A review of empirically supported marital enrichment programs*

Autor: Richard B. Miller, Heidi Brunner, Scott F. Jakubowski, Eric P. Milne
Rok vydání: 2004
Předmět:
Zdroj: Family Relations. 53:528-536
ISSN: 1741-3729
0197-6664
DOI: 10.1111/j.0197-6664.2004.00062.x
Popis: Considering the popularity of marriage enrichment programs, it is important for clinicians and marriage educators to know which programs have received empirical support. Using criteria established for determining empirically supported treatments (ESTs), we provide a comprehensive review of the outcome research on 13 specific marital enrichment programs. Only four programs could be considered "efficacious," three were found to be "possibly efficacious," and six were considered "empirically untested." Key Words: education, marriage, marriage enrichment, outcome research. Numerous experimental studies have found marital enrichment programs to be effective in improving relationship skills and satisfaction. These studies have been reviewed extensively in a number of comprehensive literature reviews (e. g., Sayers, Kohn, & Heavey, 1998; Silliman, Stanley, Coffin, Markman, & Jordan, 2002). For example, in the most comprehensive meta-analysis of marriage enrichment, Giblin, Sprenkle, and Sheehan (1985) analyzed 85 studies, which collectively involved more than 15 marriage enrichment programs, to determine the effects of marriage enrichment programs. The analysis revealed an overall effect size of .419 for marriage enrichment programs, which is considered a medium effect (Cohen, 2003). The most recent review of marital education programs was published in 2003 (Halford, Markman, Stanley, & Kline, 2003) and examined 12 controlled trials of programs that had follow-up assessments of at least 6 months. Their results indicated that marital education programs consistently lead to an improvement of communication skills and relationship satisfaction. Based on this review, Halford and colleagues presented seven guidelines for best practice in marital education. These seven guidelines included assessing the risk profile of couples, encouraging high-risk couples to attend relationship education, assessing relationship aggression, offering marital education at change points, promoting early presentation of relationship problems, matching content to couples with special needs, and enhancing accessibility of evidence-based marital education programs. Although these reviews have conclusively demonstrated the effectiveness of marital enrichment programs, in general, less information is available about the effectiveness of specific programs. Thus, conclusions address the overall field of marital education. Indeed, the guidelines for best practice from Halford and colleagues (2003) made a significant contribution to the advancement of the field, but it transcended specific programs and offered several general guidelines to marital educators. The empirically supported treatment (EST) movement offers an additional useful approach to evaluating the effectiveness of marital education programs. Rather than examining the empirical evidence for marital education programs, in general, the EST perspective examines each program individually and uses established criteria to designate the level of empirical support that each program has earned. There is now a critical mass of outcome research on couple enrichment programs, so it is possible to review these programs using EST criteria. Thus, our task was to do just that. Empirically Supported Treatment The EST movement, which has become an important and influential component in the delivery of mental health services, began largely as a response to demands by managed care for treatment accountability (Crane & Hafen, 2002). The movement emphasizes the value of empirical validation of psychotherapy and marriage and family therapy treatment models as a way to guide the clinical treatment decisions made by therapists (Sprenkle, 2002). The operational definition of ESTs and the criteria used to designate treatments as ESTs emerged from several task forces in the American Psychological Association (APA) during the middle and late 1990s. These task forces determined that the primary standard for an EST was the existence of randomized clinical trials (RCT) that demonstrated that the treatment was more effective than control groups not receiving the treatment. …
Databáze: OpenAIRE
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