Behavioral Couples Therapy

Treatment Components, Efficacy, and Cost-Effectiveness

BCT evolved from early behavioral approaches to martial therapy. Early forms of behavior marital therapy incorporated traditional behavioral theory principles, including operant conditioning, positive reinforcement, punishment, negative reinforcement, and behavioral contracting. In operant conditioning, it is assumed that behavior is a function of its antecedents and consequences. Behavior that is rewarded is maintained or increased via positive reinforcement. Negative reinforcement involves the reduction of an undesired behavior in order to eliminate a negative stimulus. Punishment entails an aver-sive condition to reduce a negative behavior.

In recent years, BCT has assimilated concepts from Bandura's social learning theory (e.g., modeling and cognition) and Thibaut and Kelley's social exchange theory (e.g., negative reciprocity and coercion), as well as other theoretical approaches and techniques. It is important to recognize that several distinct types of therapy have coalesced under the name BCT. As such, behavioral couples therapists employ many different techniques. Each approach focuses on changing concrete behaviors to reduce negative exchanges and increase positive couple interactions by means of building on communication skills and developing positive contingent behavioral exchanges. Although BCT is a common name for this form of therapy, other names, such as behavioral martial therapy, also are used in the literature.