Can talk therapy mend more than mood in marital crisis?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Meets DSM-5-TR diagnostic criteria for major depressive disorder, confirmed by the Mini International Neuropsychiatric Interview (MINI) structured clinical interview (American Psychiatric Association, 2022). 2. Beck Depression Inventory-II (BDI-II) total score of 20 or above, indicating moderate to severe depressive symptoms (Beck et al., 1996). 3. Dyadic Adjustment Scale (DAS) total score of 97 or below, operationally defining marital crisis (Spanier, 1976). 4. Age between 20 and 60 years. 5. Currently taking a single antidepressant medication for a minimum of two weeks. Rather than being required to remain on an unchanged dose, participants agree to have their antidepressant regimen managed by their treating psychiatrist according to clinical need for the duration of the study; any change in medication or dose is documented and included as a time-varying covariate in the analysis. Exclusion Criteria: 1. Current diagnosis of symptomatic bipolar mood disorder or psychotic disorder which would interfere with their ability to answer questionnaires and participate in the study. 2. History of substance abuse or acute alcohol use disorder. 3. Prior receipt of any structured psychotherapy before study enrollment. 4. Severe physical illness or cognitive impairment that would prevent meaningful participation in group therapy sessions or completion of assessment instruments. 5. Current exposure to active intimate partner violence or domestic abuse. This is screened at the face-to-face assessment using a brief standardized instrument, and it is applied to safeguard participant safety during the disclosure of marital distress in the group setting. Individuals who screen positive are not enrolled and are referred to appropriate local domestic-violence support services.