The usefulness of cognitive restructuring as an adjunct to behavioral marital therapy

Abstract

This investigation is the first controlled outcome investigation to evaluate the effectiveness of marital therapy which combines cognitive restructuring with commonly used behavioral marital therapy strategies. Twenty-four maritally distressed couples were assigned to one of two experienced marital therapists in one of three experimental conditions: behavioral marital therapy (BMT Alone); cognitive behavior therapy plus behavioral marital therapy (CBT+BMT); or a wait-list condition (WL). The results indicated that, overall, treatment was superior to the WL condition. Couples receiving both BMT Alone and CBT+BMT showed significant pretest to posttest improvements in overall marital adjustment and behavioral indices of change; only couples receiving CBT+BMT demonstrated consistent cognitive changes. However a direct comparison between BMT Alone and CBT+BMT indicated no significant differences between the two treatments. More detailed analyses found that approximately 50% of the couples receiving treatment moved into the nondistressed range of marital functioning by the end of treatment. Overall improvement was maintained at 6-month follow-up. Recommendations for future investigations are provided, encouraging movement toward more customized treatment for each couple.