Thaindian News

Washington, April 20 (IANS) The largest, most comprehensive clinical trial of couple therapy ever conducted has found it can help even very distressed married couples - if both partners want to improve their marriage.
The study also involved the longest and most comprehensive follow-up assessment of couple therapy ever conducted.

“It takes only one person to end a marriage but two people to make it work,” said Andrew Christensen, University of California Los Angeles (UCLA) professor of psychology, who led the study.

The study included 134 married couples, 71 in Los Angeles and 63 in Seattle. Most were in their 30s and 40s, and slightly more than half had children. The couples were “chronically, seriously distressed” and fought frequently, but they were hoping to improve their marriages.

“We didn’t want couples who would get better on their own,” Christensen said. “We wanted couples who were consistently unhappy. We excluded almost 100 couples who wanted couple therapy but who did not meet our criteria of consistent and serious distress.”

The couples received up to 26 therapy sessions within a year. Psychologists conducted follow-up sessions approximately every six months for five years after therapy ended.

The couples all participated in one of two kinds of therapy. The first, traditional behavioural couple therapy, focuses on making positive changes, including learning better ways of communicating, especially about problems, and better ways of working toward solutions.

The second, integrative behavioural couple therapy, uses similar strategies but focuses more on the emotional reactions and not just the actions that led to the emotional reactions. In this approach, couples work at understanding their spouse’s emotional sensitivities.

Christensen uses the integrative therapy, the second approach, which he described in his 2000 book “Reconcilable Differences” (Guilford Press).

The couples who used this approach read the book as part of their treatment, while the couples in the traditional therapy group read a different self-help book.

When the therapy sessions were over, about two-thirds of the couples overall had shown significant clinical improvement.

“Given this population, that’s a good figure,” said Christensen, who for more than 30 years has been working with couples in therapy, as well as training and supervising others doing couple therapy.

“If couples do not improve in 26 sessions, that is a bad sign,” he said. “This is not psychoanalysis.”

The integrative therapy approach was significantly more effective than traditional therapy over the first two years of follow-up. The difference between the treatments, however, was not dramatic and did not last as the years went on.

Five years after treatment ended, about half the couples were significantly improved from where they were at the start of treatment, about a quarter were separated or divorced, and about a quarter were unchanged.

At that five-year mark, about a third of the couples were “normal, happy couples”, said Christensen, who considers that figure to be quite good, given the serious and persistent distress with which these couples entered treatment, said an UCLA release.

For another 16 percent, their marriage was significantly improved and was tolerable, if not very happy. “They’re clearly better and their marriages might last,” Christensen said.

These findings appeared in the current issue of the Journal of Consulting and Clinical Psychology.