Principle‐Based Integrative Therapy with Couples: Theory and a Case Example

Abstract

The Principle‐Based Integrative Therapy (PBIT) framework harnesses the principles of change underlying each theoretical model within integrative couple therapy treatments. PBIT has commonalities with other integrative approaches, and additional advantages stemming from its four tenets that guide therapists in combining strengths across models and overcoming each of their deficiencies. Tenet 1 advises that each model adds a core principle or mechanism of action that other models do not automatically address. Tenet 2 focuses on how techniques of one model may actualize the principles of other models. Tenet 3 ensures complementarity and a lack of conflict across principles. A case study and common case considerations are presented to illustrate how Tenets 1–3 can work in integrating Cognitive‐Behavioral, Multicultural, and Emotionally Focused Therapy models in working with a couple. Finally, Tenet 4 advocates for the use of models and empirically supported principles that also have received empirical support with diverse populations. Prerequisites and training implications for PBIT, and future clinical and research directions to further the utility of PBIT are discussed.

Couple therapy in the 2020s: Current status and emerging developments

“…And from this perspective, marital therapy without much self‐reflection often spoke primarily to the experience of white, middle‐ and upper‐class Americans and Europeans. Feminist, queer, and multicultural perspectives, as well as the dissemination of couple therapy around the world, have very much changed this perspective (Addison & Coolhart, 2015 ; Kelly et al, 2019 ). Couple therapy is now a vehicle for helping with intimate relationships across gender, sexual preference, class, culture, race, ethnicity, and other facets of social location.…”

Editorial: Integration in Couple and Family Therapy

“…The papers in this section also show how integration is increasingly becoming interwoven with the translation of research into practice (Chambers, ; Kelly et al., ; Lebow, ). A vast body of empirical knowledge about families and couple and family therapy has accrued.…”

“…As I suggest in my article in this issue (Lebow, ), integration across methods of practice is very much with us. One prominent aspect in many integrations is the melding of individual and systemic concepts and of individual and conjoint session structures (Chambers, ; Fraenkel, ; Kelly et al., ; Russell & Breunlin, ; Scheinkman, ). Although there remain some pure form “old school” systemic practitioners who focus exclusively on the family system, couple and family therapy has for good or ill (I think mostly for good though others may disagree) become therapy that includes such an integration of individual and systemic processes.…”

“…In a closely related development, several of these papers (Chambers, 2019;Davis & Hsieh, 2019;Kelly et al, 2019;Russell & Breunlin, 2019;Scheinkman, 2019) push beyond specific methods of integration to suggest underlying principles of practice in couple and family therapy. Perhaps the most important effect of such lists of principles lies in their potential for launching conversation about these principles.…”

“…In their papers, Chambers () and Kelly et al. () also call our attention to the now frequent presence of methods with a major focus on culture in integrative practice. Cultural context has been demonstrated to make a difference, and cultural competence is an important skill for every therapist regardless of theoretical orientation (Hardy & Bobes, ), but the point here extends beyond repeating these widely accepted observations to highlight the emergence of a focus on cultural context and other intersectionality as a major theoretical and clinical framework that now often occupies a central place in many integrative couple and family therapies (McDowell, Knudson‐Martin, & Bermudez, ).…”