1 - (SYM 41) Sudden Gains During Integrative Behavioral Couple Therapy in a Sample of Community Couples

Sudden gains are common responses to psychotherapy in which measured symptom improvements between sessions are large in magnitude relative to an individual’s previous scores and are unlikely to occur by chance (Shalom & Aderka, 2020; Tang & DeRubeis, 1999). A large body of evidence documents this phenomenon in individual treatment modalities for a variety of mental health conditions, with some research indicating that individuals who experience sudden gains have better outcomes post-treatment and at follow-up compared with those who do not (Aderka et al., 2012). Many evidence-based couple therapies assume gradual, relatively constant improvement in relationship satisfaction over a course of therapy. Despite this, Doss et al. (2011) found sudden gains in relationship satisfaction among couples receiving therapy in the VA system.

The current study replicates and builds on the findings of Doss et al. (2011) in a sample of N = 24 community couples treated for at least 8 sessions by integrative behavioral couple therapy (IBCT) therapist trainees. Participants were required to be interested in receiving couple therapy, married for at least one year, aged 18 or older, and fluent in English. Couples were offered up to 26 sessions of IBCT at no charge (i.e., 4 assessment sessions followed by 22 weekly psychotherapy sessions). Progress was monitored through brief, weekly self-report questionnaires including the 4-item Couples Satisfaction Index (CSI-4; Funk & Rogge, 2007) to measure relationship satisfaction. Relationship satisfaction increased for 26 (54%) of partners over time. Of the 26 partners benefitting from treatment, approximately 18 (70%) demonstrated sudden gains in relationship satisfaction. Understanding the rate and trajectories of change in partners undergoing IBCT may help therapists establish realistic expectations for partners at the outset of treatment.