Observed communication in couples two years after integrative and traditional behavioral couple therapy: outcome and link with five-year follow-up

J Consult Clin Psychol. 2011 Oct;79(5):565-76. doi: 10.1037/a0025121.

Abstract

Objective: To examine changes in observed communication after therapy termination in distressed couples from a randomized clinical trial.

Method: A total of 134 distressed couples were randomly assigned to either traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979) or integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998). Videotaped samples of each couple's interactions were coded from pre-therapy, post-therapy, and 2-year follow-up assessments. At these 3 time points, each partner chose 1 current relationship problem to discuss. Relationship satisfaction was assessed at 2-year follow-up, and clinically significant treatment response and marital status were assessed 5 years after treatment.

Results: Observed negativity and withdrawal decreased from therapy termination through the 2-year follow-up as expected, but problem solving did not change, and observed positivity decreased. IBCT produced superior changes from post-therapy to the 2-year follow-up assessment compared with TBCT. Post-therapy levels and changes in communication over follow-up were associated with wife satisfaction at 2-year follow-up; only post-therapy to 2-year follow-up changes in communication were associated with husband satisfaction at 2-year follow-up. Post-therapy levels of problem solving and changes in wives' positivity from pre-therapy to post-therapy were associated with 5-year relationship outcomes. We found some counterintuitive results with positivity, but they were no longer significant after controlling for withdrawal.

Conclusions: We found support for improvements in observed communication following treatment termination, with IBCT demonstrating greater maintenance of communication improvement over follow-up. We found limited evidence of associations between communication and relationship outcomes at 5-year follow-up.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Communication*
  • Couples Therapy / methods*
  • Family Conflict / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Models, Psychological
  • Stress, Psychological / therapy*
  • Time Factors
  • Treatment Outcome