Which couples stay together after going through therapy?
Tuesday, October 14, 2014
Posted by: Lorenzo Lorenzo-Luaces Valencia
Apparently it depends on the type of couple and the type of therapy. Although couples therapy has shown to improve marital satisfaction, over time these gains are often lost. Baucom, Atkins, Rowe, Doss and Christensen (2014) argue that the variables that predict marital satisfaction at the end of treatment are not the same ones that predict longer-term outcomes like divorce. Thus, they set out to explore features of couples that predict short and long-term treatment outcomes after going through Traditional Behavioral Couple Therapy (TBCT) or Integrative Behavioral Couple Therapy (IBCT). TBCT focuses on changing the behaviors of individuals in the couple so that interactions become more pleasing and less negative. IBCT builds on TBCT but emphasizes that the negative emotional reactions to a partner’s behavior contributes to distress in a marriage, and that sometimes accepting differences can actually promote change and improve marriage quality. Although both therapies seem to be effective, in this study only about half of the couples whose satisfaction with their marriage improved maintained those gains 5 years after completing treatment.
Couples who had been married for a longer period of time showed a better response to either treatment than those who married more recently. For couples who entered the study with moderate (as opposed to severe) levels of distress and who were randomized to receive IBCT, the wife’s desire for closeness predicted good outcomes. By contrast, for couples who entered treatment with moderate levels of distress and who got TBCT, the wife’s desire for closeness actually predicted worse marriage quality at the end of treatment. Over the long-term, being married for a longer period of time when entering the study and having reported as a highly committed couple predicted a lower change of getting divorced/separated. The wife’s desire for closeness also influenced the chances of getting divorced differentially by treatment, although this was only true for moderately (and not severely) distressed couples. Across either treatment, for severely distressed couples there was no relationship between the wife’s desire for closeness and likelihood of separation/divorce. However, for moderately distressed couples, the wife’s level of closeness predicted lower odds of separation/divorce in the IBCT condition but higher odds of separation in the TBCT condition.
As in other studies, these authors find that the number of years married was a predictor of positive short and long-term outcomes, irrespective of which treatment the couple receives. Interestingly, the level of commitment reported at baseline predicted long-term, but not short term, outcomes. Thus, although highly committed couples may not experience higher levels of marital satisfaction, they are more likely to stay together than couples that are not as committed to each other.
Perhaps the most clinically useful finding from this study is that the wife’s self-reported desire for closeness predicted positive outcomes in one therapy, IBCT, but negative outcomes in the other. The authors hypothesize that IBCT’s greater focus on emotional acceptance and empathy may make couples where the wife has a higher desire for being closer to her husband as better candidates for IBCT. Notably, for severely distressed couples, there was no relationship between desire for closeness and outcomes. The authors suggest that a great level of distress in relationships overwhelms whatever positive effect a desire for closeness may have.