Traditional Behavioral Couple Therapy Research Articles

Trajectories of Sexual Satisfaction and Frequency During and After Couple Therapy for Relationship Distress

Using a sample of 134 distressed, different-sex couples, this study investigated the effects of Integrative Behavioral Couple Therapy and Traditional Behavioral Couple Therapy on sexual dissatisfaction and sexual frequency both during treatment and in the five years following treatment. Therapy effects depended on treatment type, gender, and whether sexual distress was identified as a presenting problem; while couple therapy may initially improve some aspects of the sexual relationship, impacts tend to fade over follow-up. Couple therapy may benefit from incorporating a greater emphasis on sex and inclusion of techniques from sex therapy.

Prediction of treatment response at 5-year follow-up in a randomized clinical trial of behaviorally based couple therapies.

Building on earlier work examining predictors of short- and moderate-term treatment response, demographic, intrapersonal, communication, and interpersonal variables were examined as predictors of clinically significant outcomes 5 years after couples completed 1 of 2 behaviorally based couple therapies. One hundred and thirty-four couples were randomly assigned to Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) or Traditional Behavioral Couple Therapy (TBCT; Jacobson & Margolin, 1979) and followed for 5 years after treatment. Outcomes include clinically significant change categories of relationship satisfaction and marital status at 5-year follow-up. Optimal subsets of predictors were selected using an automated, bootstrapped selection procedure based on Bayesian information criterion. Higher levels of commitment and being married for a longer period of time were associated with decreased likelihood of divorce or separation (odds ratio [OR] = 1.39, p = .004; OR = 0.91, p = .015). Being married for a longer period of time was also associated with increased likelihood of positive, clinically significant change (OR = 1.12, p = .029). Finally, higher levels of wife-desired closeness were associated with increased odds of positive, clinically significant change and decreased odds of divorce for moderately distressed, IBCT couples (OR = 1.16, p = .002; OR = 0.85, p = .007, respectively), whereas the opposite was true for moderately distressed, TBCT couples (OR = 0.77, p < .001; OR = 1.17, p = .002, respectively). Commitment-related variables are associated with clinically significant outcomes at 5-year follow-up as well as at termination and moderate-term follow-up.

Changes in dyadic communication during and after integrative and traditional behavioral couple therapy

To examine changes in dyadic communication, as well as links between communication and long-term relationship outcomes, 134 distressed couples randomly assigned to either Traditional Behavioral Couple Therapy (TBCT; Jacobson & Margolin, 1979) or Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) were observed in video-recorded interactions. Observers rated discussions of relationship problems at 3 time points (pre-therapy, post-therapy, 2-year follow-up) and relationship outcomes (i.e., treatment response and relationship stability) were measured at a 5-year follow-up. Consistent with previous examinations of individual partner communication (K.J.W. Baucom et al., 2011; Sevier et al., 2008), TBCT produced greater improvements from pre-therapy to post-therapy (d = 0.27–0.43) and superior communication at post-therapy (d = 0.30–0.37). However, IBCT produced greater improvements from post-therapy to 2-year follow-up (d = 0.32–0.39). Both levels of, and changes in, dyadic communication were associated with relationship outcomes, even when controlling for individual communication. Our findings lend additional support for theoretical and practical differences between these two therapies and the utility of assessment at the level of the couple. Furthermore, they contribute to a broader pattern of findings in which relationship outcomes are more consistently linked with constructive communication than with destructive communication.

Infidelity and behavioral couple therapy: Relationship outcomes over 5 years following therapy.

Prevalence rates for infidelity in American marriages range from 20% to 40%. Nevertheless, there is a paucity of research on the effectiveness of couple therapy when there has been an infidelity. In the present study the posttherapy outcomes of 19 infidelity couples were examined for up to 5 years following participation in a larger (N 134) randomized clinical trial of couple therapy. All couples were randomized to Integrative Behavioral Couple Therapy (IBCT) or Traditional Behavioral Couple Therapy (TBCT) regardless of infidelity status. They were assessed approximately every 6 months for 5 years posttherapy, and current analyses focus on three outcomes: divorce, relationship satisfaction, and marital stability. Divorce was examined using logistic regression, whereas relationship satisfaction and marital stability were examined using hierarchical linear modeling. Divorce rates were significantly higher for secret infidelity couples (80%, n 4) than for revealed infidelity (43%, n 6) and noninfidelity couples (23%, n 26). Infidelity couples who eventually divorced reported the highest marital instability; however, infidelity couples who remained married did not differ in marital stability or relationship satisfaction from noninfidelity couples. Furthermore, couples who remained married reported an increase in relationship satisfaction over time, regardless of infidelity status. Results suggest two potential pathways for couples recovering from infidelity such that some infidelity couples continue to improve and remain indistinguishable from their noninfidelity counterparts whereas other infidelity couples appear to markedly deteriorate and divorce.

Up and Down or Down and Up? The Process of Change in Constructive Couple Behavior during Traditional and Integrative Behavioral Couple Therapy

Observed positive and negative spouse behavior during sessions of Traditional (TBCT) and Integrative Behavioral Couples Therapy (IBCT) were compared for couples with successful outcomes and their unsuccessful counterparts. One hundred and thirty-four married chronically and seriously distressed couples (on average in their forties and 80% Caucasian) were randomly assigned to TBCT or IBCT. Trained observers made ratings of 1224 segments from approximately 956 sessions sampled from the course of up to 26 sessions. Multilevel modeling was used to examine change over time. TBCT treatment responders demonstrated a boost-drop pattern, increasing in constructive behaviors early (more positive behaviors and less negative behaviors) but decreasing later. IBCT responders demonstrated an opposite, drop-boost pattern, decreasing in constructive behaviors early and increasing later. Patterns were significant for positive behaviors (p < .05) and approached significance for negative behaviors (p = .05). In both treatments, nonresponders showed a significant pattern of decline in positive and increase in negative behaviors over time, although a trend (p = .05) indicates that TBCT nonresponders initially declined in negative behaviors. This study helps clarify the different process of change in two behavioral couple therapies, which may assist in treatment development and provide a guide for therapists in considering behavioral markers of change during treatment.

Integrative Behavioral Couple Therapy vs. Traditional Behavioral Couple Therapy: A theoretical review of the differential effectiveness

The purpose of this review is to compare the differential effectiveness of two couple therapies, the Traditional Behavioral Couple Therapy (TBCT) and the Integrative Behavioral Couple Therapy (IBCT). Although the latter can be seen as an evolution of the first, both are based on different theoretical concepts. Starting from the analysis of 12 studies comparing TBCT and IBCT, conclusions about effectiveness and future perspectives of both approaches are discussed. Our results show that TBCT and IBCT have distinct courses of change and differ fundamentally in what the therapist does in-session, impacting couple behavior both in and out of session. Currently, in line with the most important randomized trials in this field, a slight advantage for IBCT over TBCT in treating distressed couples at two points in time —when treatment is completed and in the first years post-therapy— can be confirmed, although at a five-year follow-up results equalize. Furthermore, some studies cannot confirm significant changes, but clinically relevant ones, which point toward a higher impact of IBCT. Lastly, the article includes limitations of the review as well and offers some orientations, which should be considered for future research.

Integrative Behavioral Couple Therapy vs. Traditional Behavioral Couple Therapy: A theoretical review of the differential effectiveness

The purpose of this review is to compare the differential effectiveness of two couple therapies, the Traditional Behavioral Couple Therapy (TBCT) and the Integrative Behavioral Couple Therapy (IBCT). Although the latter can be seen as an evolution of the first, both are based on different theoretical concepts. Starting from the analysis of 12 studies comparing TBCT and IBCT, conclusions about effectiveness and future perspectives of both approaches are discussed. Our results show that TBCT and IBCT have distinct courses of change and differ fundamentally in what the therapist does in-session, impacting couple behavior both in and out of session. Currently, in line with the most important randomized trials in this field, a slight advantage for IBCT over TBCT in treating distressed couples at two points in time —when treatment is completed and in the first years post-therapy— can be confirmed, although at a five-year follow-up results equalize. Furthermore, some studies cannot confirm significant changes, but clinically relevant ones, which point toward a higher impact of IBCT. Lastly, the article includes limitations of the review as well and offers some orientations, which should be considered for future research.

Observed Communication and Associations With Satisfaction During Traditional and Integrative Behavioral Couple Therapy

To investigate changes in couple communication and potential mechanisms of change during treatment, 134 distressed couples, who were randomly assigned to either traditional or integrative behavioral couple therapy (TBCT; IBCT), were observed in relationship and personal problem discussions prior to and near the end of treatment. Analyses were conducted using the Hierarchical Linear Modeling program. Over the time in therapy, during relationship problem discussions, positivity and problem solving increased while negativity decreased. Compared to IBCT, TBCT couples had the largest gains in positivity and reductions in negativity. During personal problem discussions, negativity decreased, while withdrawal increased and positivity decreased. TBCT couples had larger declines in negativity. In both discussion types, increases in marital satisfaction were associated with increases in positivity and problem solving. Declines in marital satisfaction were associated with increased negativity during relationship problem interactions and increased withdrawal during personal problem interactions. However, no treatment differences in these associations were found. Differences in rule-governed and contingency-shaped behavior change strategies between the two therapies and implications of findings are discussed.

Treating Affair Couples: Clinical Considerations and Initial Findings

Infidelity can have devastating effects on couples’ relationships. Not only are couples typically confused and uncertain about how to proceed, but couple therapists also report that treating infidelity is one of their greatest clinical challenges. In the current article, we present a conceptual model of response to infidelity with a corresponding infidelity-specific, couple-based intervention. This intervention incorporates interventions from cognitive-behavioral, insight-oriented, trauma-based, and forgiveness approaches to working with couples. In addition to this intervention created specifically for treating infidelity, we discuss how existing, empirically supported couple therapies such as traditional behavioral couple therapy (TBCT) and integrative behavioral couple therapy (IBCT) approach the treatment of infidelity. Finally, we present preliminary findings from two small treatment studies that provide initial, encouraging findings for the utility of the infidelity-specific intervention as well as TBCT and IBCT for treating infidelity.

Integrative Behavioral Couple Therapy is as effective as Traditional Behavioral Couple Therapy for distressed couples

Christensen A, Atkins DC, Berns S, et al . Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples. J Consult Clin Psychol 2004;72:176–91.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q...

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

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. …