IBCT Assessment

TBCT

• Learning theory:

  • Reinforcement erosion: tendency for couples to lose enjoyment in habitual activities 

    • Solution is to increase behavior 

  • Hedonic adaptation: stimulus over and over again will loose attraction 

  • Brain is always seeking novel things

  • Skills can bring improvement 

• Social exchange theory: costs/benefits

  • Might fluctuate over time

  • Always weighs costs and benefits

TBCT Limitations

• High relapse

• Not as effective 

  • Higher distress

    • Can be depend on initial distress levels

  • Chronic distress

  • Emotional disengagement 

  • Older

IBCT Expands on TBCT

• Expands assessment 

• Focuses on accepting differences

• Focuses on change/patterns 

• Focuses on family impact, emotions, and strength

TBCT vs. IBCT Therapists

• TBCT teaches and coaches and is active/direct 

  • Psychoeducation and jumps in and be active 

• IBCT teach/coaches + active/drect

  • Focuses on couple conceptualization 

  • Focuses on acceptance strategies 

Session 1 Assessment (Conjoint)

• Goals

  • Orient couple to treatment 

  • Assess relationship history 

  • Build triadic consensus 

  • Couple leaves

    • Feeling understood

    • Supported

    • Hopeful 

• Tasks 

  • Informed consent 

  • Why coming in 

  • FOO histories

  • Relationship history 

  • Sexual relationship

  • trauma/substance use

  • Relationship strengths 

  • Goals 

Sessions 2 and 3 Assessment (Individual)

• Part 1 

  • 9 areas of relationship distress, commitment and history 

• Part 2

  • Contraindications for therapy 

    • Ongoing IPV 

    • Ongoing infedility 

    • Unreated mental health disorders that seriously impacts relationships 

3 Goals in Conjoint

• Orient couple to treatment 

• Assess relationship history 

• Build triadic consensus 

3 Tasks in Conjoint

• Informed consent 

• Why coming in 

• Relationship strengths 

Questions to ask in individual assessment

• How distressed are you about the relationship on a scale of 1-10, 1 being things are perfect and 10 being I don’t think its fixable and have lost hope?

• How committed are you to the relationship on a scale of 1-100, with 1 being I’m ready to walk out the door, and 100 being I’m a 100% committed?

• Problem and motivation/goals

  • Tell me about the main reason that you came to therapy

  • Was it more your decision to come to counseling or your partners?

  • What are the main goals you want to achieve?

• Relationship history 

  • Tell me a little more about your relationship - what was it that originally attracted you to your partner?

  • What was the quality of the relationship like when you were dating?

  • What was the first year of marriage like (or cohabitation). Was it an easy or difficult transition? Would you say it was more stable or up and down?

  • When did you first notice things were becoming more difficult.

• What are the main relationship issues that divide you, and why is it that these issues are the main challenges you face?

• What are the strengths in your relationship?

• How hopeful are you that coming to therapy can help your relationship?

Problem Area Questionnaire

• 14 items about dissatisfaction

• Clients will fill it out and circle the three most important areas to discuss

• See if there are similarities or differences and create a triadic consensus 

Contra-indicators

• Ongoing IPV 

• Ongoing infedility 

• Unreated mental health disorders that seriously impacts relationships