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Common complaints presented by couples who seek behavioral marital therapy (BMT) are lack of communication and inability to solve problems. This study concerns itself with the following questions: (a) Do couples change their communication and problem-solving behavior when treated with BMT? (b) Are these changes significant in a clinical sense? (c) Do treated couples change both the frequency and the sequence or pattern of their communication? Three samples were used as follows: 29 couples treated with BMT, 14 waiting-list control couples, and 12 nondistressed couples. Behavioral codings obtained from couples' videotaped problem discussions provided the measure for communication and problem solving. The results of the frequency analysis showed that the treatment was effective in changing the base rates of the couples' communication skills in the expected direction and to a clinically significant extent. Changes became even more apparent when methods of sequential analysis were used. The interaction patterns of the treated couples closely resembled the pattern exhibited by the nondistressed couples while the waiting-list couples did not change at all during their waiting time. However, one unexpected finding emerged. After therapy, BMT couples appeared to be sensitized to react to aversive stimuli from their spouses. In general, the results point to the value of behavioral observation in order to improve therapeutic interventions on an empirical basis.Perhaps the most common complaint presented by couples who seek marital therapy is lack of communication (Birchler, 1979). Therefore, some form of communication skills training is germane to any treatment program for relationship problems (Jacobson & Margolin, 1979). Accordingly, in most behavioral marital therapy (BMT) programs communication training (CT) and problem-solving training (PST) are an integral part of the treatment. This focus on communication is due not only to the obvious needs of the clients but also follows directly from theoretical assumptions borrowed from Social Learning

Controlled studies evaluating the efficacy of behavioral marital therapy (BMT) have not shed light on the clinical significance of reported treatment effects, nor have proportions of improved clients been reported in a consistent or rigorous manner. Using a reliable change index to classify couples receiving BMT into categories of improved, unimproved, or deteriorated, and using a posttest score that falls outside the range of marital distress as a cutoff for clinical significance, data from four previous outcome studies were reanalyzed. Two types of questions were posed: First, what proportion of couples improve when they are treated behaviorally? Second, how often do these improved couples truly join the ranks of the nondistressed? Across the four studies, response to BMT was evaluated in 148 couples. Slightly more than half of the couples improved, ranging from 39.4% in one study to 72. 1 % in another; deterioration was rare. In about 40% of the improved couples, positive changes in marital satisfaction were confined to one spouse. Excluding the one analogue study, slightly more than one third of the treated couples actually changed their status 1 This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Controlled studies evaluating the efficacy of behavioral marital therapy (BMT) have not shed light on the clinical significance of reported treatment effects, nor have proportions of improved clients been reported in a consistent or rigorous manner. Using a reliable change index to classify couples receiving BMT into categories of improved, unimproved, or deteriorated, and using a posttest score that falls outside the range of marital distress as a cutoff for clinical significance, data from four previous outcome studies were reanalyzed. Two types of questions were posed: First, what proportion of couples improve when they are treated behaviorally? Second, how often do these improved couples truly join the ranks of the nondistressed? Across the four studies, response to BMT was evaluated in 148 couples. Slightly more than half of the couples improved, ranging from 39.4% in one study to 72.1% in another; deterioration was rare. In about 40% of the improved couples, positive changes in marital satisfaction were confined to one spouse. Excluding the one analogue study, slightly more than one third of the treated couples actually changed their status from distressed to nondistressed by the end of therapy, ranging from 21,2% to 58.1%. During a 6-month follow-up period, the majority (about 60%) of couples maintained whatever gains they had made. In the absence of treatment, improvement was rare.

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ZusammenfassungBei der atopischen Dermatitis handelt es sich um eine Hauterkrankung, deren Häufigkeit in den letzten 30 Jahren stark zugenommen hat. In vorliegender Untersuchung wurden in einem randomisierten Kontrollgruppendesign 33 Patienten mit atopischer Dermatitis entweder mit Hypnotherapie behandelt oder einer Kontrollgruppe zugewiesen. Nach 12 einstündigen individuellen Therapiesitzungen ergab die Auswertung: Während sich die Patienten der Hypnosegruppe hinsichtlich sämtlicher erhobener Variablen hoch signifikant (p < 0,01) verbessern konnten, wiesen die Patienten der Wartelisten-Kontrollgruppe eine jahreszeitbedingte ebenfalls signifikante Verschlechterung in etwa derselben Gröûenordnung auf (p < 0,01). Die typischen Symptome der atopischen Dermatitis sowie die durch sie verursachten psychosozialen Belastungen waren bei den hypnotherapeutisch behandelten Patienten nach Abschluss der Therapie gegenüber denjenigen der Kontrollgruppe im Schnitt weniger als halb so stark ausgeprägt. Die Veränderungen können als klinisch bedeutsam bezeichnet werden. Die Effektstärken lagen deutlich über denen vergleichbarer Therapieprogramme. Die Ursache hierfür wird hauptsächlich in der Anwendung problemorientierter Behandlungsstrategien gesehen. Die hypnotherapeutische Behandlung der atopischen Dermatitis erweist sich somit als eine wirkungsvolle Alternative zur konventionellen somatischen Behandlung dieser Hauterkrankung. AbstractDuring the last 30 years atopic dermatitis is a skin disease of increasing frequency. In this study with a randomised controlgroup-design 33 patients with atopic dermatitis received a treatment in hypnotherapy or no treatment in the control group. After 12 single sessions lasting one hour the following results were found: The patients in the hypnosis group showed a highly significant improvement (p < 0,01) in all variables. The patients of the waiting-control-group showed seasoning effect visible in a significant deterioration of the same order of magnitude (p < 0,01). At the end of therapy in patients treated with hypnotherapy in the treatment group compared with the control group the typical symptoms of atopic dermatitis as well as the psychosocial strains caused by the skin disease on average were less than a half of the size. The changes can be interpreted as clinical significant. The effect size went significantly over the effect size of comparable therapy programs. As reason for this essentially the application of problem-oriented treatment strategies is seen. Therefore the hypnotherapeutic treatment of atopic dermatitis has proved as an effective alternative in contrast to the conventional somatic treatment of this skin disease.