The emotional pain and concomitant psychological and behavioral consequences of couple relationship distress are rivaled by few other life crises and stresses. Negative reciprocity has been found to exist to a degree in both distressed and nondistressed couples. This chapter provides a view of the evolution of Cognitive Behavior Couple Therapy (CBCT) identifying the predominant influence of Behavioral Marital Therapy (BMT) along with the work of early cognitivists. The chapter also provides social workers with effective methods for the treatment of problems in intimate committed relationships. It presents conceptualization of couple functioning and treatment and clinical procedures that are highly relevant for same gendered couples. The chapter depicts the use of cognitive behavior methods to ameliorate problems in intimate relationships. Communication problems have been identified as the greatest area of limitation among unhappy couples. Cognitive behavioral couple therapy is comprised of approaches that are compatible with evidence-based practice.