**7. Conclusion**

The current chapter has provided a comprehensive literature review and description of the theoretical underpinnings, possible therapeutic mandates and main assessment and intervention methods used in CBCT. This chapter has also highlighted the empirically demonstrated effectiveness of CBCT for the treatment of a significant number of couple struggles ranging from communication difficulties and dissatisfaction with expressed affection to the management of explosive conflicts. This chapter also demonstrated that CBCT can be very effective in treating individual problems by using the intimate relationship as a therapeutic tool.

The scientific literature suggests that CBCT is a highly effective treatment approach to improve relational well-being as well as a way to address many difficulties and concerns couples may face. This is especially true for difficulties in communication, problem-solving and conflict resolution as they arise spontaneously between partners or as a result of comorbid psychological difficulties in one or both partners, for which specific techniques have been developed and are regularly used by couple therapists. Interestingly, CBCT also offers a good foundation on which therapy can be customized to various needs partners may hold. For instance, recent developments in CBCT have started to incorporate more complex and specific variables in the understanding and treatment of couple functioning by considering the roles of attachment [139], relational schemas [140] and mindfulness [141] as possibly underlying certain couple dynamics.

Results from psychotherapeutic outcome studies presented in this chapter must be examined by considering certain drawbacks. Indeed, evidence-based studies have become the gold standard to evaluate the effectiveness of psychotherapeutic interventions yet, not all studies on the effectiveness of CBCT include large sample sizes, randomized controlled trials (RCT) or follow-up data extending beyond 6 or 12 months. As such, the effectiveness of CBCT for different couple difficulties must be considered within this reality. In addition, going from theory to practice can be quite a challenge, especially because in CBCT, clients are two different people who consult together. Indeed, CBCT therapists must learn to work not only with both parties' personalities, feelings, cognitions and behaviors but also with the couple's dynamics as they take place during and between sessions. The complexity of this type of therapeutic work also lies in the therapist's role, as he/she is called to inquire about, and directly witness, couples' most intimate moments and feelings while maintaining a respectful and professional distance.

Finally, it is also important to note that regardless of the concerns for which a couple seeks therapy, the CBCT process in itself holds certain limitations. Indeed, both partners must be strongly committed to making their relationship work by demonstrating honesty, openness, caring and interest in the other's experience. They must also demonstrate commitment towards the therapeutic process. For instance, in cases when partners do not really want to see their problem solved (e.g., when changes in the couple are considered as too anxietyprovoking) or when partners come to therapy to have the therapist determine who is "right" or "wrong," it is often difficult to induce change in the relationship and enhance relational functioning. Fortunately, empirical and clinical work from the past decades has offered precious insights in the understanding of such dynamics and in the training of CBCT therapists that are not only aware of these therapeutic intricacies but also use them to further their work with couples.
