We propose a pilot study to prepare us for a clinical trial comparing the efficacy of two treatments for marital discord: traditional couple therapy (TBCT) and a new integrative behavioral treatment (IBCT). The purpose of the pilot study is to determine whether or not: 1) therapists can keep the two treatments distinct; 2) our scale for rating treatment integrity can discriminate between the two treatments; 3) we can adequately coordinate a two site study between University of Washington and UCLA; and 4) develop a detailed procedural IBCT treatment manual from the current one.
A second aim of the present application is to develop instruments for measuring emotional acceptance in marital relationships, and assess the reliability and validity of these instruments. The proposed pilot study will require three years of funding. When it is completed (and assuming the pilot data are encouraging), we plan to request continuation funds for a clinical trial comparing IBCT to TBCT. This trial will involve 228 couples being randomly assigned to one or the other treatment. IBCT includes TBCT, but adds an emphasis on emotional acceptance (EA) which is deemphasized in TBCT. The clinical trial will also be used to evaluate the change mechanisms associated with the two treatments. We believe that, to the extent that TBCT affects marital satisfaction, it does so by promoting behavior change. In contrast, a primary mechanism by which EA increases marital satisfaction is through promoting acceptance of partner behavior as is. Divorce and marital discord are among the most common precipitants of physical and mental disorders. The design and testing of maximally effective marital therapies are crucial components to the treatment and prevention of mental disorders.
