Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) is an evidence-based couple therapy that facilitates the development of emotional acceptance to improve relational satisfaction. IBCT's efficacy has been demonstrated up to five years post-therapy (Christensen, Atkins, Baucom, & Yi, 2010), yet less is known about what couples actually do in therapy that alleviates distress. The current study expands upon previous investigations of the relationship between individual change processes and treatment outcome in IBCT in two main ways: first, through utilizing a dyadic lens (rather than an individual emphasis), and second, through a qualitative, discovery-oriented methodology that focuses on the interactions believed to promote or interfere with IBCT's change mechanism, emotional acceptance. The first component of this study involved the development of a dyadic rating system for interactions among couples in therapy that may directly serve to enhance partner acceptance (e.g., partner one vulnerability + partner two validation) or interfere with the potential for acceptance (e.g., partner one vulnerability + partner two criticism). This global coding system was generated based on theoretical literature, past research, expert consultation, clinical judgment, and observation of videotaped IBCT sessions. The second component of the study involved observation and analysis of six sessions per each of the seven selected couples that participated in IBCT's original outcome study (Christensen et al., 2004); these couples were classified into growth (n=4), no growth (n=1), or decline (n=2) categories based on the amount of emotional acceptance the couple reported between pre-treatment and 26 weeks. Results revealed that all couples engaged in multiple acceptance promoting and interfering interactions, typically initiated by vulnerability or aversive partner behaviors, and that the meaning of these interactions were unique to the emotional context of the couple. Growth couples tended to maintain an open, respectful, and often humorous interactional style, whereas no growth and decline couples appeared to maintain an accusatory, defensive stance and sarcastic or belittling humor. Future research should continue to employ a dyadic, qualitative approach to understanding the change processes that occur within couple therapy. Additional research implications and clinical recommendations are provided.

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; Couples therapy

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Eldridge, Kathleen;