The Clinical Representativeness of Couple Therapy Outcome Research JOHN WRIGHTw STEL PHANE SABOURINz JOSIANNE MONDORw PIERRE MCDUFFw SALIMA MAMODHOUSSENz n The clinical representativeness of outcome studies is defined as the generalizability of recruitment processes, assessment/diagnostic procedures, treatment protocols, and therapeutic results from research settings to naturalistic treatment settings. The main goal of the present study was to examine the clinical representativeness of couple therapy in outcome studies. The data set was formed by 50 published clinical trials, including 34 couple therapy outcome studies for marital distress (CTMD) and 16 couple therapy outcome studies for comorbid relational and mental disorders (CTMD þ C). The present findings showed that, overall, the clinical representativeness of couple therapy outcome studies is only fair (i.e., the mean global score is slightly lower than the midpoint of the rating scale used to assess representativeness). CTMD þ C studies fared better than CTMD studies on many dimensions of clinical relevance. Studies in which pretherapy training was less intensive (for CTMD studies only), treatment was less structured, and therapists were more experienced showed larger effect sizes than those in which such was not the case. Keywords: Couple Therapy; Marriage Counseling; Treatment Effectiveness; Clinical Representativeness; Effect Size Fam Proc 46:301–316, 2007 Family Process, Vol. 46, No. 3, 2006 r FPI, Inc. 301 n Medical Clinic, National Defence, Montre´al Garison, Montre ´al, Que ´bec, Canada. This research was supported in part by grants to John Wright, Ste´phane Sabourin, and Yvan Lussier from the Fonds que ´be´cois de recherche sur la socie ´te´ et la culture and from the Centre de recherche inter- disciplinaire sur les proble`mes conjugaux et les agressions sexuelles. We thank He´le `ne Poitras-Wright, Danielle Lefebvre, and Ge´rald Coˆte´, clinical researchers associated with the Centre de recherche inter- disciplinaire sur les proble`mes conjugaux et les agressions sexuelles, for their contribution to our analyses of the clinical representativeness of couple therapy outcome studies. Correspondence concerning this article should be addressed to John Wright, De´partement de psychologie, Universite ´ de Montre ´al; Case Postale 6128, Succursale Centre-Ville, Montre´al, Canada, H3C 3J7. E-mail: john.wright@umontreal.ca wDe ´partement de psychologie, Universite´ de Montre ´al [Department of Psychology, University of Montre- al], Que´bec, Canada. zE ´ cole de psychologie, Universite´ Laval [School of Psychology, Laval University], Que ´bec, Canada.