Religion-accommodative psychotherapy has developed with trends toward equal or improved outcomes compared with psychotherapy that pays no attention to spirituality or religion (Worthington, Hook, Davis, & McDaniel, 2011b; Worthington, Hook, Davis, Gartner, & Jennings, 2013). Research on religion-accommodative psychotherapy in couples contexts is sparse, with a few studies of enrichment and prevention and only 1 study of couples therapy. The current study used a clinical trial design of 92 community couples seeking counseling to determine whether religion-accommodative hope-focused couples psychotherapy would differ from standard hope-focused couples treatment (Worthington, 2005). Results indicate that the 2 types of treatment demonstrated improvement for couples over time but were not different from each other on most comparisons. Implications for accommodating religion for couples therapy in an ethical and diversity-sensitive way are discussed (Hathaway & Ripley, 2009).