of communication, appraisals, and coping for individuals living with chronic illness. Journal of Religion and Health, 54(5), 1870–1885. Scholar
  24. Rolland, J. S. (1994). In sickness and in health: The impact of illness on couples’ relationships. Journal of Marital and Family Therapy, 20(4), 327–347. Scholar
  25. Shields, C. G., Finley, M. A., Chawla, N., & Meadors, P. (2012). Couple and family interventions in health problems. Journal of Marital and Family Therapy, 38(1), 265–280. Scholar
  26. Shields, C. G., Finley, M. A., Elias, C. M., Coker, C. J., Griggs, J. J., Fiscella, K., & Epstein, R. M. (2013). Pain assessment: The roles of physician certainty and curiosity. Health Communication, 28(7), 740–746. Scholar
  27. Ward, B. W., Schiller, J. S., & Goodman, R. A. (2014). Multiple chronic conditions among US adults: A 2012 update. Preventing Chronic Disease. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Megan R. Story
    • 1
  • Benjamin Finlayson
    • 1
  • Lauren Creger
    • 1
  • Elise Bunce
    • 1
  1. 1.Texas Tech UniversityLubbockUSA

Personalised recommendations