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The Findings of a Cochrane Meta‐Analysis of Couple Therapy in Adult Depression: Implications for Research and Clinical Practice
Author(s) -
Barbato Angelo,
D'Avanzo Barbara
Publication year - 2020
Publication title -
family process
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.011
H-Index - 74
eISSN - 1545-5300
pISSN - 0014-7370
DOI - 10.1111/famp.12540
Subject(s) - context (archaeology) , psychotherapist , meta analysis , psychology , interpersonal psychotherapy , depression (economics) , clinical psychology , distress , psychiatry , randomized controlled trial , medicine , paleontology , economics , biology , macroeconomics
The association between depressive symptoms and distressed intimate relationships supported the assumption that couple therapy, by focusing on the interpersonal context of depression, might be more effective as a treatment for depression than individual psychotherapy or drug therapy. This issue was addressed by a Cochrane meta‐analysis assessing the evidence from clinical trials of couple therapy for depression in comparison with individual psychotherapy, drug therapy, and no/minimal intervention, including fourteen studies with 651 participants. No study was found free of bias and the quality of the evidence was low, with major problems of small sample sizes, missing outcome data, selective reporting, lack of information on random sequence generation and allocation concealment, recruitment of people not representative of clinical practice, and allegiance bias. The meta‐analysis showed that both couple therapy and individual psychotherapy improved depressive symptoms at end of treatment and after 6 months or longer, with moderate effect sizes, without any difference between the two treatments. Couple therapy was more effective in reducing couple distress. This effect was larger in studies with distressed couples only and should be considered as relevant in its own right. Couple therapy is a viable option for the treatment of a depressed partner, especially in discordant couples. Future research should address several issues left open to provide a sound empirical foundation for clinical practice.