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Couples therapy: Who it’s for, how it works, and how to choose a therapist

Reviewed by Stephanie Steinman, PhD, CSAC

Two men stand outside looking serious as they discuss their relationship

Who should get couples therapy?

Couples therapy is a type of treatment where a professional counselor helps a romantically involved couple work through challenges in their relationship. This type of therapy is sometimes called “marriage counseling,” but you don’t have to be married to access it. All kinds of couples can benefit, including:

  • Couples of all genders and sexual orientations
  • Unmarried partners
  • Premarital/engaged couples
  • Happily married partners
  • Couples contemplating divorce or separation of some kind
  • Parents who may or may not be in a romantic relationship
  • Partners from different faith backgrounds
  • Couples with a large age gap

Reasons for couples therapy

You don’t need to be on the verge of divorce or a breakup to seek therapy. Therapy can help relationships on the brink of collapse, but it’s usually more effective before a crisis hits, not after. Instead of treating couples therapy as an emergency solution, think of it as preventive medicine. It can help you address relationship problems or weaknesses before they become overwhelming or seem impossible to fix.

Couples therapy can address issues such as:

  • Relationship transitions (like moving in together, getting married, or expecting a child)
  • Life transitions (such as getting a new job, moving to a new city, or starting a degree)
  • Distant or resentful feelings
  • Changes in physical and/or emotional intimacy
  • Struggles with illness or addiction
  • Financial stress
  • Challenges with parenting or fertility
  • Navigating relationships with in-laws
  • Shared grief or loss
  • Feeling “stuck”

When should a couple get counseling?

There’s no wrong time to seek couples therapy. You can do it before you’re married, after you’re married, or if you never plan to marry at all. Some couples go to therapy during the divorce process to work through tricky issues. What’s important is that both people are committed to having a healthier relationship.

While it’s never too late for counseling, the process requires two willing participants. If your partner doesn’t agree to go, you can’t force them.

Couples therapy vs. individual therapy

In couples counseling, the relationship itself is the client, not the two individuals in the relationship.

If one partner has a mental health concern, it will typically be addressed only in terms of how it affects the relationship. For example, if someone with posttraumatic stress disorder (PTSD) is prone to angry outbursts toward their partner, a couples therapist can help that person work through their anger and develop healthier communication strategies—but the counselor won’t use the session to dive into the PTSD’s root causes.

If you’re struggling with a mental health condition that’s affecting your relationship, it may be best to seek individual therapy instead of—or in addition to—couples therapy.

Types of couples therapy

Your counselor can choose from a number of therapeutic techniques that strengthen relationship bonds. Common approaches include:

  • Emotionally focused therapy (EFT) helps you meet each other’s attachment needs.
  • The Gottman Method teaches healthy forms of communication so you and your partner can avoid the “four horsemen” of relational apocalypse: criticism, contempt, defensiveness, and stonewalling.1
  • Imago relationship therapy helps you avoid repeating unhelpful or harmful relationship patterns learned from childhood (often from your families of origin).
  • Relational life therapy (RLT) encourages you to abandon traditional roles so you can have more authentic relationships.
  • Cognitive behavioral therapy (CBT) can help both individuals and couples identify and reshape unhelpful thought patterns.

How does this kind of therapy work?

Most couples therapists recommend starting with weekly or biweekly sessions. Each session typically costs $100 to $250 and may or may not be covered by your health insurance. Be sure to ask your insurer in advance about your plan, and ask your therapist if they take your insurance. Some therapists may offer discounted prices for couples who can’t afford their standard rates.

What to expect in sessions

In your first session, your therapist will ask some basic questions to get to know you both individually before asking questions about your relationship. They’ll probably also ask what you hope to get out of therapy.

It’s okay to be honest about your expectations. Some people want to do everything in their power to save their relationship from a crisis. Others just want to strengthen the healthy relationship they already have. Some people are open to a breakup or divorce but want to have a healthier relationship so they can coparent together. Whatever your goals, your therapist can help you start working toward them.

After your first session, your therapist will likely set up a regular schedule of sessions. They may assign tasks or “homework” for both of your to do between sessions.

Couples therapy doesn’t last forever. At a certain point, your therapist will begin expressing the belief that you and your partner have gotten as much out of the experience as you can. They may recommend you and/or your partner try individual therapy to continue working toward a healthier life and healthier relationships.

How to choose your couples therapist

You’ll want to find a therapist who’s a good fit for both you and your partner. This may take time. Try to identify what’s most important for each of you—if your therapist shares the same faith background as you, for example, or if they have experience with LGBTQIA+ couples. Be honest with your partner about what you’re looking for. This will help you both feel comfortable once you settle on a counselor to work with.

Education and certifications

Most therapists have a master’s degree in counseling or a related field, a doctoral degree in psychology, or a medical degree in psychiatry. Some have specific certifications for certain kinds of treatment.

Common degrees and certifications for couples therapists include:

  • LMFT (licensed marriage and family therapist)
  • LMSW (licensed master social worker)
  • LCSW (licensed clinical social worker)
  • LPC (licensed professional counselor)
  • CGT (certified Gottman therapist)

Note that a therapist can have a different degree than the ones listed above and still be qualified to counsel couples.

Therapists often list their specialties on their website or in an online directory like ours. You can look for areas of practice that relate to your needs: marriage, relationships, couples therapy, sex therapy, parenting, domestic violence, and more.

Treatment method

Your therapist likely relies on one or more therapeutic methods to treat clients. If you prefer a specific approach, like the Gottman method, look for a therapist who uses it.

If you don’t have a preference, that’s okay. Find a therapist you like and trust, and ask them what methods they typically use. You can always voice any difficulties or frustrations you may have during treatment, so your therapist can alter their approach to better meet your and your partner’s needs.

Shared values or experience

You don’t have to choose a therapist whose life experiences are similar to yours. In fact, it sometimes helps to work with someone who feels like a complete outsider.

However, some people feel safer with therapists whose backgrounds or values resemble their own. For example, if you and your partner practice a specific religion, you may want to work with someone who has firsthand knowledge of that faith.

It’s fine to have preferences when you’re finding a therapist—and it’s also good to keep an open mind. Secular therapists can help religious couples find healing, and straight therapists can help LGBTQIA+ couples discover greater intimacy.

Wisdom can come from where you least expect it. What’s most important is that you and your partner trust your therapist, no matter how similar or different their life is to yours.

About the author

The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.

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