A comparison of the effectiveness of relationship enhancement and strategic marital therapy using the strength of the therapeutic alliance to predict statistically significant and clinically meaningful outcome
Abstract
The problem under investigation in this study was to determine the relative effectiveness of Relationship Enhancement therapy and Strategic Marital therapy for the treatment of distressed married couples, as well as to examine the development of the therapeutic alliance within a marital therapy context and to use the strength of the alliance as a predictor of outcome. Outcome was evaluated from two perspectives: clinical significance and clinically meaningful. Twenty-three married couples seeking marital therapy at a university based clinic were administered a battery of tests to determine the nature and severity of their marital dysfunction. The assessment battery consisted of five instruments: ENRICH, FACES, Kvebaek, Couple Rapid Assessment Scale and the Family Goal Attainment Scale. Couples were randomly assigned to one of two treatment conditions. Treatment was administered by experienced therapists trained by recognized experts in their respective approaches. Therapist's adherence to their respective treatment models was evaluated. Couples were administered the Couple Therapy Alliance Scale after each therapy session and were administered a post-test after 14 sessions or at termination, whichever came first. Results of analyses regarding the alliance called into question the psychometric properties of the Couple Therapy Alliance Scale. There were no significant differences in the alliance attributable to husbands vs. wives, sex of therapist, or treatment group and it was not a good predictor of outcome. Results of the analysis examining statistically significant differences comparing the two treatment groups revealed minor significant differences and minor discernable patterns between scores on the five assessment instruments. Results of the analysis examining clinically meaningful outcome revealed a larger proportion of couples in the Relationship Enhancement treatment group achieved functional status at post-test than in the Strategic treatment group. This difference of proportion between the two treatment groups was not statistically significant.
Degree
Ph.D.
Advisors
Sprenkle, Purdue University.
Subject Area
Psychotherapy|Academic guidance counseling|Educational psychology
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