Does Couples Therapy Really Work?

Has your relationship hit a rough patch? Couples therapy may help get it back on track.

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You and your partner can’t seem to communicate without ending up in an argument. You often spend more time apart than as a couple. At least one of you is pretty unhappy with the state of your relationship. You love your partner deeply, so you don’t want to end your relationship, but you feel your current situation is untenable. Or maybe none of those things are happening, but you feel that something is off with your relationship and you’re not sure how to fix it. Sound familiar? If so, couples therapy may be able to help you and your partner get your groove back. I spoke with licensed family and marriage therapists who specialize in couples therapy to get answers to some of the questions surrounding it and to find out whether it really works—and how to know when it might be time to give couples therapy a try.

Signs You and Your Partner May Need Couples Therapy

First of all, it’s important to remember that happy couples go to counseling too. “Counseling [can] strengthen a relationship, even if it is already strong,” says licensed marriage and family therapist Sara Stanizai of Prospect Therapy in Long Beach, California. “It would be like saying that people who are fit [or] in shape should be embarrassed about going to the gym!” But if you can’t honestly describe your relationship as a happy one, your relationship may need professional intervention, Stanizai explains. Each partner rates or describes the relationship differently. You may rate your relationship as unsatisfactory, but your partner may think things are great. No matter how each of you views your relationship, you may want to start thinking about couples therapy if you experience any of the following on a regular basis:

  • You are unhappy in the relationship more days than not.
  • You are having regular, frequent disagreements (especially if the same issue keeps coming up).
  • You feel nervous, anxious, or depressed thinking about your relationship or when you’re with your partner, but you’re okay with your friends, family, at work, or even around strangers.

This list is by no means exhaustive, says Stanizai. In fact, you may want to give couples therapy a go for other seemingly minor issues that have begun to cause a rift in your relationship over time. For example, your partner may always leave dishes in the sink, which drives you crazy. They say, “But it’s just dishes!” To you, though, it might be a bigger issue. As Stanizai explains, “If you keep having the same disagreement, there is an underlying issue that is coming up in different situations in your relationship. It’s not about doing the dishes, but it’s about showing respect, trust, or aligned values.” That said, it’s a myth that couples have to be actively unhappy to seek couples counseling or marriage therapy. Your relationship with your partner might be great—so great, in fact, that you find yourself unable to function without your partner. “If you feel like your identity is wrapped up in your partner and you struggle to be your own person, if you can’t make decisions without them…that’s unhealthy too,” says Stanizai.

Does Couples Therapy Really Work?

How to Know if You Need Couples Therapy

Everywhere from the workplace to the doctor’s office, women are often accused of overreacting, being overly emotional, or worst of all, the “C” word. No, not that one, the other “C” word: crazy. In fact, researchers in a joint study by Arizona State University and the University of Illinois at Chicago found that men are perceived as being more influential when they assertively express themselves, but the opposite holds true for women. Unfortunately, this can be all too common in relationships as well.

If you can’t ‘get over’ the issue or you’re still upset about it later, it means it was more than a temporary irritability. Sara Stanizai, LMFT

So how do you know if you’re “overreacting” to a situation or if there is a real problem between you and your partner? “If it’s a repeat issue or you have had the same disagreement before, it’s a sign there’s an underlying issue at play,” explains Stanizai. “Likewise, if you can’t ‘get over’ the issue or you’re still upset about it later, it means it was more than a temporary irritability.” If you still feel upset, sad, or angry about an issue in your relationship, then your feelings are valid, regardless of whether your partner agrees with you. In this case, a marriage and family therapist may be able to help you and your partner communicate effectively to gain clarity on how each of you is feeling.

How to Convince Your Partner to Go to Couples Therapy

It’s not a good idea bring up the topic of marriage counseling or couples therapy in the middle of an argument, says Stanizai. Issues in your relationship are the responsibility of both you and your partner. But bringing up therapy during an already tense conversation could result in your partner showing hostility toward couples counseling because they may feel blamed for the situation (even if that wasn’t your intent). Stanizai recommends that people “bring up couples therapy during a calm, happy time in your relationship … instead of bringing it up during or right after a disagreement.” She adds that people are less likely to be defensive if they’re both already in a calm place in the relationship. You’ll be able to explain why you think you need couples therapy without inadvertently placing an unfair share of blame on their shoulders. Licensed marriage and family therapist Whitney Hawkins of the Collaborative Counseling Center in Miami, Florida, echoes Stanizai and says that if your partner gets upset when you mention couples therapy, it’s time to take a break from the conversation. “Table this conversation for a later time. Once one or both of you are flooded with emotion, it will be impossible to make any headway. You can say something as simple as, ‘I understand why you would feel that way. I’ll give you some time to think [and] we can talk about it tomorrow.’ Set another time to have a discussion about what is going on in your relationship.” Even if you feel very strongly that you and your partner should attend couples counseling or marriage counseling, don’t make the decision for the both of you. Instead, suggest couples therapy to your partner as one option for working through your relationship issues and explain why you’d like to give couples counseling a try; end your proposal by telling your partner that it’s a decision you’d like to make together. If your partner is totally unreceptive to the idea of going to couples therapy, then don’t give up completely.

The first step to eliminating stigma around couples therapy is simply talking about it.” —Whitney Hawkins, LMFT

“Remind them it’s not a ‘done deal,’ or an ultimatum, says Stanizai. “Say they can think about it and see if it’s something they’re interested in pursuing. People freak out because they feel they don’t have an option. If given the option, especially if they are having the same disagreements with you over and over, they are more likely to agree.”

The Stigma Around Couples Therapy

When you demonstrate shame about a subject, people often assume it is something to be ashamed of,” says Hawkins. But that shouldn’t be the case with couples therapy. “The first step to eliminating stigma around couples therapy is simply talking about it,” she continues. When you start talking openly about therapy, Stanizai says you might be surprised to find that many couples have either thought about therapy or participated in couples therapy exercises. If you’re worried that your family and friends already suspect something’s up or if you’ve been asked directly if you and your partner are in couples counseling, you’re under no obligation to share any personal information about your relationship. Plus, you don’t have to worry about your therapist sharing that information, because couples counseling and marriage therapy sessions are 100 percent confidential.   Still, if you want, you can talk to people about counseling without revealing what goes on in your therapy sessions. Here are some responses Stanizai recommends for when your well-meaning mother or best friend wants to know what’s going on:

  • “We’re getting a relationship tune-up.”
  • “We got a great recommendation for a therapist and thought, ‘Why not?’ We’re excited to see how therapy can help our relationship grow.”
  • “We’re meeting with someone who specializes in [xyz issue, demographics, profession, ethnicity, etc.] so we’re interested to see how it works for us.”
  • We keep having the same disagreement and we’re over it, so we’re hoping to get to the bottom of it with some professional help.”

How to Choose a Couples Therapist

“An objective third party is never a bad idea,” Hawkins says. “When things get heated or tense in a relationship, it can be really difficult to remain objective, because you are invested emotionally. A professional can help shine a light on the dynamics that are keeping you stuck and teach you new ways to interact and support one another.” Choosing the right therapist is critical to whether you and your partner will see positive results from couples therapy. To ensure that you and your partner pick a therapist that you both like, make sure you are both involved in the initial consultations and that you both address any questions or reservations that you may have. You’ll also want to make sure that the therapist you choose uses a treatment model that works for your relationship issues. For couples seeking help with substance abuse and other addictions, behavioral couples therapy (BCT) is an ideal treatment model, because it incorporates couples counseling techniques that promote abstinence from drugs and alcohol and help to build a stronger support system. Emotionally focused therapy (EFT) puts the emphasis on a couple’s emotions and how to transform negative emotions eroding a relationship into positive ones. If you’re dealing with multiple relationship issues, your therapist may use couples therapy techniques from a variety of treatment models. Both Stanizai and Hawkins use the Gottman method of couples counseling. In this treatment model, couples complete extensive assessments and therapists use their findings to create a unique, research-based treatment plan for each couple. While the most important thing is choosing a therapist who is going to help you improve your relationship, couples also have to consider the practicality of couples therapy. Therapy can get pricey, and according to both Stanizai and Hawkins, it’s rarely covered by insurance. Sessions vary in price depending on where you live, but you can expect to pay between $100 and $300 per session. If money is one of your big relationship stressors, perhaps you can compromise by agreeing to one session and have the therapist help you come up with a plan for how to budget couples counseling together.

What to Expect in Couples Therapy

Once you’ve chosen a therapist, you’ll dive into the actual work of couples therapy. In the beginning, you can expect to attend weekly couples counseling sessions, with the first few sessions focused on gathering information about the relationship, says Hawkins. Don’t be alarmed if your therapist interviews both of you together and separately to get to the root of what’s causing your relationship issues. “We gather that information and focus on your strengths as a couple as well as the areas that are mismatched [and] areas of growth,” Stanizai says about the Gottman method of couples counseling. “People worry that ‘all their problems’ will come out in couples therapy, but we also focus a lot on what you’re doing well.” You can expect that couples therapy sessions will be hard work, Stanizai explains. Your therapist will guide you through the counseling session, but they’ll really allow you and your partner to work out disagreements in your sessions, as they also teach you to communicate effectively. As therapy continues and you show progress as a couple, the frequency of sessions will typically decrease to every other week, then once a month or on an as-needed basis, but there is no set schedule for when weekly meetings end.

Couples Therapy Coping Skills

During couples counseling, you won’t just focus on everything that’s bad in your relationship. In fact, you can expect to spend some sessions building on what is already working and enhancing your friendship with your partner. This is what you’ll want to focus on between sessions. Plus, your therapist will often give you communication tools to use at home. “People will see the benefits as their therapy tools start working at home as they use them,” says Stanizai. “As with any new set of tools (like learning a new language—you’re saying the same things but using different language) it will feel awkward at first. The best way to learn is to practice, which you can do in and out of session.” It’s imperative that both of you commit to therapy if you want it to work, says Hawkins. “It can be very difficult to engage a partner who wants out of the relationship and has been forced into attending counseling,” Hawkins continues. “For some couples, marriage counseling is actually divorce counseling because they’ve already decided it’s over. Some partners may use counseling as a venue to dissolve the relationship, but if you and your partner are open to the process, a lot of great change can be made.” That can be tough to hear if you’re committed to working things out but your partner isn’t. Still, if you mutually decide to end your relationship, that doesn’t mean you failed as a couple. If the relationship is not able to be salvaged this does not constitute a failure,” Hawkins emphasizes. “Maybe throughout the course of therapy, you decide you would like to end the relationship. …Keeping a relationship intact is not the only option in couples counseling. You and the clinician can work together to create goals that are appropriate for your life and provide you with the best result.”

Katie Martin
Katie Raye Martin is a freelance writer, navy wife, new mom, and chocoholic. In addition to HealthyWay, she has contributed to NextGenMilSpouse, a blog for the millennial military spouse, and Pregnant Chicken, a pregnancy blog. Since welcoming her first son a few months ago, Katie has become a pregnancy expert and cloth diapering connoisseur. When she’s not writing (or changing diapers) Katie is training for her first half-marathon.