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Couples Therapy

Reviewed by Psychology Today Staff

Couples therapy is a type of therapy that aims to help romantic partners address relationship conflicts, improve communication, and increase affection and empathy for one another. Couples therapists may employ techniques from a variety of modalities, including emotionally focused therapy, the Gottman Method, cognitive-behavioral therapy (CBT) for couples, Imago relationship therapy, and others.

While it’s common for couples to begin therapy when their relationship is on the brink of collapse, an impending split is not a prerequisite for couples therapy. Indeed, many couples who have an otherwise strong bond pursue therapy to address one or two specific issues that are causing strife and make their relationship the best it can be.

The terms “couples therapy” and “couples counseling” are sometimes used interchangeably, even by clinicians. Strictly speaking, however, couples counseling is a short-term approach that focuses on addressing one concrete problem, often in six sessions or less. Couples therapy, by contrast, is typically a longer-term process that explores a couple’s personal history and relational patterns in a deeper, more open-ended way.

When It's Used

Partners who seek couples therapy do so for a wide variety of reasons; often, these include communication challenges; frequent or intense conflicts; persistent disagreements about finances, child-rearing, the division of labor, or other quotidian concerns; or challenges related to sex and intimacy. Infidelity by one or both partners can also lead a couple to seek therapy.

Many couples on the verge of splitting up seek therapy, either to determine whether the relationship can be saved or to navigate the breakup in the healthiest, least destructive way possible; the latter approach may be especially valuable for couples with children who wish to co-parent effectively. Entering couples therapy does not mean a couple is destined to break up, though couples may determine over the course of therapy that a peaceful dissolution would be best for both parties.

Couples therapy may also be beneficial if one or both partners suffer from physical health problems, anxiety, depression, substance abuse, PTSD, or related challenges, as these issues can disrupt connection or drive a wedge between partners. In such cases, the affected partner(s) may also pursue individual therapy.

Couples therapy may be utilized in cases of domestic violence or other kinds of emotional or sexual abuse. However, many domestic violence organizations, including the National Domestic Violence Hotline, contend that couples therapy alone cannot fix abuse. Anyone who feels unsafe around their partner is encouraged to reach out to the police or to a local support organization. In the U.S., call 1-800-799-SAFE (7233).

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What to Expect

What to expect during couples therapy depends on several factors—including the issue(s) that drove the couple to seek help, the approach(es) employed by the therapist, and the personal preferences and dynamics that are unique to each couple. Broadly, however, couples can expect to each spend time sharing their concerns, identifying the emotions they feel toward their partner and toward the relationship, exploring personal history (both the individual partners’ personal history and their shared history as a couple), and learning skills—such as anger management techniques, conflict resolution, and joint problem-solving skills—that can help them approach challenges more effectively going forward.

It's common for one or both partners to have some desire to “win” at therapy—that is, they want the therapist to agree with them, take their side, and designate the other partner as the cause of the couple’s problems. This is, however, an unrealistic expectation. A competent, ethical couples therapist will not take sides, and their job is not to declare one partner guilty and the other innocent. Instead, the therapist will assist both partners in understanding how they may be contributing to the couple’s larger issues and encourage them to see things from their partner’s point of view.

Most couples therapy sessions will happen with both partners present. In some cases, therapists will also conduct individual sessions with one or both partners to gain deeper insight into their unique challenges. It is also possible for someone to attend couples therapy alone, often because their partner is not open to therapy or doesn’t believe it will help.

How It Works

Romantic relationships are among the most important relationships in our lives, and when they’re not working well, the effects on partners’ well-being, day-to-day functioning, and other relationships can be severe. Yet many couples find it challenging, if not impossible, to fix dysfunction on their own. Most of us have deep-seated biases and patterns of relating to ourselves and others; adapting our ways of thinking and behaving to help our romantic relationship thrive may not come easily. Personal insecurities and cultural taboos may also make it difficult for partners to raise sensitive topics, such as sexual difficulties or past trauma, with each other.

Effective couples therapy, then, will guide partners through this challenging but often deeply rewarding process. The therapist, as an impartial third party, can help couples identify patterns that are keeping them stuck, and the “neutral” space of the therapy room can be a safe haven for each partner to express their emotions, hopes, and fears. Ideally, this process will promote greater compassion—both for one’s partner and for oneself—and help the couple learn more productive ways of managing conflict and navigating problems as they arise.

What to Look for in a Couples Therapist

Couples interested in pursuing couples therapy should look for a licensed mental health professional—such as a psychologist, clinical social worker, or marriage and family therapist—who has completed training in couple-focused modalities. Many couples therapists have sought additional certifications from professional associations specializing in couples therapy or in sex therapy, like the American Association for Marriage and Family Therapy (AAMFT) of the American Association of Sexuality Educators, Counselors, and Therapists (AASECT).

As in individual therapy, the relationship between the therapist and the clients is of prime importance. Couples should look for a therapist with whom they both feel at ease and who has experience treating their particular concerns. It’s normal—indeed, even encouraged—for couples to interview several therapists to identify one who feels like the best fit.

American Association for Marriage and Family Therapy (AAMFT)
American Association of Sexuality Educators, Counselors, and Therapists (AASECT)
National Domestic Violence Hotline. "Should I Go To Couples Therapy With My Abusive Partner?"…