Empirically Supported Couple Therapy Models for Couple Relationship Distress: A Replication and Update

Abstract

This systematic review replicated and updated Baucom and colleagues' (1998) evaluation of empirically supported treatments (ESTs) for couple relationship distress using the Chambless criteria, the primary framework used by the American Psychological Association to classify ESTs. Applying these criteria to 40 eligible studies, we found that, in contrast to Baucom and colleagues, no couple therapy models met the standards for strong empirical support; insufficient sample size and lack of independent replication were the most frequent limitations. Seven models demonstrated modest support: behavioral, cognitive-behavioral, emotionally focused, Gottman, integrative behavioral, insight-oriented, and strategic couple therapies. Findings highlight the need for rigorous large-scale studies with more diverse couples to strengthen the empirical foundation and generalizability of couple therapies. Limitations of the Chambless criteria underscore the importance of evaluating couple therapy models with the recently adopted Tolin criteria, which synthesize a broader base of evidence via meta‑analysis and emphasize clinical significance to improve treatment recommendations.