Comparing the Effect of Cognitive Behavioral Couple Therapy and Integrative Behavioral Couple Therapy on Communication Patterns in Couples with Extramarital Relationships

Document Type : Original Article


1 Ph.D Student of Psychology, Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran

2 Assistant professor, Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran



Introduction: The aim of this study was to compare the effectiveness of Cognitive Behavioral Couple Therapy (CBCT) and Integrative Behavioral Couple Therapy (IBCT) on the communication patterns of couples with extramarital relationships.
Method: This semi-experimental study was conducted on all couples referred to counseling centers in Mashhad, 2020. For this purpose, 39 couples were selected by convenience method and were randomly divided into two experimental groups and one control group. The experimental groups were subjected to treatment protocol intervention and the control group was not subjected to any intervention. The Communication Patterns Questionnaire (CPQ) of Christensen and Sullaway (1984) was used for collecting data. Data were analyzed through one way ANCOVA and SPSS software.
Results: There was a significant difference between the scores of mutually constructive communication pattern, avoidance and expectation/withdrawal in the groups of CBCT and IBCT with control group (P<0.05). The results showed that CBCT is more effective on the mutually constructive pattern; while the IBCT group had a higher effect on the avoidance and expectation/withdrawal pattern (P=0.001).
Conclusion: According to the findings of the present study, as infidelity in a couple’s relationship is a multi-causal and combined issue, using these two approaches is suggested to be used in order to investigate infidelity more comprehensively.


  1. Fincham FD, May RW. Infidelity in romantic relationships. Current opinion in psychology. 2017;13:70-4.
  2. Snyder DK, Balderrama‐Durbin CM. Current status and challenges in systemic family therapy with couples. The Handbook of Systemic Family Therapy. 2020;3:1-25.
  3. Perel E. The state of affairs: Rethinking infidelity-A book for anyone who has ever loved: Hachette UK; 2017.
  4. Mark KP, Janssen E, Milhausen RR. Infidelity in heterosexual couples: Demographic, interpersonal, and personality-related predictors of extradyadic sex. Archives of sexual behavior. 2011;40(5):971-82.
  5. Abdolmaleki M, Azadeh MA, Ghazinezhad M. The relationship of global media, modern reflexivity and tendency to extramarital relationship among married couples of Qorveh city. Journal of Family Research. 2015;11(43):309-32.
  6. Bhowmik M. A Grounded Theory Investigation of the Subjective Responses from Partners in Couples Where Infidelity Has Occurred: City University of New York; 2020.
  7. Christensen A, Sullaway M. Communication patterns questionnaire. Unpublished manuscript, University of California, los angeles. 1984.
  8. Lavner JA, Karney BR, Bradbury TN. Does couples' communication predict marital satisfaction, or does marital satisfaction predict communication? Journal of Marriage and Family. 2016;78(3):680-94.
  9. Baucom DH, Snyder DK, Gordon KC. Helping couples get past the affair: A clinician's guide: Guilford Press; 2011.
  10. McGinn MM, Benson LA, Christensen A. Integrative behavioral couple therapy: An acceptance‐based approach to improving relationship functioning. Acceptance and mindfulness in cognitive behavior therapy: Understanding and applying the new therapies. 2011:210-32.
  11. Barraca J, Polanski TX. Infidelity treatment from an integrative behavioral couple therapy perspective: Explanatory model and intervention strategies. Journal of Marital and Family Therapy. 2021;47(4):909-24.
  12. Baucom DH, Gordon KC, Snyder DK, Atkins DC, Christensen A. Treating affair couples: Clinical considerations and initial findings. Journal of Cognitive Psychotherapy. 2006;20(4):375-92.
  13. Jacobson NS, Christensen A. Integrative couple therapy: Promoting acceptance and change: WW Norton & Co; 1996.
  14. Askari I. The role of the belief system for anger management of couples with anger and aggression: A cognitive-behavioral perspective. Journal of Rational-Emotive & Cognitive-Behavior Therapy. 2019;37(3):223-40.
  15. Durães RSS, Khafif TC, Lotufo-Neto F, Serafim AdP. Effectiveness of cognitive behavioral couple therapy on reducing depression and anxiety symptoms and increasing dyadic adjustment and marital social skills: An exploratory study. The Family Journal. 2020;28(4):344-55.
  16. Abbsi Bourondaragh S, Kimyaee SA, Ghanbari Hashemabadi B. Investigation and comparison of effectiveness of integrative-behavior and cognitive-behavior of couple therapy on communicational beliefs of couples who want to divorce. Journal of modern psychological researches. 2013;8(31):53-71.
  17. Thompson A. Integrative behavioral couple therapy: A therapist's guide to creating acceptance and change. Journal of Marital and Family Therapy. 2021;47(3):805-6.
  18. Christensen A, Doss BD, Jacobson NS. Integrative behavioral couple therapy: A therapist's guide to creating acceptance and change: WW Norton & Company; 2020.
  19. Heidari Z, Ghamari M, Jafari A, Armani Kian A. The effectiveness of integrative behavioral couple therapy (ibct) on emotional divorce of couples: A randomized clinical trial. Journal of Iranian Medical Council. 2021;4(2):72-9.
  20. Barraca J. Integrative Behavioral Couple Therapy (IBCT) as a third-wave therapy. Psicothema. 2015; 27(1): 13-18.
  21. Heavey CL, Larson BM, Zumtobel DC, Christensen A. The Communication Patterns Questionnaire: The reliability and validity of a constructive communication subscale. Journal of Marriage and the Family. 1996:796-800.
  22. Samadzadeh M, Shaieri MR, Javidi N. Communication patterns questionnair: The reliability and validity. Family Counseling and Psychotherapy. 2013;3(1):124-50.
  23. Fitter J. Getting past the affair. A program to help you cope, heal, and move on–together or apart. Sexual and Relationship Therapy. 2007;22(3):380.
  24. Gurman AS. The theory and practice of couple therapy: History, contemporary models, and a framework for comparative analysis. 2015.
  25. Roohi Karimi T, Shirazi M, Sanagouye Moharrer GR. Comparison of the Effectiveness of Cognitive-Behavioral Couple Therapy and Acceptance and Commitment Couple Therapy on the Couple Burnout and Post-traumatic Stress of Women Affected by Marital Infidelity. Family Counseling and Psychotherapy. 2021;10(2):41-74.
  26. Gharagozloo N, Moradhaseli M, Atadokht A. Comparing the effectiveness of face-to-face and virtual Cognitive-behavioral Couples Therapy on the Post-traumatic stress disorder in Extra-Marital Relations. 2018.
  27. Baran-Oladi S, Etemadi O, Ahmadi SA, Fatehizade M. Couples Therapy after the Infidelity of Men: A Controlled Trial Study. Journal of Research in Behavioural Sciences. 2018;16(1):32-8.
  28. Bodenmann G, Kessler M, Kuhn R, Hocker L, Randall AK. Cognitive-behavioral and emotion-focused couple therapy: Similarities and differences. Clinical Psychology in Europe. 2020;2(3):1-12.
  29. Shahbazfar R, Zarei E, Hajializadeh K, Dortaj F. Comparison of Effectiveness of Cognitive-Behavioral Couple Therapy and Acceptance Commitment Therapy Approaches in Affective-sexual Needs. Journal of Research in Behavioural Sciences. 2020;18(3):403-15.
  30. Sevier M, Atkins DC, Doss BD, Christensen A. Up and down or down and up? The process of change in constructive couple behavior during traditional and integrative behavioral couple therapy. Journal of marital and family therapy. 2015;41(1):113-27.
  31. Baucom KJ, Baucom BR, Christensen A. Changes in dyadic communication during and after integrative and traditional behavioral couple therapy. Behaviour research and therapy. 2015;65:18-28.
  32. Kalai C, Eldridge K. Integrative Behavioral Couple Therapy for intercultural couples: Helping couples navigate cultural differences. Contemporary Family Therapy. 2021;43(3):259-75.
  33. Marín RA, Christensen A, Atkins DC. Infidelity and behavioral couple therapy: Relationship outcomes over 5 years following therapy. Couple and family psychology: Research and practice. 2014;3(1):1-12.
  34. Atkins DC, Eldridge KA, Baucom DH, Christensen A. Infidelity and behavioral couple therapy: optimism in the face of betrayal. Journal of consulting and clinical psychology. 2005;73(1):144-150.
  35. Roddy MK, Stamatis CA, Rothman K, Doss BD. Mechanisms of change in a brief, online relationship intervention. Journal of Family Psychology. 2020;34(1):57-67.
  36. Salari Feizabad H, Nouranipoor R, Zahrakar K. Comparison of the effectiveness of integrative couple therapy and integrative behavioral couple therapy on increasing the resilience of couples affected by infidelity. Shenakht Journal of Psychology and Psychiatry. 2021;7(6):100-14.
  37. Fia SD. Efficacy of Integrative Behavioural Couples Therapy and Cognitive Behavioural Therapy in Reducing Conflict and Violence-Related Marital Distress. European Scientific Journal. 2020;16(20):66-71.

38. Christensen A, Doss BD. Integrative behavioral couple therapy. Current opinion in psychology. 2017;13:111-4.