This page provides
information regarding: (1) differences are between the various approaches
to couple’s therapy, (2) whether couple’s therapy is effective,
and (3) whether one approach to therapy is better than another. The
best way to address these questions is to consider results from scientific
research.
Research on couple’s
therapy
Researchers began investigating the effectiveness of couple’s
therapy in the 1970ies. Currently, over 25 studies have been conducted,
and altogether these studies include over 1,000 participating couples.
Overall, this research finds that many, but not all, couples are helped
by couple’s therapy. Specifically, about one or two thirds of
couples that complete couple’s therapy improve their relationship
as a result of therapy and also maintain their gains over time. Other
couples, however, improve initially and then later relapse, or simply
fail to improve altogether. Thus, if a couple is experiencing relationship
distress, there is a good chance that couple’s therapy will be
helpful, but there is no guarantee. Possibly, one of the most important
factors in determining success is the extent to which both partners
are motivated to improve the relationship.
Although research
finds that therapy is helpful for many couples, not all types of therapy
are based on scientific research. Moreover, it is not uncommon for a
therapist to develop his or her own unique approach to couple’s
therapy, likely based on years of experience, but not necessarily based
on scientific research. The difficulty that, if there is no research
regarding a particular approach to couples therapy, there is no way
to tell whether the therapy is generally effective. Like an experimental
drug, it may work, but then again, it could be entirely useless or even
harmful. Unlike the drugs used in healthcare, however, there are no
laws prohibiting the use of untested forms of couple’s therapy.
Unfortunately, many popular forms of therapy are not based on research.
Just because a therapist has a degree, or is licensed, or has published
a book, does not mean that the therapist is using a research-based form
of therapy.
Basic component
of research-based approaches
Which types of couple’s therapy, then, are based on research?
There are several research-based approaches to couple’s therapy
and a common component for most of these approaches is that they teach
couples communication skills for resolving relationship conflicts. One
of the best predictors of whether a relationship will be successful
is the way a couple communicates when there is relationship conflict.
All relationships experience conflict from time to time. In successful
relationships, couples are able to negotiate and resolve their conflicts.
However, a relationship can become distressed if a couple has difficulty
managing conflict. Difficulties can arise when conflicts escalate out
of control, or when couples withdraw from each other because of conflict.
Sometimes one partner escalates and the other partner withdraws. Regardless,
the result is that conflicts remain unresolved and the relationship
deteriorates. Because distressed couples typically have difficulty resolving
conflict, most marital therapists teach couples ways to manage conflict.
Often the therapist helps the couple to identify and reduce destructive
forms of communication and to increase positive forms of communication.
When a therapist teaches a couple ways to negotiate conflict, it is
often called communication skill training.
Most research-based
approaches to couple’s therapy include some form of communication
skill training. Differences between approaches have to do with (1) what
a therapist does in addition to communication skill training, and (2)
in the extent to which communication skills are emphasized. Below, different
research-based approaches to couples therapy are described. All of the
approaches below have been tested in high-quality research studies,
and all have been found to be generally effective. That is, couples
receiving therapy are, on average, better off than couples receiving
no therapy. Although some studies indicate that one approach is slightly
better than another, there is not yet any consistently replicated finding
suggesting the superiority of a specific approach. To date, the best
conclusion may be that all the approaches listed below are about equally
effective.
Behavioral Couples
Therapy
The oldest form of research-based couple’s therapy is Behavioral
Couples Therapy. Compared to other approaches, this approach places
the strongest emphasis on communication skills training. In this approach,
couples are also given exercises to complete to increase rewarding interactions
and decrease negative interactions. Because Behavioral Couple’s
therapy has been around for many years, there is more research supporting
the effectiveness of this form of therapy than there is for many of
the other approaches. Some of the more recent approaches to couples
therapy represent attempts to improve upon Behavioral Couples Therapy.
Integrative Behavioral
Couples Therapy
developed by Neil Jacobson and Andrew Christensen
Integrative Behavioral Couples Therapy was developed by some of the
same psychologists that were initially involved in testing Behavioral
Couples Therapy, and both approaches include many of the same components.
The unique feature of Integrative Behavioral Couples Therapy is that
couples are taught both to change problems that can be changed, and
to accept aspects of the partner or of the relationship that can not
be changed. Acceptance involves being able to understand one’s
partner and also finding feasible ways of meeting one’s own needs.
One of the largest studies regarding the effectiveness of marital therapy
has recently been completed, and this study found that Integrative Behavioral
Couples Therapy is effective even with severely distressed couples.
Cognitive Behavioral
Couples Therapy
developed by Donald Baucom and Norman Epstein
Cognitive Behavioral Couples Therapy also represents an expansion of
Behavioral Couples Therapy. The unique feature of Cognitive Behavioral
Couples Therapy is that it addresses cognition – that is, the
thoughts that people have. Many of the thoughts a person has about his
or her relationship predict relationship success. For example, relationship
success is related to thoughts regarding what is likely to happen and
what should happen in the future. Thoughts are especially important
when there is relationship conflict. This includes thoughts regarding
what caused the conflict and thoughts on whether one’s partner
is to blame. In Cognitive Behavioral Couples Therapy, couples are taught,
not only to improve communication, but also to identify and change destructive
thoughts. (Note that the term “cognitive behavioral” also
describes a general approach to clinical or counseling psychology. Just
because a therapist uses cognitive behavioral therapy does not necessarily
mean the therapist is using the specific version of cognitive behavioral
couples therapy developed by Baucom and Epstein.)
Emotionally
Focused Couples Therapy
Developed by Les Greenberg and Susan Johnson
As implied by the name, Emotionally Focused Couples Therapy emphasizes
emotion. Presumably, people are biologically designed to form strong
emotional bonds with mates, and therefore, one’s relationship
with his or her mate will necessarily involve emotion. According to
Emotionally Focused Couples Therapy, all emotions (including negative
emotions) are naturally beneficial for relationships when they function
well, but they can become destructive for relationships when they malfunction.
In Emotionally Focused Couples Therapy, the therapist helps the couple
to identify emotional exchanges that are harmful for the relationship
and replace these with emotional exchanges that are beneficial. In this
way, the couple reduces levels of destructive conflict and increases
relationship intimacy and mutual understanding.
Insight
Oriented Couples Therapy
Developed by Doug Snyder
In Insight Oriented Couples Therapy, the therapist draws from different
techniques depending on the couple’s current level of functioning.
If a couple is having difficulty managing conflict, they are taught
communication skills. Typically, the therapist also helps the couple
identify the origins of their difficulties. The therapist may help the
couple recognize how their previous emotional experiences are having
a negative influence their current relationship interactions. This could
involve discussing experiences from childhood or from previous relationships.
In this way, couples can increase understanding for each other and gain
increased control over their thoughts and behaviors toward each other.
