ASSIGNMENT#6NRNP
To prepare:
Review this weeks Learning Resources and reflect on the insights they provide on group work and group therapy.
Select one of the articles from the Learning Resources to evaluate for this Assignment.
Note:
In nursing practice, it is not uncommon to review current literature and share findings with your colleagues. Approach this Assignment as though you were presenting the information to your colleagues.
You will select One of the following 5 Articles on Group Therapy to evaluate for this weeks Assignment.
1-Blanger, C., Laporte, L., Sabourin, S., & Wright, J. (2015). The effect of cognitive-behavioral group marital therapy on marital happiness and problem solving self-appraisal. American Journal of Family Therapy, 43(2), 103-118. doi:10.1080/01926187.2014.956614
2-Himelhoch, S., Medoff, D., & Oyeniyi, G. (2007). Efficacy of group psychotherapy to reduce depressive symptoms among HIV-infected individuals: A systematic review and meta-analysis. AIDS Patient Care & Stds, 21(10), 732-739.doi:10.1089/apc.2007.0012
3-Pessagno, R. A., & Hunker, D. (2013). Using short-term group psychotherapy as an evidence-based intervention for first-time mothers at risk for postpartum depression. Perspectives in Psychiatric Care, 49(3), 202-209. doi:10.1111/j.1744-6163.2012.00350.x
4-Sayn, A., Candansayar, S., & Welkin, L. (2013). Group psychotherapy in women with a history of sexual abuse: What did they find helpful? Journal of Clinical Nursing, 22(23/24), 3249-3258. doi:10.1111/jocn.12168
5-Yildiran, H., & Holt, R. R. (2015). Thematic analysis of the effectiveness of an inpatient mindfulness group for adults with intellectual disabilities. British Journal of Learning Disabilities, 43(1), 49-54. doi:10.1111/bld.12085
The Assignment
In a 10- to 12-slide PowerPoint Presentation, address the following:
1-Provide an Overview of the article you selected, including answers to the following questions:
2-What
type of group was discussed?
3-Who
were the participants in the group?
Why
were they selected?
4-What
was the setting of the group?
5-How
often did the group meet?
6-What
was the duration of the group therapy?
7-What
curative factors might be important for this group and why?
8-What
exclusion criteria
did the authors mention?
9-
Explain the Findings/Outcomes
of the study in the article. Include
Whether
this will translate into practice with your own client groups. If so,
How
? If not,
Why
?
10-Explain Whether the limitations
of the study might impact your ability to use
the Findings/Outcomes presented
in the article. The American Journal of Family Therapy, 43:103118, 2015
Copyright Taylor & Francis Group, LLC
ISSN: 0192-6187 print / 1521-0383 online
DOI: 10.1080/01926187.2014.956614
The Effect of Cognitive-Behavioral Group
Marital Therapy on Marital Happiness
and Problem Solving Self-Appraisal
CLAUDE BELANGER
University of Quebec in Montreal (UQAM), Montreal, Canada,
McGill University, Montreal, Canada, and
The Interdisciplinary Research Centre on Intimate Relationship Problems and Sexual Abuse
(CRIPCAS), Montreal, Canada
LISE LAPORTE
McGill University Health Center, Montreal, Canada
STEPHANE SABOURIN
The Interdisciplinary Research Centre on Intimate Relationship Problems and Sexual Abuse
(CRIPCAS), Montreal, Canada, and Laval University, Quebec City, Canada
JOHN WRIGHT
The Interdisciplinary Research Centre on Intimate Relationship Problems and Sexual Abuse
(CRIPCAS), Montreal, Canada
Problem solving self-appraisal affects problem solving performance
and marital adjustment. This study investigated the effects of
cognitive-behavioral group marital therapy on couples adjustment
and their self-appraisal of problem solving activities. Sixty-six cou-
ples participated in group couples therapy. Subjects were randomly
assigned to an experimental or a waiting list control group. They
completed the Problem Solving Inventory and the Marital Happiness
Scale. Therapy was effective in improving global couple adjustment
and problem solving self-appraisal. The program had a differential
effect on the improvement of self-perceived problem solving abili-
ties depending on the spouses initial self-appraised problem solving
ability level.
Address correspondence to Claude Belanger, Departement de Psychologie, Universite du
Quebec a Montreal, C.P. 8888 succursale Centre-ville, Montreal, QC H3C 3P8, Canada. E-mail:
[emailprotected]
103
104 C. Belanger et al.
Marital therapy based on social learning principles aims to enhance com-
munication and/or to teach problem solving skills, with the expectation
that such behavioral changes will lead to an increase in marital satisfaction
(Woodin, 2001). However, increased attention has been devoted to the
role of individual cognitive variables in mediating the relationship between
communication/problem solving behaviors and marital distress (Belanger,
Sabourin & El-Baalbaki, 2012). The importance of cognitive processes in the
development and maintenance of marital dysfunction has been confirmed in
several investigations of the implications of spouses cognitions in outcome
research (Dunn & Schwebel, 1995).
Researchers have evaluated problem solving self-appraisal as a deter-
minant of individuals adaptational outcomes (Godshall and Elliott, 1997;
Heppner, Kampa, & Brunning, 1987). Problem solving self-appraisal refers
to a relatively stable attitude toward ones personal problem solving reper-
toire as well as toward the self-regulatory processes at work while a problem
is being solved (Heppner & Krauskopf, 1987).
Social problem solving abilities are used in social contexts, and they af-
fect interpersonal adjustment (Elliott & Grant, 2008). For instance, family care-
givers demonstrating effective problem solving styles reported greater rela-
tionship satisfaction (Shanmugham, Cano, Elliott & Davis, 2009). Self-efficacy
in response to personal problems is related to the way the person appraises
his or her problem solving skills. Accordingly, to develop good coping ca-
pacities, it is important for a person to be able to appraise his or her problem
solving skills and style (Heppner & Dong-Gwi, 2009). Moreover, Banduras
work strongly supports the notion that peoples perception of self-efficacy af-
fects their motivation to face challenges, their decision-making behaviors and
their emotional reactions in difficult situations (Bandura, 1986; Carre, 2004).
Perceived self-efficacy has also been related to many personal difficulties
such as depression (Dreer, Elliott, Fletcher, & Swanson, 2005; Rivera et al.,
2007; Nezu, Kalmar, Ronan & Clavijo,1986), psychosocial impairment (Shan-
mugham, Elliott & Palmatier, 2004) and alcoholism (Elliott, Grant & Miller,
2004); it has also been associated with psychological adjustment (Heppner &
Anderson, 1985), physical health (Heppner, Kampa, & Brunning, 1987) and
personality (DZurilla, Maydeu-Olivares & Gallardo-Pujol, 2011).
The well-established links between problem solving self-appraisal and
relationship satisfaction have led researchers to investigate problem solving
capacities and self-appraisal in relation to coping skills and the marital
relationship. These studies were based on the basic premise that, for most
people, the quality of their marital relationship is an important predictor of
their general well-being (Hertzog, 2011). When facing stressful life events,
partners use joint efforts in problem solving interactions and other coping
strategies to reestablish satisfaction and maintain marital adjustment. A
failure in these cognitive and behavioral adaptation mechanisms often leads
to marital distress.
Impact of Group CBT on Marital Happiness and Self-Appraisal 105
Dyadic coping strategies encompass both the cognitive and behavioral
components that influence marital satisfaction. Therefore, it is necessary
to understand the relationships between the cognitive strategies and so-
cial behaviors that partners adopt during their problem solving interactions.
If there is such a link, then what is the exact nature of this interrelation,
and in what ways do these cognitive (problem solving self-appraisal) and
behavioral (problem solving efficacy) strategies influence marital satisfac-
tion? The preoccupation with understanding the cognitive and behavioral
problem solving determinants of marital adjustment can be found in a lim-
ited number of studies that have addressed these particular issues (Baucom
& Kerig, 2004). In line with these questions, an investigation in our lab-
oratory showed that problem solving self-appraisal differentiates distressed
from non-distressed partners (Sabourin, Laporte, & Wright, 1990). Distressed
spouses expressed less problem solving confidence, a stronger tendency to
avoid different problem solving activities, and less control over their behav-
ior than their non-distressed partners (Sabourin et al., 1990). Another study
that was run by the same team (Lussier et al., 1997) examined the rela-
tionship between spouses attachment styles, coping strategies, and marital
satisfaction. These researchers pinpointed many links between attachment
strategies, coping skills and marital adjustment. These results are consistent
with Bodenmann et al. (2006), who reported several studies showing that
positive dyadic coping significantly correlates with a better quality of mari-
tal relationship, lower levels of stress and better physical and psychological
well-being, and in some studies, these correlations are stronger for women
than for men. Kurdek (1991) tried to conceptualize these variables into a
model in which he assessed the role of cognitively and behaviorally ori-
ented problem solving determinants on the relationship satisfaction of gay
and lesbian partners. His results support a problem solving model in which
relationship satisfaction is related to strategies used by partners to resolve
their conflicts.
In a recent study, Belanger and his colleagues (2012) investigated the
mutual contributions of a self-reported cognitive strategy, coping, observed
problem solving behaviors, and marital adjustment. In line with Kurdek
(1991), they hypothesized that the specific coping strategies would be re-
lated to the quality of the problem solving behaviors and that both these
variables would be related to marital satisfaction. Their results propose that,
for both men and women, there are significant relationships between cog-
nitive and coping strategies, problem solving behaviors displayed during
marital interactions, and marital adjustment.
Thus, because empirical studies have demonstrated that problem solving
self-appraisal is directly related to problem solving performance (Heppner
& Dong-Gwi, 2009), spouses should not only possess the problem solving
skills necessary to confront and alleviate their marital difficulties but also
believe in their capacity to do so. To be of maximum value, marital therapy
106 C. Belanger et al.
should therefore not only aim to enhance specific problem solving skills but
also should work to alter spouses appraisal of their problem solving abilities.
To the best of our knowledge, very few outcome studies have investigated
such an effect of couples cognitive-behavioral therapy on the partners self-
appraisal of their problem solving abilities and marital satisfaction.
Accordingly, the main purpose of this paper is 1) to evaluate the overall
effectiveness of cognitive-behavioral group marital therapy in bringing about
positive changes in marital satisfaction and 2) to study the effects of such a
program on partners self-appraisal of problem solving abilities.
The specific hypotheses were that group marital therapy subjects would
report changes in a) their marital satisfaction; b) the overall appraisal of
their problem solving abilities; c) their problem solving confidence; d) their
approach to problem solving activities; and e) their strategies to control their
behavior when they try to solve a problem.
The second purpose of this study is to examine the differential effects
of cognitive behavioral group marital therapy on appraisal from spouses as
being effective or ineffective problem solvers (Nezu, 1985).
It was hypothesized that, following the program, partners who initially
appraised their problem solving as ineffective and who believed that they
had problem solving deficits would report more changes in their marital
adjustment level (Marital Happiness Scale) and in their problem solving skills
(Problem Solving Inventory) than subjects who initially appraised themselves
as effective problem solvers.
METHOD
Subjects
Sixty-six French-Canadian couples participated in the study. The subjects had
been living together an average of 12.8 years (SD = 8.7 years, range 1 to
31 years), and their age ranged from 20 to 76 years (M = 38.2 years, SD =
1.7 years). The mean number of children for the sample was 1.2 (88% of the
couples had children). The average education level was 14.5 years (SD =
2.9 years) for women and 15.7 years (SD = 3.7 years) for men.
Procedure
Subjects were recruited through publicity in various media. Couples who
expressed interest were briefly informed of the nature of the program and
invited to an assessment interview. To be selected, couples had to be living
together, free of any important individual psychopathology, free of drug or
alcohol problems, free of primary sexual dysfunctions, not in intense marital
crisis (no pending divorce or physical abuse) and not currently following
another therapy. During the assessment interview, all couples completed
a battery of questionnaires that included a demographic questionnaire, the
Impact of Group CBT on Marital Happiness and Self-Appraisal 107
Problem Solving Inventory (Heppner & Petersen, 1982), and the Marital
Happiness Scale (Azrin, Naster, & Jones, 1973). Partners completed the ques-
tionnaires independently. A research assistant remained in the same room as
the couple during the task and was available to help participants. Subjects
were ensured of the confidentiality of their responses.
Couples were randomly assigned to the experimental group (n = 30 cou-
ples) or to the control group waiting list (n = 36 couples). After completing
the program, all couples were administered the same self-report measures.
Couples on the waiting list then received the same assessment and treatment
procedures.
Treatment
The Couples Survival Program is a group marital therapy program based
on a cognitive-behavioral approach to solving marital difficulties designed
by researchers in our laboratory (Wright, 1986). Couples are taught skills
focused on effective communication, problem solving, exchange of positive
experiences and anger expression. The cognitive and behavioral compo-
nents of problem solving skills were taught for two sessions (6 hours) in
which couples learned different problem solving stages through reading, in-
structions, modeling rehearsal, dyadic practices, feedback, cognitive restruc-
turing, group discussions, and homework assignments (Dattilio & Epstein,
2005)
Each group comprised four couples. They met once a week, for nine
consecutive weeks, in three hour sessions. Each group was led by a licensed
psychologist with a minimum of two-years experience in marital therapy and
group intervention. The co-therapist had at least a masters degree in clinical
or counseling psychology. All group leaders received 30 hours of training
and weekly supervision between sessions.
Measures
The Problem Solving Inventory (PSI; Heppner & Petersen, 1982) is a 32-
item measure that evaluates perceptions of personal problem solving behav-
iors and attitudes. It yields an overall score as well as three factor scores:
problem solving confidence (11 items), approach-avoidance style (16 items),
and personal control (5 items). High scores indicate that the subject per-
ceives himself/herself as having ineffective problem solving abilities and thus
has little problem solving confidence, tendencies to avoid different problem
solving activities, and a lack of personal control. Reliability estimates (alpha
ranges from .72 to .85) are adequate, and acceptable validity coefficients have
been reported in several investigations (Heppner & Anderson, 1985; Nezu &
108 C. Belanger et al.
Ronan, 1988; Tracey, Sherry, & Keitel, 1986). Moreover, PSI scores have been
found to correlate significantly with observational ratings of problem solving
competence (Heppner et al, 1982). The French version of the PSI (Laporte,
Sabourin, & Wright, 1989) has demonstrated equally sound psychometric
properties (alpha ranges from .65 to .86).
The Marital Happiness Scale (Azrin, Naster, & Jones, 1973) is a self-report
questionnaire that allows the subject to rate his satisfaction on nine aspects
of his marital life (household responsibilities, money management, etc.) and
to give an overall assessment of his happiness within the relationship. The
scores range from 1 to 10, with a higher score indicating a higher level of
marital happiness. The instrument possesses good reliability and discriminant
validity. The Marital Happiness Scale has been found to be highly correlated
(.85) with the Locke-Wallace Marital Adjustment Test (Locke & Wallace,
1973), and inter-item correlations (p < .05 for all correlations) suggest the
presence of an underlying single dimension (Libman, Takefman, & Brender,
1980). The French version of the questionnaire has been demonstrated to
have equally sound psychometric qualities (alpha ranges from .71 to .80)
(Bourgeois, Sabourin, & Wright, 1990).
Pre-Treatment Equivalence
Independent t-tests were conducted to determine if there were any sig-
nificant differences between the experimental and control groups in terms
of sociodemographic variables. The results indicated that the experimental
group participants were significantly younger (t (137) = 2.38, p < .02),
had more children (t (130) = 6.02, p < .0001) and had been living together
for a shorter period (t (125) = 5.09, p < .0001) than their control group
counterparts. There were no significant differences between the two groups
in terms of income or educational level.
Data showed that a randomization of couples to groups at the onset
of the treatment did not produce optimal matching of sociodemographic
variables such as age, children and length of relationship. However, Pear-
son product-moment correlation coefficients established that the correlations
between those variables and the scores on the dependent variables under
investigation were very low. There were no significant correlations between
socioeconomic variables and problem solving self-appraisal scores (range
from .01 to .20), and there was a small relationship between the Marital
Happiness Scales scores and the ages of the men (p < .02). A two-way
analysis of variance was performed on the pretest scores of the experimen-
tal and the control groups to determine if there were any initial differences
between the groups in the self-appraisal of problem solving abilities and
marital adjustment prior to the program. The results indicated that there
were no significant differences between the two groups in problem solving
Impact of Group CBT on Marital Happiness and Self-Appraisal 109
TABLE 1 Means and Standard Deviations of Pretest and Posttest for the Experimental and
the Control Group
Male Female
Group Experimental Control Experimental Control
Time T1 T2 T1 T2 T1 T2 T1 T2
PSI total M 91.3 77.0 86.9 80.9 94.8 82.1 102.5 97.1
SD 23.8 18.5 28.9 26.8 20.7 17.1 21.7 24.8
PSI M 24.7 23.0 26.0 23.5 27.0 22.9 29.0 28.2
Confidence SD 8.9 7.1 10.3 9.1 7.5 6.6 9.5 10.6
PSI M 49.4 39.1 44.1 42.4 48.5 42.5 52.7 50.4
Approach SD 15.1 9.3 15.5 15.2 13.5 10.2 11.9 13.0
PSI M 17.2 15.0 16.7 14.9 19.4 16.6 21.0 18.5
Control SD 5.6 4.3 6.6 5.2 4.3 3.9 4.3 4.4
Marital M 6.3 7.3 6.3 6.6 6.2 6.9 5.9 6.3
Happiness SD 1.3 1.1 1.1 1.4 1.3 1.2 1.5 1.6
Note. M = mean; SD = standard deviation; PSI = Problem Solving Inventory.
self-appraisal (F(3,60) = 0.8, p <.5) or marital adjustment (F(1, 63) = 2.2,
p < 0.14).
Effectiveness of the Program
To determine the effect of treatment and sex on problem solving self-
appraisal and marital satisfaction, three series of analysis of variance were
performed. The means and standard deviations for the men and women of
the experimental and the control groups are presented in Table 1.
MARITAL HAPPINESS SCALE
A 2 (male vs. female) 2 (pre vs. post) 2 (experimental vs. control)
analysis of variance (ANOVA) was conducted on this scale using sex as a
repeated measure because of the interdependence of husbands and wives
scores (Kenny & Cook, 1999). The results indicated a significant main effect
for Time (F(1, 63) = 26.2, p <.01), which was qualified by a significant Group
Time interaction effect (F(1,63) = 4.1, p < .05). There was no significant
Group Time Sex interaction effect. The mean scores revealed that cou-
ples from the experimental group had significantly higher marital adjustment
following the program than couples on the waiting list (see Table 1).
PROBLEM SOLVING SELF-APPRAISAL
First, an ANOVA was conducted on the overall score of the PSI. The results
revealed a significant effect for Time (F(1,64) = 21.8, p < .0001), which
110 C. Belanger et al.
TABLE 2 Means and Standard Deviations of Pre-Waiting Period, Post-Waiting Period, and
Post Program for the Subjects of the Control Group
Male Female
Moment T1 T2 T3 T1 T2 T3
PSI total score 86.5 81.2 71.4 102.9 96.8 84.3
SD 30.0 27.7 22.4 22.6 24.7 25.5
PSI Confidence 25.8 23.8 21.9 29.2 28.3 25.6
SD 10.4 9.3 9.6 9.7 10.8 8.9
PSI Approach 44.2 42.4 37.1 52.9 50.0 42.4
SD 16.0 15.6 11.8 12.4 12.9 13.5
PSI Control 16.5 15.0 12.4 20.8 18.5 16.3
SD 6.8 5.4 4.9 4.4 4.5 5.0
Marital Happiness 6.3 6.5 7.4 5.9 6.2 7.0
SD 1.3 1.3 1.2 1.6 1.5 1.6
Note. T1 = pre-waiting; T2 = post-waiting; T3 = post-treatment; SD = standard deviation; PSI = Problem
Solving Inventory.
was qualified by a significant Group Time effect (F(1,64) = 3.9, p < .05).
The Group Time Sex interaction effect was not significant. Couples who
participated in the program generally appraised themselves as more effective
problem solvers than couples who were on the waiting list.
To further explore the nature of treatment gains, a two-way MANOVA
was conducted on the three problem solving subscale scores. The results in-
dicated a significant main effect for Time (F(3, 62) = 11.16, p< .0001), which
was qualified by a significant Group Time interaction effect (F(3, 62) =
3.11, p < .03). The Group Time Sex interaction effect was not signifi-
cant. Subsequent ANOVAs revealed that, compared to subjects on the waiting
list, spouses who followed the group marital therapy reported a significantly
stronger tendency to approach diverse problem solving activities (F(1, 64) =
7.2, p < .009). However, they did not rate themselves as approaching prob-
lem solving activities more readily or as having more personal control than
the subjects who did not received treatment (see Table 1).
Quasi Replication Analysis
The effect of the program on couples on the waiting list provided an own-
control analysis and represented a partial replication of the study. ANOVAs
with repeated measures were performed on the data with pre-waiting scores,
post-waiting scores and post-treatment scores as the 3 time points. Table 2
summarizes the means and standard deviations for all measures.
The 3 (pre-waiting vs. post-waiting vs. post-program) 2 (male vs. fe-
male) analysis of variance showed a significant main effect of Time for the
Marital Happiness Scale (F(2, 31) = 23, p < .0001), for the overall score
of the Problem Solving Inventory (F(2, 31) = 16, p < .0001), and for all
Impact of Group CBT on Marital Happiness and Self-Appraisal 111
PSI subscales (F(6, 26) = 9, p < .0001). The Time Sex interaction ef-
fect was not significant. To determine the source of these differences, two
series of analyses of variance were conducted. The first analyses assessed
the changes from the pre-waiting to the post-waiting period, whereas the
second provided the evaluation of the effect of the program (post-waiting to
post-program).
The results of the first series of analyses of variance (pre- to post-
waiting) indicated a significant Time effect for marital adjustment (F(1.34) =
7.5, p < .01) and for overall PSI score (F(1, 35) = 8.1, p < .007). At the
second evaluation, waiting list subjects reported a slight increase in mari-
tal adjustment and in the appraisal of their problem solving abilities. The
MANOVA conducted on the PSI subscale scores revealed another significant
Time effect (F(4, 31) = 3.6, p < .02). Subsequent analyses revealed that
subjects reported a significant increase in their problem solving confidence
(F(1, 34) = 11.7, p < .002) following the waiting period (see Table 2).
The second series of analyses, which evaluated the effect of the treat-
ment, demonstrated a significant Time effect for marital adjustment (F(1,
32) = 26.2, p < .0001) and for PSI total score (F(1, 32) = 14.5, p < .001).
MANOVAs conducted on the PSI subscales revealed another significant Time
effect (F(429) = 9.6, p < .001). Univariate analyses demonstrated substantial
changes following the program on all subscales: problem solving confidence
(F(1.32) = 5.2, p < .03), approach to problem solving activities (F(1, 32) =
15.5, p < .0001) and strategies to control their behaviors (F(1, 32) = 2.62, p
< .02). As shown in Table 2, score increments recorded by the group follow-
ing the program were consistently superior to those reported by the same
group during the control period. The data confirm that participation in the
group marital therapy increased marital adjustment and enhanced spouses
self-perceived problem solving efficacy.
Differential Effectiveness of the Program
To investigate the effects of group marital therapy on spouses who appraise
their problem solving as either effective or ineffective, three 2 (PSI: effective
vs. ineffective) 2 (pre vs. post) analyses of variance were conducted on the
Marital Happiness Scale and on the Problem Solving Inventory (total score
and subscales). Because the analyses require a within-group comparison,
experimental and control group data were combined to examine the changes
from pre- to post-program. Because men and womens Problem Solving
scores had different distributions (respectively, 33 to 161 and 47 to 154), and
because they differed significantly from one another (F(1, 61) = 9.8, p <
.003), analyses were conducted separately for the sexes using the split half
overall PSI score of both groups (men = 83 and women = 94) to subdivide
them into effective and ineffective PSI scorers.
112 C. Belanger et al.
TABLE 3 Means and Standard Deviations of Pre-Program and Post-Program for Effective and
Ineffective Scorers
Male Female
Group Ineffective Effective Ineffective Effective
Time pre post pre post pre post pre post
PSI total M 104.3 81.5 64.5 65.4 112.6 92.4 77.5 73.1
SD 20.0 21.3 12.6 16.2 16.9 23.7 10.8 13.7
PSI M 28.7 23.9 18.9 20.6 33.6 27.1 21.2 21.4
Confidence SD 9.1 8.8 5.5 7.9 8.6 9.3 4.5 4.7
PSI M 56.7 42.6 32.9 32.7 58.5 47.7 39.2 36.6
Approach SD 12.3 10.4 6.7 8.3 9.4 12.8 8.0 7.5
PSI M 18.9 15.0 12.7 12.0 20.5 17.7 17.1 15.1
Control SD 5.1 5.1 4.1 3.8 12.8 4.4 4.0 4.2
Marital M 6.2 7.3 6.6 7.4 5.9 6.7 6.5 7.1
Happiness SD 1.3 1.3 1.2 1.3 1.4 1.5 1.3 1.2
Note. M = mean; SD = standard deviation; PSI = Problem Solving Inventory.
MARITAL HAPPINESS SCALE
The results indicated an absence of a significant difference between the
effective and ineffective scorers on the Marital Happiness scale (respectively,
for men and women, F(1, 61) = .66, p < .3); F(1, 61) = .38, p < .5)). The
mean scores revealed that both groups of men and women (effective and
ineffective scorers) reported similar improvement in their marital satisfaction
following the program (see Table 3).
PROBLEM SOLVING INVENTORY
Analyses of the Problem Solving Inventory total scores revealed a significant
PSI Group Time effect for men (F(1, 61) = 18.55, p < .0001) and women
(F(1, 61) = 11.05, p < .001). Following the program, women who initially
perceived themselves as ineffective problem solvers reported more changes
in the overall appraisal of their problem solving abilities than women who,
before the program, perceived themselves as effective problem solvers. Sim-
ilarly, men who initially appraised themselves as ineffective problem solvers
reported more improvements in their overall PSI score following the program
than men who initially perceived themselves as effective problem solvers
(see Table 3).
The results of the MANOVAs conducted on the Problem Solving Inven-
tory subscales revealed a significant PSI Group Time effect (F(3, 59) =
6.26, p < .001) for women and for men (F(3, 59) = 6.2, p < .001). Univari-
ate analyses of variance conducted on the group of women indicated that,
following the program, women who initially appraised themselves as inef-
fective problem solvers noted more improvement in their problem solving
Impact of Group CBT on Marital Happiness and Self-Appraisal 113
confidence (F(1, 37) = 9.3, p < .004) and in their approach to problem solv-
ing activities (F(1, 37) = 8.03, p < .007) than women who initially appraised
themselves as effective problem solvers. The two groups of women (effective
and ineffective) did not differ, however, in their perceived personal control
following the treatment (see Table 3).
As for the men, subsequent univariate analyses indicated that only the
ineffective problem solvers reported improvement in their problem solving
confidence (F(1, 61) = 10.5, p < .002), in their approach to problem solving
activities (F(1, 61) = 18.4, p < .0001) and in their personal control (F(1, 61) =
9.4, p < .004) following the program (see Table 3).
DISCUSSION
The results of this study generally support the hypothesis that couples
marital happiness increases significantly following participation in cognitive-
behavioral group marital therapy (Baucom, Epstein, Kirby & LaTaillade, 2010;
Butler, Chapman, Forman, & Beck, 2006). Furthermore, the program was
shown to significantly alter spouses appraisal of their problem solving effi-
cacy. More specifically, the results indicated that, following the intervention,
partners reported a significant improvement in their capacity to confront dif-
ferent problem solving activities. Moreover, in the analyses that measured
their perception of control, all measures demonstrated a significant change
in the expected direction. After completing the program, spouses appraised
themselves as having more confidence in their problem solving capacities, a
stronger tendency to face problem solving activities rather than avoid prob-
lems, and better personal control of their behaviors while solving problems
related to their dyadic interactions. Both the experimental versus control
group analyses and the perception of control analyses yielded substantially
similar results. Although from the perception of control analyses, there was
a significant change in some variables from the pre- to post-waiting period,
the impact of the treatment was made clear by the important gains in all
measures from post-waiting to post-program. This small initial gain between
the pre- and post-waiting period could have been due to habituation to the
testing situation and to the instruments and does not challenge the efficacy
of the treatment.
The results also suggest that the program helped couples improve their
marital adjustment independently of how they initially appraised their prob-
lem solving abilities. However, the results indicate that cognitive-behavioral
group marital therapy had a differential effect on the improvement of self-
perceived problem solving capacities depending on the sex of the partic-
ipant and on the initial self-appraisal of his/her problem solving abilities.
Generally, the program had a favorable impact on womens perception of
self-efficacy, and women who initially perceived themselves as ineffective
114 C. Belanger et al.
problem solvers reported even more positive changes following the program
than those who initially appraised themselves as effective problem solvers.
As for men, only those who initially appraised their problem solving abili-
ties as ineffective reported improvement in their problem solving appraisal
after completion of the program. However, as was the case for women, the
program was less useful in helping men who initially perceived themselves
as effective problem solvers to change their cognitions.
These results suggest that cognitive-behavioral
