Pastor, I feel like I'm at the end of my rope. Everything I do or say to my wife only seems to fuel her anger toward me. I can't seem to do any thing to make her happy. She's nothing like the sweet girl I fell in love with and married 30 years ago. Life should not have to be this hard! The only time I feel content is when I'm away at work. I'm thinking more and more that divorce is the only answer, but I thought about talking to you before I did anything like that. Can you help me?" "Hello, Pastor! I need to talk to you. I think I'm losing my husband! Ever since the baby was born he's always having to work late. And he never has time for the family or to help me with the baby. I think he's having an affair! What should I do?"
"Pastor, do you have a minute to talk? Last week my wife told me she doesn't want to remain married to me anymore. She says she's going to take the kids and move to a place where I'll never find them. I've been walking around in a daze ever since. I really thought we were happy together! Can you help me sort through it all?"
As clergy we often find ourselves more and more involved in ministering to troubled couples and hurting families. Sometimes we feel overwhelmed by the magnitude and multitude of what seems like a stream of families crying for our attention. We may feel altogether inadequate or unprepared to approach the complex marital and family conflicts that come our way. Nothing in our regular training for ministry seems to have prepared us for such complexities.
We can, of course, choose to refer people to someone in the community for counseling. Quite frankly, that might be the best thing we can do in some situations. But that is not possible or needful in every case.
Spiritual leaders
For many in our communities the church is traditionally the first source of help they turn to when marital or other family crises arise. Our parishioners consider us spiritual leaders, and they expect us to help them in their emotional crises. They may also turn to us for help because of financial constraints that may not permit them to go to professional counselors. For these and other pastoral reasons, it is necessary that we have a working knowledge of marriage counseling.
Pastors may be eager to minister to those who have such needs, but that eagerness is often met by frustration because of a lack of training and skill in how best to deal with marital and family problems in a professional and effective manner. Such frustrations may tempt some pastors to choose to avoid situations that involve counseling, particularly marriage and family counseling.
For clergy who might be struggling with these and similar frustrations, I'd like to suggest a therapeutic approach called behavioral marital therapy as a possible solution.
We'll approach this study of behavioral marital therapy in six basic steps: (1) the theoretical cause of breakdown in marital relationships, (2) diagnosis and assessment, (3) building relationships between the pastor and the couple/family, (4) a general outline of how sessions are utilized, (5) therapeutic techniques, and (6) termination.
Theoretical cause of breakdowns
Successful marriages can be measured by the amount and range of reciprocating positive reinforcement that is shared between spouses. Distressed marriages, however, are characterized by acts of coercion, withdrawal, and retaliatory behaviors.1
The basic premise underlying behavioral marital therapy is that in happy marriages, the rewards of the relationship outnumber or outweigh the costs or stresses. The reverse is also true: Marital discord shifts the balance to where the costs outnumber the rewards.2
In troubled marriages the interactions between spouses are locked in a pattern of problematic behaviors that only serve to perpetuate the marital discord. In such a negative pattern, each spouse refuses to change his or her behavior until a change is first seen in the other's behavior.3
Behavioral marital therapy attempts to decrease the negative, destructive behavior patterns that characterize troubled marriages in order to increase the positive behavioral experiences.4 Evidence reveals that the main sources of marital conflict are found in a lack of communication, poor problem solving skills, and a lack of reciprocal exchange.
When behavioral martial therapy is employed—which involves behavior exchange along with training in proper communication skills—the results are statistically observable in improved patterns of communication, problem-solving skills, and overall satisfaction for most couples in marital distress.
Diagnosis and assessment
Behavioral marital therapy is primarily based on observations of marital couples, interactions of couples with the counseling pastor, and sound exchange theory.5 The goal is to analyze and modify the unwanted interaction behavior of a distressed couple rather than focusing on analyzing the personal growth taking place in their family relationship.
The therapeutic process begins with a thorough assessment that is usually distinct from actual counseling per se. In some instances, couples agree to an assessment process and then make a separate agreement for treatment, if they choose to undergo counseling. In other cases, assessment is more brief and is actually an additional part of counseling.
Generally speaking though, assessment may be thought of as a more or less elaborate part of behavioral marital therapy according to the personal frame of reference of the individual clergy/counselor. It usually involves some combination of interviewing, self-report questionnaires, behavioral observations, and perhaps some self-monitoring by the spouses.6
On the basis of the assessment and diagnosis of the troubled marital relationship, data is collected and a treatment plan using standardized modules is offered to the couple. The therapeutic plan is usually designed and tailored to meet each couple's particular needs.7
Building relationships between counselor and couple
The beginning phase in behavioral marital therapy is for the counseling pastor to create a positive therapeutic alliance with the couple, in which they are comfortable working together toward agreed upon counseling goals.
The first session involves asking spouses to express their feelings when it comes to the actual marital problems the couple is experiencing. Special attention is given to the couple's motivation to reestablish a new behavior pattern of marital interaction.
Assessment is the cornerstone of counseling. If properly performed, it can create confidence in the pastor's ability to help the couple succeed in improving their relationship. Assessment in the initial phase of counseling offers the therapeutic structure and foundation of the counseling process. It helps couples know what to expect and predicts the course and possible success of their efforts.
Emphasis on behavioral change is pivotal to behavioral marital therapy. Yet there is just so much change that is possible, especially in some relationships. If the focus is primarily on change rather than .upon the process that achieves change (the couple learning how to unite their efforts against their problems), then counseling will succeed or fail depending on the degree of change that is achieved, and disappointment will result when the amount of change falls short of the ideal.8 Thus it is important for the emphasis to be upon learning the means for achieving interpersonal behavioral change, rather than upon the change itself.
How sessions are utilized
Behavioral marital therapy typically addresses four basic areas: (1) a behavioral analysis of the couple's troubled relationship, which is based on interviews, self-report questionnaires, and behavioral observations; (2) initiating a pattern of positive reciprocity using various activities designed to foster such a response, i.e., "caring days," which will be discussed later; (3) communication skills training, for example, using "I" messages to express personal feelings, dealing with problems of the present instead of dwelling on the past, describing each partner's actual behavior instead of labeling it, providing positive feed back to each other, and (4) training in problem solving, i.e., specifying the problem, negotiating a resolution, and contracting for agreed upon ways to achieve that resolution.9
Since behavioral marital therapy seeks to bring about a lasting change in the communication pattern in the troubled marital relationship, the couple is taught to utilize the skills presented to them during the counseling intervention sessions, and then to use them on their own.10
Behavioral marital therapy is relatively structured, and therefore the methods employed by different counselors are somewhat similar. What is going to happen during each session is generally known before counseling begins, because the therapeutic task has already been established in the early assessment period. So the day-to day crises that undoubtedly will be presented each week by the couple are not a distraction to the counseling pas tor because the goals and focus of counseling are already clear.
Steps of behavioral therapy
Eight steps are involved in the process of behavioral marital therapy.
1. Each spouse separately completes a marital pre-counseling inventory, i.e., the Marital Status Inventory, the Couple's Pre-counseling Inventory, the Personal Assessment of Intimacy in Relationships, or a similar marital assessment instrument. This gives details of daily activities, general goals, current satisfactions, areas for change, as well as determining a level of commitment to marriage. This data helps in planning an effective intervention program.
2. A contract is made between the spouses and the pastoral counselor. The contract involves further counseling for a certain period of time, usually three to six sessions. Setting a time limit on counseling helps make the task seem more manageable and less threatening for the couple as well as the pastor.
The contract also includes ground rules for counseling, agreement on joint sessions, and permission to share with both partners what information each has provided with no secrets kept by the pastor from either spouse. It also includes mutual agreement on any change that is to be initiated by the couple.11
3. The first joint session is devoted to discussing and understanding the basic principle, that the most effective way to bring about change in a distressed marital relationship is to increase the amount of positive behavioral interaction between spouses.
4. Step four involves an activity called "caring days." This activity is calculated to motivate both partners to reach success in attaining their counseling objectives. These "caring days" are used by each spouse to demonstrate a type of commitment that is performed independently of the other spouse's actions or responses. Caring activities are based on a list of specific positive behaviors that each spouse desires of the other. A record is kept by each partner of the number and type of caring behaviors he or she offers each day. Ideally that would be between four and twenty behaviors.
5. Training the couple to communicate accurately, honestly, and constructively without negative misinterpretation or comment.
6. Behavioral contracting based on the quid pro quo principle—"some thing for something"—in which the couple exchange desired behaviors with one another. More on this later.
7. The couple learns important principles or strategies for effective mutual decision making.
8. The couple learns to maintain the positive changes that have taken place in their relationship. They establish rules to continue to grow positively. Follow-up will occur at four-month intervals, or as needed in order to gauge progress and to renegotiate, as needed, further change over time.12
A description of therapeutic techniques
With several decades of studies and research on the efficacy of behavioral marital therapy, it can be stated that this approach to treating marital dis cord is effective in most situations. It puts emphasis on initiating positive family activities and on teaching as well as implanting effective conflict resolution strategies, with communication training being the strongest part of the intervention.
For behavioral marital therapy to be used competently, five sets of clinical skills are needed: (1) inducing positive expectancies; (2) structuring; (3) instigation; (4) teaching; and (5) emotional nurturing. Each of these skills is evaluated by a set of intervention strategies which include interrupting couples when they deviate from a stated rule or preplanned agenda, involving the couple in a dialogue regarding why they are being interrupted, and training them to gradually regulate their own behavior through recognizing their own rule violations.13
Behavioral marital therapy advocates the importance of the cognition (thoughts) and emotions of marital functioning. Yet the primary focus has typically been on the couple's behavior. So most therapeutic strategies of behavioral marital therapy rely largely on increasing the positive reinforcements and decreasing the negative interactions based on what each spouse finds subjectively pleasing. A major source for those rewards and costs for either partner is the behavior of their spouse.14
The use of contracts between spouses
Of particular interest are the con tracts used in behavioral marital therapy. Contracts are written agreements that stipulate specific behavioral changes. Spouses state in detail what behaviors they want increased by their partner. This eliminates the excuse of not knowing what the other spouse wanted or intended. The expectation of immediate reciprocation is eliminated also. Ironically, this can increase the likelihood of spontaneous reciprocation and counter a couple's resistance to change.
Two types of behavioral exchange contracts are quid pro quo, referred to earlier, and good faith contracts.
Quid pro quo contracts give the couple a chance to say to one another in effect: "If I do this, will you do that?" It is a negotiated agreement made between them that as one partner does something positive (or ceases to do something negative) for the other, the other will do something of equivalent value for the one.
Good faith contracts are agreements that specify what one spouse agrees to do for the other spouse. These things are done regardless of how the other spouse behaves or responds. This contractual technique comes closer to reflecting the foundation of Christian behavior as stated in the golden rule of Matthew 7:12, which instructs a per son to do to others what they would like to have done to themselves.
Termination
Termination is the final phase of behavioral marital therapy. It usually begins one or two sessions before the final session between the couple and the counseling pastor. It should be affable and satisfactory, with the main goal of promoting commitment between the couple toward their marriage. Changes that have been made are solidified, and counseling ends.
During the termination phase four things happen: (1) The time period between sessions is increased as the counseling relationship nears an end; (2) a written evaluation is given describing what gains have been made and suggestions of what the couple needs to continue working on in their relationship; (3) a verbal evaluation takes place with the couple; and (4) the couple and the pastor end the counseling relationship according to the time frame that they contracted for in the beginning.
There will no doubt be a certain amount of ambivalence in the termination process. Yet as the counseling pastor moves toward termination, it becomes an opportunity to inspire the couple to continue working together toward further improving their relationship.
The termination process is also an opportunity to help the couple strengthen their relationship with God, who is able to sustain their efforts and safeguard their home against the attacks of Satan.
1 I. Goldenberg and H. Goldenberg, Family Therapy: An Overview (Pacific Grove, Calif.: Brooks/Cole Publishing Co., 1991).
2 E. L. Worthington, Marriage Counseling: A Christian Approach to Counseling Couples (Downers Grove, III.: InterVarsity Press, 1989).
3 Goldenberg and Goldenberg.
4 S. L. Sayers, D. H. Baucom, T. G. Sher, R. L. Weiss, and R. E. Heyman, "Constructive Engagement, Behavioral Marital, and Changes in Marital Satisfaction," Behavioral Assessment 13 (1991): 25-49.
5 Worthington; Goldenberg and Goldenberg.
6 Ibid.
7 Worthington.
8 N. S. Jacobson, "Toward Enhancing the Efficacy of Marital Therapy and Marital Therapy Research," Journal of family Psychology 4 (1991) 4:373-393.
9 Goldenberg and Goldenberg; Gottman.
10 Sayers, Baucom, Sher, Weiss, and Heyman; K. Hahlweg, and H. J. Markman, "Effectiveness of Behavioral Marital Therapy: Empirical Status of Behavioral Techniques in Preventing and Alleviating Marital Distress," Journal of Consulting and Clinical Psychology 56 (1988) 3: 440-447.
11 Plachary; Goldenberg and Goldenberg.
12 Ibid.
13 Jacobson.
14 Worthington.
