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Integrative behavioral couples therapy
Behavioral marital therapy, sometimes called behavioral couples therapy, has its origins in behaviorism and is a form of behavior therapy. The theory is rooted in social learning theory and behavior analysis. As a model, it is constantly being revised as new research presents.
==History==
Behavioral marital therapy started with simple research conducted on couples in the 1960s. Robert Weiss and Richard Stuart were the original authors of such research.〔Vincent, J.P., Weiss, R.L. & Birchler, G.R.(1975). A behavioral analysis of problem solving in distressed and nondistressed married and stranger dyads. ''Behavior Therapy, 6,'' 475-487.〕〔Stuart, R.B.(1969). Operant-interpersonal treatment of marital discord. ''Journal of Consulting and Clinical Psychology, 33'', 675-682.〕 In early 1970s Nathan Azrin published his concept of mutal reinforcement and reciprocity 〔Azrin, NH, Naster, BJ, and Jone, R. (1973). Reciprocity counseling: A rapid learning-based procedure for martial counseling. Behaviour Research and Therapy, 11, 365-382.〕 Azrin stated that (1) human behavior is maintained by reinforcement on the person who performed the behavior (2) people have a tendency to treat others as they are treated and (3) mutual reinforcement accounts at least partially for concepts like friendships, joy, and love. Neil Jacobson pioneered the behavioral marital therapy approach. He published a book with Gayla Margolin, which launched a social learning model of couples therapy.〔Jacobson and Margolin (1979).''Marital therapy: Strategies based on social learning and behavior exchange principles.'' New York: Brunner/Mazel.〕 In this model of therapy, partners learn to be nicer to each other through behavioral exchange (contingency contracts), communicate better and improve their conflict-resolution skills. Early support came when Gottman found that as long as the ratio of positive to negative interactions remains at least five to one, the relationship is sturdy. When the ratio dips below there is a 94 percent chance that a couple will divorce.〔Gottman, J. M., & Levenson, R. W. (1999). "What predicts change in marital interaction over time? A study of alternative models." ''Family Process'', 38 (2), pp.143-158〕 Other authors have found a role for exchanges as well 〔Williams, A.M. (1979). The quantity and quality of marital interaction related to marital satisfaction: A behavioral analysis. ''Journal of Applied Behavior Analysis, 12,'' 665-678〕 Behavioral marital therapy model remains the most researched model of family therapy and was found to be effective for treating marital discord and depression in women.〔William O'Donohue and Kyle E. Ferguson (2006): Evidence-Based Practice in Psychology and Behavior Analysis. ''The Behavior Analyst Today, 7(3)'' 335- 347 ()〕 Parts of the behavioral couples therapy model, in particular strategic use of the communication skills to reinforce drug abstinence and open dialogue about treatment, were introduced as a method for getting drug abusing partners into treatment ''(see Community Reinforcement Approach and Family Training)''.〔Smith, J.E., Milford, J.L and Meyers, R.J. (2004). CRA and CRAFT: Behavioral Approaches to Treating Substance-Abusing Individuals. ''The Behavior Analyst Today, 5.(4),'' 391-402 (BAO )〕
Early research suggested that the components of behavioral marital therapy worked as predicted. The social exchange component led to increases in marital satisfaction in the short run. The communication training program led couples to communicate better and produced more long term changes in contingencies between couple members 〔Jacobson, N. S., & Follette, W. C. (1985). Clinical significance of improvement resulting from two behavioral marital therapy components. ''Behavior Therapy, 16,'' 249-262.〕
Disillusionment with the traditional model began with a study in which it was found that only 50% of couples responded to the therapy 〔Christensen A, Atkins DC, Berns S, Wheeler J, Baucom DH, & Simpson LE (2004) Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples. ''J Consult Clin Psychol.72(2),'' 176-91〕 In addition, traditional couple therapy did not produce more significant outcomes compared to insight-oriented couple therapy 〔Snyder DK & Wills RM. (1989). Behavioral versus insight-oriented marital therapy: Effects on individual and interspousal functioning''.J Consult Clin Psychol. 57(1)'' 39-46〕
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