To work with married couples in crisis is to face two people suffering pain and disappointment. The wedding photographs which, however posed and public, were once the expression of private hopes and intentions, stand as a rebuke or 'have been put away. If there are children who were conceived in joy or, at least, with a shared commitment, they may have become a source of guilt or a focus of conflict. The future, once certain, if only in being a shared one, has become threatening and clouded with anticipated loss. Whatever skills we have to offer as professionals to people in such a situation must seem small in relation to this central pain; and yet the brief assistance of therapists of many different temperaments and persuasions can, in many cases, enable couples to live better, often together, sometimes apart. It is the purpose of this chapter to examine the nature of such therapeutic interventions, confining attention to those approaches that are transactional in Olson's (1970) sense; that is to say, where the couple are treated together, with the attention being on their relationship.