Research should also examine the hypothesised mediators of
any beneficial effects of couple therapy feedback. As mentioned
earlier, several possible mediators have been proposed. However, it
remains unclear what exact processes are responsible for any effects
of feedback on therapy progress. One possibility is that feedback
enhances the therapeutic alliance which in turn enhances
outcome, but it is necessary to assess the alliance in couple therapy
sessions conducted with and without feedback in order to
adequately test this proposition. It is also possible that feedback to
the therapist may prompt clinicians to adapt or modify their
approach when a couple is not benefitting from treatment. It would
also be important to explore whether there are particular types of
couples who benefit the most from progress feedback. Lambert's
(2010) research consistently demonstrates that off-track clients
benefit the most from feedback in individual therapy. It would be
important to test whether this is the case for couple therapy.