Depression is second after heart disease as the most damaging health condition in the world. The NHS has devoted huge resources to training thousands of psychological therapists to work in ‘Improving Access to Psychological Therapies’ services specifically to treat depression in adults and couple therapy has been identified as one of the effective ways of treating it. Couple Therapy for Depression is an integrative 20-session couple therapy designed to treat depression in couples where there is also relationship distress. Following the recommendations of the UK’s National Institute for Clinical Excellence for a behaviourally-based couple therapy treatment, it draws on RCT studies of efficacy as well as ‘best practice’ in behavioural, cognitive, emotionally-focused, systemic, and psychodynamic couple therapies. Sticking closely to the competencies identified for the treatment of depression and relationship distress in couples, it outlines the ways in which couple therapists can reduce damaging interactions between couples, build emotional openness and closeness, improve communication and behaviour, change unhelpful cognitions and perceptions, and help the couple cope with the ordinary and not-so ordinary stresses that arise in the course of everyday relating. Written by couple therapists who understand deeply the unique challenges of doing therapy with couples, it is based on the training programme for Couple Therapy for Depression commissioned by the NHS for use in its Improving Access to Psychological Therapies services. It begins by describing the causes and consequences of depression, and then focuses on its impact on the adult couple. Highlighting the particular techniques needed in safe and effective work with distressed couples, it goes through the different ways in which the couple’s feelings, thoughts, and behaviours need to be understood and worked with in order to reduce relationship distress. It outlines the treatment of 4 different couples to illustrate the therapy in action and will be helpful for any therapist wanting to enhance their work with couples.