Efficacy of Treatment Approach

A series of clinically controlled outcome studies have consistently shown that CBCT is equally effective in treating marital distress when compared to other treatment strategies, including BCT. In addition, CBCT has been shown to affect partners' actual cognitions. Baucom, Epstein, and Rankin (1995) have identified several reasons why CBCT has not been shown to be more effective than BCT alone. First, couples were randomly assigned to either BCT or CBCT. Because the need for cognition restructuring varies in couples, matching couples to treatment is necessary to determine whether CBCT will be more effective in helping those couples with distorted and maladaptive cognitions. Second, the interventions (skills training and cognitive restructuring) were separated in time rather than integrated. This is inconsistent with a naturalistic intervention, which would use cognitive restructuring when needed by the couple, not when dictated by the protocol. Finally, the cognitive restructuring phase was often very brief (about 3 weeks), which is probably insufficient. For these reasons, it remains unclear whether adding cognitive components to BCT increases the effectiveness of BCT.

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