Comparing the Effectiveness of Emotion-Focused Therapy (EFT) and Cognitive-Behavioral Couple Therapy (CBT) in Reducing Anxiety, Depression, and Improving Relationship Quality Among Couples with Childhood Trauma

Abstract

The objective of this study was to compare the effectiveness of Emotion-Focused Couple Therapy and Cognitive-Behavioral Couple Therapy in reducing anxiety and depression and improving relationship quality among couples with a history of childhood trauma. This study employed a randomized controlled trial with a pretest–posttest and three-month follow-up design. The sample consisted of 45 couples (90 individuals) recruited from counseling centers in Tehran and Karaj and randomly assigned to EFT, CBT, or control groups. The intervention groups received structured weekly therapy sessions based on their respective protocols, while the control group received no intervention. Anxiety, depression, and relationship quality were assessed at three time points using standardized measures. Data were analyzed using repeated measures analysis of variance and Bonferroni post-hoc tests in SPSS version 27. The results indicated significant main effects of time and group, as well as significant time-by-group interaction effects for anxiety, depression, and relationship quality. Both EFT and CBT led to significant reductions in anxiety and depression and significant improvements in relationship quality compared to the control group. However, EFT demonstrated significantly greater effectiveness than CBT in improving relationship quality and reducing depressive symptoms, with treatment gains maintained at the three-month follow-up. Both therapeutic approaches are effective for trauma-exposed couples, but Emotion-Focused Couple Therapy appears to be more effective in producing deeper and more sustained improvements in relationship quality and depressive symptoms, highlighting the importance of emotionally and attachment-oriented interventions in this population.