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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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Forty-two male patients and their sexual partners were studied. Sixteen of the patients had psychogenic erectile failure (eight each with the primary and secondary forms), 16 were premature ejaculators, and 10 had diabetes-related impotence. Because of the higher mean age of the diabetics, two control groups were used, an age-matched older group (eight healthy males and their partners) and an age-matched younger group (16 healthy males and their partners). The results for the various groups on a semi-standardized interview about sexual behavior and on five psychological assessment scales were compared. Of the 88 questions on the semi-standardized interview, 11 permitted assignment of the patients to the correct group. The diabetics suffered from "prevailing erectile impotence." They viewed themselves as being less disturbed sexually than the other patients did, although on the basis of their symptoms their impotence was actually more severe. The patients with psychogenic erectile impotence had a "situational" sexual disorder in which sexual anxiety played an important role. They viewed themselves as more insecure than the diabetics and the controls and they overidealized their partners and mothers. There appear to be two subgroups of premature ejaculators: The E1 group of patients seemed to be less "neurotic" than the E2 group. On the psychological measures the latter was quite similar to the group of patients with psychogenic erectile impotence. All patient groups except E1 were significantly more depressed than the control groups.