Problem solving and contingency contracting in the treatment of marital discord

Effects of Creative Problem Solving Training on Communication Behaviors in Small Groups

This study investigated tlhe differences in communication behaviors in small groups trained in creative problem solving (CPS) with groups not trained in CPS. Forty groups of five members each were evaluated (22 trained groups and 18 untrained groups). Communication behaviors evaluated were amount of participation, evenness of participation, verbal indications of criticism, verbal indications of support, and verbal and nonverbal indications of humor. Groups were also evaluated on the quantity of ideas generated. Results indicated that groups trained in CPS participated more, criticized ideas less, supported ideas more, exhibited more verbal and nonverbal indications of humor, and produced more ideas than did untrained groups-all at a significant level. Groups trained in CPS did not participate evenly as compared to groups not trained in CPS. This finding is examined in light of the role of the idea recorder in the groups.

Behavioural Marital Therapy: An Overview

Behavioural marital therapy (BMT) has developed from the application of social exchange and social learning theories to the understanding and modification of marital interaction. Encouraging high rates of exchange of positive behaviours, and training in communication skills, have been the major focuses of BMT till recently. While these strategies produce therapeutic change, there are still many couples whose marriages do not improve with this sort of therapy. Recent developments have focused on the role of cognitive, affective and situational variables in marital interaction. Outcome research has shown the value of cognitive and affective interventions in their own right, but it is unclear if the addition of these interventions will enhance the efficacy of BMT.

Observed communication and associations with satisfaction during traditional and integrative behavioral couple therapy

To investigate changes in couple communication and potential mechanisms of change during treatment, 134 distressed couples, who were randomly assigned to either traditional or integrative behavioral couple therapy (TBCT; IBCT), were observed in relationship and personal problem discussions prior to and near the end of treatment. Analyses were conducted using the Hierarchical Linear Modeling program. Over the time in therapy, during relationship problem discussions, positivity and problem solving increased while negativity decreased. Compared to IBCT, TBCT couples had the largest gains in positivity and reductions in negativity. During personal problem discussions, negativity decreased, while withdrawal increased and positivity decreased. TBCT couples had larger declines in negativity. In both discussion types, increases in marital satisfaction were associated with increases in positivity and problem solving. Declines in marital satisfaction were associated with increased negativity during relationship problem interactions and increased withdrawal during personal problem interactions. However, no treatment differences in these associations were found. Differences in rule-governed and contingency-shaped behavior change strategies between the two therapies and implications of findings are discussed.

Improving dyadic coping in couples with a stress-oriented approach: a 2-year longitudinal study

This study sought to assess the effectiveness of a marital distress prevention program for couples by examining how marital quality, especially marital competencies such as dyadic coping, could be improved by means of a prevention program focusing on the enhancement of coping resources (Couples Coping Enhancement Training). The study consisted of 59 couples in the intervention group and 59 couples in the matched comparison group. The results reveal that it is possible to improve marital quality, especially marital competencies, by means of one short-term intervention lasting 18 hr. However, the effects decreased after 2 years, raising the importance of booster sessions in helping to maintain effects over a longer period of time.

Methodologically sound, cost-effective research on the outcome of couple therapy

Because of its potential to answer pressing applied questions about what treatments to use with which couples as well as its potential to answer basic questions about couple functioning, outcome research on couple therapy is vital to the field. This article describes the primary methodological issues that an investigator faces in conducting outcome research during treatment development, efficacy testing, and effectiveness evaluation. Descriptions of what has been done in the past are integrated with recommendations about what should be done in the future. Mindful of the potential expense of outcome research, the authors suggest ways in which questions can be investigated cost effectively.

Effects of Behavioral Marital Therapy: A Meta-Analysis of Randomized Controlled Trials

This meta-analysis summarizes results from 30 randomized experiments that compare behavioral marital therapy with no-treatment control with distressed couples. Results showed that behavioral marital therapy is significantly more effective than no treatment (d=.585). Although behavioral marital therapy research studies tend to be conducted under conditions that are less clinically representative than other samples of studies, representativeness was not significantly related to outcome. However, evidence also suggested that publication bias may exist in this literature whereby small sample studies with small effects are systematically missing compared with other studies. This bias may inflate the effects of behavioral marital therapies reported in previous meta-analyses, though we also explore a number of alternative explanations for this small sample bias.

An overview of child physical abuse: developing an integrated parent-child cognitive-behavioral treatment approach

This article reviews and summarizes the extant literature regarding child physical abuse (CPA). Literature is summarized that describes the wide range of short- and long-term effects of CPA on children as well as the documented characteristics of parents/caregivers who engage in physically abusive parenting practices. Although the reviewed research documents that interventions geared only toward the parent have been found to produce significant improvements with respect to parenting abilities, parent-child interactions, and children's behavior problems, there is a paucity of research examining the efficacy of interventions developed specifically to target the child's emotional and behavioral difficulties. Based on the few studies that have shown emotional and behavioral gains for children who have participated in treatment, an integrated parent-child cognitive-behavioral therapy (CBT) approach is proposed here to address the complex issues presented by both parent and child in CPA cases. The direct participation of the child in treatment also may improve our ability to target posttraumatic stress disorder (PTSD), depressive symptoms as well as anger control and dysfunctional abuse attributions in the children themselves. Implications for practice, public policy, and research are also addressed.

Observation of couple conflicts: clinical assessment applications, stubborn truths, and shaky foundations

The purpose of this review is to provide a balanced examination of the published research involving the observation of couples, with special attention toward the use of observation for clinical assessment. All published articles that (a) used an observational coding system and (b) relate to the validity of the coding system are summarized in a table. The psychometric properties of observational systems and the use of observation in clinical practice are discussed. Although advances have been made in understanding couple conflict through the use of observation, the review concludes with an appeal to the field to develop constructs in a psychometrically and theoretically sound manner.

The acceptability of behavioral treatments for marital problems. A comparison of behavioral exchange and communication skills training procedures

Married female undergraduates were asked to provide ratings of the acceptability of two treatment components commonly used within the framework of behavioral marital therapy. The study compared subjects' evaluations of detailed taped descriptions of behavioral exchange/contracting procedures and communication/problem-solving skills training as they were applied to two hypothetical clinical marital cases. The study also evaluated the extent to which the severity of the marital problems influenced treatment acceptability evaluation. Communication/problem-solving skills training was judged as more acceptable than behavioral exchange/contracting procedures and received a higher score on the Evaluative and Potency dimensions of the Semantic Differential. Judgments of treatment Potency were also found to be influenced by idiosyncratic features of the cases described in association with problem severity. Implications and directions for future research are briefly discussed.

Research-structured vs clinically flexible versions of social learning-based marital therapy

The purpose of this study was to compare our structured research-based version of marital therapy from a social learning perspective with a clinically flexible version of the same treatment where treatment plans were individually-based and there was no specific number of treatment sessions. Thirty distressed married couples were randomly assigned to one of these two treatments. Assessment of outcome was based on global marital satisfaction, spouse reports of functioning in specific areas, and direct observational measures of communication. At posttest there were no differences in efficacy between structured and flexible treatments, although both treatments led to significant improvements. At a 6-month follow-up couples treated with the structured format were more likely to have deteriorated and flexibly treated couples were more likely to have maintained their treatment gains.

Three approaches to marital enrichment: toward optimal matching of participants and interventions

Three approaches to marital enrichment were examined to determine if predictors of client gains could be identified empirically. Direct training of spousal communication skills by one of two male-female co-trainer teams, observation of videotaped simulations of direct training, and bibliotherapy with telephone contacts were the three approaches, and a wait-list control group was also evaluated. Clear predictive relationships emerged between initial indices of marital and family adjustment and prior experience with therapy, and client changes on self-report measures of marital and family adjustment. Different predictors and predictive relationships characterized each of the three different enrichment approaches, and prediction of outcome was more robust for these three trained groups than for the wait-list group. Changes in clients' communication behaviors were not well predicted, leading to the conclusion that attitudinal changes in marital enrichment programs may be facilitated by optimal matching of different clients with the appropriate type of intervention, but that behavior changes are more a function of systematic skills training for all clients.

Choices among marital observation coding systems

It is argued that researchers and therapists could benefit from a detailed comparison of marital observation coding systems. The five chosen for comparison are Weiss' Marital Interaction Coding System, Gottman's Couples Interaction Scoring System, Filsinger's Dyadic Interaction Scoring Code, Olson and Ryder's Marital and Family Interaction Coding System, and Raush's Coding Scheme for Interpersonal Conflict. The strengths and weaknesses of each are noted, along with recommendations for their use in clinical situations.

Contingency Contracting in the Treatment of Alcohol Abuse

Historically, contractual agreements to control alcohol consumption have been tied to religious and temperance organizations. Recently, however, contingency contracting has been developed and investigated as a behavior therapy technique. After outlining the standard components of a contingency contract, studies investigating contingency contracting with alcohol abusers are reviewed, and clinical and ethical considerations in contracting are discussed. The research investigations show that the technique has been applied successfully with different populations of alcohol abusers and various drinking and non-drinking target behaviors. Research has also studied important aspects of the contracts themselves and has begun to recognize the role of subject characteristics in contracting. The review suggests that contracting is an effective procedure that can influence drinking and related behaviors, but this technique is relatively new and more research is needed about its most effective components and the most applicable target behaviors.

Naturalistic observation in assessment of behavioral marital therapy

The purpose of the present study was to gather preliminary naturalistic observations on the effects of behavioral marital therapy. A second purpose was to gather preliminary data on the importance of the sequence of components of a behavioral marital treatment involving communication training and training in negotiation and contracting. Marital satisfaction of seven couples participating in a marital intervention program was assessed with questionnaires and home observations during a baseline period, after a didactic education phase, after training in communication, and after training in negotiation and contracting. Four couples received communication skills training prior to training in negotiation and contracting; three couples received these components in the reverse order. A 1-yr. follow-up of marital satisfaction was also conducted. Significant increases were noted in self-reported marital satisfaction throughout the program although there was no significant relationship between outcome and the sequence of the two main treatment components. Data from naturalistic observation showed decreases in the rate of both negative and positive behaviors in marital interaction over the course of therapy.

Behavioral response to induced conflict in families with a hypertensive father

To clarify the possible environmental mediation of familial aggregation of blood pressure (BP), we examined whether the behavior of family members differed between families with a hypertensive (n = 16) or a normotensive (n = 15) father. Three-member families consisting of a father, mother, and a boy or girl aged 8-13 years were videotaped as they interacted under standard conditions calling for disagreement or conflict. Their BPs were recorded before and after interactions. The videotaped material was reliably coded into behavioral categories by independent observers. The aggregate of all three members of families with hypertensive fathers, as well as normotensive mothers and the children in these families, showed significantly more negative nonverbal behavior than their counterparts in families with normotensive fathers.