What is Behavioral Couples Therapy and How Does it Work?

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Written By:

Starla Brown

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Our Editorial Content Team

Chances are good that you’ve heard of cognitive behavioral therapy or perhaps you’re participating in one of the various forms of this widely used modality. In fact, cognitive behavior therapy (CBT) is the most used psychotherapeutic treatment in use today.

CBT has been adapted for use with couples, with families and for specific disorders. No matter what type of cognitive-behavioral treatment is used, the basic assumption of CBT remains the same: that maladaptive or unproductive thinking and behavior is behind the problem or issue that is interfering with your experience of a positive, productive life.

As a result, CBT is used to help individuals better understand how maladaptive thoughts thwart growth, and to teach more productive ways of thinking and behaving.

Pioneering psychologist Albert Ellis is widely recognized as the influential force behind modern types of CBT. In the 1960s, psychiatrist Aaron Beck used Ellis’ theories to develop cognitive therapy. Today CBT is very popular as a short-term treatment approach and a great deal of clinical research has been conducted that shows encouraging rates of clinical success.

Many CBT treatments have been tailored to address substance use disorder and to assist individuals in changing problematic behavior and thoughts.

Specifically, Behavioral Couples Therapy (BCT) is a type of treatment used to help both the individual who is seeking help for alcohol or other substance use issues, as well as their partner.

What Happens in Behavioral Couples Therapy?

Improving a couple’s relationship while building support for recovery is one of the main goals of BCT. This is done by improving the communication flow between partners, as well as addressing how both acceptance and change can help to influence successful recovery from alcohol and other substances.

Behavioral Couples Therapy revolves around the idea that behaviors do not occur in isolation, but are influenced in part by rewards and consequences in one’s environment. That rewards and consequences influence our behavior is one of the hallmarks of CBT. In other words, how we are rewarded or punished for certain behaviors works to reinforce and/or inhibit behaviors.

Historically, substance abuse was viewed as an individual problem, either a moral defect or a character flaw, and treated in isolation from one’s significant others. However, modern research indicates that partners, significant others and families have the ability to influence a person’s addictive behavior.

In line with this way of thinking, it is recognized that family members, partners or significant others of an individual with a substance use disorder have the power to reward recovery efforts, abstinence and/or treatment goals. Within BCT, addiction is seen as an issue that exists within a couple’s relationship or the larger family system, and thus a couple or a family is treated as a whole entity.

Clinicians have also recognized that when one partner experiences alcohol or drug use disorder, the relationship often suffers. For example, couples in this situation frequently report extensive relationship problems including increased levels of instability, dissatisfaction and even aggression.

By extension, unresolved problems in the relationship are linked to a continuance of problematic substance use as well as a rise in relapse rates.

Backed By Science

A significant body of data demonstrates that Behavioral Couples Therapy is both effective and shows the ability to be a long-lasting treatment intervention. For example, randomized clinical studies have shown that when compared to a placebo or no treatment, BCT has higher success rates than either alternative.

Research also indicates that the use of Behavioral Couples Therapy can increase recovery rates as well as improve the quality of a couple’s relationship more so than treatment that only includes the individual who is experiencing a substance use issue. BCT is also associated with beneficial effects on the couple’s children, specifically in the area of emotional problems.

So, how exactly does BCT work? Every clinician has a unique working style, but the basics of BCT are similar no matter who is using the method as a part of an addiction recovery process. To begin with, BCT implements a treatment strategy that is consistent with a cognitive-behavioral therapy approach. This means that during the course of treatment, couples will address faulty thinking and behavior patterns. Second, BCT focuses on the mutual goals of both acceptance and change as desirable outcomes for couples in therapy.

Research shows that couples who succeed in psychotherapy are able to make concrete changes that accommodate the other person’s needs, while at the same time exhibiting increased emotional acceptance of each other.

Be Ready to Do The Work 

Behavioral Couples Therapy may begin soon after the partner with substance use issues seeks help. A typical course of Behavioral Couples Therapy may consist of approximately 12-20 weekly couple’s sessions spread out over a period of several months. If you participate in BCT you may be asked to do one or more of the following: make a commitment to your partner, make an effort to increase positive engagement with your partner, engage in couple’s appreciation exercises and/or homework projects.

Many times BCT involves the use of a recovery contract. The purpose of the contract is for couples to participate in daily activities that reward recovery efforts. While Behavioral Couples Therapy emerged in the latter half of the last century, this treatment intervention has grown in popularity and today remains a treatment of choice for many clinicians.

Recovery is possible—recover your unique, purposeful, sober life by reaching out to the dedicated experts at Cumberland Heights.

Addiction is a chronic, progressive and potentially fatal disease. For over 50 years we have carefully provided the highest quality of care for adults, adolescents and families who suffer from, or are affected by this devastating disease.

Our nonprofit alcohol and drug addiction treatment center is located on a peaceful, pastoral 177-acre campus on the banks of the Cumberland River in Nashville, Tennessee. We provide a continuum of services through two 12-Step immersion campuses, 12 outpatient recovery centers and 4 sober living homes.

At Cumberland Heights, we always put the patient first and value the importance of family participation in the recovery process. Take the first step toward healing by calling us at (866) 899-5231 today.

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