Last modified on Friday, 26 December 2008 15:37
Research Assessing Couples Therapy
The research on couples' relationships has helped identify the key focal points in marriages that should be the targets of therapeutic interventions. In parallel, a second set of investigators has begun to develop a significant body of work assessing whether couples therapy works and, if so, which interventions work best. The findings from these studies show that couples therapy is generally effective in reducing distress in relationships. The metanalysis produced by William Shadish and Scott Baldwin, for example, finds effect sizes for couples treatments to be in the same range as those for individual therapy--typically helping three out of four couples.
Couples therapy, both alone or in combination with other interventions, also has been demonstrated to be effective for treating several individual disorders. such as depression, anxiety disorders, and substance abuse. Two quite different factors appear to account for this result. First, partners can play a useful role in encouraging and supporting treatment in a partner. For example, Barbara McCrady of Rutgers University and the team of William Fals-Stewart from the Research Institute on Addictions in Buffalo, N.Y., and Timothy O'Farrell from Harvard Medical School have shown that one partner can help the other more fully engage in treatment, and encourage him or her to behave in ways that reduce the likelihood of substance abuse. The second factor stems from the remarkably high rates at which marital distress occurs along with individual disorders. In a recent national study of comorbidity, Mark Whisman of the University of Colorado found that 28 percent of individuals in distressed marriages also suffered from anxiety disorders, 15 percent met criteria for a diagnosis of depression, and 14 percent for
substance-use disorder. Thus, for a subset of individuals with these disorders, it's an open question whether the more pivotal problem is the individual disorder or the marital distress.
Following this logic, two different research groups--Steven Beach and Daniel O'Leary, then of the State University of New York, Stony Brook, and Neil Jacobson and colleagues--each found that a behavioral form of marital therapy was an effective treatment for individual depression affecting partners in distressed marriages. And whereas individual treatment in these studies also was shown to have an effect on individual depression, only the marital therapy had any effect on the marital distress. Marital therapy thus emerged as the treatment of choice for those with both depression and distressed marriages.