Efficacy of E-Therapy for Couples in Marital Distress: A Mixed-Methods Study in Oyo, Nigeria

The rapid expansion of digital counselling has increased interest in e-therapy as a practical alternative to face-to-face interventions for couples experiencing marital distress. However, empirical evidence comparing its effectiveness with conventional therapy remains limited, particularly in developing contexts. This study examined the efficacy of e-therapy in improving relationship outcomes among couples in marital distress, in comparison with traditional face-to-face therapy. A sequential explanatory mixed-methods design was adopted, beginning with a randomized controlled trial followed by qualitative interviews. A sample of 100 couples (N = 200) in Oyo, Nigeria, was randomly assigned to either an e-therapy group or a face-to-face therapy group. Standardized instruments assessed relationship satisfaction, communication skills, and emotional intimacy at baseline, post-intervention, and six-month follow-up, while therapeutic alliance was measured post-intervention. Quantitative data were analysed using repea