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New Tactic for Troubled Couples

Accept, Not Attack
By
WebMD Feature
Reviewed by Craig H. Kliger, MD

Feb. 19, 2001 -- Trouble at home? If you and your spouse are headed for marriage counseling or therapy, be forewarned of its less than stellar track record. Only about half of the couples that seek professional help for crumbling marriages are able to meaningfully improve their relationships. And many relationships that seem to improve are in trouble again within two years, according to researchers.

Andrew Christensen, PhD, a professor of psychology at UCLA, hopes to improve those odds with an innovative new type of marriage therapy called integrative couple therapy, or ICT.

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The prevailing mantra of couple therapy is that, in order to minimize conflict, partners in an unhappy union should work toward common ground by changing their behaviors. An extrovert husband, for example, might agree to more romantic evenings at home if his homebody spouse agrees to join him in nights on the town with their friends.

ICT turns this approach around completely by encouraging couples to accept the very differences that are tearing their relationships apart.

A study of the technique, published in the April 2000 issue of the Journal of Consulting and Clinical Psychology, compared the impact of ICT with the impact of behavioral couple therapy (BCT), a popular form of therapy that emphasizes behavioral change. Following therapy, 70% of the couples undergoing ICT were significantly improved compared with 55% of the couples undergoing BCT, according to Christensen and his co-authors.

Although the preliminary study was small -- involving only 21 couples, randomly assigned either to ICT or BCT -- the results were striking enough to impress the National Institute of Mental Health, which has granted $3 million for a five-year follow-up study comparing the two techniques. It is the largest grant ever awarded by the NIMH for research on marital therapy.

ICT, more popularly dubbed "acceptance therapy," is the brainchild of Christensen and the late Neil Jacobson, PhD, who was a professor of psychology at the University of Washington in Seattle until his death in 1999.

The two therapists, both experts in BCT, found themselves frustrated at the high failure rate of that approach, and decided to de-emphasize the push for change. "The natural inclination is to try to change your partner, but efforts directed solely at change often accentuate the conflict," Christensen says. Sometimes people just can't change, he says, but even if they can, requests for change from a partner often foster resentment.

Acceptance therapy shifts the emphasis to developing empathy between partners through understanding. "When you genuinely accept your partner, and understand what he or she is experiencing emotionally, you can stop pushing each others' buttons," Christensen says.

In acceptance therapy, a couple and therapist develop a clear description of the couple's relationship -- one upon which both partners can agree. Christensen calls this process writing the "story" of a relationship.

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