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Table 1 Dyadic learning modules

From: Couplelinks - an online intervention for young women with breast cancer and their male partners: study protocol for a randomized controlled trial

DLM

Theme

Goal

Activity

1

Celebrating our Strengths

To create an opportunity for partners to reflect upon and communicate about their individual and shared strengths. Individual strengths consist of qualities in the other that one values, enjoys, or admires. Shared strengths include those that define the couple relationship as strong or resilient and help in the process of coping with BC.

Independently, each partner enters 10 positive qualities about their partner online. Then the partners brainstorm together about the strengths they share as a couple in general and log these online. They are then asked to together choose from this list the couple strengths that they bring to bear on their experience with BC. Their entries are transformed into an image of a tree with their individual strengths listed in the roots and their couple strengths listed in the foliage. The couple is asked to review the image and discuss these together.

2

Understanding your Partner’s Inner World

To help partners more accurately understand the other’s thoughts and feelings in relation to BC based on the assumption that previous relationship schemas may have to be revised or altered in the context of the illness.

Independently, each partner answers a series of questions about their own and their partner’s preferences and experiences progressing from trivial to more serious topics (including cancer-related). These lists are then reviewed together in order to stimulate discussion and clarification.

3

Creating Connection

To help partners become more aware of the other person’s ‘bids’ for interaction and support, and to pay attention to their own ‘turning toward’ and ‘turning away’ behaviors on a day-to-day basis [96].

Over the course of the week, each partner is asked to attend to his or her own turning toward and away behaviors as well as his/her partners turning toward behavior . These are tracked and recorded online. At week’s end, the couple reviews and discusses their entries that appear in chart format.

4

Facing Cancer as a Unified Front

To assist couples in adopting a team orientation in relation to BC (a sense of ‘us’ versus ‘it’). Also, to foster the attitude that the illness is a shared experience (not ‘belonging’ to woman with cancer).

Couples are guided through an exercise designed to get them thinking metaphorically about cancer, and then to create a visual representation of the illness in order to fortify sense of ‘we-ness’ in relation to cancer.

5

Getting Physical

To assist couples in reconnecting physically and sensually as a stepping stone to re-engaging sexually, as many couples find their sexual life is disrupted by treatment.

Independently, each partner recalls and records a physically pleasurable shared time from their past. The couple then discusses each memory. Next, couples engage in a Sensate Focus exercise.

6

Looking Back and Moving Forward

To assist couple with moving forward after BC by situating the illness in the context of the larger relationship history and by having the couple consider new goals and directions for themselves (particularly in the wake of lost goals and dreams).

Together partners co-construct a relationship timeline illustrating pivotal events and/or periods in their shared history (high and low points). The website transforms relationship events and phases inputted by the couple into a relationship timeline. This relationship timeline forms a basis for discussion.

(optional)

Intentional Dialogue

To learn a communication skill that partners can use to share their concerns more effectively and increase their understanding of each other’s perspective.

Couples are taught active listening skills by watching an instructional video clip of another couple demonstrating an Intentional Dialogue. Couples are asked to then attempt this skill on their own. First, using a neutral topic and then using a more meaningful topic. Completion dates are entered online.

  1. Adapted from Fergus et al., 2014 [97].