Most couples therapy theories are developed and tested in the USA. In this clinical study, we investigated such therapies in a Swedish context. Over 300 couples were enrolled in the study of whom just under half completed the end-of-treatment assessment and just over 40 per cent a two-year follow-up. At the start, the study group displayed severe problems in marital adjustment, dyadic interactions and psychiatric symptoms. A relatively short treatment was used and 50 per cent of the couples attended less than nine sessions. Outcomes of treatment showed significant improvements in relationship matters, individual mental health and enhanced coping abilities. At long-term follow-up, all results remained the same and in some aspects improved for both sexes. This study confirms the effectiveness of such therapies in a Swedish context.