Couples Therapy

Couples therapy is always a reasonable choice for couples who find themselves wanting to improve their communication or intimacy issues to build a healthier relationship. Sometimes, relationship therapy is something partners with urgent needs undergo as it can address a range of problems, including mental health issues, life crises, and relationship distress. However, a lot of patients actually find that couples therapy is helpful at addressing ongoing issues and sustains the happiness and completeness of an already healthy relationship by teaching you and your partner how to communicate, accept any differences, solve relationship issues you are currently facing, and find common interests.

Couples therapy differs from family therapy because it is for a couple, any couple – married, non-married, monogamous, polyamorous, or even an individual working on a partnered relationship. This form of therapy can be helpful for relationships of any kind – whether you're in a long-term relationship, long-distance, an open relationship (or considering entering one), or all and none of the above. And couples seeking therapy don’t need to be married (or monogamous) to consider therapy. While family therapy may touch upon many of the same issues – reconciling troubled relationships and building healthy communication skills, couples therapy concerns the interests of the couple as well as the whole family.

A good couples counselor should be helpful to move the relationship forward by giving couples a safe and open space to talk and tackle problems that they may be reluctant to address. The exact focus of your treatment will depend on the particulars of your relationship counseling sessions, and your therapist’s approach. Understanding the basics of your relationship and comparing that to information about a counselor is a great basis for finding the right couples therapist and therapeutic tools for you.

What Couples Counseling Can Help With

Here are a few areas that couples counseling can help you with:

Infidelity — whether that's a physical affair or emotional cheating. In the wake of an affair, marriage counseling can help you to see past the hurt and repair the relationship. Many couples come away stronger after treatment with a professional for infidelity issues.
Life crises that are out of your control. A therapist can help you navigate the aftermath of a crisis together. That may include a situation like a medical illness, ongoing mental health issues, substance use relapse, job loss, or the death of a loved one.
Difficulty communicating with each other. Whether you've always had a different fighting style, or you've recently hit a rut after welcoming a baby into your life, relationship counseling can help you understand where your partner is coming from, develop better communication skills with effective tools, and create space for you to reconnect.
Financial issues and money concerns. Money can be a heated, stressful subject. Discussing the "F" word (finance!) with the guidance of a seasoned pro can help cool things down and be honest where it really matters.
Challenges related to sex and intimacy. Maybe you're not having sex, or maybe you're having sex but not feeling intimate, or maybe it just feels like you've lost touch with each other altogether. A couples counselor can help you be honest with your feelings and reconnect, especially in regard to intimacy issues. You can also work with a specially certified sex therapist who sees couples as part of their work.
Issues with friends or other family members. Issues related to friends and family can be tricky. It could be that you've never felt respected by your in-laws and wish your partner had your back more when they're around, or perhaps you resent all the time your partner spends with their friends. Relationship counseling can help you find a middle ground where you both feel comfortable and respected.
Getting ready for marriage. Some couples decide to attend premarital counseling before they tie the knot. The benefit of this highly specialized type of therapy is that it helps couples prepare for all aspects of marriage, from raising children and visiting in-laws, to how much sex they want to have, handling conflict, and sharing finances. Premarital counseling can be religious (and some religions and beliefs require, or strongly urge, couples to attend, as with Pre-Cana in Catholicism), or it can be secular.
General relationship skills and strengthening. You don't have to have a particularly acute problem to seek relationship therapy. In fact, many couples who seek counseling are simply looking for an added resource to strengthen their bond and make their relationship even happier!

What to Expect When Starting Couples Therapy

The first session will give you a glimpse of whether the therapist is right for you and your partner. However, it’s best not to immediately conclude that your chosen therapist can’t solve your problems during your first session.

Any therapy session, including couples therapy, usually takes three to four sessions to build rapport and allow the therapist to assess how they can help.

While the exact structure of your treatment will depend on your specific needs and your therapists' approach, here is the general structure of what you can expect from couples therapy:

When you first meet, you'll discuss your shared goals and any concerns you have and set a treatment plan. You’ll often begin with an open-ended discussion of your concerns and goals around couples therapy, both as individuals and as partners. Together, you’ll work with your therapist to set up a treatment plan and shared goals in your early sessions.
You may meet individually with your therapist before continuing treatment as a couple. Either before or after your first couples session, many therapists recommend starting with one or more individual therapy sessions. This way, the therapist can get to know you and your partner as individuals and get a balanced perspective on your work as a couple.
Your therapist will recommend discussions and activities after they've gotten to know you. Once you've gotten to know your therapist better (and they you!), later sessions will include a mixture of discussion and activities. These activities might include role-playing, communication exercises, mindfulness practices, and conflict resolution techniques, among others.
There's a good chance you'll have "homework" between sessions. If your counselor assigns homework between sessions – and many do – then your sessions will also include a review of that homework and how it may have affected your relationship outside of sessions. Homework might include trying out new communication strategies, scheduling time to spend together, or observing your typical interaction patterns.

Know Which Type of Couples Counseling Suits Your Relationship

Keep in mind that couples therapy has two basic variations. The variation will depend on the problem you want to work on and the kind of therapist you choose.

Here’s a quick look at the types of couples therapy:

Open-ended Relationship Counseling

An open-ended couples therapy, which is the usual type that couples need, emphasizes open discussion, how to process difficult feelings and emotions, and gage intended (or unintended) emotional responses. To do so, a couple’s counselor may use activities that are designed to guide you and your partner towards building skills together and understanding the current state of your relationship.

Structure-oriented Couples Therapy

Structure-oriented counseling involves a therapist observing how you and your partner interact during every session. This observation is needed so the expert can provide some advice concerning what strategies your relationship should implement so you can eliminate the root of the problem.

Search for a Therapist with Expertise in Couples Therapy

Just because a therapist is an expert, it does not mean that they are well-versed in relationship counseling. Hence, only opt for a professional that has specific training and supervision in marriage counseling and different couples therapy approaches.

Look for Referrals

One of the most convenient ways to find the best therapist for couples therapy is through referrals. Fortunately, there are three great ways to find a therapist via this method: EAP; online directories; and asking friends, family members, or a trusted professional.

Use Employer’s Employee Assistance Program for Referrals

Employers in many areas of the country usually offer Employee Assistance Program (EAP) services for their employees. An EAP often provides in-person or over-the-phone short-term counseling, which is free of charge.

By using your EAP, you can inquire or have access to therapists in various areas of expertise. The therapist can even refer you to a professional that may be best suited to handle your relationship problem.

Utilize Directories

An online directory that is centered around couples therapy has a convenient counselor-search feature. Most, if not all, platforms may even include the therapist’s specialties and qualifications. Try using the following online directories:

Gottman Method Referral Directory
The National Registry of Marriage Friendly Therapists
American Association of Marriage and Family Therapists (AAMFT)

Ask Close Friends, Family Members, and Colleagues

If you know someone who has personally undergone couples therapy or relationship counseling, then they can be a reliable source of information about a therapist, specifically how their relationship improved due to the therapist’s intervention.

Also, if you know someone who is in the medical field, like a nurse or primary care physician, ask them if they know a reliable couples therapist.

Review the Therapist

If you already have prospects, give time to read and review a therapist’s biography, training attended, years of service in therapy, clinical experience, and approach. If any piece of essential information is not displayed, you can always ask the following questions so you can gauge if the therapist is right for your relationship:

Prioritize someone who has experience working with similar clients, and with whom both you and your partner feel comfortable. Since every clinician is different, both you and your partner should be comfortable opening up during counseling. You may also prefer to work with someone who has experience working with clients who either had similar backgrounds, were facing similar challenges, or both.
Look for someone who has experience working with clients who are similar to you. You might prefer to look for a counselor who has experience with couples who share some aspect of your identity, such as same sex relationships, LGBTQ+ and sexual orientation concerns, or interracial couples. Also, if you're facing a specific issue that is relatively niche – such as co-parenting through adoption, mental health and/or physical health issues, or entering an open relationship — don't be afraid to ask the therapist if they have experience working with similar clients.
Remember that couples counselors should remain neutral — if you feel your therapist is taking sides, don't be afraid to look for a new therapist. Couples therapists will never take sides in any disputes. The therapist is there to work with both parties equally and will do their best to balance each partner’s goals and concerns. If you don't feel like that's the case with your therapist, consider looking for a new fit.

Furthermore, even if a therapist’s qualifications are displayed, it is still part of your due diligence to ask and answer questions. This is even more important if the therapist you have in mind is not a direct referral or hasn’t any web presence.

Also, you can even ask about the therapist’s relationship or marital status. Doing so may allow you to feel more comfortable sharing any unresolved conflicts in your relationship.

Learn About Their Approach

The therapeutic approach refers to the method or professional training the couples counselor uses when addressing problems, providing counsel, or practicing relationship therapy. There are tons of approaches, and it is important for you to understand each one before pushing on with your choice. Ideally, you should look through each approach first and try to figure out which one would work best for your relationship issues. From there, you can narrow down the search for a therapist who uses these counseling methods:

The Gottman Method Couples Therapy — The Gottman Method, started by Drs. John and Julie Gottman, is a highly customized therapy method that starts with individual therapy sessions before merging into a couple's session. The goal is to resolve conflicting verbal communications and increase respect, affection, and intimacy issues among couples.
Emotionally Focused Couples Therapy — This therapy works by identifying the conflict among couples and separating the cycle where this conflict occurs. By finding the pattern, the therapist can gain access to the root of the conflict by deciphering the emotions underneath those actions.
Psychobiological Approach of Couples Therapy — This approach is very direct and quickly gets to the heart of the matter. Using PACT, couples immediately address relationship distress and tension by skipping the talking and arguing part of the therapy.
Developmental Model of Couples Therapy — This method focuses on the growth and development of the couple as individual people. From there, the couple’s therapist will also guide them in developing their relationship together. The idea is that development as individuals, to resolve their own issues — one partner at a time — can help pave the way to a stronger and more developed, healthy relationship together.
Relational Life Therapy — This method is best for couples experiencing relationship issues due to the assumptions implemented by society and outside forces. Instead, the therapist puts the focus back on the people’s relationship and helps partners resolve conflicts with proper communication.
Discernment Counseling — This is typically undertaken by couples who are on the brink of or close to divorcing each other. The counselor helps the parties figure out if divorce is really the best course of action.
Integrative Behavioral Couples Therapy — This method relies heavily on behavior therapy and investigates you and your partner’s behavior as a couple to guide counseling to improve relationship satisfaction.

Your couples counselor may specialize in one particular approach, or they may integrate several different modalities into your relationship counseling. Be sure to ask the therapist about their preferred approach to couples therapy. Ask them why this is their chosen method and have them explain how this works in relation to your situation.

Regardless of methodology, the aim of couples therapy is to provide a safe, non-judgmental space for a couple to reconnect and tackle whatever issues or concerns they're facing, reduce relationship distress, explore the positive aspects of the couple’s relationship, instill positive communication strategies, and bring the partners closer in their relationship.

Additional Certifications

Ideally, your therapist should be certified by the American Association of Sexuality, Educators, Counselors, and Therapists. Certification under this association makes your counselor a sex therapist and should help with any issues related to the sexual side of the relationship. While this is not mandatory, you will find that their added knowledge as a sex therapist can greatly help in other factors involving physical contact.

Set an Ideal Payment Method and Schedule

Since couples therapy isn’t cheap, make sure that you and your partner have already discussed and set a general budget. Additionally, make sure that both of you are on the same page when it comes to the time, style, and goals of therapy; weekly therapy is a legitimate estimate for starting counseling.

Moreover, before you schedule your first couples therapy session, note that most insurances do not cover couples therapy in-network. If your insurance doesn’t cover a couples therapy session, then ask the therapist if they’re willing to provide their services to you on a sliding scale.

Effectiveness and Duration of couples counseling

Research shows couples therapy is highly effective at improving relationship satisfaction and emotional health whether you engage in online couples therapy or in-person couples therapy sessions.

Studies show that counseling can be an effective treatment on both an individual and a shared level for couples who are facing issues in their relationships:

One report shows counseling was associated with improved relationship outcomes for 70% of surveyed couples. [1]
Over 98% of clients who saw a licensed marriage and family therapist (LMFT) said that their emotional health had improved [2]

As with any therapy, the number and frequency of sessions you have with a couples counselor can vary; but generally speaking, couples counseling tends to be shorter-term than individual counseling.

Depending on your goals and challenge, you might see a counselor for only a few sessions, or you might continue weekly therapy for a few weeks or several months; the average number of sessions with a marriage and family therapist is typically 12. Like all other types of therapy, there is no one-size-fits-all plan but starting with weekly therapy meetings and working with your chosen professional, you can build a safe space for reconnection and healing.

New to therapy? Considering online couples therapy? Learn about how to find a therapist here.

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