What is behavioural couples therapy?
Behavioural couples therapy is a way of working with couples that focuses on what you each do. You attend with your partner, and the relationship becomes part of the work.
It is a plain behavioural model, not a brand. It shares its roots with behavioural therapy for one person.
It is the couples approach NICE names for depression.
Source: NICE NG222
When NICE recommends it
NICE words it this way:
Consider behavioural couples therapy for people with either less severe or more severe depression who have problems in the relationship with their partner if:
- the relationship problem(s) could be contributing to their depression, or
- involving their partner may help in the treatment of their depression.
NICE chose consider rather than offer. The two verbs carry different weight.
In England, NHS Talking Therapies offers it as one of two couple therapies for depression. The other is Couple Therapy for Depression.
NICE's advice reaches this model only. It does not extend to the other couples methods.
Sources: NICE NG222, NHS England: talking therapies manual
What sessions look like
The guideline sets a dose:
Deliver behavioural couples therapy for people with depression that:
- follows the behavioural principles for couples therapy
- provides 15 to 20 sessions over 5 to 6 months.
15-20
sessions over five to six months
the NICE guideline on depression NICE NG222
- Attend together Both partners take part in a planned course with a therapist.
- Focus on behaviour The work uses behavioural principles to address relationship problems linked with depression.
NICE names this approach for depression in a relationship context. That recommendation does not extend to every couples method.
Source: NICE NG222
Integrative behavioural couple therapy
Integrative behavioural couple therapy, or IBCT, is one form of this work. Andrew Christensen and Neil Jacobson developed it.
It keeps the same tools and adds acceptance. Some differences between partners will not change. The work helps you understand them and live with them, as well as change what can change.
A trial assigned 134 seriously distressed married couples to IBCT or the traditional form. Treatment lasted about eight months.
Five years later, half the IBCT couples and 46% of the others had clinically improved. About a quarter of each group had separated or divorced.
50%
of IBCT couples clinically improved after five years
one trial of 134 couples Christensen et al. 2010
IBCT did better in the first two years after therapy. After that the two forms gave similar results.
Sources: Roddy et al. 2016, Christensen et al. 2004, Christensen et al. 2010
Who it may suit
Behavioural couples therapy can be a good fit if you:
- Have depression, and the relationship is part of the strain
- Want practical changes and a clear plan
- Want to learn ways to talk and solve problems together
- Would like to accept some differences rather than fight them
If one of you is afraid of the other, couples work is not the right start. Our couples page explains why, and where to begin instead.
The evidence
The trial above was large for couples research. One of its authors developed the therapy.
A 2026 review gave both forms modest support. It found no model with strong support.
NICE names it for depression with relationship problems. The problems may add to the low mood, or a partner may help. For relationship difficulties alone, our couples page compares the methods you may hear about.
Sources: Roddy et al. 2016, Jackson et al. 2026, NICE NG222
Thanks for your interest. We're not taking on new clients at the moment.
Looking for behavioural couples therapy?
We ask what matters to you, then find professionals who fit.
- I am low and it is affecting my relationship
- I want to try behavioural couples therapy
- We need practical ways to talk and solve problems
- My GP mentioned couples therapy for depression
References
- National Institute for Health and Care Excellence (2022). Depression in adults: treatment and management (NG222). nice.org.uk
- NHS England (2024). NHS Talking Therapies for anxiety and depression manual, version 7. england.nhs.uk (PDF)
- 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. doi:10.1037/0022-006X.72.2.176
- Christensen, A., Atkins, D. C., Baucom, B. & Yi, J. (2010). Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology. doi:10.1037/a0018132
- Roddy, M. K., Nowlan, K. M., Doss, B. D. & Christensen, A. (2016). Integrative behavioral couple therapy: Theoretical background, empirical research, and dissemination. Family Process. doi:10.1111/famp.12223
- Jackson, J. B., Codecá, L., Miller, R. B., Simpson, J. E., O'Leary, A. M. & Renner, S. M. (2026). Empirically supported couple therapy models for couple relationship distress: A replication and update. Journal of Marital and Family Therapy. doi:10.1111/jmft.70162
