Behavioral versus insight-oriented marital therapy: labels can be misleading

Snyder, Wills, and Grady-Fletcher (1991) reported a 4-year follow-up comparing insight-oriented (IOMT) with behavioral marital therapy (BMT). The effects of IOMT were more durable than those of BMT. These comments question the adequacy with which the two treatments were represented. The BMT treatment manual adequately represents behavioral technology as it existed in 1980 but fails to include more recent clinical innovations. The IOMT treatment manual includes many clinical skills that are integral to BMT but not included in the BMT manual. Documentation is provided that therapists in the BMT condition were not using these important techniques. These and other questions regarding the adequacy of training and supervision may have compromised the integrity of BMT. Nevertheless, the findings do suggest that traditional BMT technology alone may be neither necessary nor sufficient for long-term change.