developed an expert derived algorithm to
predict couple therapy outcome by asking experts in couple therapy
what sort of change at what point in therapy would signal a couple
as being off track to benefit from couple therapy. In brief, the experts
suggested that deterioration in any of the first four sessions would
constitute being off track, and failure to improve after 5 or more
sessions would constitute being off track. (Note the criterion for
being off track changes across sessions as it is anticipated on track
clients show a trajectory of increasing improvement across time).
They tested the accuracy of this predication algorithm in a sample of
n ¼ 132 distressed couples who were assessed for progress at midtherapy.
They found that failure to evidence any improvement at
mid-therapy accurately classified outcome at the end of therapy
(improved or not) for 70% of couples. However, there was a large
miss rate with 54% of couples who did not benefit from therapy
being classified as on-track at mid-therapy, and a substantial false
alarm rate with 29% of couples who were identified as off-track at
mid-therapy ultimately benefiting from therapy. Given that progress
was only assessed once at mid-therapy (approximately 3.5
months into a seven-month course of treatment), it is possible that
session-by-session progress monitoring might increase prediction
accuracy. Further, if accurate prediction of couple therapy outcome
could occur earlier in the course of therapy that might reduce premature
drop-out, and enhance couple therapy outcome.