Powerful Testimony from the Research Demonstrating the Long-term Effectiveness of the Relationship Enhancement® Model
Robert Scuka, Ph.D.
Interest has been expressed in having a review of some of the research on the Relationship Enhancement (RE) model that has been conducted over the years. In this brief review, I will focus on three studies that are particularly illuminating because of what they demonstrate regarding RE’s long-term effectiveness. The first two studies involve mother-daughter dyads, while the third study involves couples.
In the first study (Guerney, Coufal, & Vogelsong, 1981), mother and daughter pairs were assigned to a no-treatment group, a structured RE therapy treatment group, or a “Traditional Treatment” (TT) group involving unstructured open communication about roles, feelings and desired behaviors. Participants in the no-treatment group showed virtually no improvement while the TT group participants showed improvement only in the general quality of their relationships. By contrast, participants in the structured RE therapy group showed significant gains in all areas measured: empathy, expressive skill, general communication patterns, and the general quality of their relationships. This study lends some indirect support to the supposition that the structured nature of the RE skills-training model is one factor contributing to its outcome effectiveness.
In a follow-up to the previous study (Guerney, Vogelsong & Coufal, 1983), the researchers sought to evaluate the comparative effectiveness of a booster program at reinforcing the gains from the original interventions. Fifty percent of the original participants in both the RE group and the TT group took part in a booster program at six months follow-up. Both Booster and No-Booster RE treatment groups gained more than their TT group counterparts on measures of empathy, expressiveness and general relationship quality, again reinforcing the superiority of the RE intervention. Not surprisingly, RE Booster group participants gained more than RE Non-Booster participants, thus validating the hypothesis that booster sessions would help maintain gains. But the most interesting result was that follow-up testing of Non-Booster RE participants showed gains on all measures rather than the expected decrease that typically follows post-testing. This result demonstrates not only that RE can foster a longer-term maintenance of gains even in the absence of a booster intervention, but that the positive effects of RE treatment may continue to build long past the termination of treatment.
In a study involving the RE Program (Griffin & Apostal, 1983), couples participated in an RE group for 2.5 hours per week over a six-week period after waiting for six weeks in order to create a control condition. The study was designed to evaluate the capacity of RE to increase the general quality of the marital relationship, functional differentiation, and differentiation of self – the latter a concept deriving from Bowenian therapy. At post-test, couples experienced significant increases in their functional differentiation and the quality of their marital relationships. At one-year follow-up, these gains were maintained. A further interesting result is that gains in differentiation of self were found at one-year follow-up that had not been present at post-test. This suggests that RE intervention results in long-term positive change in couples that may not be found significant at post-test. This is an important finding in support of the long-term effectiveness of the RE model.
The real importance of these studies, to my mind, lies with the unanticipated but powerful results at follow-up in the last two studies. As hoped for, each of these two studies substantiated the maintenance of gains over time for the RE participants, the first study at six months, the second study at one year. Even more significantly, both studies also documented that the RE intervention had a continuing positive influence resulting in an actual increase in gains at follow-up compared to post-test. This is a fairly unusual and exceedingly powerful result. The usual research expectation is that at follow-up there will be some reversion toward pre-test levels compared to post-test, as the positive effects of the original intervention gradually wear off. The fact that the mother-daughter dyads from the first study that did notparticipate in booster sessions in the second study nonetheless showed additional gains on all measures is a rather stunning result. Likewise, that the couples in the third study showed gains in self-differentiation at follow-up that had not shown up at post-test demonstrates that RE can have a continuing and increasingly positive impact over time even after the intervention has ended. Both of these results are a powerful testimony to the long-term effectiveness of RE as an intervention.
I believe that the explanation for these extraordinary research results lies in the skills-training component of the RE model, including its emphasis in the Maintenance Skill on reinforcing behaviors that would increase the likelihood that participants continue to use the skills learned in their relationships on an ongoing basis even after the intervention period has concluded. The impact of this, as reflected in both studies, is that the participants benefited from the self-reinforcing gains derived from the skills-learning and the resulting transformation of their patterns of interaction. What this demonstrates is that RE not only succeeds at helping people change their patterns of behavior, but also succeeds at helping people preserve their changes and even succeeds in fostering a continuation of positive change beyond the treatment period.
Guerney, B. G., Jr., Coufal, J., & Vogelsong, E. (1981). Relationship Enhancement versus a traditional approach to therapeutic/preventative/enrichment parent-adolescent program. Journal of Consulting and Clinical Psychology 49: 927-939.
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 (pp. 738-756). Beverly Hills: Sage Publications.
Griffin, J. M., Jr., & Apostal, R. A. (1983). The influence of Relationship Enhancement training on differentiation of self. Journal of Marital and Family Therapy 19: 267-272.
“Powerful Testimony from the Research about the Long-term Effectiveness of the Relationship Enhancement Model” first appeared in RE/Filial News, January, 2009, published by the Association for Filial and Relationship Enhancement Methods.
Robert Scuka, Ph.D., is Executive Director of the National Institute of Relationship Enhancement and author of Relationship Enhancement Therapy: Healing through Deep Empathy and Intimate Dialogue (Routledge, 2005). Information about Relationship Enhancement Therapy can be found at www.nire.org. Additional information about Rob Scuka can be found at www.robscuka.com.