From traditional behavioral couple therapy to integrative behavioral couple therapy: New research directions.

Abstract

Integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1996) grew out of traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979), but has expanded on this approach to emphasize the important role of acceptance in relationships. Addressing many of the limitations highlighted in research on TBCT, integrative behavioral couple therapy focuses on different controlling variables in the development of couple dysfunction and is part of an ongoing movement in behavior therapy toward the use of acceptance strategies. Early in its development, IBCT has not yet been researched thoroughly enough to be classified as efficacious; however, this approach has the potential to significantly enhance TBCT and is being evaluated in ongoing clinical trials. Future research should capitalize on the unique emphasis in IBCT on acceptance. Specific recommendations for future research include (a) establishing IBCT as an empirically supported treatment, (b) investigating the efficacy of IBCT to varied populations, (c) more closely defining and examining the mechanisms of action in IBCT. ********** Traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979) has had the distinction of being the most widely studied and empirically supported intervention available for the treatment of relationship distress for more than two decades. TBCT was developed to target the dysfunctional patterns, communication difficulties, and poor problem-solving behaviors often associated with relationship discord. Based on social learning theory and findings from research with distressed couples, TBCT consists largely of strategies to promote skill acquisition and behavioral change among partners. Empirical support for the efficacy of TBCT is considerable; however, several studies have highlighted key limitations of this approach. In an effort to address the shortcomings of TBCT, Jacobson and Christensen (1996) developed Integrative Behavioral Couple Therapy (IBCT). IBCT is grounded in contextually based behavioral theory and interweaves the well-established components of TBCT that promote accommodation and change between partners with newer acceptance-based strategies. Consequently, many of the treatment recommendations in IBCT share similarities with those proposed in several of the burgeoning treatment approaches based in contextual-behavioral theory that emphasize acceptance-based strategies, such as Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 2000), Functional Analytic Psychotherapy (FAP; Kohlenberg & Tsai, 1991), and Dialectical Behavior Therapy (DBT; Linehan, 1993). Traditional Behavioral Couple Therapy (TBCT) Jacobson and Margolin (1979) developed TBCT (formerly known as behavioral marital therapy; BMT) largely based on social learning and behavioral exchange theories of marital discord. Research from social learning theory suggested that couples who exchange negative or aversive behaviors with high frequency and who lack communication and problem resolution skills were likely to experience poor relationship adjustment (Gottman, 1980). These findings fit well within the context of social exchange theory, which posits that relationship satisfaction is associated with the ratio of costs and benefits received in the current relationship, relative to perceived alternatives to the current relationship. A higher ratio of positive to negative behavior denotes a higher frequency of reinforcing behaviors, fewer punishers, and more satisfaction. From this framework, TBCT treatment primarily involves: (a) behavioral exchange, strategies aimed at increasing the exchange of positive behaviors between partners, (b) communication training, to enhance skills in communicating desires, needs, feelings and thoughts, and (c) problem resolution training, to improve the couples' facility and efficiency in working together to resolve problems inside and outside of the marriage. …