Integrative behavioural couple therapy

Domain V · Systemic, relational, group & community · Andrew Christensen, Neil S. Jacobson · 1996 · USA (UCLA; University of Washington)

What it is

Integrative Behavioral Couple Therapy (IBCT) was developed by Andrew Christensen (UCLA) and the late Neil S. Jacobson (University of Washington). It is a behavioural couple therapy that keeps the change techniques of traditional behavioural couple therapy (TBCT: behaviour exchange, communication…

Format

• Format. Conjoint couple therapy, except for two individual assessment sessions. Sessions are weekly and just under an hour, later spaced every other week or further apart. The standard protocol is 4 assessment/feedback sessions plus 20 to 22 active treatment sessions, about 26 in all, over roughly…
• Phase 1: Evaluation (sessions 1 to 3)

Who practises it, and how they are trained or regulated

• Who may deliver it. IBCT is not a licensed programme with a franchise or site licence. The developers offer a hybrid IBCT Level 1 training: 12 hours of recorded lessons, four 2-hour live sessions with role-plays, and a final test, worth 20 APA CE credits. A review of the 2020 manual reports that certification as an IBCT therapist involves extensive observation of actual sessions by a trainer, and that the book is…
• Suitability. The trials excluded couples with moderate-to-severe domestic violence in the past year, current alcohol dependence, concurrent psychotherapy or psychotropic medication, or sexual dysfunction as the only complaint. Treat these as reasons for extra caution, not as manual-stated contraindications.
• Version followed: IBCT as set out in Christensen, Doss & Jacobson (2020), Integrative Behavioral Couple Therapy: A Therapist's Guide to Creating Acceptance and Change (2nd ed., Norton), the current therapist manual, together with the standard protocol published by the UCLA IBCT site. The book's structure is taken from the developers' site, the developers' training pages and published summaries. Older concepts from…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Suggestions that favour one partner. Keep them balanced.
• Expecting a relapse-free future. Normalise setbacks as part of the pattern.
• Over time, incidents getting shorter and less intense, and recovering faster.
• Partners using the book against each other ("see, it says you..."). Redirect to self-observation.
• Interrupting so often that one partner feels silenced. Balance your interruptions between partners.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.