Cognitive-behavior therapy (CBT) is an effective psychological treatment that can easily be adapted and integrated for therapy with families and couples. There exist several practical applications of this classic therapy.
Behavioral Marital Therapy (BMT)
This treatment focuses on altering a couple’s unrealistic expectations and aims to help them build happier, less distressed relationships based on mutual acceptance. The main form of intervention is cognitive restructuring or the creation of new attitudes and beliefs leading to a general shift in psychological focus.
Often BMT will include teaching communication and problem-solving skills through instruction, modeling, and behavioral practice either in sessions or with homework. The therapist serves as educator or coach whose task is to help the couple stay positive, solution-focused, specific, and balanced.
BMT goals include
- Increasing the frequency of positive (rewarding) partner behavior
- Decreasing the frequency of negative (punishing) partner behavior
- Improving interpersonal communication skills
- Improving problem-solving skills.
Behavioral Parent Training (BPT)
Emphasis here is on child management and the modification of undesirable behavior. Parents’ definition of the problem is accepted, although the degree to which parents’ problematic thinking and behavior maintains the problem is dealt with when necessary. The therapist functions mainly as an educator, coach, or consultant to parents.
Although other necessary CBT techniques might precede or augment this training, the following steps are typical examples of what a BPT training process entails:
- Explain the principles of social learning theory parents need to know.
- Define the problem behavior targeted for change.
- Analyze antecedents and consequences of the problem behavior.
- Establish a baseline (pre-intervention) frequency of the problem behavior.
- Train parents in specific procedures for modifying problem behavior including
- defining rules and expectations for the child;
- changing the antecedent conditions to the problem behavior;
- setting precise procedures to positively reward compliance; and
- setting specific procedures for discipline.
CBT Applied to Families
The aim of this treatment is to help families and children overcome or learn to deal with existing pathological behavior of youngsters. This might involve parents and families in several different ways.
- As with BPT, parents can be trained to directly manage or control their child’s behavior by employing social learning principles and behavior management contingencies.
- Parents can also be trained to interact with each other and the rest of the family differently, so as to provide an environment that is supportive of evolving or desired changes in the troubled child.
- Parents can be co-trained along with their child (or children) so they experience first hand what new cognitive-behavioral techniques their child must learn thereby learning to become coaches themselves.
- Parents can be trained themselves to overcome personal difficulties that trigger undesirable child behavior and to respond differently and model new child behavior.
- Parents can be educated regarding their child’s conditions and the typical triggers or struggles and ways of best dealing with it.
Either CBT family therapy above aims to provide sufficient basis for the child to be instructed, coached, and supported at home, a critical outcome required for long-term behavior change.
The work that applies CBT to family issues is fundamentally about training parents to model, coach, de-escalate, and reduce triggers for undesirable behavior.
For additional reading on related topics, please see the following articles:
Children and Behavioral Problems
Psychology Therapies for Children
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