What Is Cognitive Behavior Therapy?

Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.

Changes or goals might involve:

  • A way of acting: like smoking less or being more outgoing;
  • A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
  • A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
  • A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past. They concentrate on a person’s views and beliefs about their life, not on personality traits. Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families. Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.

HOW TO GET HELP: If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet. You may, or may not, find a competent therapist in this manner. It is wise to check on the credentials of a psychotherapist. It is expected that competent therapists hold advanced academic degrees. They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association. Of course, they should be licensed to practice in your state. You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations. You may, of course, visit our website ( and click on "Find a CBT Therapist"

The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition. These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.

According to recent census data, approximately 50% of first marriages end in divorce, one of life's most stressful events. Even for those marriages that do not end in divorce, many are characterized by unhappiness. For example, it has been estimated that approximately 20% of all married couples experience marital distress at any given time. Despite the risk associated with marriage, almost 90% of the population chooses to marry at least once, and nearly 75% of divorced individuals choose to remarry. Therefore, understanding marital distress and its consequences, and developing effective marital therapy treatment programs, have been a major focus of individuals in the field of mental health.

What Is Marital Distress?

Although couples become unhappy with their marriages for a variety of reasons, there are several recurring themes that are frequently associated with marital distress. The most frequent problem reported by unhappy couples is poor communication. Spouses often feel that their partners are making excessive demands or requesting much more than they can give. Other spouses feel that their partners are too withdrawn or do not share or open up enough. Finally, distressed spouses often avoid talking about problems in their relationships because they end up arguing and fighting with each other. These communication problems often result in spouses feeling bad about themselves, their partners, and their relationships.

A second problem frequently associated with marital distress is unrealistic expectations that spouses may hold about marriage or about each other. For example, spouses may believe that their partners should know what they are thinking and feeling without asking. In addition, distressed spouses are likely to have negative explanations for their partners' behavior. For example, distressed spouses are likely to blame their partners for anything bad that occurs in the relationship.

A third problem frequently associated with marital distress is lack of intimacy or loving feelings between spouses. Although the strong emotions associated with courtship naturally decline over time in most relationships, many spouses become upset when they observe such a decline. They may perceive this natural decline as a loss of loving feelings, which is then often associated with a decrease in demonstrations of affection and decreased sexual activities. Other difficulties reported by distressed couples include specific problem topics, such as money management, jealousy, conflicts over values, and problems with in-laws. Other spouses become distressed when confronted with negative life events, such as the death of a family member or a serious illness. Still other couples become distressed because of changes or advancements in one person's life that leave the partner feeling excluded. Employment success and making new friendships are common examples of this.

What Are the Consequences of Marital Distress?

Evidence indicates that individuals who have problems in their marriages are more likely to have a variety of psychological problems, including depression and alcoholism. Compared to individuals who are married and getting along with their spouses, both men and women who are in unhappy marriages are much more likely to be clinically depressed. Distressed spouses are also more susceptible to physical health problems. Another problem reported by spouses who are having marital problems is violence within the relationship. Almost one third of all married couples will experience violence at some time in their marriage, with distressed spouses being at greater risk. Marital violence can have a major impact on the relationship and on the psychological, as well as the physical, well-being of each spouse. Finally, behavioral problems in children are more common in families in which the parents are unhappily married. A number of studies have found that children who are exposed to marital distress, particularly to violence in the home, are at greater risk for their own emotional problems.

Behavioral Treatment

By the time they consider therapy, many couples also have considered the option of divorce. Therapy can help to answer questions of whether or not the relationship can provide what each spouse needs for a satisfying marriage. Although there are a number of treatment programs for unhappily married couples, the most widely researched form of treatment for marital distress is behavioral marital therapy. There are several general goals of this approach to marital therapy. First, spouses are taught how to identify and increase the number of caring behaviors they do for one another. Second, they are taught specific communication skills in order to improve the quality of their communication. Improving communication often produces greater emotional closeness and intimacy in the marriage. Third, spouses are taught problem-solving skills so that they can successfully resolve problems in their relationship without getting into destructive arguments. Finally, they are taught how to improve the quality of their sexual relationship through sexual enhancement, as well as how to identify and modify unrealistic beliefs that may be contributing to their unhappiness.

Many studies have been conducted in the United States and in Europe to evaluate the effectiveness of behavioral marital therapy. Results have shown that about 65% to 75% of the couples treated with this method improve substantially at the end of treatment and maintain these gains following treatment. As with all forms of therapy, however, spouses must be committed to improving the quality of their relationship and be willing to make changes in themselves for therapy to be effective.

Because marital distress is so strongly associated with a variety of psychological problems, nearly 50% of all individuals who seek psychotherapy do so because of marital problems. Research has shown that in addition to improving the quality of the marriage, behavioral marital therapy is an effective treatment for many psychological problems, including depression and alcoholism.

Finally, a number of studies have shown that behavioral premarital intervention programs based on the same principles as behavioral marital therapy programs are effective in helping couples develop and maintain a successful marriage.


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