Empirically Supported Couples Therapies
More than emotional validation and date nights.
Photo by cottonbro studio
Last week, we looked at how to choose a couples therapist, and one of the key factors was the therapist’s familiarity with empirically supported therapies, or those that have been developed and refined through years of clinical research.
When couples seek help, they need something that’s been tested, honed, and replicated in diverse populations. Empirical support means that a therapy has undergone rigorous investigation—demonstrated by randomized controlled trials, quasi-experimental studies, longitudinal studies, cohort studies, systematic reviews and meta-analyses—to determine not just whether it works, but how it works, for whom, and under what conditions.
Couples are unique. What works beautifully for one may fall flat for another, but empirically supported therapies give therapists a solid foundation: a collection of interventions that reliably work across a wide range of couples. This allows for flexibility and nuance: therapists can adjust their approach while still leaning on evidence-based principles.
This is also where assessment comes in. In empirically supported models, assessment is an ongoing process that digs deep into the dynamics of the couple. A well-done initial assessment helps the therapist understand a couple’s strengths and vulnerabilities, as well as the specific cycles that keep them stuck. With that knowledge, therapy is not a guessing game. It’s precise, intentional, and data-driven.
The Folklore Problem
Not every couples therapist uses evidence-based methods. Some rely on what I call folk therapy, a patchwork of reflective listening, date nights, and personal experience. Well-meaning, often empathetic, but not a treatment plan.
This kind of approach also tends to carry cultural baggage about what a "good" relationship should look like. Folk therapists project their own beliefs onto couples, assuming what worked for them, or what they believe should work, applies universally. But every relationship is a unique ecosystem: they thrive or wither based on the resolution of specific dynamics.
In some cases, those therapists may be quite skilled in individual therapy but out of their depth with couples. Lacking specific training, they default to familiar individual techniques, like boundary setting or self-discovery, which may work for personal growth but fail at relational repair.
At best, folk therapies are ineffective and a waste of time and money. At worst, they can make problems worse or cause couples to give up hope. We can do better than that.
Four Therapies that Work
The good news is that decades of research have shown four couples therapy treatments to be effective for a wide variety of problems: the Gottman Method, Emotionally Focused Therapy, Acceptance and Commitment Therapy, and Integrative Behavioral Couple Therapy. While the Gottman Method is often seen as the gold standard due to its extensive research base, each of these therapies has substantial empirical support and each has unique elements that may be better suited for certain couples or specific relationship issues.
The Gottman Method
The Gottman Method was developed by Dr. John Gottman and Dr. Julie Schwartz Gottman. Grounded in forty years of research with thousands of couples, the Gottman Method is a widely used approach that helps partners develop skills that are associated with happy couples while letting go of habits that predict divorce. The Gottman Method incorporates principles from cognitive, behavioral, and emotion-based therapy; existential and humanistic psychology; and systems theory. It focuses primarily on improving communication, managing conflict, and deepening emotional bonds.
How does the Gottman Method work?
The primary goals of the Gottman Method are to improve verbal communication skills; increase intimacy, respect, and affection; remove barriers that create feelings of stagnancy; and foster empathy and understanding. These goals are achieved by focusing on three main areas: friendship, conflict management, and the creation of shared meaning.
Therapy begins with a comprehensive assessment of the couple’s relationship using nine research-supported dimensions of relationship health. This assessment helps pinpoint strengths and vulnerabilities, providing a roadmap for therapy. Based on the results, the couple and the therapist collaboratively decide on the frequency and duration of sessions, tailored to the specific needs identified during assessment.
Research Base
The Gottman Method has a substantial research base dating back to the 1970s. Multiple outcome studies, including randomized controlled trials and longitudinal research, have demonstrated its effectiveness in reducing conflict, increasing relationship stability, and improving overall satisfaction. The Gottman Method has been shown to address a wide range of relationship challenges, including communication problems, conflict resolution, parenting issues, infidelity, addiction, and domestic violence. Its focus on communication and conflict resolution is grounded in empirical findings from studies involving over 3,000 couples.
Who can provide Gottman Method Therapy?
Gottman Method therapy should be provided by a licensed mental health professional who has completed formal training in the Gottman Method. There are four levels of training and certification in the Gottman Method.
Emotionally Focused Therapy for Couples
Emotionally Focused Therapy (EFT) was developed in the 1980s by Dr. Sue Johnson and Leslie Greenberg. EFT is grounded in attachment theory and focuses on creating secure emotional bonds between partners. Through structured conversations, EFT helps couples identify and disrupt negative cycles driven by unmet attachment needs. The goal is to transform conflict into moments of connection by deepening vulnerability and trust. It operates on the principle that emotions, rather than reason, are the organizing experiences of human life. It incorporates elements of experiential therapy such as gestalt and person-centered approaches, systemic therapy, and attachment theory.
How does EFT for Couples work?
EFT is based on the psychological theory of attachment bonds and centers on emotions and their role in our identity and decision-making. The therapist helps couples identify negative interaction patterns that contribute to conflict and then reframe those conflicts in terms of the feelings driving the pattern. The process helps to reduce conflict and creates a more secure emotional bond as each partner learns to share their emotions and develop acceptance and compassion for the other, resulting in new communication strategies and interaction patterns marked by more effective conflict strategies.
Research Base
EFT is one of the most rigorously studied couples therapies, with randomized controlled trials showing its effectiveness in fostering emotional security and reducing distress in couples. Meta-analyses report significant improvement in relationship satisfaction for up to two years post-therapy.
Who can provide EFT for Couples?
EFT can be provided by licensed mental health professionals who have additional training and experience in EFT. Therapists can receive certification through the International Centre for Excellence in Emotionally Focused Therapy (ICEEFT).
Acceptance and Commitment Therapy for Couples
Acceptance and Commitment Therapy (ACT) is a third-wave behavior therapy developed at the University of Nevada in the 1980s. Originally designed by Dr. Steven Hayes as an individual therapy, ACT helps clients accept their emotions and commit to making necessary behavior changes, regardless of their feelings or life circumstances.
As a couples therapy, ACT encourages partners to acknowledge their emotional responses without judgment, stay present, and use their mutual core values to guide decisions. Couples commit to behaviors that align with their values, fostering growth, connection, and resilience.
How does ACT for Couples work?
ACT focuses on fostering emotional acceptance and psychological flexibility. The ACT therapist helps couples accept their thoughts and feelings without over-identifying with them and then commit to actions aligned with personal and shared values. Mindfulness-based practices are at the core of ACT, enhancing emotional awareness and validation.
Through ACT, couples learn to identify core values, approach conflict resolution nonjudgmentally, and align individual values within the relationship. The result is greater empathy, compassion, and a more meaningful life together.
Research Base
ACT has an extensive research base as an individual treatment. While newer to the couples therapy landscape, ACT has been supported by quasi-experimental studies and longitudinal research highlighting its role in enhancing emotional resilience and communication skills. Preliminary trials indicate its effectiveness in reducing conflict and promoting relational well-being.
Who can provide ACT for Couples?
Qualifications for providing ACT can vary as there is no standardized certification program. Providers typically include licensed mental health professionals with expertise in couples and family therapy. Training in ACT is typically covered in graduate programs, clinical trials, and specialized workshops.
Integrative Behavioral Couple Therapy
Integrative Behavioral Couple Therapy (IBCT) is a behavioral approach developed by Dr. Neil Jacobson and Dr. Andrew Christensen at UCLA in the 1990s. Unlike traditional behavioral models that prioritize change, IBCT blends principles of behavioral therapy with emotional acceptance, helping couples understand and accept each other’s differences instead of trying to eliminate them. The model acknowledges that some conflicts are perpetual but still manageable with acceptance and empathy. IBCT integrates various treatment strategies within a consistent behavioral framework, emphasizing both acceptance and change as positive therapeutic outcomes.
How does IBCT work?
IBCT is structured around three main phases: evaluation, feedback, and treatment. In the evaluation phase, the therapist works with the couple to understand their dynamics, conflict cycles, and emotional triggers. This is followed by feedback, where findings are shared, and collaborative goals are set.
In the treatment phase, IBCT emphasizes both emotional acceptance and behavioral change. Unlike traditional behavioral therapy, which often prescribes the “right way” to communicate, IBCT helps partners understand and accept each other’s unique communication styles.
IBCT aims to reduce emotional reactivity and increase acceptance, making room for more adaptive communication and deeper connection.
Research Base
IBCT is supported by randomized controlled trials and cohort studies, demonstrating its effectiveness in reducing relationship distress and maintaining long-term improvements in relational stability. Its holistic, flexible and personalized approach to treatment planning addresses limitations observed in more heavily structured traditional behavioral couples therapy.
Who can provide IBCT?
IBCT is typically provided by licensed mental health professionals with specialized training in couples therapy. Qualifications for providing IBCT can vary as there is no standardized certification program
How to Choose the Right Approach
Each of the four therapies described above offers distinct strengths:
If you’re looking to improve communication and manage conflict effectively, the Gottman Method’s structured approach may be the best fit.
For couples seeking deeper emotional connection and a way to heal attachment wounds, EFT’s focus on vulnerability and bonding is often transformative.
If you’re navigating life transitions or dealing with ongoing external stressors, ACT’s emphasis on psychological flexibility and values-based living can help you stay grounded and connected.
If you and your partner struggle with accepting each other’s differences or feel stuck in repetitive conflict cycles, IBCT’s blend of acceptance and behavior change provides a path forward.
That said, each of these four therapies is flexible enough to cover all the areas above. In fact, most therapists, even if they mainly practice one method, will often draw from the others to meet the needs of the couple in front of them. The main thing is to find a provider you trust, who is well-trained enough to effectively provide at least one of the evidence-based therapies above.
The key takeaway: don’t settle for guesswork. Choose a therapy backed by decades of research, one that’s been shown to help couples heal, connect, and thrive.