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Effects of Cognitive Behavioral Couple Therapy With Integrated Mindfulness on Mindful Attention, Depressive Symptoms, and Dyadic Adjustment in Low‐Income Couples: A Pilot Randomized Clinical Trial

Ricardo S. S. Durães, Zila Elizabeth Pulache Vargas, Ana Cristina Garcia Dias, Francisco Lotufo‐Neto, Renato T. Ramos, Antonio de Pádua Serafim

Journal of Marital and Family Therapy October 1, 2026 DOI: 10.1111/jmft.70169 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Pilot randomized clinical trial Peer reviewed
Sample size 34
Population Low-income Brazilian couples (per-capita household income up to one minimum wage); 17 heterosexual couples
Duration Eight 80-minute conjoint sessions plus daily home exercises; assessments at baseline, post-treatment, and 3-month follow-up
Measures R-DAS, MAAS, IHSC, BDI-II
Topics Meditation
Key findings Time-by-group effects favored CBCT with mindfulness over waitlist for dyadic adjustment, mindful attention, and depressive symptoms, with moderate-to-large effect sizes, but not for marital social skills. The authors present this as preliminary evidence that the approach may benefit disadvantaged couples.

Abstract

ABSTRACT Psychosocial distress can exacerbate marital conflict, maladjustment, and mental health vulnerability. This pilot randomized clinical trial examined cognitive‐behavioral couple therapy (CBCT) integrated with mindfulness in low‐income Brazilian couples (per‐capita household income up to one minimum wage). Thirty‐four participants (17 heterosexual couples) were randomized (independent computer‐generated sequence) to an experimental ( n = 16) or waitlist control group ( n = 18). We assessed dyadic adjustment, mindful attention, marital social skills, and depressive symptoms (R‐DAS, MAAS, IHSC, BDI‐II) at baseline, post‐treatment, and 3‐month follow‐up. The intervention was eight 80‐min conjoint sessions plus daily home exercises. Time × group effects favored the experimental group for dyadic adjustment, mindful attention, and depressive symptoms (all p < 0.001, = 0.20–0.37), but not marital social skills ( p = 0.14). Because two outcomes differed at baseline, effects were confirmed with baseline‐ and dependence‐adjusted sensitivity analyses. These findings provide preliminary evidence that CBCT with mindfulness may benefit disadvantaged couples.