in a particular family member. Baucom, Shoham,
Mueser, Daiuto, and Stickle (1998) report that fam-
ily treatment appears to be helpful in treating two
particular psychological disorders. Specifically,
family-assisted exposure plus response prevention
treatment for obsessive-compulsive disorder (see
Chapter 14) was superior to the traditional form
of treatment without a family member assisting
(Mehta, 1990). Family therapy has also been
shown efficacious for a second psychological disor-
der, schizophrenia. Baucom et al. (1998) report that
behavioral, supportive, and family systems forms of
family therapy provided for at least 9 months to the
families of patients with schizophrenia appear effi-
cacious in reducing relapse rates for the disorder.
Relapse rates for patients with schizophrenia typi-
cally range between 50% and 75%, but the relapse
rates for patients whose families received treatment
were typically 35% or less.
Finally, Shadish and Baldwin (2003) summa-
rized 20 previous meta-analyses that evaluated the
efficacy of different forms of family therapy. Results
indicated that the average effect size of family ther-
apy across all studies was .58, slightly higher than
their previous estimate (Shadish et al., 1993). No
form of family therapy was consistently superior
to the others.
As for the “ingredients” of successful family
therapy, Sexton, Alexander, and Mease (2004)
point to evidence suggesting that redefinition of
the problem into a“family problem,”the ability to
resolve impasses, strong therapeutic alliances, a
reduction in within-session negative family interac-
tions, and fostering improved family communication
were all linked to positive family therapy outcome.
Couples Therapy. In addition to the data on
family therapy, Table 15-1 presents Shadish et al.’s
(1993) meta-analytic results for couples therapy.
First, it should be noted that even fewer studies
and effect sizes were available to evaluate couples
therapy than family therapy. As can be seen in
Table 15-1, the average effect size for any form of
couples therapy was .60, somewhat higher than for
family therapy. Shadish et al. found great variability
in the efficacy of different forms of couples therapy;
humanistic couples therapy appeared to be much
less efficacious than other forms.
Baucom et al. (1998) provide additional infor-
mation on the efficacy of different forms of couples
therapy. They concur that behavioral marital therapy
(BMT) is efficacious, noting that data suggest that
between one-third and two-thirds of the couples
who receive BMT are likely to be similar to nondis-
tressed couples (based on their scores on outcome
measures of relationship functioning) by the end of
treatment. In addition, Baucom et al. (1998) report
that the available evidence suggests that emotionally
focused couples therapy (EFT) is an effective form of
treatment, especially with mildly to moderately dis-
tressed couples, and that EFT was superior to BMT
in at least one study (Johnson & Greenberg, 1985).
Finally, Baucom et al. note that cognitive, cognitive-
behavioral, and insight-oriented forms of couples
therapy appear promising in their effects to date
and should be investigated further.
More recent studies offer stronger evidence for
the efficacy of couples therapy. For instance,
Powers, Vedel, and Emmelkamp’s (2008) meta-
analyses reveal superior long-term effects for behav-
ioral couples therapy as compared to individual
CBT in the treatment of substance use disorders.
Snyder, Castellani, and Whisman (2006) report sev-
eral examples of couples therapy as an efficacious
approach to treat depressive symptoms, anxiety
disorders, as well as the reduction of several
health-related behaviors (e.g., smoking, overeating,
etc). As noted by Snyder and colleagues, couples
therapy appears to be efficacious not only in reduc-
ing the psychological symptoms of an individual
but also simultaneously addressing related marital-
satisfaction partner issues (e.g., partner aggression,
sexual dysfunctions, extramarital affairs) that are
comorbid with these symptoms.
In summary, reviews of the empirical litera-
ture suggest that, in general, these treatments
appear to be efficacious in reducing relationship
distress. Further, both couples and family therapy
may be useful in the treatment of specific psycho-
logical disorders in individual partners or family mem-
bers (Baucom et al., 1998; Carr, 2009a, 2009b;
Shadish & Baldwin, 2003).GROUP THERAPY, FAMILY THERAPY, AND COUPLES THERAPY 453