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.

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. In early 1970s Nathan Azrin published his concept of mutal reinforcement and reciprocity. 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. 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. Other authors have found a role for exchanges as well. 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. 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).

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.

Disillusionment with the traditional model began with a study in which it was found that only 50% of couples responded to the therapy. In addition, traditional couple therapy did not produce more significant outcomes compared to insight-oriented couple therapy.

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