Couples Therapy Outcome Study written by Susan Connor, Research Associate
In order to be considered an evidence based treatment RLT needs to conduct at least two therapy outcome studies. These studies need to demonstrate that there is a significant improvement in the behaviors or other variables being targeted by the treatment, and that the improvement is a result of the intervention. The major variable generally targeted in couples therapy is relationship satisfaction, which can be measured in a number of ways. We also expect changes in self and other compassion, in attachment behaviors, and in emotion regulation. This area of research responds directly to the American Psychological Association’s (APA) call for evidence-based practice in psychology (EBPP), defined as “the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences.” Further, in order for clinical psychology training programs to be approved by the APA, they must incorporate empirically supported treatments (ESTs) into their courses and internships, defined as “clearly specified psychological treatments shown to be efficacious in controlled research with a delineated population” (Chambless & Hollon, 1998, p. 7). Currently the APA identifies two ESTs for distressed couples: Behavioral Couples Therapy for Alcohol Use Disorders and Emotionally Focused Couples Therapy (EFCT).
As the most consistently studied manualized model of couple therapy, EFCT will serve as a control for assessing efficacy of RLT, with outcomes focused on establishing both non-inferiority (RLT produces outcomes similar to EFCT) and superiority of RLT (RLT produces outcomes superior to EFCT). We are currently in the process of updating a survey of the literature for methods and approaches to inform planning of the Couples Therapy Outcomes Research Study. Due to the sensitive and highly personal nature of this research, full review by the WCG IRB will most likely be required. Over the next quarter, we will work on finalizing research plans and protocols and preparing an IRB submission. The goal is to be ready to launch the Couples Therapy Outcomes research study by the final quarter of 2023. As there are, at this point, relatively few fully qualified RLT therapists, we will invite therapists to enroll in the study as they graduate. We expect it will take a full year to enroll enough therapists (who are then able to recruit couples willing to participate) in order to have a sample size that is adequate for statistical analysis. Ideally we would like to see 15-20 therapists enrolled in the study, with one to three couples per therapist participating.
To maximize results, this project will require ongoing supervision of therapists. In addition, for validity purposes, we will require therapists to provide recorded samples of their work so that we can check for adherence to RLT protocols. This will require paid time on the part of the few senior RLT therapists on the faculty. As this is the first couple therapy outcome study we know of to be conducted with a hybrid of in-person and on-line treatment, with therapists in many different locations, and with all questionnaires provided on-line, there are a number of variables that have no precedent in the literature at this time. Thus we anticipate that we may need to do some course-corrections at various points, but hope to have enough data for preliminary analysis by the end of 2024.