When one member of a couple develops a serious illness, the lives of both partners are likely to be affected. Interventions directed at both partners are generally lacking, however. In the present study, a brief counseling program directed at couples confronted with cancer was evaluated. The intervention focused mainly on the exchange of social support and help between both partners and was aimed at restoring perceptions of equity. Couples were randomly assigned to an experimental group or a waiting-list group. After the intervention, both patients and their partners reported lower levels of perceptions of underinvestment and overbenefit, and higher levels of relationship quality. Moreover, among patients psychological distress decreased after the intervention. These effects were generally maintained until follow-up three months later. Associations between perceptions of equity and relationship quality and psychological distress were also examined. Copyright (C) 2003 John Wiley Sons, Ltd.