ABSTRACT
This chapter explores in detail what is known regarding the clinical effectiveness of a behavior exchange approach in the treatment of relationship problems. There is no empirical basis for the assertion that behavior therapy is more effective than other approaches to treating relationship problems. The comparative studies are inconclusive, and replete with methodological limitations. If the spouse becomes the assessor, no matter how quantifiable or objective the recording becomes, a reliability problem is introduced, which can be monitored only by bringing an observer back into the home, which in turn might change the behavior being monitored. Once a treatment package has been demonstrated to be effective relative to some control baseline, two areas of extension and elaboration become the primary focus of investigators-the identification of active ingredients within the treatment, and the generalizability of the findings. In the early years of behavior therapy with couples, reports consisted primarily of replicated case studies.
