University of Miami, USA.
Behav Ther. 2012 Mar;43(1):216-27. doi: 10.1016/j.beth.2011.06.006. Epub 2011 Jun 24.
Despite the numerous challenges facing U.S. veterans and their relationships, there have been no examinations of the effectiveness of couple therapy for relationship distress provided to veterans. In the present study, 177 couples presenting for couple therapy at two Veteran Administration Medical Centers completed assessments of relationship satisfaction prior to therapy and weekly during therapy. Results revealed that the average couple showed significant gains in relationship satisfaction during treatment (d=0.44 for men; d=0.47 for women); gains were larger for couples beginning therapy in the distressed range (d=0.61 for men; d=0.58 for women) than for couples in the nondistressed range (d=0.19 for men; d=0.22 for women). Rates of premature termination were high, with 19% of couples completing fewer than three sessions and 62% rated as not completing a "full course" of therapy. Benchmarking analyses demonstrated that the average gains were larger than would be expected from natural remission and similar to previous effectiveness trials; however, average gains were smaller than those observed in couple therapy efficacy trials. Relationship, psychological, and demographic characteristics were generally unrelated to the amount of change in therapy after controlling for initial satisfaction. However, African American couples showed significantly larger gains than Caucasian, non-Hispanic couples. Thus, though yielding smaller effects than those shown in efficacy trials, the impact of couple therapy for veterans' relationship problems appears to generalize across various demographic, psychological, and relationship characteristics.
尽管美国退伍军人及其人际关系面临着诸多挑战，但目前尚未对向退伍军人提供的夫妻治疗对关系困扰的有效性进行研究。在本研究中，177 对在两个退伍军人事务医疗中心接受夫妻治疗的夫妇在治疗前和治疗期间每周进行关系满意度评估。结果显示，平均每对夫妇在治疗期间关系满意度显著提高（男性 d=0.44；女性 d=0.47）；在治疗开始时处于困扰范围的夫妇（男性 d=0.61；女性 d=0.58）比处于非困扰范围的夫妇（男性 d=0.19；女性 d=0.22）获得的收益更大。提前终止治疗的比例较高，19%的夫妇完成的疗程少于 3 次，62%的夫妇被评为未完成“全程”治疗。基准分析表明，平均收益大于自然缓解所预期的收益，与之前的有效性试验相似；然而，平均收益小于夫妻治疗疗效试验中观察到的收益。在控制初始满意度后，关系、心理和人口统计学特征通常与治疗中的变化量无关。然而，非裔美国夫妇的收益明显大于白人和非西班牙裔夫妇。因此，尽管夫妻治疗对退伍军人关系问题的影响小于疗效试验中观察到的效果，但夫妻治疗对退伍军人关系问题的影响似乎适用于各种人口统计学、心理和关系特征。
