Do NHS talking therapies services and couple therapy for depression have a relationship problem?

This article focuses on the provision and challenges of Couple Therapy for Depression (CTfD) within NHS Talking Therapies Services (NHSTTS) in the UK. CTfD is a systemic and behavioural intervention involving both partners, shown to be effective for treating depression and relationship distress, with recovery rates comparable to other high-intensity therapies. Despite training over 1,100 CTfD therapists since 2010, access remains extremely limited, with only about 1,574 couples receiving CTfD in 2021/22, due to organizational constraints, inadequate promotion, inappropriate referrals, and insufficient supervision. The article highlights systemic barriers within NHSTTS, including an individual-focused culture and lack of leadership support, and recommends expanding CTfD capacity, improving referral processes, enhancing staff training, and increasing promotion to ensure equitable access and better use of trained therapists.