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L o v e ,  S e x  &  H e a l t h
The Marriage Savers
Does couples therapy really work? The divorce rate says no, but a new breed of therapists offers hope


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January 19, 2004 Health
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The cynic Ambrose Bierce defined love as "a temporary insanity, curable by marriage." It's truer to say the first blush of love is a vacation from reality; marriage is the job you return to. You may like your job, even love it. But you have to work to keep it.

In modern America, there's no shortage of professionals ready and willing to pitch in with the task. In fact, over the past 40 years, the couples-counseling business has exploded. In 1966 there were only about 1,800 experts practicing in the field, according to the Department of Health and Human Services. In 2001 the American Association for Marriage and Family Therapy listed 47,111 marriage and family therapists in the U.S. and estimated that they treat 863,700 couples a year.

Yet how many were helped? The growth of the marriage-industrial complex has not done much to slow the national divorce epidemic. In 1965 the divorce rate was 2.5 per 1,000 people; it reached a high in 1979 and 1981, with 5.3 per 1,000. Today the figure hovers at about 4.0, pretty much where it has been for five years. In some quarters, the suspicion has lingered that the therapist's job is to validate a patient's complaints and act as ministers in reverse, putting couples asunder. "The idea of therapist neutrality often came down to support for breaking up," says William Doherty, director of the Marriage and Family Therapy Program at the University of Minnesota. And therapists weren't appreciated for it. In a 1995 Consumer Reports poll, couples seeking therapy gave marriage counselors low grades for competence.

Lately, however, a new breed of therapist and "marriage educator" is shaking up the profession. These therapists reject the passive, old-style therapies that emphasize personal growth over shared commitment and take a more aggressive, hands-around-the-neck approach to saving marriages. "They feel therapists have been too quick in calling an end to relationships and having people move on," says University of Chicago sociology professor Linda Waite. The new breed also advocates premarital skill training and early intervention in problems—learning the ropes before tying the knot. "It's like a vaccination," says Waite, "instead of having to do surgery when something goes wrong."

The new, pro-marriage generation "is young, far more conservative and more religious" than traditional therapists, says Doherty, author of Take Back Your Marriage. "This generation has seen the fruits of the divorce revolution. And they don't think they have to be value-neutral about it." They also tend to be pragmatists. Many of them favor short-term, low-cost interventions based on methods with a record of proved success.

These qualities have drawn the support of religious leaders and conservative politicians, including First Husband George W. Bush, who would like to make marriage education for young couples part of welfare reform. "This is a social movement," says Doherty, "that involves government, church, professional and lay people." How do these therapies and lessons in connection work? A look at some methods of the movement:

GOING TO "PREP" SCHOOL

PREP, short for Prevention and Relationship Enhancement Program, aims to be the industry leader in research-based couples education. Its tenets, which emphasize structured communication, are ingredients in a variety of programs for teens, pre-marrieds and long-marrieds.

Rod Grimm Lewis and his wife Victoria paid $400 to attend a two-day PREP seminar in Los Angeles in a final attempt to save their 28-year-old marriage. "I think this will help," says Victoria, the more eager of the two. "I think of it as chemotherapy." Rod figures he's being a good sport. "I came because she asked me to," he says. "I'm about 5% of the problem, and she's 95%." Marc Sadoff, the workshop leader, says, "It's good to hear that you can acknowledge you're 5%. So many people can't see any role in the problem."

Positive communication, like Sadoff's comment, is the backbone of PREP, developed in the 1980s by psychologists Howard Markman and Scott Stanley, co-directors of the Center for Marital and Family Studies at the University of Denver. In developing it, Markham spent years taping couples having arguments and devising ways to break bad habits. The method, which relies partly on videos of other couples using the technique, is continually tweaked in light of new research, says Stanley. "The idea was to build a program for couples that was based on sound research," he says, "rather than armchair clinical speculation."

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