Identifying client-by-treatment interactions in couple therapy

Abstract

Treatment-matching research involves matching clients to the best fitting treatment to enhance overall treatment efficacy. Specific matching hypotheses are supported by superior treatment gains in matched cases over mismatched cases and are identified statistically by client-by-treatment interactions. The purpose of the present study was to address the current dearth of treatment matching research conducted with couples and to capitalize on the unique features of an archival data set comparing traditional behavioral couple therapy (TBCT) and insight-oriented couple therapy (IOCT; Snyder & Wills, 1989). Three variables were hypothesized to affect treatment outcome in matched versus mismatched cases. Partners with an externalizing coping style were hypothesized to do relatively better in TBCT than IOCT, more psychologically-minded partners were hypothesized to do relatively better in IOCT than TBCT, and less positive partners were hypothesized to do relatively poorly in IOCT as compared to TBCT. Regression analyses conducted to test for client-by-treatment interactions were uniformly nonsignificant, failing to confirm the proposed hypotheses. However, the current study offers a theoretical framework from which client variables can be identified and treatment approaches can be conceptualized.