TCI: Therapeutic Couples Intervention

The Therapeutic Couples Intervention (TCI) was designed by Dr. Emilie Godwin, Dr. Jeffrey Kreutzer, and Ms. Jennifer Marwitz to assist couples with positively adapting and coping with common losses and changes that result from a TBI. A curriculum-based intervention, the TCI is informed by resilience theory and draws upon more than 20 years of clinical experience. This manualized intervention includes ten topics that address the multi-faceted components of relationships and provides a specified framework for assisting couples in strengthening the quality of their relationships in response to injury. The curriculum-based nature of the intervention allows clinicians the flexibility to individualize sessions in order to remain responsive to each couple’s unique relational dynamics, characteristics and course of recovery.

The TCI was constructed with sensitivity to research that reports the nature of the formidable challenges that a brain injury presents to couples, and that many couples experience a decline in marital quality after one partner has suffered a brain injury. Eight important guiding assumptions drove the development of the TCI and guide the program’s delivery. These assumptions are:

  1. Injury causes drastic changes in couples’ relationships;
  2. Most couples want their old lives and relationships back;
  3. The losses that follow injury are often ambiguous, challenging couples’ ability to effectively manage stress, set goals, and problem solve;
  4. Well-informed people do better;
  5. Each partner is important and deserves respect;
  6. Each partner has the right to make choices in recovery, good or bad;
  7. In the long-term, spouses often assume primary responsibility for helping the survivor;
  8. Spouses must learn to take care of themselves in order to effectively help their partner.

The TCI is implemented in a five-session format with two or three topics covered during each 90 to 120 minute session. A sixth optional 90 to 120 minute parenting session is offered to couples that have children living in the home. Sessions focus on skill-building to help clients enhance existing skills and develop new skills; psychological support through offering empathy, encouragement, and hope; and education via instruction and discussion. The sessions are designed to be implemented by a clinician with expertise in working with couples and are most effectively delivered in a hierarchical format; lessons from earlier topics provide a foundation for later topics. To learn more about TCI topics or see the answers to frequently asked questions, please visit the FAQs tab to the left. Further information can be obtained by emailing Nancy Hsu at The TCI Intervention Kit and Manual are available for purchase through the university at our store.


The contents of this website were developed over time under a series of grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this website do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

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