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NCT Number: NCT07604740

The Effectiveness of Couple Therapy and Relationship Support

This randomized and controlled study investigates the effectiveness of relationship counselling and couple therapy in improving couples' relationship satisfaction and overall well-being. It compares four intervention groups both with each other and with a waitlist control group. The groups are:

1. HUS Self-Help (Mielenterveystalo.fi): Participants independently complete online self-help tasks based on couple therapy, developed by Helsinki University Hospital (HUS) Psychiatry and Väestöliitto. 2. Peloton Parisuhde (eng. Fearless Relationship) Online Course: Based on Emotionally Focused Couple Therapy (EFCT), this course by EFCT trainers Eklund-Mikola & Pinomaa uses online lectures and exercises to help couples identify negative interaction patterns and strengthen their emotional connection. 3. Short Manualized Emotionally Focused Couple Intervention: Five face-to-face sessions with a couple therapist. 4. Face-to-Face Couple Therapy (Treatment As Usual): 1 to 10 sessions, with the therapeutic approach varying depending on the therapist's training.

The study is conducted at the Relationship Counselling Unit of the City of Helsinki's Social Services in Finland, which provides counselling and family guidance under Section 26 of the Social Welfare Act to couples with children living in Helsinki. A total of 200 couples from the unit's treatment queue will be invited to participate and randomly assigned to one of the interventions or the control group, with 40 couples in each group.

Participants will complete questionnaires at the beginning and end of the service, and at a 4-month follow-up. The questionnaires measure relationship satisfaction and well-being, among other things. The study also examines how individual, couple-level, and treatment-related background factors influence and mediate the effectiveness of the interventions.

In addition to the questionnaires, registry data, therapist assessments, and ongoing treatment feedback collected within the unit is utilized. The results will provide new scientific insights into the effectiveness of short interventions and their suitable target groups and can be used to develop relationship counselling work both within the unit and nationally.

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Key information

Conditions

Healthy Adult

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Relationship Counselling

Helsinki, Finland

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Parents (couple) and blended families, and at least one of the parents is resident of Helsinki
  • Couples expecting their first child. The couple is experiencing one or more of the following (1) severe relationship conflict, (2) a serious threat of separation, (3) significant challenges in forming a family or navigating a blended family relationship.
  • couples eligible for treatment at the couple counselling faculty of Helsinki

Exclusion criteria

  • Inadequate Finnish written language skills (the questionnaires are only available in Finnish)
  • if both spouses do not complete the baseline questionnaires within the given deadline.

Treatment and study plan

Self-Help Program for Couples

Behavioral

Self-Help Program for Couples (Mielenterveystalo.fi) developed by HUS, this online self-help program provides couples with psychoeducational content and practical exercises designed to enhance relationship well-being. Partners can complete the tasks together or individually. The materials aim to strengthen emotional connection and improve communication.

Peloton Parisuhde (eng Fearless Relationship) Online Course

Behavioral

Based on Emotionally Focused Couple Therapy, this course by Eira Eklund-Mikola and Hanna Pinomaa uses online lectures and exercises to help couples identify negative interaction patterns and strengthen their emotional connection.

Manualized Short-Term EFT-Based Couple Intervention

Behavioral

Manualized Short-Term EFT-Based Couple Intervention is a structured program consisting of five face-to-face sessions with a trained couple therapist. Based on Emotionally Focused Therapy (EFT), the intervention helps partners explore emotional patterns, improve communication, and strengthen their bond through guided therapeutic exercises.

Standard Face-to-Face Couple Therapy (Treatment as Usual)

Behavioral

This intervention consists of 1 to 10 in-person sessions with a couple therapist. The therapeutic approach varies depending on the therapist's professional background and training. It reflects typical clinical practice and is not standardized, allowing for flexibility in addressing the couple's specific needs.

Primary outcomes

  1. Relationship Satisfaction (Dyadic Adjustment Scale)

    Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.

    The Dyadic Adjustment Scale (DAS) is a self-report questionnaire assessing relationship satisfaction and adjustment between romantic partners. The scale measures consensus, satisfaction, cohesion, and affectional expression. Total scores range from 0 to 151, with higher scores indicating better relationship adjustment and satisfaction.

  2. Depression severity (Patient Health Questionnaire-9)

    Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.

    The Patient Health Questionnaire-9 (PHQ-9) is a validated self-report measure assessing the severity of depressive symptoms over the past two weeks. Total scores range from 0 to 27, with higher scores indicating more severe depressive symptoms.

  3. Anxiety Severity (Generalized Anxiety Disorder-7)

    Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.

    The Generalized Anxiety Disorder-7 (GAD-7) is a validated self-report measure assessing the severity of generalized anxiety symptoms over the past two weeks. Total scores range from 0 to 21, with higher scores indicating more severe anxiety symptoms.

Secondary outcomes

  1. Adult Attachment (Experiences in Close Relationships - Revised

    Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.

    The Experiences in Close Relationships - Revised (ECR-R) is a widely used self-report questionnaire that assesses adult attachment styles in romantic relationships. The instrument measures two dimensions: attachment anxiety and attachment avoidance, reflecting how individuals experience closeness, trust, and emotional connection with their partner. Scores on each subscale typically range from 1 to 7, with higher scores indicating greater attachment anxiety or greater attachment avoidance.

  2. Reflective Functioning (Reflective Functioning Questionnaire)

    Time frame: Measured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup.

    The Reflective Functioning Questionnaire - RFQ-8 is a brief self-report measure developed by Fonagy and colleagues to assess reflective functioning, or mentalizing-the ability to understand one's own and others' thoughts, feelings, and intentions. In couple research, it helps evaluate how well partners can interpret each other's behavior in emotionally meaningful ways, which is essential for healthy communication and emotional connection.

  3. Communication Patterns (Communication Patterns Questionnaire)

    Time frame: Masured at enrollment before randomization, after treatment (or waitlist condition) and at a 4 months followup

    Communication Patterns Questionnaire - Short Form (CPQ-SF) Developed by Christensen and Sullaway, the CPQ-SF is a self-report measure that assesses how couples communicate during conflict. It focuses on typical interaction styles-such as constructive communication, avoidance, and demand-withdraw patterns-providing insight into how partners argue and resolve disagreements in their relationship.

Sponsors and collaborators

Lead sponsor

University of Helsinki

Other

Collaborators

  • City of Helsinki

Registry information

Official study title

The Effectiveness of Couple Therapy and Relationship Support: a Randomized Controlled Trial

Acronym: ECoT

Important dates

Study start
2025
Primary completion
2028
Study completion
2029
First posted
May 22, 2026
Registry last updated
May 22, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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