Summary of Characteristics of Included Studies

First Author,
Publication
Year,
Country(s)

Patient
Population,
mean age,
mean length
of
relationship

Intervention,
Number of
Couples,
length of
treatment

Comparator,
Number of
Couples,
length of
treatment

Outcomes
Measured

Validated
Questionnaires

Randomized Controlled Trial

Lee, 2014, Canada¹⁷

Couples with a pathological gambling member, 49 years (35–70 years), 18 years

Congruence couple therapy, n = 9, 12–20 sessions

Waiting list, n=9, 12 weeks

Relationship satisfaction

Systemic functioning

Mental stress

Dyadic Adjustment Scale
Systemic Therapy Inventory of Change
Brief Symptom Inventory

Navidian, 2014, Iran¹⁶

Couples referred to pre-divorce counselling, males: 32.5 years, females: 40.3 years (overall 23–63 years), 11 years

Hope- and forgiveness-focused therapy, n=15, 8 sessions

Hope-focused therapy, n=15, 8 sessions

Forgiveness-focused therapy, n=15, 8 sessions

No intervention, n=15, N/A

Interpersonal cognitive distortions

Interpersonal Cognitive Distortions Scale

Dalton, 2013, Canada¹¹

Couples referred to or self-referring for couples therapy for the female with a history of intrafamilial child abuse, 43 years (22–65 years), 14 years

Emotionally focused couples therapy, n = 12, 24 sessions

Waiting list, n=10, 24 weeks

Relationship satisfaction

Trauma symptoms

Dyadic Adjustment Scale
Trauma Symptom Inventory

McLean, 2013, Canada⁴

Couples indicated for or self-requesting psychosocial referral for couple distress due to end stage cancer, 50.25 years, 20.8 years

Emotionally focused therapy, n=22, mean 8 (SD = 0.94) weekly sessions

Usual care, n=20, 2–8 sessions

Relationship satisfaction

Caregiver burden

Depression

Hopelessness

Revised Dyadic Adjustment Scale
Relationship-focused Coping Scale
Beck Depression Inventory
Beck Hopelessness Scale

Kamalabadi, 2012, Iran⁸

Couples referred for therapy for borderline personality disorder in the male, 18–50 years, NR

Couple dialectical behavioural therapy, n=15, 14 weekly sessions

Waiting list, n=15, NR

Relationship quality

Perceived Relationship Quality Components Inventory

Kroger, 2012, Germany¹⁰

Couples self-referred to therapy for a recently disclosed affair, 45.3 years, 17 years

Traditional behavioral couples therapy, N=46, mean 29 weekly sessions (range 22–35)

Waiting list, n=43, 3 months

Relationship satisfaction

Depression

Event related distress

Partnership Questionnaire
Beck Depression Inventory
Impact of Event Scale-Revised

Monson, 2012, Canada and United States⁶

Couples self-referring for couples therapy for PTSD, 37.4 years, 6.8 years

Cognitive behavioural conjoint therapy, n=20, 15 sessions over 12 weeks

Waiting list, n=20, 12 weeks

Relationship satisfaction

Depression

Anxiety

Anger

Dyadic Adjustment Scale
Beck Depression Inventory
State-Trait Anxiety
State-Trait Anger Expression

Manne, 2011, United States⁵

Couples in therapy for prostate cancer, 58 years, 27 years

Conjoint intimacy enhancing therapy, n=37, 5 sessions

Usual care, n= 34, NR

Relationship satisfaction

Relationship intimacy

Self-disclosure

Perceived partner disclosure Perceived partner responsiveness Communication

Psychological distress and psychological well-being
Event related distress

Dyadic Adjustment Scale
Personal Assessment of Intimacy in Relationships
Unvalidated instrument
Unvalidated instrument

Unvalidated instrument

Communication
Communications Pattern Questionnaire
Mental Health Inventory

Impact of Events Scale

Cohort Study

Schumm, 2009, United States²⁶

Couples enrolled in couples counselling for alcoholism in the female, males: 42.2 years, females 40.0 years, 11.5 years

Behavioural couples therapy, n=103, 20–22 weekly sessions

Demographically matched non-alcoholic males and females, n=103, no treatment

Verbal aggression and violence

Conflict Tactics Scale

Pre-Post observational

Dalgleish, 2014, Canada²³

Couples referred or self-referring for couples therapy due to insecure attachment, 44.6 years (28–64 years), 15.9 years

Emotionally focused couple therapy, n=32, 13–35 sessions

N/A

Relationship satisfaction

Attachment anxiety

Emotional control

Trust

Dyadic Adjustment Scale
Experiences in Close Relationships
Courtauld Emotional Control Scale-Revised
Relationship Trust Scale

Abramowitz, 2013;⁹ Belus, 2014, United States⁷

Couples self-referring to couples therapy due to a member with obsessive compulsive disorder, OCD partner 33.1 years, partner: 34.7 years, NR

Couple-based cognitive behavioural therapy, n=21, 16 sessions

N/A

Relationship satisfaction

Communication

Depression

Dyadic Adjustment Scale
Communication Patterns Questionnaire
Beck Depression Inventory, Hamilton Rating Scale for Depression

Collins, 2013, Australia¹⁹

Referred during a follow up visit at cancer centre, 64 years (median), NR

Cognitive existential couple therapy, n=12, 6 weekly sessions

N/A

Psychological distress

Marital function

Coping

Event-related distress

Mental Health Inventory
Family Relationship Index
Brief Cope, Benefit Finding Scale
Impact of Event Scale-Revised

Balfour, 2012, United Kingdom²⁰

Couples applying for or referred to couples therapy, 38.3 years (28–53 years), NR

Psychodynamic psychotherapy, n=18, 40 weekly sessions

N/A

Relatedness

Couple functioning

Psychological function

Personal Relatedness Profile
Golombok Rust Inventory of Marital State
Clinical Outcomes in Routine Evaluation

Doss, 2012, United States;¹⁴ Rowe, 2011¹⁵

Referred or self-referred to couples therapy at Veterans Affairs Medical Centres, men: 49.8 years, women: 46.5 years, 13.6 years

San Diego site
Behavioural therapy, with cognitive and emotion-focused goals, n=94, mean 12.3 sessions (SD=7.75)

Charleston site
Problem focused therapy, n=83, mean 4.49 sessions (SD=3.37)

N/A

Relationship satisfaction

Quality of Marriage Index

Conradi, 2011, Netherlands²¹

Couples referred for inpatient couples therapy, males: 53.9 years (27–72),females 51.0 years (25–70 years), 23.5 years

Psychotherapy, n=36, daily for 7 weeks

N/A

Problem solving capacity

Psychological stress

Interactional Problem Solving Questionnaire
Symptom Check List

Klann, 2011, Germany and Austria²⁴

Couples self-referring for couples therapy, males: 41.0 years, females: 38.6 years, NR

Couples therapy (varied approaches), n=305 (plus 47 individuals from couples where the partner refused), approximately six months of therapy

Similar group from a study published in 1997

Relationship satisfaction

Depression

Marital Satisfaction Inventory Center for Epidemiological Studies Depression Scale

Greenberg, 2010, Canada²²

Couples self-referring for therapy for an unresolved emotional injury, 45.2 years (25–74 years), 16.5 years

Emotion-focused couples therapy, n=20, 10–12 weekly sessions

N/A

Relationship satisfaction

Forgiveness

Trust

Resolution of unfinished business

Couple specific problems

Symptom distress

Dyadic Adjustment Scale
Enright Forgiveness Inventory, Forgiveness Measure
Trust Scale

Unfinished Business Empathy and Acceptance Scale, Unfinished Business Feelings and Needs Scale
Target Complaints Discomfort and Change Scale
Global Symptom Index

Halchuk,2010, Canada²⁵

Couples self-referring for couples therapy for attachment injury, 36.5 years, 10.1 years

Emotionally focused therapy, n=12, approximately 13 weeks

N/A

Relationship satisfaction

Trust

Relationship experience

Forgiveness

Attachment injury

Dyadic Adjustment Scale
Relationship Trust Scale
Experiences in Close Relationships
Interpersonal Relationship Resolution Scale
Attachment Injury Measure

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Couples Therapy for Adults Experiencing Relationship Distress: A Review of the Clinical Evidence and Guidelines [Internet].

APPENDIX 3Summary of Characteristics of Included Studies

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