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We update this prior work by accounting for therapist effects and investigating clinical cut\u2010offs for depression and relationship distress. We used a sample of 417 mixed\u2010sex couples and 122 therapists from the Marriage and Family Therapy Practice Research Network. Using multilevel modeling in Mplus, couples had an average of 11.73 sessions with therapists explaining 7.40% of the variance. Having one partner meeting the relationship distress cut\u2010off as well as both partners meeting depression cut\u2010offs were associated with longer treatment. Additionally, therapists in the Western region of the United States and treatment after the COVID pandemic were associated treatment length. These findings can aid clinicians in providing treatment plans and clearer expectations for treatment length. Couple therapy modalities can consider briefer adaptations to meet shorter treatment lengths.<\/jats:p>","DOI":"10.1111\/jmft.70132","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T05:45:40Z","timestamp":1775195140000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Depression and Relationship Distress Predict Longer Couple Therapy Treatment in Naturalistic Settings?"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3837-4609","authenticated-orcid":false,"given":"Preston C.","family":"Morgan","sequence":"first","affiliation":[{"name":"Human Development and Family Sciences Department Oklahoma State University Stillwater Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6410-9521","authenticated-orcid":false,"given":"Chi\u2010Fang","family":"Tseng","sequence":"additional","affiliation":[{"name":"Human Development and Family Studies Department Michigan State University East Lansing Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Doman","sequence":"additional","affiliation":[{"name":"Hope Therapy Orem Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Kansas City Relationship Institute Independence Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/01926187.2019.1572478"},{"key":"e_1_2_7_3_1","unstructured":"American Psychological Association. 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