Research Demonstrating the Effectiveness of
Relationship Enhancement® Therapy and the RE Program
Relationship Enhancement® Therapy and the RE Program
Avery, Ridley, Leslie, and Milholland (1980) compared an eight-week, 24-hour Relationship Enhancement (RE) program with a Relationship Development Lecture-Discussion (RDLD) program of the same length and format. The premarital couples in the RDLD participated in lecture and discussion groups and reviewed material designed to promote better understanding of relationships and marriage. The researchers found that RE, a skills-training model involving supervised practice, yielded greater increases both in self-disclosure (apparent honesty and openness) and empathy (understanding and acceptance of partner). This finding held true immediately after the program and in a six-month follow-up.
A meta-analytic study by Giblin et al. (1985) analyzed 85 studies with 3,866 couples or families varying widely in age, income, education, location, and nature of treatment. A meta-analysis is a unified statistical analysis of results from many individual studies for the purpose of integrating their findings and drawing additional conclusions from their data. Conducting a meta-analysis requires a common expression of treatment effectiveness, which is called “effect size.” Giblin et al. (1985) state that in social, personality, and clinical research, effect sizes typically range from -1 to +1. The larger the effect size, the greater the difference between the compared groups. In the social sciences, relatively small effect sizes are the norm.
The study examined outcomes from 16 programs for married couples and four for families. In both categories, RE had by far the largest improvement, with the more distressed couples showing greater change than the less distressed. Whereas the average effect size of all couple and family programs was a moderate .44, the effect size for Marital and Family RE programs each averaged a very high .96. Using statistical tables, that means that the average individual in a Relationship Enhancement program does better than 83% of those in the control group.
Brooks (1997) studied the efficacy of Relationship Enhancement (RE) therapy in a rural, southern outpatient setting with distressed couples coming for marital therapy. The 41 participants who had completed the 12-week time-limited RE Couples Group Therapy were compared to the 20 participants who had been waiting for therapy during the 12-week period. Significantly more improvement occurred during the treatment than during the waiting period, and this difference was also found at the 12-week follow-up. This was the case for all variables studied: trust-intimacy, marital communication, adjustment, and problem solving.
Preliminary Studies and Case Reports. Aside from the tightly controlled experimental studies, Relationship Enhancement (RE) has been found to be effective with a wide variety of clinical and other special populations in preliminary empirical studies and case reports. It has been found to be effective at improving relationships and reducing symptoms and problems with psychiatric outpatients and their families, with patients in a community residential rehabilitation center, alcoholics, co-dependents, spouse batterers, depressed clients, juvenile delinquents, drug addicts in rehabilitation, and those suffering from narcissistic personality disorder. Because, with rare exceptions, the RE therapist does not intervene except to coach skills, leaving the participants free to resolve their problems/conflicts in accord with their own cultural values, RE has been recommended as particularly suited for African-American couples, and it is the basis for a program designed for cross-cultural couples’ counseling. Similarly, it has been deemed excellent with respect to gender sensitivity.
Summary Statement of the Effectiveness of the RE Method
Very strong evidence indicates that, for premarital couples, distressed and non-distressed married couples, and parents and their adolescent children, RE:
- improves the general quality of relationships, including trust and intimacy
- enhances the ability to communicate effectively, as evaluated by participants themselves and by condition-blind experts
- helps clients transfer the use of their skills to situations outside of the therapy
- improves participants’ ability to resolve conflicts and problems
- enhances personal psychological health not only indirectly, through improving family interactions, but also in terms of self-esteem and differentiation of self
- can be delivered effectively by para-professionals and lay leaders
The evidence is considered very strong because much of it is based on studies that randomly assigned subjects not only to control groups but also to alternative methods that were themselves effective. Also noteworthy is that the same leaders/therapists very often administered both treatments, which controls for personality variables, and that the participants rated leaders as equal in both treatments with respect to all measured traits: confidence, enthusiasm, understanding, acceptance, and genuineness.
These controls and other checks indicate that the results reflect the specific qualities of the treatment itself and not generic factors (such as experimenter-demand, placebo, suggestion, and Hawthorne effects) or differences in the personalities, attitudes, or leadership qualities of the group leaders.
Another source of confidence in the findings summarized here is the meta-analytic study (Giblin et al., 1985) comparing RE with other major enrichment/therapeutic approaches. This study shows that RE has by far the largest effect sizes – a measure of the superiority of the method to controls or other treatment groups.
The effects of RE not only are maintained in follow-ups of approximately a year (Griffin & Apostal, 1993; Waldo, 1986) but can become even stronger over time (Griffin & Apostal, 1993; B. Guerney, Vogelsong, & Coufal, 1983).
It should be pointed out that there are RE Program materials that are designed for the illiterate, that the reading materials for the literate are at the 7th or lower grade level; that most of the results were obtained with populations ranking at the bottom two levels (IV & V) of the Hollingshead Index of socio-economic/educational status; and that the results are based on at least as many rural subjects as urban subjects.
Very recently a videotaped training program, with coaching by phone, has been developed to train RE group leaders by distance education, allowing for a much more economical and geographically dispersed body of trainers.
For a more detailed summary of three of the most important research studies on RE, please check out: Powerful Testimony from the Research about the Long-term Effectiveness of the Relationship Enhancement Model.
Accordino, M. P., & Guerney, B. G., Jr. (2001). The empirical validation of Relationship Enhancement® couple and family therapy. Chapter 13 in D. J. Cain & J. Seeman (Eds.), Humanistic Psychotherapies: Handbook of Research and Practice, (pp. 403-442). Washington, D.C.: American Psychological Association.
Avery, A. W., Ridley, C. A., Leslie, L. A., & Milholland, T. (1980). Relationship Enhancement with premarital dyads: A six-month follow-up. American Journal of Family Therapy, 8, 60-66.
Brooks, L. W. (1997). An investigation of Relationship Enhancement therapy in a group format with rural, southern couples. Unpublished doctoral dissertation, Florida State University School of Social Work, Tallahassee, FL.
Giblin, P., Sprenkle, D. H., & Sheehan, R. (1985). Enrichment outcome research: A meta-analysis of premarital, marital and family interventions. Journal of Marital and Family Therapy, 11, 257-271.
Griffin, J. M., Jr., & Apostal, R. A. (1993). The influence of Relationship Enhancement training on differentiation of self. Journal of Marital and Family Therapy, 19(3), 267-272.
Guerney, B. G., Jr., Vogelsong, E., & Coufal, J. (1983). Relationship Enhancement versus a traditional treatment: Follow-up and booster effects. In D. Olson & B. Miller (Eds.), Family Studies Review Yearbook Vol. 1. Beverly Hills: Sage Publications, 738-756.
Waldo, M. (1986). Group counseling for military personnel who battered their wives. Journal for Specialists in Group Work, 2(3), 132-138.