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marital therapy works as well as it should. 
Each year, hundreds of thousands of couples go into counseling in an effort to save their troubled relationships.
But does marital therapy work? Not nearly as well as it should, researchers say. Two years after ending counseling, studies find, 25 percent of couples are worse off than they were when they started, and after four years, up to 38 percent are divorced.
Many of the counseling strategies used today, like teaching people to listen and communicate better and to behave in more positive ways, can help couples for up to a year, say social scientists who have analyzed the effectiveness of different treatments. But they are insufficient to get couples through the squalls of conflict that inevitably recur in the long term.
At the same time, experts say, many therapists lack the skills to work with couples who are in serious trouble. Unable to help angry couples get to the root of their conflict and forge a resolution, these therapists do one of two things: They either let the partners take turns talking week after week, with no end to the therapy in sight, or they give up on the couple and, in effect, steer them to divorce.
"Couples therapy can do more harm than good when the therapist doesn't know how to help a couple," said Dr. Susan Johnson, professor of psychology at the University of Ottawa and director of the Ottawa Couple and Family Institute.
To be sure, many couples credit counseling with strengthening their marriages. And therapists say they could save more marriages if couples started therapy before their relationships were in critical condition.
"Couples wait an average of six years of being unhappy with their relationship before getting help," said Dr. John Gottman, emeritus professor of psychology at the University of Washington and executive director of the Relationship Research Institute in Seattle. "We help the very distressed couples less than the moderately distressed couples."
In the last few years, efforts to find ways to save more marriages and other long-term relationships have increased.
With an experimental approach called integrative behavioral couples therapy, for example, 67 percent of couples significantly improved their relationships for two years, according to a study reported in November to the Association for the Advancement of Behavior Therapy.
Instead of teaching couples how to avoid or solve arguments, as traditional counseling techniques do, the integrative therapy aims to make arguments less hurtful by helping partners accept their differences. It is based on a recent finding that it is not whether a couple fights but how they fight that can destroy a relationship.
But some experts who were trained as couples therapists have become so disillusioned that they question the value of couples therapy in any form. They say couples are better off taking marriage education courses -- practical workshops that teach couples how to get along and that do not ask them to bare their souls or air their problems to a third party.
Two large nationwide marriage education programs, Practical Application of Intimate Relationship Skills and the Prevention and Relationship Enhancement Program, offer such workshops.
Over more than two decades of videotaping and analyzing the behavior of happy and unhappy couples, Gottman has found that all couples fight and that most fights are never resolved. What is different between happy and unhappy couples is the way they fight.
The happy couples punctuate their arguments with positive interactions, he said, like interjecting humor or smiling in fond recognition of a partner's foibles. The unhappy couples have corrosive arguments, characterized by criticism, defensiveness and other negative words and gestures.
Of course, even the happiest of couples can get nasty sometimes. But Gottman has found that as long as the ratio of positive to negative interactions remains at least 5 to 1, the relationship is sturdy. When the ratio dips below that, he says, he can predict with 94 percent accuracy that a couple will divorce.
Source: Susan Gilbert, New York Times 4/19/05
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