Empirical Basis Of Cbt With Couples And Families

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As stated earlier, early studies in behavior therapy with couples and families set the pace for more contemporary research. The use of social exchange theory and operant learning strategies to facilitate more satisfying interaction among distressed couples subsequently surfaced in the professional literature. Later, Patterson et al. (1967) applied operant conditioning and contingency contracting procedures to develop parents' abilities to control behaviorally regressive children. It was subsequently that behaviorally oriented therapists added communication and problemsolving skills training components to their interventions with couples and families. Research studies confirm the premise of social exchange theory, indicating that members of distressed couples exchange more displeasing and less pleasing behaviors than members of nondistressed relationships and the behavioral interventions (see Epstein & Baucom, 2002, for a more extensive review).

It was not until the late 1970s that cognitions were introduced as an auxiliary component of treatment with behavioral paradigms in couple and family therapy (Margolin & Weiss, 1978). During the 1980s and 1990s, cognitive factors became an increasing focus in the couples research and therapy literature, and cognitions were addressed in a more direct and systematic way than in the other theoretical approaches to family therapy (Dattilio, 1998; Dattilio & Padesky, 1990).

Similarly, behavioral approaches to family therapy were broadened to include members' cognitions about one another. Ellis was also one of the pioneers in introducing a cognitive approach to family therapy. A more progressive expression of literature on cognitive-behavior family therapy expanded rapidly throughout the 1980s and 1990s (Dattilio, 1998).

Epstein (2001) has produced an excellent overview of the empirical status of CBT with couples. More recently, Dattilio and Epstein (2003) published an overview of both couples and family therapy with additional emphasis on family schema.

Unfortunately, the area of CBT in couples has substantially more quantitative studies than family therapy (Baucom et al., 1998; Dattilio & Epstein, 2003; Epstein, 2001). The most recent of the family therapy studies include addressing the treatment of schizophrenia in the early 1980s as well as those studies conducted by Barrowclough and Tarrier (1992).

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