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.     

Bridging the enormous gaps of theory with therapy research and practice

Convey remarkable advances in therapy outcome research and exemplify how leading investigators connect interventions to conceptual views about therapy. These comments focus on the distinction between broad conceptual views and theory about therapeutic change processes. Although there are explanations of why a treatment focus seems reasonable, there is very little testable theory or tests of theory in therapy research. The role, importance, and paucity of theory in child and adolescent psychotherapy research is described, underscored, and lamented, respectively, in these comments. Recommendations are made to move toward the goal of this series, namely, to bridge the gap of theory and clinical practice but also the gap of theory and therapy research.     

Bridging the schism between behavioral and cognitive analyses

A major schism in modern scientific psychology has occurred between behavior analysts and cognitive psychologists. The two groups speak in different languages, but the languages can be translated so that they are mutually understandable; when either language is translated into the other, similarities emerge from seeming differences. We draw an analogy between the basic units of behavior analysis (the operant and the establishing operation) and cognitive psychology (the production). We argue that both units describe behavior as a function of motivative and discriminative antecedents. In addition, the two perspectives account in analogous ways for ongoing changes in motivation and for control by verbal statements. Adherents of the two perspectives have experimentally analyzed some of the same problems and fashioned similar solutions for applied problems. We conclude that many of the commonly cited differences between the two perspectives are the result of misunderstanding, and that the real differences need not preclude communication and collaboration. The schism can be bridged.     

Bridging between basic theory and clinical practice

This paper articulates and discusses the parts played by different processes and representations in the overall conduct of applied clinical science. It distinguishes two sorts of representation, theories in the science base and bridging representations needed to map from real world behaviour to basic theory and from theory back to the real world. It is then argued that macro-theories of the "normal" human mental architecture could help synthesise basic theoretical accounts of diverse psychopathologies, without recourse to special purpose clinical cognitive theories of particular psychopathologies or even specific symptoms. Using the Interacting Cognitive Subsystems model [Affect, Cognition and Change: Re-modelling Depressive Thought, Lawrence Erlbaum Associates, Hove, 1993], some specific macro-theoretic variables are identified. Concrete illustrations are given of how the essence of quite complex basic theory can be translated into a simpler representational format to help clinicians conceptualise a psychopathological state and pinpoint relevant variables that might be changed by therapeutic interventions. Some suggestions are also offered about how the inevitable problem of complexity in multiple component theories might be directly confronted.     

A theory of clinical practice: the cognitive and the narrative

Today the extent of the difference between theoretical models of therapy is under discussion. There have been proposals to abandon such models altogether, or to create others, such as integrative or meta‐ theoretical models. This article proposes, through the analysis of a clinical situation, the possibility of building a theory of practice which could account for most of the aspects of the therapeutic process that remain tacit and implicit. Such a theory could help us explain what concretely happens when a therapist is doing therapy, and also how theoretical models interact with the everyday practice of therapists.     

Applying behavioral theory to practice: an examination of the behavioral momentum metaphor

This paper discusses some of the difficulties that arise in the practical applications of theories derived from specific experimental settings. Nevin's metaphoric extension of the physical concept of momentum to modifying behavior (i.e., behavioral momentum) is used as a recent example. Problems in the application of behavioral momentum are discussed, alternative analyses are offered, and methods for further testing the process are suggested. ©1997 John Wiley & Sons, Ltd.     

Integrative approaches to couple therapy: implications for clinical practice and research

Although meta-analyses affirm that various treatments for couple distress produce statistically and clinically significant outcomes, research findings also indicate that a large percentage of couples fail to benefit or subsequently deteriorate following current therapies. Based on these findings, we advocate potential advantages of integrative approaches to couple therapy. We distinguish among assimilative, transtheoretical, and pluralistic approaches to integration and describe exemplars of each. Integrative approaches to couple therapy are compared to distillatory or common factors approaches emphasizing common elements of treatment components, therapist characteristics, and client or relationship attributes. We argue that clinical practice of integrative approaches to couple therapy requires conceptual and clinical decision-making skills transcending those of any one theoretical modality and emphasizing the selection, sequencing, and pacing of diverse interventions in a coherent manner. We conclude with implications of integrative couple-based treatments for future research.     

Applications of Carl Rogers' theory and practice to couple and family therapy: a response to Harlene Anderson and David Bott

Recent articles by Harlene Anderson and David Bott in the Journal of Family Therapy (Volume 23) are a gratifying examination of the contribution of Carl Rogers' philosophy and practice to family therapy. However, in my view, an already existing highly effective application of Rogers' approach to couple and family therapy was omitted from Bott's review of the literature. My reading of the two articles has inspired the following response given in the spirit of dialogue with the hope of furthering a conversation on this subject.     

认知行为治疗的生物学机制

现阶段认知行为治疗的生物学机制尚不明确。本文将从脑功能、神经电生理、神经内分泌与免疫以及遗传与表观遗传这四个方面对认知行为治疗的生物学机制进行讨论, 综合心理、生理和遗传三方面的结果, 从微观、中间和宏观多层面提出了认知行为治疗生物学机制的整合模型。并进一步对目前研究的局限性进行了讨论, 为未来探究认知行为治疗的生物学机制提供了新的方向。     

Three applications of functional analysis with group dynamic cognitive behavioral group therapy

Case illustrations from group dynamic cognitive behavioral group therapy are presented to demonstrate three applications of functional analysis and the resulting cognitive behavioral interventions. The principles of group dynamic cognitive behavioral group therapy are explained. A functional analysis is applied first to the problem behavior of an individual group member. A clinical case illustrates how the group members help to change this individual group member's behavior from a learning theory perspective. Next, the circular interactional problem behavior between two group members is reduced to the individual functional analysis of each of the two member's problem behaviors. It is then illustrated how the two group member's problem behaviors, as well as feedback from others, contribute toward helping to change each others behavior. The paper concludes that functional analysis and ensuing behavioral interventions can be also applied to group as a whole behavior.