Predicting Couples' Response to Marital Therapy A Comparison of Short- and Long-Term Predictors Douglas K. Snyder Department of Psychology Texas A&M University Laurel F. Mangrum Department of Psychology Texas A&M University Robert M. Wills Department of Psychiatry Wayne State University ABSTRACT This study identified predictors of couples' response to marital therapy at termination and 4 years posttreatment for 55 couples receiving either behavioral or insight-oriented marital therapy. Couples were more likely to remain maritally distressed at termination if either spouse reported high levels of negative marital affect or depressive symptomatology at intake. Couples were more likely to be divorced or maritally distressed 4 years after completing therapy if spouses' intake measures reflected high levels of negative marital affect, poor problem-solving skills, low psychological resilience, high levels of depression, low emotional responsiveness, or if neither spouse was employed at a semiskilled or higher level position. Termination measures of negative marital affect and poor communication skills also predicted couples' status at 4-year follow-up. Joint contingency tables relating predictors to outcome were constructed. Correspondence may be addressed to Douglas K. Snyder, Department of Psychology, Texas A&M University, College Station, Texas, 77843-4235. Received: December 27, 1991 Revised: May 6, 1992 Accepted: May 28, 1992 Snyder, Wills, and Grady-Fletcher (1991) recently published 4-year follow-up data for 59 couples who were treated in a controlled comparative marital therapy outcome study ( Snyder & Wills, 1989 ). At termination, 18 of these 59 couples (31%) continued to describe their marriage as significantly distressed. By comparison, of 55 couples contacted 4 years after completing treatment, 11 couples (20%) had divorced, and an additional 8 couples (15%) reported significant relationship distress. What factors predict couples' response to marital therapy? Do predictors of couples' marital status at termination differ from those predicting longer term outcome years after therapy has been completed? Previous studies addressing these questions have examined a broad range of potential predictors of marital therapy outcome including demographic measures, indicators of both individual and relationship functioning, and therapist/treatment characteristics. Among demographic indicators, several studies of behavioral marital therapy (BMT) have obtained some evidence of more favorable treatment outcome for younger couples ( Baucom, 1984 ; Bennun, 1985 ; Hahlweg, Schindler, Revenstorf, & Brengelmann, 1984 ; O'Leary & Turkewitz, 1981 ), although Journal of Consulting and Clinical Psychology © 1993 by the American Psychological Association February 1993 Vol. 61, No. 1, 61-69 For personal use only--not for distribution. Page 1 of 1311/27/2000http://spider.apa.org/ftdocs/ccp/1993/february/ccp61161.htmlother studies from various theoretical perspectives have failed to replicate these findings ( Crowe, 1978 ; Freeman, Leavens, & McCulloch, 1969 ; Jacobson, Follette, & Pagel, 1986 ; Mendonca, Lumley, & Hunt, 1982 ). Similarly, mixed findings have been cited relating education to outcome. Crowe reported that less educated couples responded more favorably to BMT, whereas Freeman et al. linked poor treatment response to spousal discrepancies in educational attainment; by contrast, Mendonca et al. found no relation between prior educational level and treatment outcome. Other demographic variables that have been examined but not found to relate to marital therapy outcome have included occupational status, length of marriage, number of previous marriages, and number of children ( Crowe, 1978 ; Freeman et al., 1969 ; Mendonca et al., 1982 ). Various aspects of relationship functioning have been examined as predictors of couples' response to marital therapy. In general, higher levels of negative marital affect at intake, various indicators of spouses' disengagement, and concrete steps taken toward separation or divorce have all been found to predict poorer treatment outcome ( Beach & Broderick, 1983 ; Bennun, 1985 ; Crane, Newfield, & Armstrong, 1984 ; Crowe, 1978 ; Hahlweg et al., 1984 ; Jacobson et al., 1986 ; O'Leary & Beach, 1990 ). Specific areas of marital distress have inconsistently predicted treatment outcome ( Bennun, 1985 ; Hahlweg et al., 1984 ). For example, Bennun's findings suggested more favorable response to BMT when couples present more focused complaints around specific domains of spousal interaction (e.g., sexual behavior, finances, childrearing, and household-domestic concerns) but poorer outcome for those complaints emphasizing more general issues (e.g., jealousy, dependency, or nonsexual affection). Specific communication patterns have also yielded mixed results in predicting response to marital therapy. For example, Jacobson, Schmaling, and Holtzworth-Munroe (1987) noted that couples' continued practice of communication skills was not related to 2-year maintenance of treatment gains versus relapse; Baucom and Mehlman (1984) found that couples showing higher positive communication at the end of treatment were more likely to divorce at follow-up. Psychopathology in one or both spouses has typically been found to predict poor treatment response ( Bennun, 1985 ; Emmelkamp, 1985 ). However, inconsistent findings have been obtained regarding the predictive utility of pretreatment levels of depression. Jacobson et al. (1986) reported more favorable outcome in response to behavioral marital therapy for couples in which one spouse exhibited significant pretreatment depression. By contrast, O'Leary and Beach (1990) found that pretreatment depression levels were unrelated to marital satisfaction or posttreatment depression after behavioral marital therapy or individual cognitive behavioral therapy with depressed wives. Sher, Baucom, and Larus (1990) reported that maritally distressed couples in which one spouse exhibited individual psychopathology other than depression showed poorer response to cognitive behavioral marital therapy than either (a) maritally distressed couples without additional psychopathology or (b) maritally distressed couples in which one partner was also significantly depressed. Additional dimensions of individual functioning predicting therapy outcome have included measures of femininity and masculinity ( Baucom & Aiken, 1984 ), patterns of
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