The American Journal of Family Therapy, 36:229–241, 2008
Copyright © Taylor & Francis Group, LLC
ISSN: 0192-6187 print / 1521-0383 online
DOI: 10.1080/01926180701290941
The Relationship Between Stages of Change
and Outcome in Couple Therapy
RACHEL B. TAMBLING and LEE N. JOHNSON
University of Georgia, Department of Child and Family Development, Athens, Georgia, USA
Individuals who present for couple therapy may not be equally pre-
pared to change. To explore the impact of readiness to change in
couple therapy, this study examined the relationship between indi-
vidual stage of change, dropout, and therapy outcomes in a sample
of 469 individuals from 290 couples in marital therapy. Findings
indicated that women were more distressed and more motivated to
change than men, and that men were more variable in terms of
readiness to change. Individual stage of change was unrelated to
dropout or outcome.
INTRODUCTION
Researchers in the field of marital therapy have long been interested in un-
derstanding for whom therapy works and why. Despite these efforts, marital
therapy researchers continue to report significant dropout rates, high inci-
dences of early termination from therapy, and limited effect sizes (Shadish
& Baldwin, 2003). One explanation for these results is that couples often
present for therapy reporting unequal levels of distress and, subsequently,
differing readiness for change (Doss, Atkins, & Chritensen, 2003). To better
understand how couples’ varying levels of distress and readiness to change
affect outcomes in therapy, the present study examined the relationship be-
tween distress, readiness to change, premature dropout, and outcome.
Stages of Change
One framework for conceptualizing readiness to change is the Transtheoret-
ical Model (Prochaska & DiClemente, 1983). This model has been applied
to client motivation with a variety of problem behaviors and describes client
Address correspondence to Rachel B. Tambling, Department of Child and Family Devel-
opment, University of Georgia, Athens, Georgia 30602. E-mail: tambling@uga.edu
229