Comparing Brief Psychoanalytic Couple Therapy and Emotionally Focused Therapy in Reducing Relationship Distress

NCT07100951 | Recruiting

• 1 other identifier: BPCT_vs_EFT_RCT_2025
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

This study compares the effects of two different couple therapy approaches-Brief Psychoanalytic Couple Therapy (BPCT) and Emotionally Focused Therapy (EFT)-on reducing relationship problems and emotional symptoms like depression and anxiety. Many couples struggle with emotional distance, repeated arguments, and dissatisfaction in their relationships. While EFT is a widely used and research-supported therapy that focuses on rebuilding emotional bonds, BPCT is a less-studied method that aims to help couples understand how early relationship experiences and unconscious patterns affect their current interactions. The purpose of this study is to find out whether one of these therapies is more effective than the other in improving relationship satisfaction and reducing emotional distress. The study also looks at changes in how people regulate their emotions and how secure they feel in their relationships after therapy. In this randomized controlled trial, 60 heterosexual couples experiencing relationship distress and symptoms of anxiety or depression will be randomly assigned to one of three groups: BPCT group - couples receive weekly online therapy focusing on deep emotional and psychological patterns in their relationship. EFT group - couples receive weekly online therapy focusing on emotional connection and improving communication. Waitlist control group - couples do not receive therapy during the study but will be offered therapy afterward. Each therapy lasts 12 weeks, and follow-up assessments will be conducted up to 6 months after therapy ends. Data will be collected before, during, and after treatment using questionnaires that measure relationship satisfaction, depression, anxiety, emotional regulation, and attachment style. The results of this study will help determine which type of therapy is more beneficial for couples experiencing emotional and relational difficulties and may provide important insights for mental health professionals working with distressed couples.

Conditions

Depressive Disorder; Anxiety Disorders; Emotion Regulation; Attachment; Relationship Distress

Keywords

Brief Psychoanalytic Couple Therapy; Emotionally Focused Therapy; Couple Therapy; Online Psychotherapy; Relationship Distress; Emotion Regulation; Depression; Anxiety

Outcome Measures

Primary Outcomes (4)

• Change in Relationship Satisfaction (DAS-32)

  The Dyadic Adjustment Scale-32 (DAS-32) is a 32-item self-report measure of relationship adjustment. It assesses four subscales: dyadic consensus, satisfaction, cohesion, and affectional expression. Scores range from 0 to 151, with higher scores indicating better relationship quality. A score below 100 indicates relationship distress. Changes will be assessed across the four time points to evaluate therapeutic impact.

  Baseline, Week 6, Week 12, and 6-month Follow-up

• Change in Depressive Symptoms (BDI-II)

  The Beck Depression Inventory-II (BDI-II) is a 21-item self-report questionnaire measuring the severity of depressive symptoms. Scores range from 0 to 63. Scores between 14-19 reflect mild depression, 20-28 moderate, and 29-63 severe. Higher scores indicate greater severity. The change in BDI-II scores will be used to assess symptom improvement.

  Baseline, Week 6, Week 12, and 6-month Follow-up

• Change in Anxiety Symptoms (BAI)

  The Beck Anxiety Inventory (BAI) is a 21-item self-report inventory that measures the severity of anxiety symptoms. Scores range from 0 to 63, with scores above 16 indicating clinically significant anxiety. Higher scores indicate more severe anxiety. Changes in BAI scores will track anxiety symptom reduction.

  Baseline, Week 6, Week 12, and 6-month Follow-up

• Change in Emotion Dysregulation (DERS)

  The Difficulties in Emotion Regulation Scale (DERS) is a 36-item measure assessing six dimensions of emotion regulation: nonacceptance, goals, impulse, awareness, strategies, and clarity. Total scores range from 36 to 180, with higher scores indicating more difficulties in emotion regulation. Changes in total scores across time points will be evaluated.

  Baseline, Week 12, and 6-month Follow-up

Secondary Outcomes (1)

• Change in Adult Attachment Style (AAS)

  Baseline, Week 12, and 6-month Follow-up

Study Arms (3)

Brief Psychoanalytic Couple Therapy (BPCT)

EXPERIMENTAL

Couples in this arm will receive 12 weekly online sessions (50 minutes each) of Brief Psychoanalytic Couple Therapy (BPCT). Therapy focuses on unconscious relational dynamics, early attachment schemas, and projective identification. The therapist facilitates insight through interpretation of symbolic meaning in conflict and reenactments of early object relations. The stance is neutral and exploratory.

Behavioral: Brief Psychoanalytic Couple Therapy

Emotionally Focused Therapy (EFT)

ACTIVE COMPARATOR

Couples in this arm will receive 12 weekly online sessions (50 minutes each) of Emotionally Focused Therapy (EFT). EFT targets negative emotional interaction cycles, encourages expression of primary emotions, and fosters attachment security. The therapist plays an active and emotionally attuned role to restructure relational bonds and increase responsiveness between partners.

Behavioral: Emotionally Focused Therapy

Waitlist Control

NO INTERVENTION

Couples in the waitlist control group will not receive active intervention during the 12-week study period but will complete the same assessments at all time points. After the 6-month follow-up assessment, they will be offered a choice of therapy (BPCT or EFT) outside the study protocol.

Interventions

Brief Psychoanalytic Couple Therapy BEHAVIORAL

Brief Psychoanalytic Couple Therapy (BPCT) consists of 12 weekly online sessions (50 minutes each) focused on uncovering unconscious relational dynamics, symbolic conflict meanings, and early attachment schemas. Techniques include relational interpretations, exploration of projective identification and transference, and analysis of emotional defenses. Therapists maintain a neutral, reflective stance to promote insight and self-awareness within the couple dynamic.

Brief Psychoanalytic Couple Therapy (BPCT)

Emotionally Focused Therapy BEHAVIORAL

Emotionally Focused Therapy (EFT) involves 12 weekly online sessions (50 minutes each) focusing on repairing emotional bonds and enhancing attachment security. The intervention targets maladaptive emotional interaction cycles and promotes the expression of primary emotions and attachment needs. Therapists actively guide couples through restructuring emotional responses and rebuilding secure, responsive communication patterns.

Emotionally Focused Therapy (EFT)

Eligibility Criteria

• Age: 24 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Heterosexual couples (both partners must participate)
• Age between 24 and 65 years
• Minimum 2 years of relationship duration
• At least one partner scoring ≤ 30 on the Dyadic Adjustment Scale (DAS-32), indicating clinically significant relationship distress
• At least one partner scoring in the mild, moderate, or severe range on the Beck Depression Inventory-II (BDI-II) or Beck Anxiety Inventory (BAI)

You may not qualify if:

• Current participation in individual or couple psychotherapy
• Use of psychiatric medication during the past 3 months
• Presence of severe psychiatric disorders (e.g., psychosis, bipolar disorder)
• History or presence of physical or severe psychological partner violence, assessed via Conflict Tactics Scale (CTS-2)
• Active substance use disorder within the past 6 months

Sponsors & Collaborators

• Beykoz University: lead
• Istanbul Nisantasi University: collaborator
• Uskudar University: collaborator

Study Sites (1)

Beykoz University

Istanbul, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Depressive Disorder; Anxiety Disorders; Emotional Regulation; Depression

Interventions

Emotion-Focused Therapy

Condition Hierarchy (Ancestors)

Mood Disorders; Mental Disorders; Self-Control; Social Behavior; Behavior; Behavioral Symptoms

Intervention Hierarchy (Ancestors)

Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Gökben Hızlı Sayar, Professor

  Üsküdar University

  STUDY CHAIR

• Metin Çınaroğlu, Phd

  İstanbul Nişantaşı University

  STUDY DIRECTOR

Central Study Contacts

Eda Yılmazer, Phd

CONTACT

+905322575880; edayilmazer@beykoz.edu.tr

Metin Çınaroğlu, Phd

CONTACT

+905324732070; metin.cinaroglu@nisantasi.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Participants (60 couples) will be randomly assigned in equal numbers to one of three parallel groups: Brief Psychoanalytic Couple Therapy (BPCT), Emotionally Focused Therapy (EFT), or a Waitlist Control group. Each active therapy group will receive 12 weekly online sessions. Assessments will be conducted at baseline, mid-treatment, post-treatment, and 6-month follow-up.

Study Record Dates

• First Submitted: July 28, 2025
• First Posted: August 3, 2025
• Study Start: July 1, 2025
• Primary Completion: December 31, 2025
• Study Completion (Estimated): July 15, 2026
• Last Updated: August 3, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, CSR, ANALYTIC CODE
• Time Frame: IPD and supporting documentation will be available beginning 6 months after the publication of primary results and for up to 5 years upon reasonable request.
• Access Criteria: Qualified researchers affiliated with academic or nonprofit institutions may request access to de-identified data for ethically approved studies. Requests will be reviewed by the principal investigator. Data will be shared via secure email or institutional repository upon approval and signed data use agreement.

Locations

TU (1)