Single session behavioral therapy with the couple

Single session behavioral therapy with the couple

The article we present today refers to research in which the effects of two alternative interventions carried out in single sessions of Couples Behavioral Therapy are explored , one focused on communication and the other on problem solving (Silva & Vandenberghe, 2007).

The objective of the article is to show how different types of intervention can make the SST meeting more effective in the specific area of ​​intervention with the couple.

What problems does the therapist encounter when working with couples?

Often the couples therapist is faced with the partners’ request to be helped to find the solution to their specific problems. A request that if satisfied often turns into an unproductive intervention. By attempting to resolve the content of partners’ conflicts , the therapist may unintentionally aggravate them or even trigger new ones (Schmaling, Fruzzetti & Jacobson, 1997).

What differentiates a couple with a relational disorder from a functional couple, in fact, is not the fact of having problems, but the inability to deal with them . In couples with problems it is often observed how one tries to convince the other to change behavior, accusing the partner or anyone else (family, friends, etc.) of not being on her side. This attitude, in addition to paradoxically reducing the ability to influence the other’s behavior (Gottman, Notarius, Gonso & Markman, 1976), leads partners to avoid each other or exacerbate the conflict (Patterson & Hops, 1972).  



How are couple problems addressed with Behavioral Therapy?

Currently in Behavioral Therapy two groups of techniques are used to intervene with the couple and obtain lasting results: communication training and problem solving training (Berns, Jacobson & Christensen, 2000; Fowers, 2001; Schmaling et al. , 1997 ; Jacobson & Christensen, 1996; Shoham, Rohrbaugh & Patterson, 1976;


  • In communication training , the goal is to systematically train the couple’s communication skills, which can be used for more fruitful interactions in everyday life (Christensen et al ., 1995). Research shows that during a conversation between spouses, partners often interrupt each other, hurt feelings more, and are harsher with each other (Gottman et al. , 1976). Typical inefficiencies of marital communication include: discussing an issue, deviating from the main topic, presupposing the intent of the partner’s statement, inserting a complaint into every response given to the partner, and reproducing the same discussion, over and over, without progress. or resolution (Carey, Wincze & Meisler, 1999).


  • In problem solving training , the couple defines a conflictual issue, negotiates a contract or pact for change (i.e. a rule) that they implement in daily life . The therapist reinforces compliance with the rule, but expects that in its absence natural reinforcers will maintain the behavior.



How are SST and Behavioral Therapy integrated into couple intervention?

In general, couple therapy requires the therapist to take a more active and reactive approach than that required in individual intervention. This guarantees greater effectiveness of the intervention, therefore already in the first session the therapist must actively demonstrate a greater repertoire of skills to respond to this type of client (Odell & Quinn, 1998).



The question, however, is “ What techniques (communication training or problem solving) can maximize the effectiveness of the first (and perhaps only) conversation with the couple? ”

The research presented in this article intends to answer this question and other specific questions:

  1. Verify the effect of awareness of one’s own verbal behavior (focus on communication) on the frequency of verbal interaction categories in the discussion of a couple problem.
  2. Verify the influence of a problem solving script on the frequency of verbal interaction categories in the discussion of a couple’s problem.
  3. To test the influence of these two types of interventions on the relative time spent by partners with the different categories during the discussion of a couple problem.



How was the study carried out?

Six couples participated in the study, divided into two groups. Three in the communication focus group (group A) and three in the problem solving group (group B). As a selection criterion, the couple had to have been in a relationship for at least one year and not be in psychotherapy. Each couple attended three meetings, with weekly breaks. Both groups underwent the same baseline (first meeting) and post-intervention (third meeting) procedures, with the intervention session (second meeting) as a differential procedure performed between the groups. For further information on the method and procedures for carrying out the research. 


Let’s see a summary of the results that emerged!

The behaviors observed in groups A and B were analyzed and classified using the same procedure, taking into account both the structural and functional aspects of verbal behavior. For research scores. From the analysis of the dialogues that took place during the baseline and post-intervention sessions, it emerged that:


  • The results of the pairs in the communication group (particularly pairs 1A and 2A) are the best . Awareness of their own verbal behavior may have influenced the change in their interaction, reinforcing the argument of Schmaling et al. (1997) according to which the simple identification of the conflict pattern may be sufficient for some couples to eliminate destructive behaviors in their interactions.


  • All couples showed positive variations with respect to the difficulty in remaining more aligned with the discussion of the chosen problem , with the exception of one couple (2B). Two pairs (2A and 1B) present in both groups significantly increased the ability to arrive at the solution. However, only one pair (2A) succeeded in solving the chosen problem.


  • The results imply that the intervention in group B (problem solving) did not have the expected effect . The couples were more involved in finding the causes of the problem than in its resolution. Two of them complained during the surgery, claiming that it was difficult to implement the procedure in daily life. Probably proposing a ready-made strategy makes it difficult for the couple to identify with it, or perhaps this type of intervention is simply less suitable for a single session. However, in cases where couples had solved the problem, they did not attribute the reason to the problem solving technique, but to other aspects.


  • Fowers (2001) advises therapists to consider self-control, courage, generosity, fairness and common sense as prerogatives of communication skills and to motivate couples to cultivate these qualities to improve communication between them. In this sense, the result of some couples (1st and 2nd) was facilitated by the low rate of interruption, empowerment and expression of mutual vulnerabilities. The couples (1A, 2A and 3B) were the only ones to admit their flaws or their partner’s qualities and break up. Their own vulnerability was expressed and welcomed with skill by couples 1A and 2A, who showed support towards the partner who expressed suffering. They were also the ones who showed the most tolerance for criticism. The couple with the most difficulty in expressing and accepting vulnerability was 3A, who presented a tense dialogue, with insults, altered voices, threats and accusations.




The research presented suggests that if couples identify their destructive communication patterns through a session , they can at the same time learn that it is possible to use functional communication to overcome their problems. Furthermore, since couples are more demanding than individuals in terms of the speed of therapeutic results to be achieved, an intervention capable of maximizing the effectiveness of a single interview can be an important incentive to continue treatment , or even to benefit of those couples who undergo a single psychotherapy session .


Angelica Giannetti
Psychologist, Psychotherapist
Team of the Italian Center
for Single Session Therapy




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Christensen, A., Jacobson, N. S. & Babcock (1995). Integrative Behavioral Couple Therapy. In: NS Jacobson & AS Gurman (Orgs.), Clinical Handbook of Marital Therapy (pp. 31-64). New York: Guilford. 

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Gottman, J. M., Notarius, C. I., Gonso, J. & Markman, H. J. (1976). A Couples Guide to Communication. Champaign: Research Press .

Odell, M. & Quinn, W. H. (1998). Therapist and Client Behaviors in the First Interview: Effects on Session Impact and Treatment Duration. Journal of Marital and Family Therapy . 24, 369-388.       

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Rose, S. D. (1977). Group therapy: A behavioral approach . New York: Appleton-Century-Crofts.        

Schmaling, K. B., Fruzzetti, A. E. & Jacobson, N. S. (1997). Problemas Conjugais. In: K. Halton, PM Salkovskis, J. Kirk & DM Clark (Orgs.), Cognitive-Behavioral Therapy for Problemas. Psychiatrists: A Practical Guide . Sao Paulo. Martins Fontes.

Silva, L. & Vandenberghe, L. (2007). Communication versus problem resolution in the only session of home behavioral therapy. Revista Brasileira de Terapia Behavioral e Cognitiva 11(1), 43 -60.


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