Four simple questions on well-being asked at the start of each session of ongoing couple therapy can greatly increase chances for reconciliation and improved relationships, according to a newly published study. The largest clinical trial with couples to date, it shows that divorce and separation rates for couples that used this feedback technique were 46.2 percent less than that of couples who received therapy as usual. The findings, published in the August 1, 2009, Journal of Consulting and Clinical Psychology, are the results of a 2-year study conducted at the Vestfold Family Counseling Center in Norway by a U.S.-Norwegian team of researchers.

From October 2005 to December 2007, 205 randomly selected couples receiving therapy in southern Norway participated in the study, which investigated the effects of providing ongoing feedback regarding the progress of treatment to both clients and therapists. The couples had problems typical of struggling relationships: communication difficulties, loss of feeling for partner, jealousy/infidelity, conflict, and coping with partner’s physical or psychological problems. Half of the study group had feedback incorporated into their therapy while the other half did not.

Couples who used the feedback method rated their well-being on an individual, interpersonal, social, and overall basis by using a visual scale called the Outcome Rating Scale (ORS) at the beginning of each session. The results were used to guide each session: if progress was not noted, new directions for therapy were discussed and implemented. Therapists participating in the study received training on how to integrate the findings of the ORS and collaborate with couples to find new solutions.

“Adding feedback can truly boost effectiveness in couples therapy,” said Dr. Barry Duncan, one of the authors of the study. “It encourages couples to honestly evaluate their progress and enables therapists to adjust therapy before it’s too late.” Although feedback has been demonstrated to improve individual psychotherapy outcomes, no studies until now have examined couples therapy.

Participants were contacted 6 months after the last therapy session. Respondents answered questions about their experience in treatment, including whether the couple remained together. The feedback couples were not only more satisfied with their relationships but also reported significantly lower rates of separation or divorce: a 18.4 percent separation/divorce rate for ORS couples versus 34.2 percent for non-ORS couples.

This study adds to growing evidence that ongoing client feedback in psychotherapy can significantly improve outcomes.

For more information on the ORS, see this website and www.myoutcomes.com .

Media Relations Contact: Barry L. Duncan, Psy.D., barrylduncan@comcast.net, (954) 721-2981, or (561) 239-3640.

Co-authors on the study were Morten G. Anker, Ph. D., the Family Counseling Office in Vestfold, Norway; Barry L. Duncan, Psy.D., the Heart and Soul of Change Project; and Jacqueline A. Sparks, Ph.D., the University of Rhode Island.

Worldwide, there are more than 20,000 registered users of the Outcome Rating Scale. The ORS is available in a variety of formats, including MyOutcomes, a Web-based software application that provides quick and easy administration and interpretation of the ORS.