Couple therapy outcomes tend to be judged by randomized controlled trial evidence, which comes primarily from the United States. United Kingdom and European outcome studies have tended to be naturalistic and there is a debate as to whether "laboratory" (RCT) studies are useful benchmarks for the outcomes of "clinic" (naturalistic) studies, not least because the therapies tested in the RCTs are hardly used in these settings. The current paper surveys the naturalistic studies in the literature and presents results from a U.K. setting of 877 individually and relationally distressed participants who completed at least 2 sessions of psychodynamic couple therapy and completed self-report measures assessing psychological well-being (CORE-OM) and relationship quality (Golombok Rust Inventory of Marital State, GRIMS). A clinical vignette is given that demonstrates the psychodynamic approach used. Analysis of the measure data conducted using hierarchical linear modeling showed an overall significant decrease in individual psychological distress for both male and female clients at the end of therapy, with a large effect size of d = -1.04. There was also a significant improvement in relationship satisfaction for both male and female clients, with a medium effect size of d = -0.58. These findings suggest that psychodynamic couple therapy is an effective treatment for couples experiencing individual and relational distress, with effect sizes similar in strength to those reported in RCTs. It argues that naturalistic effectiveness studies should be given a stronger role in assessments of which therapies work. (PsycINFO Database Record
Despite the well-established links between couple relationship quality and healthy family functioning, and burgeoning evidence from the international intervention field, there is little or no evidence of the efficacy of couples-based interventions from the United Kingdom (U.K.). This study explored whether the Parents as Partners (PasP) program, a group-based intervention developed in the United States, brought about the same benefits in the U.K. The evaluation is based on 97 couples with children from communities with high levels of need, recruited to PasP because they are at high risk for parent and child psychopathology. Both mothers and fathers completed self-report questionnaires assessing parents' psychological distress, parenting stress, couple relationship quality and conflict, fathers' involvement in child care and, importantly, children's adjustment. Multilevel modeling analysis comparing parents' responses pre- and postintervention not only showed substantial improvements for both parents on multiple measures of couple relationship quality, but also improvements in parent and child psychopathology. Analyses also indicated most substantial benefits for couples displaying poorest functioning at baseline. The findings provide initial evidence for the successful implementation of PasP, an American-origin program, in the U.K., and add support for the concept of the couple relationship as a resource by which to strengthen families.
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