Integrative behavioral couple therapy: an acceptance-based, promising new treatment for couple discord

Although traditional behavioral couple therapy (TBCT) has garnered the most empirical support of any marital treatment, concerns have been raised about both its durability and clinical significance. Integrative behavioral couple therapy (IBCT) was designed to address some of these limitations by combining strategies for fostering emotional acceptance with the change-oriented strategies of TBCT. Results of a preliminary clinical trial, in which 21 couples were randomly assigned to TBCT or IBCT, indicated that therapists could keep the 2 treatments distinct, that both husbands and wives receiving IBCT evidenced greater increases in marital satisfaction than couples receiving TBCT, and that IBCT resulted in a greater percentage of couples who either improved or recovered on the basis of clinical significance data. Although preliminary, these findings suggest that IBCT is a promising new treatment for couple discord.     

Integrative behavioral couple therapy for chronic pain: promoting behavior change and emotional acceptance

Couple therapy has been used with success in treating marital distress, psychological distress, and other problems. Researchers in the pain field have also shown that the inclusion of the spouse in pain treatment may be beneficial to the patient. In this article, we present integrative behavioral couple therapy (IBCT) as one option for therapists treating patients who have pain and marital distress. IBCT improves on traditional behavior therapy because it promotes processes that have been shown to be lacking in pain patients' relationships: emotional acceptance and empathy. After reviewing the use of behavior change and emotional acceptance strategies in couples, we describe a couple for whom IBCT improved functioning.     

Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples

A randomized clinical trial compared the effects of traditional behavioral couple therapy (TBCT) and integrative behavioral couple therapy (IBCT) on 134 seriously and chronically distressed married couples, stratified into moderately and severely distressed groups. Couples in IBCT made steady improvements in satisfaction throughout the course of treatment, whereas TBCT couples improved more quickly than IBCT couples early in treatment but then, in contrast to the IBCT group, plateaued later in treatment. Both treatments produced similar levels of clinically significant improvement by the end of treatment (71% of IBCT couples and 59% of TBCT couples were reliably improved or recovered on the Dyadic Adjustment Scale; G. B. Spanier, 1976). Measures of communication also showed improvement for both groups. Measures of individual functioning improved as marital satisfaction improved.     

Couple and individual adjustment for 2 years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy

Follow-up data across 2 years were obtained on 130 of 134 couples who were originally part of a randomized clinical trial comparing traditional versus integrative behavioral couple therapy (TBCT vs. IBCT; A. Christensen et al., 2004). Both treatments produced similar levels of clinically significant improvement at 2 years posttreatment (69% of IBCT couples and 60% of TBCT couples). Both treatments showed a "hockey-stick" pattern of change in which satisfaction dropped immediately after treatment termination but then increased for most of follow-up. The break point when couples reversed courses and gained in satisfaction occurred sooner for IBCT than TBCT couples, and those couples who stayed together generally fared better in IBCT than in TBCT. Finally, there was evidence of greater stability during follow-up in IBCT than in TBCT couples. There was little change in individual functioning over follow-up, but when change occurred it was strongly related to change in marital satisfaction. Given that this sample was selected for its significant and chronic distress, the data are encouraging about the long-term impact of behavioral couple therapy.     

Treating infidelity in same-sex couples

Psychotherapy with same-sex couples does not differ markedly from standard couple therapies; this is also true for treating couples facing infidelity. However, same-sex couples often design their relationships differently, without tradition and formal marital contracts to prescribe behavior. Based on clinical experience and the empirical research, this article addresses the differing norms involved in affirmatively treating infidelity in gay and lesbian couples within the framework of integrative behavioral couple therapy (IBCT). Two cases illustrate the process and outcome of IBCT with same-sex couples.     

Improving relationships: mechanisms of change in couple therapy

In a sample of 134 married couples randomly assigned to traditional or integrative behavioral couple therapy (TBCT vs. IBCT), a multivariate hierarchical growth curve analysis using latent variable regression revealed that measures of communication, behavior frequency, and emotional acceptance acted as mechanisms of change. TBCT led to greater changes in frequency of targeted behavior early in therapy, whereas IBCT led to greater changes in acceptance of targeted behavior both early and late in therapy. In addition, change in behavioral frequency was strongly related to improvements in satisfaction early in therapy; however, in the 2nd half of therapy, emotional acceptance was more strongly related to changes in satisfaction. Research and clinical implications are discussed.     

教学辅导提高高职学生人际交往能力的干预研究

目的探讨提高高职大学生人际能力的方法,为开展大学生心理健康教育提供依据。方法采用教学的方法,随机抽取昆明冶金高等专科学校2个班80名大学生进行干预。结果干预教学后,高职学生在冲突管理方面的能力有显著提高（P〈0．01）。结论干预提高了实验班成员的冲突管理能力,说明教学辅导对提高云南省高职大学生人际交往能力是有效的。     

团体箱庭疗法对人际交往不良大学生的治疗过程与效果研究

目的:探讨箱庭疗法对人际交往不良大学生的过程及有效性。方法:采用团体箱庭疗法对9名人际交往不良大学生进行8次团体治疗。结果:被试团体的治疗历程经过冲突呈现、协调学习、理解整合三个阶段。经过团体箱庭治疗,被试在人际交往中的交流焦虑和回避行为问题得以缓解,自我像呈现出明显的变化。结论:团体箱庭疗法能在一定程度上缓解人际交往不良大学生的交流焦虑和回避行为问题。     

“90后”高职生宿舍人际冲突问题

目的:研究高职生宿舍人际冲突特点、来源,冲突的处理策略及与学生人格特质之间的关系,为后期进行干预研究提供依据。方法:采用大学生宿舍中人际冲突来源问卷、EPQ成人个性问卷和修订后的高职生宿舍人际冲突处理策略问卷,对525名高职大学生进行了调查。结果:少数学生有强烈的宿舍人际冲突感(6.1%);人际冲突总分年级差异显著(F=3.75,P=0.029),二年级得分最高;大一、大二和大三学生人际冲突分别集中在作息习惯差异、沟通障碍和个人利益上(F=4.21,3.98,5.09;P0.05);男生在竞争攻击策略上的得分显著高于女生(t=1.99,P0.05);神经质因子与人际冲突感得分呈显著正相关(r=0.234,P=0.004)。结论:沟通技巧是学生宿舍存在的普遍问题,对不同年级要有针对性地开展宿舍人际关系教育,在宿舍人际冲突的干预中可结合学生人格特点进行。     

Measuring interrelating within couples: The Couple's Relating to Each Other Questionnaires (CREOQ)

The Couple's Relating to Each Other Questionnaires (CREOQ) are a set of four questionnaires for measuring negative forms of interrelating within couples. They enable each partner to rate his/her relating to the other and the other's relating to him/her. They are based upon the theoretical structure called the interpersonal octagon, and each questionnaire has eight scales. They are usually accompanied by a brief, single‐scale questionnaire called the US (us as a couple), by which each partner rates the quality of the relationship. The set of questionnaires was administered to 130 English couples from the community, 157 English couples seeking couple therapy and 89 Dutch community couples. The Dutch couples were also invited to rate themselves and their partners according to the items of the revised interpersonal checklist (ICL‐R). The mean scores for the US and for most of the scales of the four CREOQ were significantly higher in the couple therapy sample. The internal reliabilities of the Dutch sample were generally lower than those of the English sample. Correlations were examined between the 10 ICL‐R scales and the 8 CREOQ ones. Some agreement emerged, and for the ICL‐R, there appeared to be one close, one distant, four upper and two lower scales.     

Reconnecting with relational values in highly conflicted separating couples: A narrative therapy-informed relational interviewing teamwork-based supervision approach

This article outlines a new supervision practice of narrative therapy-informed reflecting team-based relational interviewing for a high-conflict stuck case of a separated middle-aged couple. The article demonstrates the supervision method consisting in five parts. First, the supervisor interviews the couples' relationship while the team watches from behind the one-way mirror. Second, the team responds to the interview while the couple and the supervisor witness their conversation. The couple is then invited to respond back to the team. Furthermore, there is a meta-conversation about the supervision in collaboration with the couple. The intervention ends with therapeutic letter writing to the relationship. The couple showed a meaningful shift in their positioning towards a more relational awareness and found valuable ways for continuing their therapy. The theoretical elements of the approach underpinning practice to tackle high conflict are considered through the illustration of the case.     

Therapy with religious couples

Although 95% of married couples identify with a particular religion, there is great variation in how couples rely on their religion to define or structure their relationship. Various denominations will imply particular “rules” or will shape how the couple deals with interpersonal and family challenges, such as sexuality, parenting, and power. In this article, we review couple relationships within a religious context and advance several treatment principles for treating religious couples. We present a clinical case to illustrate marital therapy with a religious couple, with an Adlerian context. ©2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65:1–13, 2009.     

Adult Attachment Anxiety: Using Group Therapy to Promote Change

Group therapy can facilitate changes for members with greater attachment anxiety who tend to struggle with negative self‐perceptions, difficulties regulating emotions, poor reflective functioning, and compromised interpersonal relationships. A clinical example of a therapy group with members who had elevated attachment anxiety and who were diagnosed with binge eating disorder demonstrates how attachment theory can be applied to group treatment. The clinical material from the beginning, middle, and end of group is presented to highlight how attachment anxiety influences members’ emotional reactions and behaviors in the group, how group factors facilitate change, and how the leader fosters the development of a secure base within the group. Pre‐ to posttreatment outcomes indicate positive changes in binge eating, depressive symptoms, and attachment avoidance and anxiety. To facilitate change in individuals with greater attachment anxiety, group therapists may foster a secure base in the group through group cohesion, which will facilitate down regulation of emotions, better reflective functioning, and relationships that are less preoccupied with loss and more secure.     

大学生一般社会信念与人际冲突解决策略的关系

目的 :探讨大学生的一般社会信念结构 ,研究一般社会信念与人际冲突解决策略的关系。方法 :运用社会公理量表和人际冲突解决量表对大学生进行测查。结果 :大学生的一般社会信念主要由四个因素构成 ,包括人性本恶观、精神超越观、修行正果观和社会灵活观。一般社会信念对人际冲突解决策略有显著的预测作用 :人性本恶观能预测妥协、竞争和逃避策略 ;修行正果观能预测竞争、折衷和合作策略 ;社会灵活观能预测合作策略。结论 :大学生的一般社会信念有一些与其他国家和地区是共同的 ,有一些是独特的 ;借助一般社会信念能有效预测大学生的人际冲突解决策略     

An Integrative Approach to Couple Therapy: Altering the Treatment Modality to Resolve an Impasse

In this article the author demonstrates an integrative approach to couple therapy in order to resolve a treatment impasse. The systematic alternation of individual and couple sessions was introduced into an ongoing couple treatment. This change in treatment modality enabled necessary work on the self systems of members of the couple which in turn improved the couple relationship. The author uses an understanding of object relations, self psychology, and systems thinking both to explore the dynamics of the couple and to explain why the restructuring of the treatment was useful.     

Prediction of response to treatment in a randomized clinical trial of marital therapy

This study investigated demographic, intrapersonal, and interpersonal predictors of treatment response in a randomized clinical trial of 134 distressed married couples, which examined traditional (N. S. Jacobson & G. Margolin, 1979) and integrative (N. S. Jacobson & A. Christensen, 1996) behavioral couple therapy. Results based on hierarchical linear modeling revealed that interpersonal variables were the strongest predictors, but their effects were largely limited to predicting initial marital dissatisfaction; greater individual mental health was also associated with less distress initially. Couples who were married longer demonstrated stronger treatment gains, and exploratory analyses suggested that sexually dissatisfied couples showed slower initial, but overall more consistent, gains in the integrative versus the traditional approach. Findings are considered in light of the previous literature on predicting response to marital therapy.     

Psychosomatic subdecompensation

The ego of a psychosomatic patient enters the relations with the external world in a very archaic way. In new traumatic situations such a personality structure possesses a very poor repertoire of adaptation mechanisms. Owing to the lack of intrapsychic elaboration of the trauma, the conflict is solved in an "interpersonal" way. The authors emphasize the importance of interpersonal conflict as an actual necessity of maintaining the connection with reality. Such a response in the development corresponds to the fixation or regression to the conflict with the object from the subphase of practising. Unpleasure, because of the early forbidding of pleasurable activities by the object, is experienced as actual, thus the object becomes a hindrance in itself. The increased hostility is being discharged through the interpersonal conflict with the object. The quality of the actual object (the therapist) affects the development of the conflict, i.e. it either allows a more successful reparation of the patient's personality structure or brings about a deeper regression.     

The influence of defense mechanisms on secondary alexithymia in hemodialysis patients.

The influence of psychodynamic aspects such as the defense mechanisms for conflict on secondary alexithymia in hemodialysis (HD) patients was examined among 35 HD patients and their family members. Although HD patients had quite strong conflicts due to HD therapy, the manifestation of conflict and expressiveness toward the family were significantly lower in HD patients with alexithymia than in those without alexithymia. Significantly positive and negative correlations were observed between conflict and expressiveness, and between expressiveness and degree of alexithymia, respectively. These results suggest that this defense mechanism strongly suppresses the manifestation of conflict, and that secondary alexithymia in HD patients may be derived from defense mechanisms such as denial.     

Children’s appraisals of interparental conflict predict event-related potential components

Interparental conflict and neural correlates of children’s emotion processing were examined. Event-related potential (ERP) data were collected from 87 children (9–11 years old) with stimuli depicting interpersonal anger, happiness, and neutrality. Three ERP components were modulated by child-reported measures of conflict, reflecting a progression from early sensory attention to cognitive control to stimulus categorization. Negative conflict predicted larger N1 and N2 amplitudes on happy than on angry trials. Greater self-blame for conflict predicted larger N2 amplitudes across emotions and larger P3 amplitudes on angry than on neutral or happy trials. Results suggest conflict-related experiences shape processing of interpersonal emotion.