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Objective: The primary objective of this study was to evaluate the effectiveness of a couples intervention in improving marital functioning in advanced cancer patients and their spouse caregivers.A secondary objective was to determine its impact on other symptoms ofpsychosocial distress and its feasibility and acceptability as a clinical intervention.Methods: Using a one-arm pre-and post-intervention prospective design, 16 couples were provided 8 weekly sessions of Emotionally Focused Couple Therapy, modified and manualized for the cancer population.Subjects marital functioning (Revised Dyadic Adjustment Scale (RDAS)), symptoms of depression (Beck Depression Inventory-Ⅱ (BDⅠ-Ⅱ)) and hopelessness (Beck Hopelessness Scale (BHS)) were assessed through self-report at T0 (baseline), T 1 (after 4 sessions), T2 (after 8 sessions), and T3 (3 months post-intervention follow up).Results: RDAS scores improved from T0 to T2, with 87.5% of the couples showing some improvement (0.5-5 points) or significant improvement (>5 points) in marital functioning and 68.8% scoring in the non-distressed range (48 RDAS).At T3, 60% of the couples (n=15) continued to score in the nondistressed range on the RDAS.BDⅠ-Ⅱ scores were significantly higher for patients than for earegivers.There was a significant reduction in the mean BDⅠ-Ⅱ score from T0 to T3 in all subjects (n=30).This reduction was more significant for patients (n=1 5).Conclusions: Providing support to couples at this challenging time may result in improved marital functioning and an opportunity for relational growth during end-stage cancer.This study serves as the first step in the development of an empirically validated intervention for couples.