Prediction of treatment response at 5-year follow-up in a randomized clinical trial of behaviorally based couple therapies.

Abstract

Objective Building on earlier work examining predictors of short- and moderate-term treatment response, demographic, intrapersonal, communication, and interpersonal variables were examined as predictors of clinically significant outcomes five years after couples completed one of two behaviorally based couple therapies. Method One hundred and thirty-four couples were randomly assigned to Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) or Traditional Behavioral Couple Therapy (TBCT; Jacobson & Margolin, 1979) and followed for 5 years after treatment. Outcomes include clinically significant change categories of relationship satisfaction and marital status at 5-year follow-up. Optimal subsets of predictors were selected using an automated, bootstrapped selection procedure based on Bayesian Information Criterion. Results Higher levels of commitment and being married for a longer period of time were associated with decreased likelihood of divorce/separation (Odds Ratio [OR] = 1.39, p = .004; OR = 0.91, p = .015). Being married for a longer period of time was also associated with increased likelihood of positive, clinically significant change (OR = 1.12, p = .029). Finally, higher levels of wife desired closeness were associated with increased odds of positive, clinically significant change and decreased odds of divorce for moderately distressed, IBCT couples (OR = 1.16, p = 0.002; OR = 0.85, p = 0.007, respectively) whereas the opposite was true for moderately distressed, TBCT couples (OR = 0.77, p < 0.001; OR = 1.17, p = 0.002, respectively). Conclusions Commitment-related variables are associated with clinically significant outcomes at 5-year follow-up as well as at termination and moderate-term follow-up. Public health significance This study indicates that couples who begin marital therapy with higher levels of commitment are least likely to get divorced and most likely to report improvements in relationship satisfaction five years after ending treatment. In addition, it appears that the impact of wives’ desired closeness depended on the type of treatment moderately distressed couple received.

Integrative behavioral couple therapy

“…Prediction studies demonstrated that, out of a number of possible variables, higher relationship commitment and longer length of marriage were independently predictive of long-term positive outcome [16–17]. Examination of mediators of change indicated that changes in frequency of targeted behavior, such as Bill being more affectionate with Sue, as well as acceptance of target behavior, such as Sue being more accepting of Bill’s level of affection, were linked with positive outcome, with frequency more strongly linked early in therapy but acceptance more strongly linked later in therapy with outcome.…”

Maintenance of Gains in Relationship and Individual Functioning Following the Online OurRelationship Program

“…Demographic characteristics are often studied as predictors of treatment outcome. For in-person therapy, being married longer and being employed are inconsistently associated with better outcomes at follow up (Baucom Atkins, Rowe, Doss, & Christensen, 2015; Baucom, Atkins, Simpson, & Christensen, 2009; Snyder, Mangrum, & Wills, 1993). For RE programs, a meta-analysis of low-income couples found participants with longer relationship length improved marginally more than couples with shorter relationship length.…”

[P4–026]: Biological Factors Contributing to the Response to Cognitive Training in Mild Cognitive Impairment

“…In cognitive behavioral therapy, homework non-compliance is one of the top most reason for therapy failure and there is a strong association between patients' motivation and homework completion as well as between homework completion and drop-out rate or therapy outcome [47]. Interestingly, when examining the number of completed homework tasks for drop-outs and completers of the intervention, we found that those who did not complete the intervention far less often completed their homework tasks (drop-outs: 3.7 ± 2.6; completers: 7.8 ± 1.7; t(23) = 4.65, p < 0.001), which remained significant when controlling for attendance rates (F (2,22) = 4.49; p < 0.05).…”