Meta-analysis of couple therapy: Effects across outcomes, designs, timeframes, and other moderators

Objectives: This study updated existing meta-analyses of couple therapy that typically do not include multiple treatment modalities, various research designs, long-term outcomes, or recent studies. Eligibility Criteria: Studies published in English that reported relationship satisfaction or other outcomes of couple therapy were included; over 70% of studies have not been included in previous meta-analyses. Methods of Synthesis: Using random effects models across 58 studies representing 40 unique samples and 2,092 couples, effect sizes were summarized within measure domains as mean gains for treatment groups and waitlist groups as well as between-groups comparisons. Results: Couple therapy has a large effect on relationship satisfaction (pre to post within-group Hedges g = 1.12, CI [0.92, 1.31], p <.001) and couples assigned to waitlists do not significantly improve (pre-to-post within-group satisfaction Hedges g = 0.12, CI [_0.04, 0.29], p >.05). Additionally, couple therapy has significant impacts on key domains including self-reported and observed communication, emotional intimacy, and partner behaviors. Moderation analyses of pre-to-post gains in relationship satisfaction for treatment groups were generally nonsignificant; however, greater baseline distress was associated with larger gains. Conclusions: Couple therapy has large effects on key relationship domains and gains are generally maintained over short-and long-term follow-up with minimal impact of tested moderators. Limitations include sample of exclusively opposite sex couples and inability to fully model dependencies within studies. The relationship between mean gain effect sizes and between-groups comparisons is discussed with implications for future research. Couple therapy positively impacts multiple domains of relationship functioning (e.g., satisfaction, communication) during treatment, and gains remain evident at short-term and long-term follow-up. Couples assigned to waitlist control groups generally do not improve. Couple therapy's effects on relationship satisfaction are consistent across individual, couple, and study characteristics.