The purpose of this study was to monitor and compare levels of anxiety, depression, satisfaction and knowledge in male coronary patients and their spouses, throughout the patients stay in hospital and at one, three and six months following discharge from the hospital. A programme of in-hospital educative-supportive counselling was introduced to determine whether it significantly affected reactions. The study design took the form of a randomized controlled trial. The counselling was provided to couples during four 30 minute sessions by a coronary care unit registered nurse. Findings from the study provide evidence to support the overall contention that this simple programme confers additional benefits over and above the usual management regime. These benefits include statistically significant reductions in reported anxiety and depression, and increases in satisfaction and knowledge in both partners. The programme of support was simple and easy to implement, requiring little investment in training personnel and none in additional staff, finances or other resources. It is concluded that in-hospital counselling for coronary patients and partners is therapeutically effective and efficient. Proposals are made for practice change and recommendations are given for the direction of future research.