Evidence-based Treatment for Depression with Couples Counselling

Evidence-based Treatment for Depression with Couples Counselling

Depression is a complex disease.  The reasons behind its development often include a mix of biological risk factors like whether there has been depression in your family (your ‘genetic predisposition’)1-2, psychological factors including how flexible your cognitive (thinking) style is3 or whether you’re more subject to anxious thoughts and feelings4-5, lifestyle factors like sleeping habits6 and social isolation7, and sociocultural factors like living through stressful life events such as the breakdown of a relationship8, poverty, trauma, or discrimination9.

It turns out, couples counselling with Emotion-Focused Couples Therapy (EFT) has been found to be an effective treatment for depression for both women and men.  Some studies even suggest EFT is even more effective than standard treatments, and that its beneficial effects last longer too.

Here’s the breakdown –

Clinical trials are research studies that are held to a higher standard than most – they are very rigorous with strict standards and sometimes involve evaluating treatments in comparison to other treatments.  This means that when clinical trials show a treatment is effective, it means that the treatment is effective not just at random but due to specific features of the intervention, and usually above and beyond other well-established treatments that it was tested alongside.

There have been several clinical trials that have looked at EFT for treatment of depression.  The first10 showed us that when compared with pharmacotherapy (that is, medication management), EFT was equally as effective in reducing depressive symptoms in women, and preliminary evidence suggested that the benefits of EFT were longer-lasting following the end of treatment as compared to medication.

Another clinical trial11 looked at whether depression symptoms would improve in women receiving antidepressant medication compared to women receiving antidepressant medications plus EFT.  While depressive symptoms improved in both groups, only the women receiving both medication plus EFT reported a significant improvement in the quality of their relationship.

Finally, a recent study12 demonstrated that while depressive symptoms were reduced in women receiving either EFT or other forms of couples counselling, when compared with other forms of couples therapy, only EFT significantly reduced depressive symptoms among men.

Click here to learn about more of the research behind EFT.

This is not at all to say that EFT is the only treatment, or even the best treatment, for depression.  Because depression is so complex, its causes and symptoms are different from person to person, meaning that the best treatment for depression is different from person to person too.

There are a multitude of treatment options for depression including medication management (see your GP for a referral to a psychiatrist), individual psychological counselling with Cognitive Behavioural Therapy (CBT), mindfulness-based treatments, and other forms of couples counselling too.

If you’re struggling with depression and need immediate support, contact Lifeline at 13 11 14 to speak to a crisis counsellor any time, 24-hours a day (it’s free to call from mobile phones), or visit your local hospital’s Emergency Department and ask to be admitted for a psychiatric evaluation if you feel unsafe to be alone with yourself.

Otherwise, contact us at 1300 784 184 or info@couplesmelbourne.com to set up an appointment to see how we can support your mental health.  Here at CTM, we have several practitioners (Elizabeth and Catherine) trained in EFT through the International Centre for Excellent in Emotionally Focused Therapy, the only internationally recognised training certification program for EFT.  Whether it’s for depression or couples counselling, we’re here to help.


By: Dr. Elizabeth Landau


1 Kendler, K. S., Thornton, L. M., & Gardner, C. O. (2001). Genetic risk, number of previous depressive episodes, and stressful life events in predicting onset of major depression. American Journal of Psychiatry158(4), 582-586.

2 Kendler, K. S., Gardner, C. O., Neale, M. C., & Prescott, C. A. (2001). Genetic risk factors for major depression in men and women: similar or different heritabilities and same or partly distinct genes?. Psychological medicine31(4), 605-616.

3 Robinson, M. S., & Alloy, L. B. (2003). Negative cognitive styles and stress-reactive rumination interact to predict depression: A prospective study. Cognitive Therapy and Research, 27(3), 275-291.

4 Pine, D. S., Cohen, P., Gurley, D., Brook, J., & Ma, Y. (1998). The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Archives of General Psychiatry, 55(1), 56-64.

5 Rapee, R. M., Schniering, C. A, & Hudson, J. L. (2009). Anxiety disorders during childhood and adolescence: Origins and treatment. Annual Review of Clinical Psychology, 5,311 41.

6 Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., … & Riemann, D. (2011). Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. Journal of affective disorders135(1-3), 10-19.

7 Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychology and aging21(1), 140.

8 Overbeek, G., Volleberg, W., de Graaf, R., Scholte, R., de Kemp, R., & Engels, R. (2006). Longitudinal associationsof marital quality and marital dissolution with the incident of DSM-III-R disorders. Journal of Family Psychology, 20, 284–291.

9 Belle, D., & Doucet, J. (2003). Poverty, inequality, and discrimination as sources of depression among US women. Psychology of Women Quarterly27(2), 101-113.

10 Dessaulles, A., Johnson, S.M., & Denton, W.H. (2003). Emotion-focused therapy for couples in the treatment of depression: A pilot study.The American Journal of Family Therapy,31, 345–353.

11 Denton, W.H., Wittenborn, A.K., & Golden, R.N. (2012). Augmenting antidepressant medication treatment ofdepressed women with emotionally focused therapy for couples: A randomized pilot study. Journal of Marital and Family Therapy, 38, 23–38.

12 Wittenborn, A. K., Liu, T., Ridenour, T. A., Lachmar, E. M., Mitchell, E. A., & Seedall, R. B. (2019). Randomized controlled trial of emotionally focused couple therapy compared to treatment as usual for depression: Outcomes and mechanisms of change. Journal of marital and family therapy45(3), 395-409.