Behavioral couple therapy

Defining Characteristics

BCT is distinct from other couple interventions because of its primary focus on observable relationship events and its grounding in social learning principles. BCT seeks to alleviate relationship distress by increasing the range and frequency of positive relationship events and reducing aversive relationship events. A beneficial ratio of relationship rewards to costs is considered an important condition for relationship satisfaction. BCT also reduces relationship distress through teaching relationship skills, particularly related to effective communication and problem solving. With relationship disagreements anticipated in all intimate relationships, partners need skills to resolve their differences before disagreements turn into serious conflicts or lead to emotional withdrawal.

The social learning perspective on couple relationships assumes that the behavior of each partner is shaped by environmental events, particularly those coming from the other partner. The partners thus have important influences on one another's behavior and relationship satisfaction. Identifying the ways that partners contribute to the behaviors that they find troublesome is accomplished through functional analysis—that is, the thorough examination of antecedents and consequences of important behaviors. It is then possible to develop hypotheses about how to alter the problem behavior through changes in these conditions. BCT steadfastly focuses on uniform and specific treatment components, that is, behavioral exchange and communication training, but the issues addressed and interactions modified are informed by a couple's individualized functional analysis.

Implementation

Behavioral exchange interventions often start with infusions of pleasing behaviors, for example, through homework assignments such as expressing appreciation on a daily basis, planning a special evening for the partner, engaging in a mutually enjoyable activity, or taking over some burdensome responsibility from the partner. The therapist assigns these activities after carefully assessing what partners find lacking in their current relationship (e.g., appreciation) and what the couple is capable of doing without resorting to conflict or criticism. These activities can be powerful reminders of each partner's ability to have a positive impact on the other and can serve as incentives for working on more difficult relationship topics.

Communication and problem-solving training generally includes two sets of skills—one to foster understanding and the other to facilitate change. Empathy and listening skills reduce negative interactions by limiting the speaker to short, clear statements and by having the listener restate the content or reflect the emotional message. The listener's demonstration of understanding builds rapport and circumvents disagreements due to misinterpretation.

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