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Augmenting Antidepressant Medication Treatment of Depressed Women With Emotionally Focused Therapy for Couples: A Randomized Pilot Study


  • Wayne H. Denton, MD, PhD, Department of Family and Child Sciences, Florida State University; Andrea K. Wittenborn, PhD, Department of Human Development, Virginia Tech; Robert N. Golden, MD, Department of Psychiatry and Dean’s Office, University of Wisconsin School of Medicine and Public Health.

  • This research was supported in part by grant K23MH063994 (Denton). Portions were presented at the 49th Annual NCDEU Meeting, Hollywood, Florida, June 2009 and at the annual conference of the American Association for Marriage and Family Therapy, Sacramento, California, October 2009. Medication was provided by Forest Pharmaceuticals, GlaxoSmithKline, Pfizer, and Wyeth Pharmaceuticals. Appreciation is expressed to colleagues who contributed to this research: Brent Bradley, Anna Brandon, Effie Clewis, Fallon Cluxton-Keller, Adam Coffey, Connie Cornwell, Clyde Hicks, Robin Jarrett, Susan Johnson, Tara Lehan, Gail Martin, Gail Palmer, Alyssa Parker, and Douglas Tilley.

Address correspondence to Wayne H. Denton , Department of Family and Child Sciences, Florida State University, 240 Sandels Building, Tallahassee, Florida 32306-1491; E-mail:


This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to 6 months of medication management alone (MM) or MM augmented with EFT (MM + EFT). MM followed the Texas Medication Algorithm Project guidelines. Fifteen EFT sessions were delivered following the EFT treatment manual. The primary outcome was severity of depressive symptoms (assessed by the 30-item Inventory of Depressive Symptomatology—Clinician Rated version [IDS-C30] administrated by evaluators blinded to cell assignment). Secondary outcome was relationship quality as assessed by the Quality of Marriage Index. Results from assessments at intake, termination, and two posttreatment follow-ups were analyzed using growth analysis techniques. IDS-C30 scores improved over 6 months of treatment, regardless of the treatment assignment, and women receiving MM + EFT experienced significantly more improvement in relationship quality compared with women in MM. Because relationship discord after depression treatment predicts worse outcome, interventions improving relationship quality may reduce depression relapse and recurrence. Testing this hypothesis in larger samples with longer follow-up could contribute to knowledge on the mechanisms involved in determining the course of depressive illness.