The Course of Dyadic Adjustment and Depressive Symptoms During and After Couples Therapy: A Prospective Follow-up Study of Impatient Treatment (original) (raw)

2010, Journal of Marital and Family Therapy

A clinical sample of adult patients suffering from relational distress and concurrent psychiatric symptoms was followed from admission, through residential couple therapy, to 1-year follow-up. At follow-up, 9.8% were separated. The remaining couples showed significant improvement in dyadic adjustment at posttreatment. However, at 1-year follow-up, a subgroup of 25% of the positive treatment responders had deteriorated to below their admission levels of dyadic adjustment. Contrary to expectation, the deteriorated group had showed significantly less distress both in depressive symptoms and in one early maladaptive schema domain-Impaired Autonomy-at admission, when compared with the rest of the sample, which suggests the need for further research and possible replication in this area. Several studies have demonstrated the efficacy of couple therapy for improving relationship satisfaction (Baucom, Shoham, Meuser, Daiuto, & Stickle, 1998; Christensen & Heavey, 1999). However, only a few studies have been conducted on long-term follow-up (Christensen, Atkins, Yi, Baucom, & George, 2006), implying that little is known about whether the improvements noted during couple therapy are long-term effects. When, in addition, there is a broad range of problems presented within family therapy practice, couple and family therapy research needs to focus on well-defined disorders and problems (Pinsof, Wynne, & Hambright, 1996). For instance, cases where individual psychiatric distress and relationship disorders co-occur are reported to represent the most difficult problems that couple therapists encounter in clinical practice (Snyder & Whisman, 2004). For this reason, these authors recommended conducting studies on how such variables are interrelated and can be treated most successfully, and whether the achieved changes will remain long-term. The aim of the present study was to investigate the course of treatment and 1-year followup results after intensive residential couple therapy for partners suffering from both individual symptoms and relational distress. To the best of our knowledge, no similar study has previously been conducted. There is no single universally accepted outcome of couple therapy, although increased dyadic satisfaction or termination of the relationship have been identified as the two main out