Couple Therapy for Depression Within a Naturalistic Setting in Finland: Factors Related to Change of the Patient and the Spouse

The study examined factors related to change in treatments for depression in couple therapy (CT; N = 29) and treatment-as-usual (TAU; N = 22). Treatments were adapted in accordance with the patient’s need. The patients’ depressive symptoms, general mental health and marital satisfaction were assessed at baseline and at 6 months post-baseline. The Hamilton Depression Rating Scale, the Beck Depression Inventory (BDI), the Symptom Check List-90, and the Dyadic Adjustment Scale (DAS) were used for the patients. The BDI and the DAS were used for the spouses. The couples in CT group assessed their subjective distress (SD) at every session by using the Outcome Rating Scale. The results showed that the spouses’ gender, the spouses’ depressive symptoms at baseline, and the number of therapy sessions were related to differing changes in the CT and TAU groups at the 6-month post-baseline assessment. The spouses in the CT group demonstrated a higher treatment response than those in the TAU group. In the CT group, the spouse’s benefit from the treatment was related to SD at the outset on the part of either the patient or the spouse or both. The change in the patient’s SD predicted the patient’s change in depressive symptoms, general mental health, and was associated with the patient’s change in marital satisfaction. The study emphasizes the importance of the spouse’s involvement in the treatment of depression, the provision of feedback on SD, and discussion of individual well-being and relational issues, in addition to the focus on depression.     

Couple therapy and the developmental phase of couple relations with students

The aim of this research project has been, in terms of couple evaluation and therapy, to study structural couplings between individual development and the epigenesis of couple relationships. The epigenesis of couple relations was studied according to the model developed by Wynne in which the epigenetic stages are attachment/ caregiving, communicating, joint problem-solving, mutuality, and intimacy. Attachment/caregiving is crucial for the success of couple therapy. The research on 57 couples makes possible a new paradigm for theoretically understanding interconnections between individual development and development of the couple relation; valuable information for planning integrated and need-specific treatment of the couple relation; and evaluation of the course and prognosis of couple relationship with student.This study was carried out at the Health Care Center for Students, in Turku, Finland, and was financially supported by the Pro Sanitate Studiosorum Institute, Helsinki, Finland. We have been in cooperation with and received invaluable constructive criticism from Lyman C. Wynne, MD, PhD, whose theoretical model we applied in this study. Ms. Birgitta Nolvi's secretarial work was greatly appreciated.