Skip to main content
Log in

Integrative Behavioral Couple Therapy for Intercultural Couples: Helping Couples Navigate Cultural Differences

  • Original Paper
  • Published:
Contemporary Family Therapy Aims and scope Submit manuscript

Abstract

Integrative Behavioral Couple Therapy (IBCT), an empirically supported third-wave behavioral approach for the treatment of couples, is examined in this multiple case study. IBCT was developed to help couples navigate challenging differences, so this study examines its use with couples reporting problems arising from differences in self-identified cultural identities, practices, or beliefs. The experiences of three therapists using IBCT in their work with intercultural couples is examined. Each participating therapist in this study contributes by describing one case in which IBCT was used to help the couple with existing conflicts related to cultural differences. These descriptions, provided through written responses to open-ended questions, were examined using cross-case analysis. Results include descriptions of the various stressors faced by intercultural couples, therapists’ formulations of cultural differences, change processes and change mechanisms during treatment, and similarities and differences across therapists’ reports. Specific quotations that demonstrate main ideas and particularly poignant or useful information are integrated. The study concludes with participating therapists’ recommendations for treatment of intercultural couples in general, their recommendations for utilizing IBCT with intercultural couples, and implications for future research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

The lead author affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that there are no discrepancies from the study as originally planned.

Code availability

Not Applicable.

References

  • APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271–285. https://doi.org/10.1037/0003-066X.61.4.271.

    Article  Google Scholar 

  • Baucom, D. H., Shoham, V., Mueser, K. T., Daiuto, A. D., & Stickle, T. R. (1998). Empirically supported couple and family interventions for marital distress and adult mental health problems. Journal of Consulting and Clinical Psychology, 66(1), 53–88. https://doi.org/10.1037/0022-006X.66.1.53.

    Article  PubMed  Google Scholar 

  • Baxter, P., & Jack, S. (2008). Qualitative case study methodology: Study design and implementation for novice researchers. The Qualitative Report, 13(4), 544–559.

    Google Scholar 

  • Benson, L., & Christensen, A. (2016). Traditional and Integrative Behavioral Couple Therapy. In T. Sexton & J. Lebow (Eds.), Handbook of family therapy (pp. 349–360). New York: Routledge.

    Google Scholar 

  • Benson, L., McGinn, M., & Christensen, A. (2012). Common principles of couple therapy. Behavior Therapy, 43, 25–35.

    Article  Google Scholar 

  • Betancourt, H., & Lopez, S. R. (1993). The study of culture, ethnicity, and race in American psychology. American Psychologist, 48, 620–637.

    Article  Google Scholar 

  • Bradbury, T., & Bodenmann, G. (2020). Interventions for couples. Annual Review of Clinical Psychology, 16, 99–123.

    Article  Google Scholar 

  • Bustamante, R. M., Nelson, J. A., Henriksen, R. R., & Monakes, S. (2011). Intercultural couples: Coping with culture-related stressors. The Family Journal, 19(2), 154–164. https://doi.org/10.1177/1066480711399723.

    Article  Google Scholar 

  • Camarota, S. A. (2001). Immigrants in the United States–2000: A snapshot of America’s foreign-born population. Retrieved from http://cis.org/ForeignBornPopulation2000

  • Christensen, A., Atkins, D. C., Baucom, B., & Yi, J. (2010). Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus behavioral couple therapy. Journal of Consulting and Clinical Psychology, 78(2), 225–235. https://doi.org/10.1037/a0018132.

    Article  PubMed  Google Scholar 

  • Christensen, A., Atkins, D. C., Berns, S., Wheeler, J., Baucom, D. H., & Simpson, L. E. (2004). Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples. Journal of Consulting and Clinical Psychology, 72(2), 176–191. https://doi.org/10.1037/0022-006X.72.2.176.

    Article  PubMed  Google Scholar 

  • Christensen, A., Atkins, D. C., Yi, J., Baucom, D. H., & George, W. H. (2006). Couple and individual adjustment for two years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology, 74, 1180–1191. https://doi.org/10.1037/0022-006X.74.6.1180.

    Article  PubMed  Google Scholar 

  • Christensen, A., Doss, B. D., & Jacobson, N. S. (2014). Reconcilable differences. New York, NY: Guilford Press.

    Google Scholar 

  • Christensen, A., Doss, B. D., & Jacobson, N. S. (2020). Integrative Behavioral Couple Therapy: A therapist’s guide to creating acceptance and change (2nd ed.). New York: Norton.

    Google Scholar 

  • Christensen, A., Wheeler, J. G., & Jacobson, N. S. (2008). Couple distress. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (4th ed., pp. 662–689). New York, NY: Guilford Press.

    Google Scholar 

  • Doss, B. D., Thum, Y. M., Sevier, M., Atkins, D. C., & Christensen, A. (2005). Improving relationships: Mechanisms of change in couple therapy. Journal of Consulting and Clinical Psychology, 73(4), 624–633. https://doi.org/10.1037/0022-006X.73.4.624.

    Article  PubMed  Google Scholar 

  • Eldridge, K., Christensen, A., & Jacobson, N. S. (1999). Integrative couple therapy. In D. M. Lawson & F. F. Prevatt (Eds.), Casebook in family therapy (pp. 51–80). Pacific Grove, CA: Brooks/Cole.

    Google Scholar 

  • Epstein, N. B., & Baucom, D. H. (2002). Enhanced cognitive-behavioral therapy for couples: A contextual approach. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Falicov, C. J. (1995). Cross-cultural marriages. In N. Jacobson & A. Gurman (Eds.), Clinical handbook of couple therapy (pp. 231–246). New York, NY: Guilford.

    Google Scholar 

  • Gaines, S. O., Jr., & Brennan, K. A. (2001). Establishing and maintaining satisfaction in multicultural relationships. In J. H. Harvey & A. Wenzel (Eds.), Close romantic relationships: maintenance and enhancement (pp. 237–253). Mahwah, NJ: Lawrence Erlbaum Associates Inc.

    Google Scholar 

  • Gurman, A. (2011). Research and the practice of couple therapy: Can we talk? Family Process, 50, 280–292.

    Article  Google Scholar 

  • Hays, P. A. (2001). Addressing cultural complexities in practice: A framework for clinicians and counselors. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Hays, P. (2016). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Hsu, J. (2001). Marital therapy for intercultural couples. In W. S. Tseng & J. Streltzer (Eds.), Culture and psychotherapy: A guide to clinical practice (pp. 225–242). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Jacobson, N. D., & Margolin, G. (1979). Marital therapy: Strategies based on social learning and behavior exchange principles. New York: Brunner/Mazel.

    Google Scholar 

  • Jacobson, N. S., Christensen, A., Prince, S. E., Cordova, J., & Eldridge, K. (2000). Integrative behavioral couple therapy: An acceptance-based, promising new treatment for couple discord. Journal of Consulting and Clinical Psychology, 68(2), 351–355. https://doi.org/10.1037/0022-006X.68.2.351.

    Article  PubMed  Google Scholar 

  • Johnson, S. M. (2020). The practice of emotionally focused couple therapy (3rd ed.). New York, NY: Brunner Routledge.

    Google Scholar 

  • Knobloch-Fedders, L. M., Elkin, I., & Kiesler, D. J. (2015). Looking back, looking forward: A historical reflection on psychotherapy process research. Psychotherapy Research, 25(4), 383–395. https://doi.org/10.1080/10503307.2014.

    Article  PubMed  Google Scholar 

  • Lebow, J. L., Chambers, A. L., Christensen, A., & Johnson, S. (2012). Research on the treatment of couple distress. Journal of Marital and Family Therapy, 38(1), 145–168. https://doi.org/10.1111/j.1752-0606.2011.00249.x.

    Article  PubMed  Google Scholar 

  • Mahgerefteh, H. (2015). Integrative behavioral couple therapy: A case study (Unpublished doctoral dissertation). Malibu, California: Pepperdine University.

    Google Scholar 

  • Mabry, C. R. (2010). The browning of America-Multicultural and bicultural families in conflict: Making culture a customary factor for consideration in child custody disputes. Washington and Lee Journal of Civil Rights and Social Justice, 16(2), 413–443.

    Google Scholar 

  • McGoldrick, M., Giordano, J., & Garcia-Preto, N. (2005). Overview: Ethnicity and family therapy. In M. McGoldrick & J. Giordano (Eds.), Ethnicity and family therapy (3rd ed., pp. 1–27). New York, NY: Guilford.

    Google Scholar 

  • Roddy, M., Nowlan, K., Doss, B., & Christensen, A. (2016). Integrative Behavioral Couple Therapy: Theoretical background, empirical research, and dissemination. Family Process, 55, 408–422.

    Article  Google Scholar 

  • Rowley, J. (2002). Using case studies in research. Management Research News, 25(1), 16–27.

    Article  Google Scholar 

  • Schachter, J. S. (2015). Processes and mechanisms of change in integrative behavioral couple therapy: A case study of one couple with distress over child rearing (Unpublished doctoral dissertation). Malibu, California: Pepperdine University.

    Google Scholar 

  • Seshadri, G., & Knudson-Martin, C. (2013). How couples manage interracial and intercultural differences: Implications for clinical practice. Journal of Marital and Family Therapy, 39(1), 43–58. https://doi.org/10.1111/j.1752-0606.2011.00262.x.

    Article  PubMed  Google Scholar 

  • Sevier, M., & Yi, J. C. (2008). Cultural considerations in evidence-based traditional and integrative behavioral couple therapy. In M. Rastogi & V. K. Thomas (Eds.), Multicultural couple therapy (pp. 187–212). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Sexton, T. L., & Datchi, C. (2014). The development and evolution of family therapy research: Its impact on practice, current status, and future directions. Family Process, 53(3), 415–433. https://doi.org/10.1111/famp.12084.

    Article  PubMed  Google Scholar 

  • Sexton, T. L., & LaFollette, J. R. (2016). Finding what works: Systematically evaluating the research evidence in couple and family therapy. In K. T. Sullivan & E. Lawrence (Eds.), The Oxford handbook of relationship science and couple interventions (pp. 164–176). York: Oxford University Press.

    Google Scholar 

  • Shadish, W. R., & Baldwin, S. A. (2003). Meta-analysis of MFT interventions. Journal of Marital and Family Therapy, 29(4), 547–570. https://doi.org/10.1111/j.1752-0606.2003.tb01694.x.

    Article  PubMed  Google Scholar 

  • Sullivan, C., & Cottone, R. (2006). Culturally based couple therapy and intercultural relationships: A review of the literature. The Family Journal: Counseling and Therapy for Couples and Families, 14(3), 221–225. https://doi.org/10.1177/1066480706287278.

    Article  Google Scholar 

  • Stake, R. E. (1995). The art of case study research. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Waldman, K., & Rubalcava, L. (2005). Psychotherapy with intercultural couples: A contemporary psychodynamic approach. American Journal of Psychotherapy, 59(3), 227–245.

    Article  Google Scholar 

  • Yin, R. K. (2014). Case study research design and methods (2nd ed.). Los Angeles, CA: Sage Publications.

    Google Scholar 

  • Zucker, D. M., (2009). How to do case study research. Retrieved from http://works.bepress.com/donna_zucker/14

Download references

Acknowledgements

The authors would like to express gratitude to dissertation committee members, Barbara Ingram, PhD and Mia Sevier, PhD.

Funding

Not applicable; this research did not require the support of funding.

Author information

Authors and Affiliations

Authors

Contributions

Research topic was initiated by Caroline Kalai as a dissertation project and supervised by Kathleen Eldridge. All authors contributed to the study conception and design. Material preparation and data analysis were performed by all authors. Data collection was performed by Caroline Kalai. The first draft of the manuscript was written by Caroline Kalai and revised by Kathleen Eldridge. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Caroline Kalai.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest/competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kalai, C., Eldridge, K. Integrative Behavioral Couple Therapy for Intercultural Couples: Helping Couples Navigate Cultural Differences. Contemp Fam Ther 43, 259–275 (2021). https://doi.org/10.1007/s10591-020-09560-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10591-020-09560-8

Keywords

Navigation