How effective is routine couple counselling? An Australian effectiveness study

Harnessing workhorses or herding cats? Collaborating across the Relationships Australia Federation to research what matters most to families
Friday 27 July, 1135 – 1155


Jemima Petch
Relationships Australia Queensland

There are over 35 randomised controlled trials of couple therapy and the efficacy of couple therapy is well established. In contrast, there is very limited information on the effectiveness of couple therapy in routine practice. Only three prospective effectiveness trials have evaluated change in relationship outcomes across the course of couple therapy in routine practice, and no Australian studies have been published.
Furthermore, the outcomes reported by effectiveness studies are not as positive as those reported by efficacy studies and it is unclear if there is a true difference in client outcomes — perhaps due to couple characteristics or treatment factors — or if the research to practice gap is a chance finding of a handful of studies.
This research presents longitudinal outcome data from 130 Australian couples attending couples counselling at a nationally provided not-for-profit organisation. Couple satisfaction and psychological distress improved for approximately half of the couples, and risk profiles predicted couple satisfaction outcomes. The study results are benchmarked against national and international couple outcome studies.
Explanations for the differences in efficacy versus effectiveness study outcomes are explored, including how variables such as the type of therapy provided (manualised vs eclectic), characteristics of couples (stringent inclusion and exclusion criteria), level of assessment, quality control, therapeutic alliance and organisational context may impact on the differential rates of couple therapy outcomes reported across studies.