A study of two marital enrichment programs and couples' quality of life.
To effectively address the increase in marital distress present in today's society, researchers must identify factors that contribute to success in marriage. Because marital conflict is almost a given for contributing to marital distress (Stanley, Markman, St. Peters & Leber, 1995), the majority of available research has been devoted to conflict resolution and communication skills (Pasch & Bradbury, 1998). Conflict aside, it appears that there is a natural decrease in marital quality that occurs over time, particularly in the first four years of marriage (Kurdek, 1998). However, several empirically supported key components have been identified as influences of relational integrity. These components include (but are not limited to) intimacy, positive and negative behaviors, and the reality of human fallibility.
Enrichment As Prevention
There is a growing concern regarding how to address marital distress in a preventive manner (Hahlweg, Markman, Thurmaier, Engl & Eckert, 1998). Although marital enrichment was originally designed to be a "marital booster" of sorts (Diskin, 1986), it is now applied as a preventive measure as well as an aid in the reduction of marital distress. In fact, some researchers are finding that many couples who report poorer marital adjustment initially have a tendency to show greater improvement after participating in some marital enrichment programs (Giblin, Sprenkle, & Sheehan, 1985; Noval, Combs, Wiinamaki, Bufford & Halter, 1996). The movement of the psychological field towards managed care has birthed a generation of research dedicated to discovering factors that prevent chronic problems as well as influence therapeutic outcome. Focusing the efforts of professional counselors on the training for and practice of the most effective, short-term mental health care as indicated by research is a valuable endeavor (Hahlweg & Markman, 1988; Lipchik, 1994; Worthington, 1996; Wylie, 1990). This is especially true of marital counseling and enrichment, which typically receives relatively little funding by insurance companies. Short-term or brief therapy dictates that therapists empower those with whom they work, giving them generalizable skills necessary to respond effectively to difficult situations. Following this guideline (whether intentionally or unintentionally), many marital enrichment programs provide the couple with tools designed to enhance the marital relationship (Hawley & Olson, 1995) and, in turn, one's overall health, or quality of life. In addition, although marital enrichment was not originally designed for couples facing serious marital problems, more current applications have included couples who do have significant conflict (Noval et al., 1996; Zimpfer, 1988).
Although couples who have been married various lengths of time may enjoy benefits from spending time focused on improving their relationships, it seems important to study couples in various stages of marriage to assess when this kind of intervention might be most effective. Hawley and Olson (1995) stress that providing the newlywed population with marital enrichment may produce positive results in areas that are unique to this group, as they are just beginning to adjust to the marital relationship and beginning to form ways of relating and communicating to one another and problem-solving. Such a crucial period may benefit from the skills that quality marital enrichment programs have to offer. In fact, newlyweds are generally very committed to the relationship and commitment can play a role in how willing people are to work on the relationship as well as how likely they are to overlook or forgive offenses (Finkel, Rusbult, Kumashiro & Hannon, 2002).
Format and Approach
Each marital enrichment program follows its own protocol, which sometimes includes having the partners meet as a couple with a consultant who provides enrichment information, or having them meet in a group with other couples. The sessions may emphasize individual needs for both spouses, communication skills, and education for problem resolution, as well as a more positive perception of the marriage from the spouses' perspectives (Zimpfer, 1988). Often, couples spend significant time learning and rehearsing specific skills designed to improve communication, problem-solving or intimacy (Ford, Bashford & Dewitt, 1984; Stanley et al., 1995; Worthington, Hight, Ripley, Perrone, & Kurusu, 1997). Zimpfer (1988) organized marital enrichment programs into three categories: those that provide a diversity of information, those that focus on communication, and those that require behavioral change from both partners.
Until recently, the role of forgiveness in healing has been, for the most part, neglected by the psychological community. In contrast to this neglect, religion has typically promoted forgiveness as a desirable act that can lead to mental, emotional, and spiritual freedom for the giver. Therefore, there are really two separate conceptualizations of forgiveness that must be considered: forgiveness from a scientific perspective as well as forgiveness from within religious tradition. Not only has forgiveness been neglected in the therapeutic/empirical community, but Gorsuch and Hao (1993) report that most of the available writings on forgiveness emphasize a religious context from a theoretical stance only, not as a focus of empirical research.
Currently, the available research on the therapeutic value of forgiveness is increasing. An act that has almost exclusively been associated with religious commitment as a commandment and a value is now being studied as a contributing aspect of mental and physical health (Witvliet, 2001). Researchers seem to agree that this is a concept and a behavior that can be taught and strengthened in psychoeducational or therapeutic settings as empathy is encouraged (Freedman & Enright, 1996; McCullough & Worthington, 1995; McCullough, Worthington, & Rachal, 1997). Hopefully, choosing not to pursue revenge either behaviorally, cognitively, or emotionally is a skill that can be learned or adapted into one's nature as it is repeatedly performed under differing circumstances. In the optimal situation, once forgiveness is offered, reconciliation may then be sought, but may not be pursued if it is an emotionally or physically unsafe situation to reconcile or if the situation does not allow for restoration due to circumstances such as death or loss of contact (McCullough et al., 1997; Worthington & DiBlasio, 1990).
Worthington (1998) described forgiveness as an act that evolves from empathetic feelings for the transgressor as well as humility on the part of the forgiver as he or she recognizes his or her own fallibility. Forgiveness is not an optional strategy to reach healing and/or restoration. Its benefits have been hailed as essential for recovery from small and larger hurts that are inevitable (Hope, 1987; Fitzgibbons, 1986); forgiveness has, therefore, been deemed a worthy goal in therapeutic settings (DiBlasio & Benda, 1991). Research suggests that people who forgive feel freer, experience less stress and have a unique sense of peace (DiBlasio & Benda, 1991; Witvliet, Ludwig & Bauer, 2002). In retrospect, those who forgive frequently view the decision to do so as life-changing. Furthermore, the repentant ones experience emotion and physiological benefits as well. Unfortunately, therapists are often hesitant to implement forgiveness into treatment. Various authors have hypothesized about reasons for this hesitation, such as the lack of an established empirical strategy or model, the limitations of research regarding ability to support religious tenets, or the wariness that professionals may feel due to ethical guidelines regarding religious influences in therapy (DiBlasio & Benda, 1991; Hope, 1987).
Anger and bitterness over past hurts do not promote healing of relationships. In fact, unforgiveness, for whatever reason, allows extraneous control of the individual's fluctuations of affect, intimacy of relationships and spiritual growth (Wahking, 1992). When a husband and wife have experienced either a number of small offenses or one or more large ones, in order to continue successfully in their marriage they must learn and make use of means to accept one another's faults, recognize that mistakes will be made, actively forgive one another and allow their commitment to one another and to the marriage to overshadow the anger and hurt and repair the relationship (Witvliet et al., 2002). This is not to negate the fact that some issues do require counsel and behavioral changes on the offender's part, especially if there is emotional or physical harm. However, daily coping requires that couples be able to deal with the past effectively, so that they can continue growing and moving forward in their relationship. Gordon and Baucom (1998), like McCullough and Worthington (1999), suggested that forgiveness encompasses cognitive, emotional, and behavioral aspects of one being. They continued by proposing that people have an inherent need to engage in the forgiveness process, particularly in the marital dyad.
Quality of Life
One way in which the overall impact of marital enrichment programs can be assessed is through changes in the way each person views his or her level of satisfaction, happiness, or quality of life (Diener, 1984). As mentioned previously, trends in current research attest to the fact that empirical findings are highly valuable in the determination of effective versus non-effective techniques. However, researchers seem repeatedly focused on pathological populations, often neglecting problems that may not be considered clinically significant, but that still influence an individual's degree of happiness, and therefore the individual's well-being. Yet many theorists (e.g., Bradburn, 1969; Cowen, 1991; Frisch, Cornell, Villanueva, & Retzlaff, 1992) have suggested that personal happiness and life satisfaction are essential factors of good mental health and adjustment, and should be regarded as valuable information when evaluating outcomes. In fact, Cowen (1991) described happiness or 'wellness' as an aspiration that exists in degrees along a linear progression and states that it can be positively or negatively influenced by various circumstances.
Interest in happiness and the effects of subjective well-being are by no means limited to the psychological field, but include (although are not limited to) economics, sociology, political science, theology, and biology. Hadaway and Roof (1978) examined the relationship between religious commitment and quality of life. In light of the view that religion is a positive influence that enables the individual to enhance his or her perception of life, they found that religious commitment was positively associated with quality of life. Their definition of religious commitment included religious meaning and religious belongingness, although they noted that the latter was important, but had less effect on quality of life than did the first. Religious meaning, particularly in American society, seems to enable people to have more positive perspectives of life in general. This perspective leads to higher self-perceptions of one's quality of life.
Frisch (1994), in response not only to the need for an empirically validated measure for subjective well-being, but also for a theoretical framework regarding the concept of quality of life, has done extensive research in order to develop a model that can be used in clinical settings. In the manual that accompanies his assessment measure, the Quality of Life Inventory (QOLI[R]), Frisch (1994) delineates his theory regarding quality of life in relation to common clinical disorders such as depression and anxiety. By addressing various domains of life and very specific problems (as seen by the client), the therapist is able to focus on the issues that are most distressing (to the client) first, and formulate a more complete treatment plan. This theory is rooted in the idea that a negative perception of oneself can, in many instances, be a significant factor in mental health issues (e.g. depression).
Because Frisch's QOLI (1994) will be used in this study, it seems appropriate to utilize his definition as well. He states that quality of life "refers to a person's subjective evaluation of the degree to which his or her most important needs, goals, and wishes have been fulfilled" (Frisch, 1994, p. 2). This definition allows for the personalization of each variable, allowing each individual to assign a value to various needs and goals.
Of course, one must also examine the limitations and problems encountered with such variables. As noted previously, there is often considerable divergence between the individual's perception of well-being and any objective data that may be collected, simply due to the nature of the data. This issue is often related to concern regarding reliability or methodological problems one might encounter (Bradburn, 1969). Strupp and Hadley (1977) suggest that such problems can be avoided by examining data in the correct context, and offer the following distinctions:
The individual client evaluating his own mental health uses a criterion distinctly different from that used by society. The individual wishes first and foremost to be happy, to feel content. He thus defines mental health in terms of highly subjective feelings of well-being-feelings with a validity all their own. Some individuals will experience contentment coincident with behavioral adaptation, and there will thus be agreement by the individual and society that he is mentally sound. But the agreement is, nonetheless, between independent evaluations made from different vantage points, and it is thus quite conceivable that an individual may define himself as mentally sound quite independent of society's or the mental health profession's opinion. (pp. 188-189)
In spite of the potential disagreement between objective and subjective data, examining them as "independent evaluations" allows researchers to more accurately assess and apply the information.
THE PRESENT INVESTIGATION
Based on the assumption that one's personal feeling and understanding of his or her life satisfaction can be a powerful element in one's well-being, self-report data becomes very important in understanding happiness and quality of life. In fact, it is the primary method of collecting information pertaining to the perspective and feelings of the individual. This current exploratory pilot study uses such self-report data to identify the impact that marital enrichment programs and changes in marital interactions have on one's quality of life. This expectation of change in quality of life is based on the assumption that communication, forgiveness, religious commitment, hope, and intimacy all influence the quality of one's life. If this assumption is true, then this study may lead to further research regarding factors in marriage that can improve overall quality of life or well-being.
Through self-report data and statistical analyses, the following questions were addressed: (a) Because of the aforementioned psychological health that is often prompted by the act of forgiveness, does the disposition to forgive have a positive effect on quality of life? (b) Because forgiveness is often thought of as a religious value, do individuals with higher levels of religious commitment also have higher quality of life in both pre- and post-tests? (c) Does participation as a couple in one of the two marital enrichment programs raise the individual's overall quality of life? (d) Will the greatest positive change in quality of life occur in the group participating in the forgiveness-based marital enrichment or in the hope-focused marital enrichment?
It was believed that those individuals who have higher dispositions to forgive would score higher on the QOLI than those who were less likely to forgive. Because forgiveness is often thought of in relation to religion, it was also predicted that individuals who have greater religious commitment would have a higher quality of life than those who are less religiously committed. Furthermore, it was expected that couples going through the interventions will experience an enhanced quality of life in the post-testing. In addition, it was also predicted that the marital enrichment program that contains the forgiveness aspect would produce higher quality of life in individuals, due to the healing nature of the component.
A total of 20 couples (N=40, half males and half females) participated in this pilot study. The average age of the overall sample was 26.8, with a standard deviation of 5. The minimum age of the sample was 20 and the maximum age was 40. The total time married averaged 4.1 months at the initial assessment: the minimum time married was two months and the maximum time married was 7 months. Of the 40 participants, 87.5% were European American (n = 35), 2.5% African American (n = 1), 2.5% Hispanic (n = 1), and 7.5% other (n=3).
Participants were randomly assigned to one of three groups. The number of couples in each group who completed both the pre-test and post-test were as follows: 8 in the Hope-Focused treatment group, 7 in the Forgiveness and Reconciliation through Experiencing Empathy (FREE) treatment group, and 5 in the control group. The mean length of time married at the initial assessment varied for each group. For control couples, length of time married averaged 3 months (M = 3, SD = 1). For Hope-Focused couples, M = 4.8 months (SD = 1.5). For FREE couples, M = 3.9, (SD = 1.7). An Analysis of Variance (ANOVA) was used to compare the length of time married for couples in each of the three groups. The ANOVA was not statistically significant, F(2, 17) = 2.23, p = .13, but the results may suggest a substantive difference.
This was a 3 x 2(S) (Intervention x Time [S]) within-subjects design with pre-test and post-test measures. Subjects were randomly assigned into one of two treatment conditions and the control condition. The first treatment condition received a marital enrichment program that emphasized forgiveness (FREE). The second treatment condition received a hope-focused (Hope-Focused) marital enrichment program. The control condition received no marital enrichment training (condition 3). The dependent variable examined in this study was quality of life.
Measures that were used included the QOLI, the Trait Forgiveness Scale (TF-48), and the Religious Commitment Inventory-10 (RCI-10). Frisch (1993) developed the QOLI in order to address life-satisfaction in a more specific, domain-based approach, and the clinical validation of the QOLI was published in 1992 by Frisch et al. They described the development of the QOLI, the procedures to be followed, and the results for both reliability and validity.
Frisch's QOLI (1994) is a health-focused (rather than disease- or symptom-focused) subjective measure of well-being that is intended to be a supplementary assessment tool to gather valuable information regarding current and future health status, prognosis, and therapeutic and medical outcome. According to Frisch, "The QOLI is based on an empirically validated model of life satisfaction and subjective well being which is then incorporated into a model of depression and related disorders" (p. 4). One should note that this is a domain-based test and the areas covered are weighted in importance (to the individual) in the scoring process, thus leading to a more accurate measure of overall satisfaction.
The score for the QOLI is derived by multiplying the importance rating for each domain by the client's reported satisfaction for that same domain, resulting in a "weighted satisfaction." These resulting scores are added (positive and negative scores can be added separately), and then the negative scores are subtracted from the positive scores. The total is then divided by the number of domains rated by the reporter, and the product of this calculation is the QOLI raw score. In addition, percentile ranks, T scores, and overall quality of life scores are available from the manual.
The TF-48 is a forty-eight item self-report measure that was designed to assess dispositional forgiveness (also known as forgivingness). Since this study was conducted, the TF-48 has been reduced to the TF-10 (See Berry, Worthington, O'Connor, Parrott & Wade, 2000, for a more extensive explanation of this transformation). This reduction was based on the fact that 10 of the already existing items on the TF-48 were empirically determined to be directly correlated with dispositional or trait forgiveness. As a result, these 10 items were extracted from the TF-48 and entered into the analyses. The 10 items remaining are now known as the Trait Forgivingness Scale (TFS). This measure is intended to assess a person's tendency to forgive others. As a self-report measure, this instrument allows the participant a subjective interpretation of forgiveness.
The Religious Commitment Inventory-10 (RCI-10) is a 10-item self-report questionnaire designed to evaluate the individual's commitment to religious values. The reliability and validity of the RCI was originally evaluated as a 17-item inventory with 155 volunteers and was compared to other measures of religiosity and morality (Worthington et al., 1998). It was then reduced to just 10 items.
The interventions used in this study were two marital enrichment programs: Hope-Focused, and FREE.. These particular programs consist of a compilation of psychoeducational material available from current empirical research and techniques that have been embraced by professionals in the psychological and counseling fields. One program (Hope-Focused) focuses on instilling hope in the marriage through teaching the importance of having faith in one's partner, a willingness to work toward a goal of improving the marriage, and encouraging love for the partner as expressed by valuing one's spouse. The two main areas addressed were communication and intimacy. Hope-Focused marital enrichment incorporates techniques from a variety of sources of marital research. The program includes assessments with written feedback from consultants, communication skills (such as active listening, reflecting, and empathy), negotiation skills for conflictual situations, intimacy-building exercises, positive behavior training, and educational teaching on steps toward divorce and how to prevent them. Much of the elements in Hope-Focused Enrichment may overlap other enrichment programs or marital therapy techniques, in part because components deemed effective through past empirical support have been gleaned and compiled with the intention of creating a brief effective program. Although empirical support has been found for the Hope-Focused program (Worthington et al., 1997), little comparative data is available at this time. This present study has been designed as an exploratory pilot study to compare two marital enrichment programs and to distinguish how a couple's quality of life is impacted by these programs.
The second marital enrichment program (FREE) focused on teaching the concept of forgiveness and why it is important, while using real examples to allow the couples to practice the actual act of forgiveness. Hurt feelings were validated, partners were taught to empathize with one another, and reconciliation (actively restoring trust when it is appropriate) was emphasized through learning to value each other.
Couples were recruited through fliers distributed in the community, a newspaper advertisement, and phone calls made to couples enrolled in a bridal registry. Informed consent forms tailored for each group were signed by each individual at the initial assessment. Couples in the treatment groups were paid $300.00 for participating in the assessments and enrichment, while couples in the control group were paid 5200.00 for their participation in the assessments. Couples were given an initial assessment which involved four steps: (a) obtaining a saliva sample before and after a visual imagery exercise (after which a feedback form was completed); (b) two five-minute video-taped segments in which the couples were instructed to discuss a decision they needed to make and something which they enjoy doing together; (c) the completion of several questionnaires (including the QOLI), a relationship rating form, a trait-forgiveness scale, and the RCI-l0; and (d) a take-home packet of demographic questions they were to complete and bring to their first marital enrichment consultation. Those assigned to the Strategic Hope-Focused program and those assigned to the FREE program were each given approximately 9 hours of consultation, typically spread over a three to five week time period, with each meeting generally lasting 2 to 2.5 hours. Consultants were trained by Dr. Everett Worthington of Virginia Commonwealth University to facilitate each of the programs. Marital enrichment sessions were audio taped to monitor different consultants' adherence to the protocol of the two programs. Control condition subjects received no marital enrichment. All couples were then given a post-assessment and a one-month follow-up assessment, although the take-home questionnaires were not repeated after the first assessment.
Concepts such as trait forgiveness can be difficult to measure. For the purpose of this study, trait forgiveness was divided into two categories: "high" and "other" levels of forgiveness. Parametric statistics were used in order to attempt to provide inferences regarding the different groups. An ANOVA with repeated measures was then used to compare the three groups involved in the study and the way in which treatment affects the individual's quality of life. The interventions, religious commitment, and trait forgivingness were the independent variables. The dependent variable was quality of life. Pearson product-moment Correlation Coefficients were used to measure the association between religious commitment, domains of quality of life, and disposition to forgive.
As noted previously, small sample size was an issue in this study and was taken into account in the results and discussion sections. This study will be used as a pilot study, in hopes that it will be replicated at a later date with a higher N.
Because the unit of analysis for all variables was the couple, the mean of husband and wife scores on each measure was used in all statistical analyses.
Pearson product-moment correlations were calculated to determine the relationship between the disposition to forgive (TF-10; assessed at time 1) and quality of life (QOLI; assessed at time 1 and time 2, see Table 1). The correlation between the disposition to forgive and quality of life at time 1 was moderate but not statistically significant, r(18) = .33, p = .15, ns. The correlation between the disposition to forgive and quality of life at time 2 was statistically significant, r(18) =.47, p <.05. These results indicate that the two variables, disposition to forgive and quality of life, do appear to correlate. Therefore, hypothesis 1, which suggested that quality of life and disposition to forgive were positively correlated, was partially supported.
The relationships between religious commitment (RCI-10; assessed at time 1) and quality of life (QOLI; assessed at time 1 and time 2) was also tested using Pearson correlations. Religious commitment was not significantly correlated with quality of life at time 1, r(18) = .13, p = .58, ns, or at time 2, r(18) = .01, p = .99, ns. Therefore, there was no evidence of correlation between these two variables and hypothesis 2 was not supported.
Treatment Group Comparisons
Treatment groups were tested on the RCI-10, TF-10, and QOLI at time 1. At time 2, all groups were assessed again using the QOLI The main hypothesis was that the FREE and Hope-Focused (HF) groups would experience an enhanced quality of life compared to the control group. Prior to testing this hypothesis, the groups were compared using one-factor analyses of variance to determine whether they were comparable at initial assessment on the RCI-10, TF-10, and QOLI
The groups did not differ significantly on Trait Forgivingness, F(2, 17) = .12, p = .89, ns (see Table 2). The mean for the control group was 38.7 (SD = 6.7), for the FREE group was 37.1 (SD = 5.6), and for the HF group was 37.4 (SD = 4.7). The groups also did not differ significantly on religious commitment, F(2, 17) = 2.1, p =.16, ns. The mean for the control group was 30.6 (SD = 5.9), for the FREE was 37.7 (SD = 14.3), and for the HF was 42.2 (SD = 7.1). Quality of life at baseline between the three groups did not differ significantly, F(2, 17) =.32, p =.73, ns. The control group's baseline QOLI mean was 2.42 (SD = 10), the FREE group's was 2.23, (SD = 11), and the HF group's was L92 (SD = 1.2).
The amount of time between the initial assessment and the post-assessment varied (Mean days between assessments was 77.2, with a minimum of 19 days and a maximum of 152 days). There was a statistically significant difference between this interval between the groups, F(2, 17) = 7.4, p < .01 Tukey's HSD analyses indicate that the control condition (M = 38, SD = 118) had a significantly shorter interval between testing periods than did the FREE group (M = 97.3, SD = 32.6) or the HF group (M= 84.2, SD = 28.4).
The main hypothesis, that the FREE and HF groups would experience enhanced quality of life in the post-test compared to the control group, was tested using a 3 x 2 (Treatment Group x Time) analysis of covariance. The treatment group was a between-subjects factor, time was a within-group factor, and quality of life was the dependent variable. The length of time that couples had been married and the time interval between the first and second testing were assessed as covariates because the groups appeared to differ on these variables.
The length of time married prior to this study was not a statistically significant covariate, F(], 15) = 0.01, p = .98, ns. However, the length of time between assessments was statistically significant, F(1,15)=6.62,p<.05.
The results indicated a significant interaction between treatment group and time on QOLI, F(2, 15) = 7.02, p < .01. The adjusted marginal means for the three groups on quality of life at time 1 and time 2 are shown in Figure 1.
[FIGURE 1 OMITTED]
The pattern indicates that over time the control group decreased in adjusted quality of life, whereas both the FREE and the HE groups increased in quality of life (p <.007). The [h.sup.2] =.48, while the observed power for this analysis was .87.
Simple main effects analyses for each of the groups separately comparing time 1 and 2 means revealed that for the control group, there was a statistically significant decrease in quality of life (p <.05) (see Figure 2). There was a statistically significant increase in quality of life for the HE group (p <.05), while the FREE group only approached statistical significance (p =.07). The larger number of couples in the HE may have accounted for this larger effect due to the extra degree of freedom.
[FIGURE 2 OMITTED]
In spite of the small sample size, these results lead to several implications as well as several questions. The hypotheses received mixed support in this research. First, there was partial support of hypothesis 1: A positive correlation exists between quality of life and disposition to forgive. Although the correlation was only moderate at the initial assessment, the correlation increased at the post-testing. In reviewing the standard deviation of the QOLI at both the pre-testing and the post-testing (time 1 and time 2), it is noteworthy that the means at time 1 were closer together than at time 2 and the standard deviation at time 2 was larger than at time 1. As the differences in quality of life grew, more variance existed at time 2, therefore creating a larger correlation. This explanation may account for these differences in the correlations at the two separate assessments. This correlation is supported by the literature, which indicates that forgiveness leads to a greater sense of well-being and peace (Fitzgibbons, 1986; Hope, 1987; McCullough et al., 1997; Witvliet, 2001; Witvliet et al., 2002). Therefore, assuming that this premise is correct, those who forgive are happier, healthier individuals, and being encouraged to practice forgiveness only augments this effect.
To our surprise, there appeared to be no correlation between religious commitment and quality of life. This was definitely unexpected, especially in light of supporting studies that suggest that those who are religious typically report higher satisfaction with life (Hadaway & Roof, 1978). We are unsure as to why this result occurred. It is possible that it is partially due to the small sample size. However, the complete lack of evidence of even a trend in the expected direction suggests that there may be other explanations. Perhaps the validity of the Religious Commitment Inventory needs to be revisited in light of this unexpected finding.
Third, we anticipated that couples in both treatment groups would increase in quality of life over the course of the treatment. As mentioned previously, literature has suggested that participation in marital enrichment does have positive repercussions on relationships (Giblin et al., 1985; Hickmon, Protinsky & Singh, 1997; Oliver, Mattson & Moore, 1993). The current findings concur that marital enrichment for newlyweds has considerable merit. When considering these results, preventive value should be taken into consideration (Zimpfer, 1988). According to the results, both treatment groups increased an equal amount in quality of life, while the post-assessment of the control couples actually revealed a decrease in quality of life. Interestingly, although the Hope-Focused group experienced a significant positive change in quality of life and the FREE group's change was only moderate, the degree of increase was very similar. Therefore, when compared on effectiveness, little difference was found among the programs. However, once again, the small sample size may have affected the resulting changes in quality of life.
The treatment groups received considerable training in skills to improve their marriage. The Hope-Focused group learned and practiced communication skills, ways to increase positive behaviors, and ways to build intimacy. As mentioned previously, available literature suggests that these factors strongly influence relational integrity in marriage (Pasch & Bradbury, 1998). Moreover, the FREE group received education and skills training on forgiveness, which involves incurring empathy for the offender and releasing any tendencies toward revenge, so that reconciliation may be sought if desired. Such a process may, in turn, promote levels of intimacy and can be seen as a positive behavior (Rotenberg, Schaut, & O'Connor, 1993). In addition, according to the literature, forgiveness promotes a sense of well-being and peace on the part of the forgiver. This anticipated change in quality of life was the focus of measurement in this study. Although relationship satisfaction is a component of quality of life, it is only a small element. Further research would be necessary to assess the implications of these programs regarding marital stability or satisfaction. On the other hand, due to the fallibility of humanity, relationships are destined to face hurts that have been invoked by each member of the couple. If forgiveness can allow the couple to resolve problems they have faced as well as those they may encounter in the future, then it seems that their chances of succeeding in marriage would also increase.
It is important to note that using the means of the couples' subjective reports is not the only method for describing the couples' quality of life (Kashy & Levesque, 2000). Other methods may include using the differences between the scores, in order to differentiate between couples who view their responses in a similar manner from those who have larger differences between husband and wife. Couples whose means are higher than others may still have a large difference between husbands' and wives' scores. Assessing differences may allow researchers to approach the data from a different perspective, by assessing couples who have small and larger differences between their scores, and lead to further research regarding differences in subjective opinions within newlywed couples. Furthermore, higher scores and/or lower scores could also be examined. If there are large differences between a husband's and wife's scores, individuals with the highest scores may be more influential, or those with the lowest scores may have a significant negative effect on the quality of the relationship. Even another method might involve examining only the husbands' scores or only the wives' scores. There are a variety of means for exploring such data, however, for the purpose of addressing the hypotheses as proposed, the means of husbands and wives were chosen as the unit of measurement.
Hypothesis 4, that those couples who received skills training in forgiveness during the FREE marital enrichment would have more improved quality of life than those who received the Hope-Focused, was not supported. This assumption was based on the theories that incorporate forgiveness as a crucial element of healing when hurts occur (Diblasio & Benda, 1991; Freedman & Enright, 1996; McCullough & Worthington, 1995; McCullough et al., 1997). However, as mentioned previously, treatment groups increased in equal amounts in quality of life. It appears that both treatments effectively improve one's overall well-being. Future research may focus on which of the 16 domains of quality of life are affected by each treatment group. Furthermore, an additional and unpredicted result of this study was that those couples in the control group actually decreased in quality of life over the one-month period. Replications and longer-term follow-up assessments would be very useful to determine the amount of decrease in quality of life over time, if this decrease is typical, and how preventive measures may impact quality of life.
There are other factors related to these results that should be taken into consideration as well. One is that the consultants, who were students in either a Master's level counseling program, or a PsyD level clinical psychology program, all had limited experience facilitating these particular programs. Continued implementation of the marital enrichment programs by these same consultants may increase familiarity and ease of presentation that may produce even more positive results. Second, follow-up data would be most helpful in determining lasting effects of these marital enrichment programs. Third, treatment group couples tended to be married longer than control group couples (although when taken into account, analyses revealed that this covariant did not create a sizable effect).
The inclusion of a former exclusively religious variable such as forgiveness provides a wide-range of implications not only for clinicians and researchers, but also for pastors and churches. The coming together of science and religion is a phenomena that has been evolving over time and can be extremely beneficial to both fields of study. With research that supports the therapeutic effectiveness of acts such as forgiveness, science can gain a new respect for theology and the importance of spiritual well-being. As a result, a variety of clients may greatly benefit from this new "friendship" (McCullough, Sandage, & Worthington, 1995). Furthermore, pastors and others who work within churches can reach out to one another with confidence that they can promote ideas that are not only biblically relevant, but also suggested to be effective through empirical study. This potential merging of science and religion is crucial for individuals who are clinically minded and have been struggling to integrate their professions with their faith.
In conclusion, both Hope-Focused and FREE Marital Enrichment Programs were shown to be effective skills training strategies in improving overall quality of life. Both FREE and Hope-Focused treatment groups showed positive changes in quality of life, whereas the control group showed a decrease over time. The small sample size was a disadvantage of this study, yet in spite of this the differences in quality of life were significant. As a pilot study, this research reveals interesting trends that deserve further attention. A larger sample size and long-term follow-up assessments are needed to determine any lasting effects of marital enrichment on quality of life for newlywed couples.
The findings from this study suggest that these two marital enrichment programs (Hope-Focused and FREE) can be very useful in the increase of couples' well being and therefore, in prevention of many of the problems that lead to marital distress. For example, the issues mentioned at the beginning of this paper (intimacy, positive and negative behaviors, communication, conflict resolution, and the reality of human fallibility) are all addressed by these programs. Settings such as churches and counseling centers invested in helping marriages succeed may find this to be very useful information. To add to their merit, instructing couples in these two programs requires a minimal amount of time and involves the teaching of very simple principles. Further consideration of this study as well as these programs is recommended to confirm these results and to contribute to discovering means of assisting couples to succeed in their marriages. Such success could have significant impact in other areas of familial life, such as decreased stress levels (which may lead to improved physical health) and other improved relationships related to the skills that are learned from these programs.
In terms of limitations, it is impossible to determine from this study if the changes in quality of life were actually due to the specific materials that were taught and practiced, or if they were related to the time, energy, and interest shown in the marriages during the enrichment programs. Further research is needed to determine if other methods, such as joint reading of specific books, watching videotapes or participating as a couple in other programs also contribute to increased quality of life. In addition, since this was an exploratory pilot study, a larger sample size with more diversity, such as differences in length of time married, would be an interesting follow-up.
A final implication of this study relates to the concept of forgiveness. As mentioned earlier in this study, research regarding the benefits of forgiveness has been sparse in the field of psychology. Most writings have focused on religious aspects of the act of forgiving (Gorsuch & Hao, 1993). However, this study supports the idea that forgiveness can be beneficial to the person who offers it. This finding is especially important when applied to therapeutic settings where one of the main goals is to improve the individual's well-being. It is the hope of the author that research such as this be applied to enriching therapeutic activity with concepts such as forgiveness that have been previously dismissed by professional psychology.
Table 1 Correlations between Disposition to Forgive, Quality of Life and Religious Commitment in Couples Trait Religious Quality Forgiveness Commitment of Life (Time 1) M RCI10 M QOL TIME 1 M TFS Pearson Correlation 1.000 .233 .329 Sig. (2-tailed) .322 .157 N 20 20 20 M RCI10 Pearson Correlation .233 1.000 -.130 Sig. (2-tailed) .322 .584 N 20 20 20 M QOL Pearson Correlation .329 -.130 1.000 TIME 1 Sig. (2-tailed) .157 .584 N 20 20 20 M QOL Pearson Correlation .471 * .000 .686 ** TIME 2 Sig. (2-tailed) .036 .998 .001 N 20 20 20 DAYS Pearson Correlation -.140 .419 .050 BETWEEN Sig. (2-tailed) .556 .066 .835 TIMES 20 20 20 1 & 2N LENGTH Pearson Correlation .008 .218 .134 Sig. (2-tailed) .973 .355 .574 N 20 20 20 Quality of *** Days Length of time (Time 2) Times married prior 1 & 2 to Time 1 M QOL TIME 2 M TFS Pearson Correlation .471* -.140 .008 Sig. (2-tailed) .036 .556 .973 N 20 20 20 M RCI10 Pearson Correlation .000 .419 .218 Sig. (2-tailed) .998 .066 .355 N 20 20 20 M QOL Pearson Collelation .686 ** .050 .134 TIME 1 Sig. (2-tailed) .001 .835 .574 N 20 20 20 M QOL Pearson Correlation 1.000 -.114 .050 TIME 2 Sig. (2-tailed) .633 .834 N 20 20 20 DAYS Pearson Correlation -.144 1.000 .595 BETWEEN Sig. (2-tailed) .633 .006 TIMES N 20 20 20 1 & 2 LENGTH Pearson Correlation .050 .595 ** 1.000 Sig. (2-tailed) .834 .006 N 20 20 20 * Correlation is significant at the 0.05 level (2-tailed) ** Correlation is significant at the 0.01 level (2-tailed) *** Time between assessment 1 and assessment 2 Table 2 Means and Standard Deviations of All Couples on All Variables (1) VARIABLES CONTROL HF M SD M SD Trait Forgiveness Scale 37.70 6.74 37.43 4.72 Religious Commitment Inventory 30.60 5.89 43.19 7.08 Quality of Life Inventory (Time 1) 2.42 1.00 1.92 1.18 Quality of Life Inventory (Time 2) 2.06 1.32 2.41 1.08 Length of Time Married (in months) 3.00 1.00 4.81 1.51 prior to Time 1 Days between Times 1 and 2 38.00 11.87 84.13 28.39 VARIABLES FREE COMBINED M SD M SD Trait Forgiveness Scale 37.14 5.77 37.65 5.36 Religious Commitment Inventory 37.79 14.26 37.75 10.57 Quality of Life Inventory (Time 1) 2.23 1.14 2.15 1.09 Quality of Life Inventory (Time 2) 2.41 0.66 2.32 0.98 Length of Time Married (in months) 3.93 1.80 4.05 1.61 prior to Time 1 Days between Times 1 and 2 97.29 32.55 77.20 35.14 (1) All variables have been rounded to 1/100.
Berry, J. W., Worthington, W. L, Jr., O'Connor, L. E., Parrott, L., III & Wade, N. G. (2000). The measurement of trait forgivingness. Unpublished manuscript.
Bradburn, N. M. (1969). The structure of well-being. Chicago: Aldine.
Cowen, E. (1991). In pursuit of wellness. American Psychologist, 46, 404408.
DiBlasio, F. A., & Benda, B. B. (1991). Practitioners, religion, and the use of forgiveness in the clinical setting. Journal of Psychology and Christianity, 10, 166-172.
Diener, E. (1984). Subjective well-being. Psychological Bulletin, 95, 542-575.
Diskin, S. (1986). Marriage enrichment: Rationale and resources. Journal of Psychotherapy & the Family, 2, 111-125.
Finkel, E. J., Rusbult, C. E., Kumashiro, M. & Hannon, P. A. (2002). Dealing with betrayal in close relationships: Does commitment promote forgiveness? Journal of Personality and Social Psychology, 82, 956-974.
Fitzgibbons, R. P. (1986). The cognitive and emotive uses of forgiveness in the treatment of anger. Psychotherapy, 23, 629-633.
Ford, J. D., Bashford, M. B., Dewitt, K. N. (1984). Three approaches to marital enrichment. Toward optimal matching of participants and interventions. Journal of Sex & Marital Therapy, 10, 41-48.
Freedman, S. R., & Enright, R D. (1996). Forgiveness as an intervention goal with incest survivors. Journal of Consulting and Clinical Psychology, 64, 983-992.
Frisch, M. B. (1993). The Quality of Life Inventory: A cognitive-behavioral tool for complete problem assessment, treatment planning and outcome evaluation. Behavior Therapist, 16, 4244.
Frisch, M. B. (1994). Manual and treatment guide for the quality of life inventory. Minneapolis, MN: National Computer Systems.
Frisch, M. B., Cornell, J., Villanueva, M., & Retzlaff, P. J. (1992). Clinical validation of the quality of life inventory: A measure of life satisfaction for use in treatment planning and outcome assessment. Psychological Assessment, 4,92-101
Giblin, P., Sprenkle, D. H., & Sheehan, R. (1985). Enrichment outcome research: A meta-analysis of premarital, marital and family interventions, Journal of Marital and Family Therapy, 11, 257-27L
Gordon, K. C. & Baucom, D. H. (1998). Understanding betrayals in marriage: A synthesized model of forgiveness. Family Process, 37, 425-449.
Gorsuch, R L. & Hao, J. Y. (1993). Forgiveness: An exploratory factor analysis and its relationships to religious variables. Review of Religious Research, 34,333-347.
Hadaway C. K., & Roof, W. C. (1978) Religious commitment and the quality of life in American society. Review of Religious Research, 19, 295-307.
Hahlweg, K. & Markman, H. J. (1988). Effectiveness of behavioral marital therapy: Empirical status of behavioral techniques in preventing and alleviating marital distress. Journal of Consulting and Clinical Psychology, 56, 440-447.
Hahlweg, K., Markman, J. J., Thurmaier, E, Engl, J. & Eckert, V. (1998). Prevention of marital distress: Results of a German prospective longitudinal study. Journal of Family Psychology, 12,543-556.
Hawley, D. R. & Olson, D. H. (1995). Enriching newlyweds: An evaluation of three enrichment programs. The American Journal of Family Therapy, 23,129-147.
Hickmon, W. A., Jr., Protinsky H. O., & Singh, K. (1997). Increasing marital intimacy: Lessons from marital enrichment. Contemporary Family Therapy, 19, 581-589.
Hope, D. (1987). The healing paradox of forgiveness, Psychotherapy, 24, 240-244.
Kashy, D. A. & Levesque, M. J. (2000). Quantitative methods in close relationships research. In C. Hendrick & S. S. Hendrick (Eds.), Close relationships: A sourcebook. (pp.3-17). Thousand Oaks, CA, US: Sage Publications, Inc.
Kurdek, L. A. (1998). The nature and predictors of the trajectory of change in marital quality over the first 4 years of marriage for first-married husbands and wives. Journal of Family Psychology, 12, 494-510.
Lipchik, E. (1994). The rush to be brief. Family Therapy Networker, 18,34-39.
McCullough, M. E., Sandage, S. J. & Worthington, E. L., Jr. (1995). Charles Williams on interpersonal forgiveness: Theology and therapy. Journal of Psychology and Christianity, 14,355-364.
McCullough, M. E., & Worthington, E. L., Jr. (1995). Promoting forgiveness: A comparison of two brief psychoeducational group interventions with a waiting-list control. Counseling and Values, 40,55-68.
McCullough, M. E., & Worthington, E. L, Jr. (1999). Religion and the forgiving personality. Journal of Personality, 67, 1141-1164.
McCullough, M. E., Worthington, E. L., Jr., & Rachal, K. C. (1997). Interpersonal forgiving in close relationships. Journal of Personality and Social Psychology, 73, 321-336.
Noval, L. S., Combs, C. W, Wiinamaki, M., Bufford, R. K. & Halter, L. (1996). Cognitive-behavioral marital enrichment among church and non-church groups: Preliminary findings. Journal of Psychology and Theology, 24,47 -53.
Oliver, R., Mattson, D. L., & Moore, J. (1993). Psychological reactance in marital enrichment training. TCA Journal, 22, 3-10.
Pasch, L. A., & Bradbury, T. N. (1998). Social support, conflict and the development of marital dysfunction. Journal of Consulting and Clinical Psychology, 66,219-230.
Rotenberg, K. J., Schaut G. B., & O'Connor, B. P. (1993). The roles of identity development and psychosocial intimacy in marital success. Journal of Social and Clinical Psychology, 12, 198-217.
Stanley, S. M., Markman, H. J., St. Peters, M. & Leber, B. D. (1995). Strengthening marriages and preventing divorce: New directions in prevention research. Family Relations, 44, 392-401
Strupp, H. H., & Hadley, S. W. (1977). A tripartite model of mental health and therapeutic outcomes. American Psychologist, 32,187-196.
Wahking, H. (1992). Spiritual growth through grace and forgiveness. Journal of Psychology and Christianity, 11, 198-206.
Witvliet, C. V. (2001). Forgiveness and health: Review and reflections on a matter of faith, feelings and physiology. Journal of Psychology and Theology, 29,212-224.
Witvliet, C. V., Ludwig, T. E, Bauer, D. J. (2002). Please forgive me: Transgressors emotions and physiology during imagery of seeking forgiveness and victim responses. Journal of Psychology and Christianity, 21, 219-233.
Worthington, E. L., Jr., (1996). Speculations about new directions in helping marriages and families that arise from pressures of managed mental health care. Journal of Psychology and Christianity, 15, 197-212.
Worthington, E. L., Jr. (1998). An empathy-humility-commitment model of forgiveness applied within family dyads. Journal of Family Therapy, 20,59-76.
Worthington, E. L., Jr., & DiBlasio (1990). Promoting mutual forgiveness within the fractured relationship. Psychotherapy, 27(2), 219-223.
Worthington, E. L., Jr., Hight, T. L., McCullough, M. E., Schmitt, M. M., Berry, J. T., Ripley, J. S., Bursley, K. H. (1998). The religious commitment inventory-10: Development, refinement, and validation of a brief scale for counseling and research. Manuscript submitted for publication.
Worthington, E. L., Jr., Hight, T. L., Ripley, J. S., Perrone, K. M., Kurusu, T. A., & Jones, D. R. (1997). Strategic hope-focused relationship-enrichment counseling with individual couples. Journal of Counseling Psychology, 44,381-389.
Wylie, M. S. (1990). Brief therapy on the couch. Family Therapy Networker, 14,26-35.
Zimpfer, D. G. (1988). Marriage enrichment programs: A review. Journal for Specialists in Group Work, 13, 4453.
BURCHARD, GLENICE. A. Address: Reception & Diagnostic Center, Department of juvenile justice, 1601 Bon Air Road, Bon Air, Virginia 23235. Title: Licensed Clinical Psychologist. Degrees: BA Oral Roberts University; MA, Psy.D, Regent University. Specializations: Mentally ill adolescents; Parent-Child Interaction Therapy; Cognitive-behavioral therapy; and Marital therapy.
YARHOUSE, MARK. A. Address: School of Psychology and Counseling, Regent University, 1000 Regent University Drive, Virginia Beach, Virginia 23464. Title: Associate Professor of Psychology. Degrees: PsyD, MA, Wheaton College, BA, Calvin College. Specializations: Marriage and family theory and therapy; human sexuality; ethics.
KILLIAN, MARCUS K. Address: European Theological Seminary, Rippoldsauer Strasse 50, D-72250 Freudenstadt-Kniebis, Germany. Title: Assistant Professor of Theology and Psychology. Degrees: M.Diiv., Church of God Theological Seminary; M.A., Psy.D., Ph.D. (ABD), Regent University. Specializations: Marital therapy and enrichment; cognitive and interpersonal therapies; integration of theology and psychology; religious assessment.
WORTHINGTON, EVERETT L., JR. Address: Department of Psychology, Virginia Commonwealth University, Box 842018, 808 West Franklin Street, Richmond, VA 23284-2018. Title: Professor and Chair. Degrees: BSNE (Nuclear Engineering), University of Tennessee-Knoxville, SMNE, Massachusetts Institute of Technology; MA, PhD, University of Missouri-Columbia (Psychology-Counseling). Specializations: Forgiveness, Marriage dynamics and interventions; religious values in family and counseling.
BERRY, JACK W. Address: Box 842018, 808 West Franklin Street, Richmond, VA 232842018. Title: Research Associate. Degree: Ph.D. Specializations: Evolutionary psychology, personality, measurement, virtues, and forgiveness.
CANTER, DAVID E. Address: Box 842018, 808 West Franklin Street, Richmond, VA 23284-2018. Title: Graduate Student in Psychology Degree: B.S., University of Maryland. Specializations: Groups, marriage, and forgiveness.
[R]"QOLI" is a registered trademark of Michael B. Frisch, PhD. The authors would like to thank both the John Templeton Foundation (under grant #239 to Everett L Worthington, Jr.) and Virginia Commonwealth University's General Clinical Research Center (under grant NIH M01 RR00065) for partial support for the project. Correspondence concerning this article may be sent to Mark A. Yarhouse, Psy.D., School of Psychology and Counseling, Regent University, 1000 Regent University Drive, Virginia Beach, Virginia 23464.
GLENICE A. BURCHARD, MARK A. YARHOUSE, and MARCUS K. KILIAN Regent University
EVERETT L. WORTHINGTON, JR., JACK W. BERRY, and DAVID E. CANTER Virginia Commonwealth University