This article discusses the outcome and process research on couple therapy and integrates the articles special section "Couples and Couple Therapy" into the discussion. All tested couple treatments show statistically significant effects relative to control groups, but there are no reliable differences between different theoretical models. Moreover, all tested approaches leave substantial numbers of couples unimproved or at least still somewhat distressed. A discussion of the strengths and weaknesses of various designs concludes that within-model comparisons have been more productive in producing knowledge than between-model comparisons. Recommendations for future research include developing a technology that would make possible matching studies focusing on Aptitude x Treatment interactions. Also, there needs to be greater emphasis on basic research and prevention.