According to a recent review in the Journal of Marital and Family Therapy, no couples therapy model met criteria for being well established under the Chambless framework for evaluating empirically supported treatments. ¹ ²
When the authors applied those criteria to 40 eligible studies, they found seven models that cleared the lower bar of probably efficacious: behavioral, CBT, EFT, Gottman, IBCT, insight-oriented, and strategic. The most frequent limitations were small samples and a lack of independent replication rather than a pattern of failed replications.
I have two thoughts about this.
One is that couples therapy trials are often costly, multi-year projects requiring trained therapists and specific clinical samples, which can limit the number of independent replication attempts. So a lack of well-established status may partly reflect the difficulty of getting that research done, as opposed to weak treatment effects.
The other is that modest support for seven different models doesn’t mean there’s only modest support for couples therapy. Rather, it may mean that the active ingredients are shared across them. Common-factors research has been saying this for decades, and this review is consistent with it, even if it doesn’t test that explanation directly. ³
None of this means these findings aren’t important. It means claims of being “evidence-based” often need some unpacking. In couples therapy specifically, a model with modest support is still more tested than one with weak support. But a lack of evidence isn’t evidence of a lack.
¹ 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, 52(4).
² The review used the Chambless criteria, developed for APA Division 12 in 1998 to classify treatments as empirically supported. Its top rating, well established, requires at least two controlled trials showing benefit, run by independent research teams rather than the model’s own developers. Lower tiers—probably efficacious, then weak support—require fewer studies or lack independent replication.
³ Sprenkle, D. H., & Blow, A. J. (2004). Common factors and our sacred models. Journal of Marital and Family Therapy, 30(2), 113–129.