Traditional couple counseling research focused on why people end relationships, with research only recently addressing what factors contribute to relationship satisfaction and stability. Yet, throughout this research, minimal attention has been paid to the role of play in couple counseling. The research available on play in couple counseling had varied definitions of couple play and was not based on current couple counseling theory. The research and anecdotal data on couple play proposed a strong relationship between couple play and the factors that predict successful, long-term couple relationships, individual physical health and emotional health. This study applied current couple counseling theory and research to define couple play and the relationship between couple play and couple bonding, physical health and emotional health. The hypotheses of the study were couple play would predict couple bonding; couple play would predict individual physical health; and couple play would predict individual emotional health. The results from a sample of 30 couples demonstrated couple play predicted measures of couple bonding, including relationship satisfaction, communication, conflict resolution, and the couple's view of the relationship. Couple play demonstrated no relationship to individual physical or emotional health. Since couple play was predictive of successful, long-term couple relationship measures, the implications were discussed for using couple play in assessment and intervention in couple counseling and future research.

Large numbers of couples seek treatment from religious counselors who integrate religion and spirituality (R/S) into counseling. The present dissertation reviewed the literature examining the effectiveness of R/S counseling. Several R/S treatments were helpful in treating psychological problems. There was little evidence that R/S treatments outperformed secular treatments. In Study 1, a nationwide survey was conducted that examined the beliefs of Christian counselors about integrating R/S into couple counseling. Christian counselors (N = 630) completed measures of religious commitment, experience in couple counseling, attitudes toward using religious techniques in couple counseling, and the use of theory in couple counseling. Counselors were highly religious, and religious commitment was a positive predictor of viewing religious techniques as appropriate. Christian couple counseling was popular and widely practiced, although there was wide variation in the number of couples seen per counselor. Counselors were influenced by both secular and Christian theories of couple counseling. There were several differences between professional, pastoral, and lay counselors, indicating that each subgroup be treated separately rather than grouped together. In Study 2, the nature of Christian couple counseling was described and the effectiveness of Christian couple counseling was examined using a longitudinal study. Counselors (N = 20) completed a measure of religious commitment, and clients (N = 60) completed measures of religious commitment, the use of religious and secular techniques in counseling, relationship satisfaction, working alliance with the counselor, and satisfaction with counseling at three time points during counseling. Religious techniques were common in couple counseling, and most were used in about 50% of the sessions. The religious commitment of counselors was a positive predictor of the number of religious techniques used in counseling. Clients attending Christian couple counseling reported increases in relationship satisfaction and working alliance with the counselor over time, and reported high levels of satisfaction with counseling. Working alliance with the counselor was a positive predictor of both relationship satisfaction and satisfaction with counseling. A close match in religious commitment between counselor and client did not predict greater improvement in relationship satisfaction, but it did predict a stronger working alliance throughout counseling.