Psychotherapy meta-analyses commonly combine results from controlled experiments that use random and nonrandom assignment without examining whether the 2 methods give the same answer. Results from this article call this practice into question. With the use of outcome studies of marital and family therapy, 64 experiments using random assignment yielded consistently higher mean posttest effects and less variable posttest effects than 36 studies using nonrandom assignment. This difference was reduced by about half by taking into account various covariates, especially pretest effect size levels and various characteristics of control groups. The importance of this finding depends on (a) whether one is discussing meta-analysis or primary experiments, (b) how precise an answer is desired, and (c) whether some adjustment to the data from studies using nonrandom assignment is possible. It is concluded that studies using nonrandom assignment may produce acceptable approximations to results from randomized experiments under some circumstances but that reliance on results from randomized experiments as the gold standard is still well founded.

This article reviews the major findings from a multiproject meta‐analysis of the effects of marital and family therapy (MFT). Across 163 randomized trials, MFT demonstrates moderate, statistically significant, and often clinically significant effects. No orientation is yet demonstrably superior to any other, nor is MFT superior to individual therapy. Cost effectiveness information is scant in these 163 studies, but supportive. Randomized experiments yield very different answers from nonrandomized experimental studies of the effects of MFT, calling into question whether we should mix the two in reviews. We have also found several new differences in the ways that marital therapy (MT) and family therapy (FT) studies are conducted, making them harder to compare. Finally, important questions still exist about whether any psychotherapy, including MFT, yet has sufficient information about how well research generalizes to everyday clinical practice.

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