Gender-specific men-only interventions for intimate partner violence (IPV) have had limited success beyond the effects of arrest alone. This review outlines current U.S. state-mandated treatments for IPV, acknowledges how conjoint treatment may better address a subtype of IPV that is not motivated by power and control, examines and reviews previously conducted couples-based treatments, and highlights policy implications and future directions. Empirical findings and theoretical support for the Duluth model, cognitive–behavioral approaches, and IPV typologies are presented, followed by a systematic review of selected quasi- and true experimental studies on couples-based approaches for IPV. U.S. state guidelines that absolutely exclude conjoint approaches are overly restrictive, considering the poor evidence of effectiveness for current gender-specific groups. Further, the theoretical foundations of most men-only groups assume unilateral, male-to-female violence, which does not fit at least one-third of court-involved cases and leaves treatment needs of couples experiencing problematic relationship dynamics unmet. For a carefully screened subset of couples that experience predominantly “situational violence,” conjoint communication and relationship skills training groups may be a viable alternative to the Duluth model and cognitive–behavioral men-only groups.