Up and Down or Down and Up? The Process of Change in Constructive Couple Behavior during Traditional and Integrative Behavioral Couple Therapy

Abstract

Observed positive and negative spouse behavior during sessions of Traditional (TBCT) and Integrative Behavioral Couples Therapy (IBCT) were compared for couples with successful outcomes and their unsuccessful counterparts. One hundred and thirty-four married chronically and seriously distressed couples (on average in their forties and 80% Caucasian) were randomly assigned to TBCT or IBCT. Trained observers made ratings of 1224 segments from approximately 956 sessions sampled from the course of up to 26 sessions. Multilevel modeling was used to examine change over time. TBCT treatment responders demonstrated a boost-drop pattern, increasing in constructive behaviors early (more positive behaviors and less negative behaviors) but decreasing later. IBCT responders demonstrated an opposite, drop-boost pattern, decreasing in constructive behaviors early and increasing later. Patterns were significant for positive behaviors (p < .05) and approached significance for negative behaviors (p = .05). In both treatments, nonresponders showed a significant pattern of decline in positive and increase in negative behaviors over time, although a trend (p = .05) indicates that TBCT nonresponders initially declined in negative behaviors. This study helps clarify the different process of change in two behavioral couple therapies, which may assist in treatment development and provide a guide for therapists in considering behavioral markers of change during treatment.

Sexual communication mediates cognitive–behavioral couple therapy outcomes: A randomized clinical trial for provoked vestibulodynia.

“…A steeper increase in women with PVD’s report of collaborative SCP during CBCT, as compared with lidocaine, explained post-treatment gains in sexual well-being for women with PVD and their partners in the CBCT condition. Findings are consistent with theory and prior studies showing that couple therapies improve couples’ communication, which benefits their relationships (e.g., Sevier et al, 2015), and extends these findings to the domain of sexuality. In contrast, treatment condition was not related to changes in negative SCPs, as women with PVD’s negative SCP significantly decreased and partners’ negative SCP remained relatively constant over the course of both treatments.…”

“…Thus, partners may not have perceived change in negative SCP through CBCT. Indeed, collaborative and negative communication patterns are often found to be distinct, but related, constructs that do not necessarily demonstrate consistent patterns of change with one another (e.g., Sevier et al, 2015).…”

A Primer for the Use of Multilevel Models in Couple and Family Therapy Research

“…There are other nuances and issues that need to be understood in MLM analyses that go beyond this primer as well. We invite the reader to explore articles that have been published that use MLM such as Bartle-Haring, Shannon, Bowers and Holowacz (2016), Bartle-Haring, Knerr, Adkins, et al (2012), Lyons and Sayer (2005), and Sevier, Atkins, Doss, and Christensen (2015).…”

Integrative Behavioral Couple Therapy: Theoretical Background, Empirical Research, and Dissemination

“…In the second half of IBCT, both positive and negative observed communication improved. In contrast, in TBCT, couples who benefited from TBCT showed improvements in constructive communication behaviors (more positive and less negative behaviors) in the first half of treatment with decreases in the second half of treatment (Sevier, Atkins, Doss, & Christensen, ).…”