When marital therapy targets global marital dissatisfaction or communication and problem-solving complaints, treated clients do significantly better than controls. Shadish et al. (1995) did not find significant differences when marital therapy was applied to major affective disorders, problems in coping with medical illness, divorce problems, and sexual dysfunction. However, they caution that the number of studies addressing these latter problems was so small prior to 1988 that it would be premature to draw any conclusions from their meta-analysis.
An intriguing confound that predicted outcome in their regression analysis was whether treatment was standardized with a manual. Their analysis suggests that treatment standardization may greatly improve outcome.
Conjoint marital therapy and depression. To begin testing this hypothesis, Prince and Jacobson(1995) reviewed the three most recent and methodologically sound studies comparing marital therapy and individual therapy for distressed couples in which the women were diagnosed as suffering with unipolar depression. O'Leary and Beach (1990) found that behavioral marital therapy (BMT) and individual cognitive therapy (ICT) produced comparable and significant improvement in depressive symptoms at termination and at 1-year follow-up. Only BMT reduced marital distress at both points. Jacobson, Dobson, Fruzzetti, Schmaling, and Salusky (1991) found that for nondistressed couples, ICT and combined BMT-ICT were more effective than BMT in reducing depression. With distressed couples, BMT and ICT were equally effective for depression, but BMT was superior for marital distress.
Prince and Jacobson (1995) conclude that outpatient marital therapy appears to be as effective as accepted individual treatments for depressed women in distressed marriages. Additionally, it appears to be more effective in alleviating marital distress. However, in terms of clinical significance, even with these improvements, fewer than half of the couples in BMT were nondistressed and undepressed at termination. "Thus, although the primary advantage of marital therapy for depression appears to lie in its capacity to resolve both depressive symptoms and marital distress, there is room for improvement in ... both problem areas" (1995, p. 391). Because it targets both depression and marital distress, Prince and Jacobson consider conjoint marital treatment more cost effective than individual treatment for depressed women in distressed marriages.
The available data did not support Prince and Jacobson's (1995) hypothesis that conjoint treatment would reduce relapse rates more than individual therapy.
MFT for Marital Conflict and Divorce
Recent statistics indicate that more than one half of the couples that marry will separate and divorce. Both marital conflict and divorce have a variety of negative effects on the physical and mental health of children and adults (Bray & Hetherington, 1993). Over the last 15 years, a considerable body of research has accumulated on the effectiveness of marital therapy for marital conflict and, more recently, for the prevention of divorce.
However, in regard to clinical significance, Bray and Jouriles (1995) echo Jacobson and Addis (1993) and Shadish et al. (1993, 1995) in noting that substantially fewer than 50% of the couples in marital therapy become undistressed after therapy. Most change, but not sufficiently to be nonsymptomatic. When long-term effects are factored in, the picture becomes even more discouraging. Jacobson, Schmaling, and Holtzworth-Munroe (1987) found a relapse rate of close to 30% among recovered couples 2 years after the termination of BMT, and Snyder, Wills, and Grady-Fletcher (1991) found a 38% divorce rate 4 years after termination of BMT.
Bray and Jouriles (1995) take a somewhat more optimistic position about longer term outcome. Of the Jacobson et al. (1987) data, they report that only 9% of the couples that received a complete BMT package separated or divorced, whereas 45% of those who received a component of BMT separated or divorced. They also cite the Snyder et al. (1991) finding that only 3% of the couples in their insight-oriented condition had divorced or separated 4 years posttherapy. Thus, complete BMT and insight-oriented marital therapy in two separate studies prevented divorce better than competing treatments. It is important to remember that the Bray and Jouriles argument for long-term effectiveness relates to marital stability and the prevention of divorce, not the reduction of marital conflict. The data at this point do not support the long-term effectiveness of marital therapy to reduce marital conflict.
Jacobson and Addis (1993), in their review of the literature, argue along with Snyder, Mangrum, and Wills (1993) that the couples that tend to do best in marital therapy are those who are least distressed, younger, less emotionally disengaged, and less polarized with respect to gender role preferences. Also, as mentioned above in regard to affective disorders, the severity of depression in a spouse diminishes the efficacy of marital therapy.
Lastly, there is confusion within the marital therapy outcome literature about the extent to which particular studies deal with marital conflict versus marital distress. At times, certain researchers use these terms interchangeably, which undoubtedly clouds research results. It is imperative for marital therapy researchers to distinguish marital distress from marital conflict and to find more reliable and effective ways to measure types and quantities of conflict.
MFT = Marital and Family Therapy
BMT = Behavioral Modification Therapy
All of the above is from the article cited by Zelmo.
And this is why citing individual studies would not help a whole lot of people decide on what to do to save their marriage. Show of hands...
Who understood all of that as it applies to the ongoing debate?
And this is just an article that compares STUDIES and not actual performance of any particular form of MFT or BMT.
Mark
I have much more faith in Dr Harleys expertise, backed up by studies than your feelings.
It's not like you need to mention infidelity or anything. The site is more than just that.
