We propose to compare the efficacy of two treatments for marital discard: traditional behavioral couple therapy (TBCT); and a new integrative behavioral couple treatment (IBCT). One hundred eighty couples will be randomly assigned to one of these treatment conditions, resulting in 90 couples per treatment condition. This study will be done at two sites: University of Washington and UCLA, with 90 couples (or 45 per treatment condition) run at each site. Professor Andrew Christensen at UCLA is submitting an identical proposal with the same title, under the R10 mechanism. One primary purpose of the study is to evaluate the utility of a new integrative treatment for marital problems which builds on TBCT but includes an emphasis an emotional acceptance (EA) which is not part of TBCT. A secondary purpose of the study is to evaluate the change mechanisms associated with the various treatments. We are hypothesizing that, to the extent that TBCT effects marital satisfaction, it does so via promoting accommodation, compromise, and collaboration (i.e., behavior change). In contrast, the primary mechanism by which EA increases marital satisfaction is through promoting """"""""acceptance"""""""" of partner behavior as is. We will be evaluating the extent to which components of each treatment operate by virtue of the processes ascribed to it. Thus, the study will not only answer clinical questions, but will enlighten us regarding the mechanisms by which couples change in marital therapy. A third purpose of the study is to identify predictors of who responds to couples therapy in general and these treatments in particular. A fourth purpose is to investigate the dynamics of marital discord, especially the roles of acceptance and change. Divorce is one of life's most stressful events, and is associated with almost every conceivable physical and psychological disorder. These mental disorders can in turn have deleterious effects on marital quality, effects which often continue despite recovery from the mental disorder. It is often easier to prevent disorders than to treat them successfully once they have emerged. Marital therapy is a problem-focused treatment that has wide applicability and has demonstrated great promise, not only in the treatment of marital problems but also as an approach to major mental disorders. However, in its present form, it also has significant limitations. The purpose of this project is to contribute to the development of effective marital therapy, to help realize its promise and overcome some of the present limitations.
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