Research illuminating which therapist techniques are used in care-as-usual couple therapy, and under what circumstances, can contribute to a fuller understanding of how therapy works. The overall goal of the present study was to better understand care-as-usual couple therapy by investigating session-by-session techniques and session content to determine how therapists modify them based on the timing of the session and couples? pre-treatment characteristics. A total of 123 heterosexual couples were examined. Therapists frequently used acceptance techniques and discussion of recent or ongoing conflict or problem. Therapists typically used the same levels of techniques and session contents over a course of therapy. In addition, there were relatively few predictors of change in therapy techniques and session content.