A Controlled Trial of Couples Group Counseling in Cardiac Rehabilitation

Fifty-eight married patients who had documented coronary artery disease and were enrolled in an outpatient cardiac rehabilitation program participated in a multicenter controlled trial comparing the effects of group counseling on psychosocial adjustment with and without spousal participation. The experimental intervention involved a ten-week series of weekly group sessions based on symbolic interactionist role theory. Data were collected at baseline, ten weeks, and six months after beginning counseling. Repeated measures analysis of variance documented significant differences among groups in patients' self-esteem (P <.01), with the highest increase in self-esteem occurring in the patient group who met without spouses and the only sustained decrease occurring in the control group. Anxiety, anger, and depression scores significantly decreased over time for all three groups (P <.05). Although the differences were not statistically significant, the patients who participated in the couples group counseling intervention reported the greatest decreases in these three affective states at the six-month follow-up. Results suggest that a group counseling program can be an effective component of outpatient cardiac rehabilitation by enhancing the long-term psychologic adjustment of the cardiac patients. However, the anticipated positive effect of spousal participation was not documented.