This study, a naturalistic investigation of the process of change in relationship adjustment and individual functioning during conjoint therapy, examined the first 8 sessions of a multisystemic model of couple therapy, integrative problem-centered metaframeworks (Breunlin, Pinsof, Russell, & Lebow, 2011; Pinsof, Breunlin, Russell, & Lebow, 2011). The sample consisted of 125 heterosexual couples who reported on their relationship adjustment and individual functioning before every session using the Systemic Therapy Inventory of Change (Pinsof et al., 2009; Pinsof, Zinbarg, et al., in press). Data were analyzed using dyadic latent growth curve and cross-lagged models. For both men and women, relationship adjustment and individual functioning showed nonlinear change, increasing during Sessions 1–4 and stabilizing during Sessions 5–8. At pretreatment, women reported lower levels of relationship adjustment than men; no gender differences existed in initial levels of individual functioning or in the change trajectories of relationship adjustment or individual functioning. Higher relationship adjustment predicted positive change in individual functioning for men (but not for women). In contrast, there were no cross-lagged effects of individual functioning on relationship adjustment for men or women. The results demonstrate the importance of examining the processes by which relational and individual pathology respond to couple-based interventions.