Dear Therapist,

Wow! Couples therapy has come of age. When I first started
teaching our Developmental Model of Couples Therapy, couples
work was considered to be inferior to individual therapy. Many
couples therapists were even embarrassed to admit they liked
this work.

That was just twenty years ago!

I used to start my workshops by saying that I believed couples
therapy was often more powerful than individual work, and that
it should not be considered a stepchild to "real therapy." Now
the statistics are starting to confirm my subjective experience.

Last month I read the 2006 Annual Review of Psychology, which
contained this sentence.

"Couples therapy continues to gain in stature."

Here are just a few of the reasons: Couples-based interventions
have been effective in treating mild to moderate levels of
aggression.

A 2003 study by Shadish and Brown demonstrated that the mean
effect for couples therapy was usually comparable to or larger
than the effect of individual therapy and/or medication.

A study comparing Behavioral Couples Therapy and
Insight-Oriented Couples Therapy using 20 sessions of each
showed that both were superior to a waiting list and gains were
maintained at six months. Four years following treatment, 38% of
couples in the behavioral condition had experienced divorce, in
contrast with only 3% of the couples treated in the
insight-oriented condition. The insight-oriented approach
emphasized the interpretation and resolution of conflictual
emotional processes related to developmental issues, collusive
systemic interactions, and maladaptive relationship patterns.

And just why is couples work needed? Couple distress,
particularly negative communication, has direct adverse effects
on cardiovascular, endocrine, immune, neurosensory, and other
physiological systems that, in turn, contribute to physical
health problems.

Maritally discordant individuals are overrepresented among
individuals seeking mental health services.

And an especially interesting evolving finding: In the very
crucial arena of treating domestic violence, couples group
therapy is emerging as an effective form of treatment.

Holtzworth-Munroe et.al (2003) concluded that conjoint couples
therapy that has a direct and specific focus on eliminating
violence "may be as effective as the more widely utilized gender
specific treatments." Male partner rates of physical aggression
at six-month follow-up were highest in the comparison group
(66%) and lower in multi-couple group (25%) than in single
couples therapy (43%). Moreover, both marital aggression and
acceptance of physical aggression decreased significantly among
participants in the multi-couple group therapy but not among
participants in either the individual-couple therapy or
no-treatment comparison conditions.

For more info, read "Current Status and Future Directions in
Couples Therapy," in "Annual Review of Psychology," Volume 57,
2006, p. 317, published by Annual Reviews in Palo Alto,
California. You can read the abstract for free at
http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.psych.56.091103.070154
Or pay and register to read the complete article and others at
www.AnnualReviews.org.

I share all of this with you to express my belief that, "What
you do is so important and valuable!"

All of us are in the trenches in a violent, scared society
trying to help couples create a haven of love, kindness and
support. This is no easy task. Yet we must remember that our
work will help our clients with their health, their children and
the legacy they leave to future generations.

Until next month,

Ellyn Bader