A qualitative study of 24 male couples, published by Starks et al. in 2024, reveals that participants valued the structured space a counselor provided to discuss challenging topics like communication, drug use, and sexual risk. the couples, comprising 48 individuals aged 18 and older—with at least one partner aged 18 to 29 who reported recent cannabis or illicit drug use—completed three sessions of motivational interviewing. According to the study,the presence of a neutral third party made it easier to start difficult conversations and reduced conflict, highlighting the potential of brief couples-based interventions to improve relationship health and reduce HIV risk factors.

How 24 Couples Found Help in Three Sessions of Motivational Interviewing

The study, as reported by the researchers, centered on a brief intervention targeting substance use and sexual risk reduction. Participants attended three sessions of motivational interviewing, each focused on these behaviors. Transcripts from the sessions were analyzed to identify what couples said they gained from the process. Three main themes emerged: taking intentional time to talk, the counselor making conversations easier, and the counselor articulating things partners struggled to say themselves. One participant summarized, “the intervention gave us the space to talk about things we are not comfortable talking about,” according to the study. This feedback underscores that even a short, focused intervention can generate perceived benefits for relationship communication.

The Counselor as a Neutral Third Party: ‘It Is Easier to Talk Through You’

The study found that for many couples,the counselor’s role extended beyond facilitation. One couple noted, “Ironically it is easier to talk through you than to each other. It helps that we don’t know you,” as cited in the research. Another participant said, “It is really nice to have a third person in the room. When people are being watched they are likely to act more cordially.” According to the researchers, the counselor was able to raise topics—such as drug use and sexual behavior—that couples found hard to broach on their own. One participant explained, “We don’t hear each other say these things that are, in fact, very true about our relationship with each other with,I guess, someone like you being present. Because we don’t know how to ask the questions you’re asking.” This suggests that the therapist’s external, non-judgmental stance may be a key mechanism for change.

Why HIV Prevention Efforts Target Male Couples’ Communication

The development of interventions that address drug use and sexual health in male couples is a priority, as the study notes, because sexual minority men face a high risk for HIV. According to Sullivan et al., 2009, many, possibly most, new HIV infections in this population are transmitted between relationship partners. Additionally, rates of substance use are higher in this population compared to heterosexual men, and drug use is consistently linked to sexual HIV transmission risk. The study’s findings reinforce that couples-based counseling may serve dual purposes: improving relationship dynamics and reducing behaviors that elevate HIV risk. The brief, three-session format makes it a potentially scalable option for community health settings.

What Remains Unknown About Brief Couples Interventions

While the study offers rich qualitative insights, several questions remain open. The sample of 24 couples is small and may not represent the diversity of male couples, including variations in relationship length, substance use severity, or HIV status. The study did not report whether the perceived benefits translated into measurable reductions in drug use or sexual risk behaviors over time—only that couples valued the sessions. Furthermore, the intervention was delivered by trained counselors in a research setting; it is unclear how it would fare in real-world clinics with less supervision. As the source report notes, “no one can guarantee specific therapy outcomes, and whether an individual couple benefits depends on many circumstances.” Future studies with larger samples and longitudinal follow-up are needed to validate these preliminary findings.