When a relationship is under strain, it is natural to wonder what therapy actually involves and whether adding mindfulness helps. A small Brazilian pilot trial found that couples who received a mindfulness-integrated form of couple therapy reported better relationship adjustment and fewer depressive symptoms than couples who waited. The study was very small, so it is a first signal rather than an answer.
The study was published online on 31 August 2026 in the Journal of Marital and Family Therapy. Most of the authors are affiliated with Brazilian institutions. It was a pilot trial, which means a small early study designed to test whether an approach is workable and worth testing at larger scale.
Seventeen different-sex couples (34 people) with low household incomes took part. Eight couples were assigned to the therapy and nine to a waitlist, using a computer-generated sequence. The therapy combined cognitive-behavioural couple therapy with mindfulness. It ran as eight 80-minute sessions with both partners over about eight weeks, plus daily mindfulness practice at home, such as a body scan, mindful walking and eating, and breathing exercises.
The researchers measured mindful attention, depressive symptoms, relationship (dyadic) adjustment and marital social skills at the start, straight after therapy and three months later. All measures were self-reported, and neither participants nor therapists were blinded to the group.
Compared with the waitlist, the therapy group improved more on relationship adjustment. At follow-up their scores were about 11 points higher after adjusting for where they started (95% confidence interval 4.6 to 17.5). Mindful attention was about 6.8 points higher (95% confidence interval 2.1 to 11.4). Depressive symptoms, measured on the Beck Depression Inventory, fell from an average of 17.5 to 9.9 in the therapy group, while the waitlist group stayed at about 11.5. The adjusted difference was 5.6 points lower in the therapy group.
One result was not clear. Marital social skills did not differ significantly between groups. The authors describe that result as inconclusive, because the trial was too small to detect a difference reliably.
The researchers also ran a check that took into account that partners in a couple are not independent of each other, and the main findings held up.
With only 17 couples, the estimates are imprecise and could change a lot in a larger trial. The groups were not equal when they began. The therapy group started out more distressed on relationship adjustment and depression, and part of the apparent improvement could be what is called regression to the mean, where very high scores tend to drift back towards average on their own.
Because everything was self-reported and nobody was blinded, people who knew they were receiving therapy may have rated their relationship more positively. The study had no group receiving the same couple therapy without mindfulness, so it cannot say that the mindfulness part was what mattered. Follow-up lasted only three months, which says little about whether changes last.
The couples were all low-income and different-sex, and most were Black or mixed-race, so the results may not apply to other couples, or to couples in other countries and health systems. The trial does not show that mindfulness or couple therapy will save a relationship or produce the same result for everyone.
This article does not apply to relationships where there is violence, control or fear. If you are not safe, call 000 in an emergency or Lifeline on 13 11 14. Couple therapy is not designed for those situations.
It helps to remember what a pilot is for. Researchers use it to check that a treatment can be delivered, that people will take part and that the measures work, before investing in a larger trial. Pilot results often look more impressive than later, bigger studies, so the sensible reading is that this approach appears worth testing properly, not that it is established. Couples considering therapy can still use the findings as a way of understanding what sessions may involve: learning to notice thoughts and feelings in the moment, practising attention at home, and working on how partners respond to each other.
Source: Effects of Cognitive Behavioral Couple Therapy With Integrated Mindfulness on Mindful Attention, Depressive Symptoms, and Dyadic Adjustment in Low-Income Couples: A Pilot Randomized Clinical Trial DOI: 10.1111/jmft.70169
AI-generated editorial illustration. The scene is fictional and does not depict a study participant or demonstrate treatment effectiveness. This article summarises published research in our own words and is general information, not personal health advice.
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