Processes and mechanisms of change in integrative behavioral couple therapy: a case study of one couple with distress over child rearing

Marital distress is common and can have a tremendous influence on an entire family. Spousal conflict related to children is known to have a particularly negative impact on both the parenting and marital relationship. A number of evidence-based therapies exist to support couples in need including integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998), which focuses on emotional acceptance and behavior change as mechanisms that improve marital satisfaction. While IBCT is well documented as an effective treatment with lasting outcomes (Christensen, et al., 2004), how and why IBCT works remains less clear. The current study used qualitative methodology to increase understanding of IBCT and expand upon literature related to marital conflict and child rearing. Recommended case study methods were combined with the spirit and steps of discovery-oriented research to provide a rich description of change processes and mechanisms associated with therapeutic progress. The research questions posed in this study were designed to mirror the components and phases of the Doss (2004) framework for studying change in psychotherapy, and were addressed in the context of a selected course of IBCT for a couple who presented with conflicts about child rearing. Results included detailed reports of the client and therapy change processes, change mechanisms, and treatment outcomes for the selected couple. These results revealed that acceptance growth and behavior change taking place over the course of therapy lead to increased marital satisfaction and a reduction of conflict related to child rearing. Important findings about how and why IBCT works were discussed. Future research might examine change processes in unsuccessful treatments so as to continue to refine therapies and expand upon knowledge of how and why therapies work