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Randomly selected samples of practicing couple therapists who were members of the American Psychological Association's Division 43 or the Association for Marriage and Family Therapy completed a survey of couple problem areas and therapeutic issues encountered in couple therapy. Therapists rated problem areas in terms of occurrence, treatment difficulty, and damaging impact. A composite of these 3 dimensions suggested that the most important problems were lack of loving feelings, power struggles, communication, extramarital affairs, and unrealistic expectations. Comparison of the findings with therapist ratings obtained by S. K. Geiss and K. D. O'Leary (1981) suggests considerable stability in presenting problems in couple therapy over the past 15 years. Therapist-generated characteristics associated with negative outcome were also identified, the most common being partners' inability or unwillingness to change and lack of commitment.
Whisman et al. (Mon,) studied this question.