Introducing the Expectations and Preference Scales for Couple Therapy (EPSCT): Development, Psychometric Evaluation, and Suggested Use in Practice and Research

• Published date: 01 December 2019
• DOI: http://doi.org/10.1111/famp.12446
• Author: Silvia Re,Christopher Quinn‐Nilas,Hannah Muetzelfeld,Olga Smoliak,Myrna L. Friedlander,Kimberly F. Colvin
• Date: 01 December 2019

Introducing the Expectations and Preference Scales

for Couple Therapy (EPSCT): Development,

Psychometric Evaluation, and Suggested Use in

Practice and Research

MYRNA L. FRIEDLANDER*

HANNAH MUETZELFELD*

SILVIA RE*

KIMBERLY F. COLVIN*

CHRISTOPHER QUINN-NILAS

†

OLGA SMOLIAK

†

While it is known that client factors account for the largest proportion of outc ome vari-

ance across treatment modalities, little is known about how clients’ characteristics affect

the process and effectiveness of couple therapy. To further knowledge in this area, we cre-

ated a brief, practice-friendly measure, the Expectation and Preference Sc ales for Couple

Therapy (EPSCT). Three self-report scales assess clients’ Outcome expectations (e.g., I

expect our relationship to improve as a result of couple therapy) and role expectations for

Self (e.g., I expect to listen to my partner’s concerns) and Partner (e.g., I expect my partner

to blame me). Three Cognitive-Behavioral, Emotionally Focused, and Family Systems pref -

erence scales use a forced-choice format to measure the comparative strength of respon-

dents’ preferences for interventions broadly reflective of each approach. A large item pool

was developed from relevant literature and clinical experience and refined based on face

and content analyses with two panels of experienced couple therapists and researchers.

Across four studies with 1,175 participants, the scales’ internal consistency reliabilities

were similar and their construct validity was supported with confirmatory factor analyses

and significant correlations with several established measures, including expectation mea-

sures developed for individual psychotherapy and measures of attitudes toward profes-

sional help seeking and valuing personal growth. Across all studies, participants had

stronger role expectations for themselves than their partners, although gender effects dif-

fered by sample. We discuss how to use the 15-item EPSCT in clinical practice and in

future research as a predictor of couple therapy processes and outcomes.

Keywords: Couple therapy; Role expectations; Outcome expectations; Preferences; Marital

therapy

Fam Proc 58:855–872, 2019

*Department of Educational and Counseling Psychology, University at Albany/SUNY, Albany, NY.

†

Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada.

Correspondence concerning this article should be addressed to Myrna L. Friedlander, Department of

Educational and Counseling Psychology, Education 220, University at Albany/SUNY, 1400 Washington

Avenue, Albany, NY 12222. E-mail: mfriedlander@albany.edu.

An earlier report of this research program was presented at the 2017 annual conference, Society for

Psychotherapy Research.

855

Family Process, Vol. 58, No. 4, 2019 ©2019 Family Process Institute

doi: 10.1111/famp.12446

“Alys” makes an initial appointment for couple therapy and then warns the therapist,

“Just so you know—my husband doesn’t want to come. He won’t say much of any-

thing to you, but he’ll come ‘cause I’m forcing him to. I told him: ‘You choose—divorce

mediation or therapy.’ I had to insist—in fact, I had to ask him five times—‘cause he won’t

commit to anything. And that’s a big part of the problem. But finally he chose therapy!”

Another woman, “Beatrice,” is quite demoralized over the state of her 40-year marriage.

In calling for an appointment, she explains: “You should know, though, we tried couples

counseling once before for a few weeks, and it didn’t work. My husband charmed the ther-

apist (like he does everyone else!) and so it was all about how amazing he is. I didn’t say

much. That therapist didn’t have any interest in what Iwas feeling.”

These women had different expectancies for whether couple therapy might make a dif-

ference in their lives. They also had different expectations about their spouses’ responses

to treatment. Although Alys was optimistic about the potential helpfulness of couples

work, she needed to pressure her husband to participate in the therapy and had low expec-

tations for his engagement. Beatrice was ambivalent due to the couple’s previous failed

attempt at couple therapy. Based on that experience, she felt a need to warn the therapist

that her husband would likely dominate the process.

To date, there has been no research on how these kinds of role and outcome expectan-

cies affect romantic partners’ willingness to seek professional help or their motivation to

make relational changes. Nor is there any evidence about how partners’ personal charac-

teristics and relationship dynamics affect their expectations for alliance development, in-

session behavior, or treatment success. Although client factors definitively account for the

most variability in therapy outcomes (Wampold & Imel, 2015), aside from gender,

researchers have yet to determine the personal characteristics of clients that carry the

most weight in couple therapy. The present research program examined two characteris-

tics: client expectations and treatment preferences.

The critical importance of client expectations, including hope for change, as a common

treatment factor has long been acknowledged (Frank, 1961). Indeed, a review of this

research concluded that “expectations may be even more vital to the psychotherapy pro-

cess than is often acknowledged” (Greenberg, Constantino, & Bruce, 2006, p. 657). Since

positive expectations—for example, that therapy will be helpful, that the process will be

smooth—contribute significantly to the success of individual psychotherapy (Constant ino,

Visla, Coyne, & Boswell, 2018), we reasoned that due to the complexity of romantic part-

nerships, expectancies are likely to be just as influential in couple therapy, if not more so.

For instance, each of the women in the preceding examples spontaneously told the thera-

pist how she expected the process to unfold. For different reasons, both women anticipated

that therapy with their husbands would be rough going.

Moreover, these women had starkly different outcome expectations. Knowing Alys’s

hopeful expectations, the therapist

1

spent some time during the first session to connect

with and engage her husband. The therapist explained her role as a neutral one and

expressed a desire to help both partners identify what they would need from each other in

order to stay married. In her initial session with the other couple, the therapist elicited

Beatrice’s complaints about her husband’s attitude, coached him to respond to her con-

cerns nondefensively, and then asked each person to describe the positive aspects of their

longstanding marriage. The therapist’s different approach to each couple was aided by the

(unsolicited) expectations of the two referring clients.

Recognizing that many couples begin therapy with starkly different expectations for

the process and outcome of treatment, we decided to develop a brief, practice-friendly mea-

sure, which we named the Expectation and Preference Scales for Couple Therapy

1

The therapist who saw these couples was the first author.

www.FamilyProcess.org

856

/

FAMILY PROCESS