Predictors of outcome in Emotionally Focused Marital Therapy.

Abstract

The present study assessed the impact of client/relationship variables in predicting outcome in a dynamic/experiential approach to marital therapy. On the basis of an examination of the theoretical assumptions underlying this approach, three predictor variables were assessed: attachment, self-disclosure, and trust. Outcome criteria included (1) marital satisfaction level, (2) marital satisfaction gains, (3) intimacy level, and (4) therapist rating of improvement. It was hypothesized that couples presenting with higher levels of attachment, self-disclosure and trust would be more likely to be maritally satisfied, as indicated by a higher level of marital satisfaction and intimacy at posttreatment and at follow-up. It was also hypothesized that couples presenting with lower levels of attachment, self-disclosure and trust would be most likely to make the largest gains in marital satisfaction at posttreatment and at follow-up, and receive a high rating of improvement from their therapist at termination. Thirty-four couples were provided with 12 sessions of Emotionally Focused Marital Therapy (EFT). Couples were assessed at pretreatment, posttreatment, and at a three-month follow-up. Couples who were most likely to be maritally satisfied at termination indicated a higher level of couple-therapist alliance at the end of the third session. Couples who were most likely to be maritally satisfied at follow-up consisted of: (a) females who indicated a higher level of faith (trust) in their partner at intake, and (b) partners who indicated a higher level of the therapeutic alliance at the end of the third session. Couples who were most likely to make the largest gains in marital sitisfaction at termination indicated a higher level of therapeutic alliance by the end of the third session. Couples who were most likely to make the largest gains in marital satisfaction at follow-up: (a) indicated a lower level of marital satisfaction at intake, (b) consisted of males who indicated a lower level of use of attachment figure at intake, and (c) indicated a higher level of couple-therapist alliance at the end of the third session. There were two additional criteria of outcome: intimacy level and therapist rating of improvement. Results revealed four significant predictors of the level of intimacy. First, the couple's general level of intimacy at intake was the strongest predictor of the couple's general level of intimacy at follow-up. Couples with a higher level of intimacy at intake tended to have a higher level of intimacy at follow-up. Second, couples who established a higher level of alliance with the therapist by the end of the third session tended to show a higher level of intimacy at follow-up. Third, one aspect of trust, the females' level of faith significantly predicted those males who were likely to have the highest level of intimacy at follow-up. Fourth, the females' level of apathy self-disclosure at intake significantly predicted her follow-up level of intimacy. The fourth criteria of outcome was the therapist rating of improvement at posttreatment. There was only one significant predictor of therapist rating of improvement. Couples who had established a higher level of alliance by the end of the third session were most likely to have been rated as improved by therapists. (Abstract shortened by UMI.)