Client-treatment interaction in marital treatment interventions.

Abstract

Outcome research on marital therapy has consistently demonstrated various treatment techniques to be effective. While therapies developed along affective, behavioral, or cognitive lines all have their proponents, there is no evidence to suggest that any one technique, or combination of techniques, is significantly better than any other. As a possible explanation, it was suggested that this finding of equal outcome among various marital therapy techniques might actually be an artifact of the way in which the research is conducted. Unlike in the marketplace, where couples may select a particular therapist with a particular orientation, couples taking part in a research project are randomly assigned to a particular treatment condition. If couples who are mismatched dropout of the project, results of equal outcome would be based only on data from those couples for whom the therapy they received was appropriate for their needs. This would suggest not that various marital therapy interventions are equal in the general population, but, rather, that different techniques are appropriate for different couples. In order to test this idea, 68 married couples were recruited and randomly assigned to a wait list control group, or one of two different marital treatment interventions. It was expected that, after an eight week intervention, the couples in the two intervention conditions would demonstrate significantly higher marital satisfaction ratings than those in the wait list control, but would not significantly differ from each other. This hypothesis was confirmed. Closer inspection, however, using Discriminant Function Analysis on pretest measures of affective, behavioral, and cognitive factors, suggested that different factors predicted which couples remained in each of the interventions, which differentially emphasized these factors. This was discussed as evidence that all marital therapy techniques are not created equal, but are differentially appropriate for different couples.