Insight proves key to marital therapy - insight-oriented vs. behavioral marital therapy in effectiveness

Science News, Feb 23, 1991

Insight proves key to marital therapy

The longest follow-up study to date comparing the effectiveness of two common approaches to marital therapy has yielded "quite unexpected" results, according to psychologist Douglas K. Snyder of Texas A&M University in College Station and his colleagues.

The study assessed the after-effects of "insight-oriented" therapy, which explores unconscious influences on marital problems, and "behavioral" therapy, which focuses on improving specific interpersonal skills.

Six months after married couples completed one or the other type of therapy, no differences in divorce rate or marital satisfaction showed up between the two groups, the researchers say. At that point, about two out of three couples who received either form of marital therapy reported happy marriages.

But the years that followed took a much greater toll on behaviorally treated couples, the team found. Ten of 26 couples divorced within four years of completing behavioral therapy, compared with only one of 29 couples who completed insight-oriented therapy. Although most still-married couples regarded their partnerships as stable, reports of marital discord emerged substantially more often in the behavioral therapy group.

The findings suggest that interpersonal skill training alone provides no more than a temporary band-aid for serious marital problems, the scientists assert in the February JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY. Insight-oriented techniques help each partner to resolve largely unconscious emotional conflicts brought to the marriage from his or her family and relationship histories, the researchers say.

In previous follow-ups covering no more than two years, couples who participated in these two therapies showed no significant contrasts in divorce rate or in marital satisfaction.

Couples in Snyder's study received random assignments to behavioral or insight-oriented therapy and attended an average of 19 weekly sessions. Five experienced clinicians trained in both techniques provided the therapies.

Psychologist Neil S. Jacobson argues that insight-oriented marital therapy probably would show no long-term advantages over state-of-the-art behavioral therapy. Jacobson, of the University of Washington in Seattle, says behavioral therapy now includes strategies aimed at altering spouses' habitual, destructive patterns of thinking.

In Snyder's view, this approach still neglects preexisting emotional conflicts. Its long-term effectiveness remains unclear, he contends.