Client perceptions of the most and least helpful aspects of couple therapy

Couple therapy research has traditionally utilized either quantitative or qualitative methods to examine the mechanisms of change and outcomes in couple therapy. Also, while studies have examined couples\u27 experiences in therapy, few have specifically examined the most and least helpful aspects of therapy according to the couple. The purpose of the present study was to utilize a mixed-methods design to examine couples\u27 written responses about their experiences in therapy. Two hundred ten individual responses were obtained from a sample of 134 couples who sought Traditional Behavioral Couple Therapy (TBCT) or Integrative Behavioral Couple Therapy (IBCT) for marital distress as part of a larger research project (Christensen et al., 2004). Content analysis of the written responses resulted in five reliably-coded domains; most and least helpful aspects of therapy included therapy, therapist, outcome, client, and logistical factors. Chi-square tests demonstrated treatment group differences on most helpful therapy, therapist, and client factors; and differences between those who recovered and those who deteriorated by 2-year follow up on least helpful therapist and outcome factors. McNemar\u27s tests (McNemar, 1947) also revealed just one significant difference between husbands and wives within IBCT on most helpful client factors. The results particularly suggest that couples in TBCT treatment report different most helpful factors than couples in IBCT treatment. Furthermore, the findings of the five domains found across treatments support the common factors research (e.g., Davis & Piercy, 2007a, 2007b; Sprenkle & Blow, 2004) and have several implications for the clinical treatment of couples