Dr. Lisa Benson

INTEGRATIVE BEHAVIORAL COUPLE THERAPY (IBCT)

If you're thinking about couple therapy, it's likely you have been struggling with relationship challenges for a long time, and you may be feeling "stuck." IBCT is a treatment shown by research to work for most couples with serious relationship difficulties.

IBCT was developed by Dr. Andrew Christensen, who was my clinical supervisor and research advisor during my Ph.D. work at UCLA, as well as Dr. Neil Jacobson from the University of Washington. In the early 1990s, Dr. Christensen and Dr. Jacobson had been practicing couple therapy like many other therapists do: focusing on getting each person to change their behavior and practice communication skills like "I statements." Unfortunately, studies began to show that these strategies don't work for many couples, especially ones that are having difficulty collaborating or tend to avoid difficult conversations (Jacobson & Christensen, 1996).

Dr. Jacobson and Dr. Christensen realized that telling couples to change their behavior directly (for example, "say something kind to your partner at least once per day") is like your doctor telling you to start running on a treadmill once per day. What they developed was an approach that's more like joining a team to play a sport you love - something that comes more naturally out of your own feelings of caring toward your partner.

How does IBCT work?

• IBCT therapists help a couple move from "my side of the story" and "your side of the story" to "our story." Together, all three of us would develop a complex personalized analysis of how natural differences between you turned into a relationship problem. Natural differences become much more difficult to deal with when the partners have emotional sensitivities in these areas, as well as difficulties communicating about them. For example, a couple may have frequent painful disagreements about how much time they should spend out with friends/family vs. alone at home. This interesting difference of introversion vs. extroversion may even have been part of what attracted them to each other. However, if the homebody was cheated on by a past very-gregarious partner, while the social butterfly fears becoming part of a "boring" couple like his/her parents, they may begin to have difficulty empathizing with the other person's position. This is only the beginning - we would work together to understand how BOTH of you have feelings and reactions that make perfect sense given your experiences before and during this relationship.

• Then, IBCT therapists help you express genuine compassion for your partner's experience. Again, the goal is not to force you to use someone else's words. We would work together to help you each feel and express that your partner fundamentally is who he or she is, and you can deeply accept them for who they are. This is NOT acceptance in the sense of giving up or allowing yourself to be mistreated. What it means is allowing your partner to be who he or she is, rather than fighting against it. Once you both stop fighting the reality of each other, you have the opportunity to come together. You may find that you feel much closer to your partner and happier in the relationship even though nothing has "changed."

• If you and your partner are able to express true acceptance of one another, you both are likely to find you actually want to make additional changes. At this point in treatment, we will also use problem-solving strategies to help you address specific issues in the relationship. The key is that you'll be doing this together out of real generosity toward each other.

How well does IBCT work?

Throughout the 1990s and 2000s, Dr. Christensen and Dr. Jacobson conducted research on how IBCT compared to TBCT, the "traditional" behavioral couple therapy that focused on changing behavior and communication. Both IBCT and TBCT are based on the same behavioral principles as cognitive-behavioral therapy (CBT), applied to couples. Dr. Jacobson and Dr. Christensen received NIH funding for a study of 134 moderately to severely unhappy couples, the largest randomized clinical trial of couple therapy ever conducted. By the end of treatment, 71% of the couples in IBCT showed statistically significant improvement in how satisfied they were with their relationships or even reached a "recovered" level of satisfaction, vs. 59% of TBCT couples (Christensen et al., 2004).

What matter even more are the results from two years after the couples finished treatment. Unsurprisingly, when couples left the therapy routine, at first they became somewhat less happy with their relationships - and this decline was worse for the TBCT couples. However, as the months went by, couples then reported their satisfaction began to increase again! Two years after finishing therapy, 69% of IBCT couples and 60% of TBCT couples were significantly happier than they had been at the beginning (Christensen, Atkins, Yi, Baucom, & George, 2006).

IBCT doesn't just ease unhappiness in the short term - it leads to long-term, sustainable changes in relationships.

How Long Does IBCT Take?

Couples in the study described above participated in IBCT for up to 26 sessions (about 6 months) depending on their particular needs. Every couple is different, but it's likely you would also see changes in 4-8 months of weekly 45 minute sessions.

My Practice of IBCT

I am passionate about working with couples and would feel privileged to be a small part of your relationship story. I believe that after going through couple therapy, your relationship can be not only as exciting as when you first met - it can be deeper and even more satisfying. I welcome the opportunity to work with couples of all sexual orientations, race/ethnicities, religions, and more. My goal is to help you identify the values on which your relationship is based and use IBCT to get you closer to the relationship that feels right for both of you.

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