Behavioral couple therapy: building a secure base for therapeutic integration.

Behavioral couple therapy (BCT), one of the two most empirically supported approaches to the treatment of couple discord, has undergone enormous changes in its four decades-long clinical and conceptual history. The evolution of thought about what maintains couple disaffection and distress and what can be done about it from a behavioral perspective is reviewed. These changes are considered in the larger context of the field of behavior therapy, noting shifts within BCT that parallel the three "waves" of development within that field. Integrative behavioral couple therapy (IBCT), the most visible and influential of the several BCT approaches, is examined, with particular attention to its functional-contextual base and the nature and role of functional analysis in clinical case conceptualization. It is argued that continuing enhancement and refinement of IBCT as an integrative therapeutic method will require greater flexibility in the techniques that are used and increased attention to the self of the IBCT therapist.