Best Couples Therapy Options — How to Compare

What this guide covers

Couples therapy helps partners communicate better, work through conflict, rebuild trust and decide how to move forward together. It can be delivered in a therapist’s office or online, and options range from independent practitioners to subscription platforms. This guide explains what couples therapy involves, how to compare services and what to ask before you start. It is not a ranking: couples’ needs differ widely, and the best predictor of success is usually the skill of the therapist and both partners’ willingness to take part.

We review the services mentioned here independently; this page contains affiliate links, which we explain in our affiliate disclosure.

When couples consider therapy

Couples seek therapy for many reasons, including:

• Frequent arguments or the same fight on repeat
• Feeling distant, lonely or like roommates
• Rebuilding trust after infidelity or a breach
• Major transitions such as a new baby, a move, job loss or caring for a parent
• Differences in parenting, money, sex or in-laws
• Deciding whether to stay together or separate with care (sometimes called discernment counseling)
• Premarital preparation

You don’t have to be in crisis. Many therapists recommend starting before problems feel unfixable.

What to compare

• Therapist training in couples approaches such as EFT (emotionally focused therapy) or the Gottman method. A general counselor is not automatically trained to work with couples.
• Session format — joint video sessions, individual check-ins, or both
• Scheduling that works for both partners, including evenings and weekends
• Pricing and insurance (couples therapy is not always covered, because many plans require an individual diagnosis)
• Credentials and licensure: marriage and family therapists (LMFTs), psychologists and clinical social workers commonly provide couples therapy
• Approach to safety: how the therapist screens for abuse and coercive control

Learn more about couples therapy and finding a couples therapist.

Common approaches

• Emotionally focused therapy (EFT): helps partners understand the emotional cycles beneath conflict and build secure attachment.
• The Gottman method: based on observational research on couples, it focuses on friendship, managing conflict and shared meaning.
• Cognitive behavioral couples therapy: targets thoughts and behaviors that fuel conflict and builds communication and problem-solving skills.
• Integrative behavioral couples therapy: balances acceptance and change.

Research generally supports several approaches, with benefits for many couples; no single method suits everyone. Ask a prospective therapist which model they use and how they decide when to see partners together versus separately.

Online options

Online couples therapy can be convenient, especially when schedules are tight or partners live in different places, and studies suggest outcomes similar to in-person therapy for many couples, although the evidence base is smaller than for individual therapy. Online options differ here too:

• BetterHelp offers couples counseling through its sister service Regain on a subscription. Couples therapy is provided through Regain, not BetterHelp’s individual service. See our BetterHelp review.
• Sesame lets you book a single online couples session with a therapist you choose, at a price shown before you pay. Prices are set by each therapist, and Sesame does not bill insurance. See our Sesame review.

A subscription may suit couples who want regular sessions and an ongoing relationship with one therapist. A pay-per-session model suits those who want to try a single session first or attend occasionally. Whichever you choose, check whether the therapist is licensed in your state and has couples experience.

Questions to ask a couples therapist

1. What training and experience do you have in couples work?
2. What approach do you use, and what does a typical session look like?
3. How do you handle individual sessions, and what is shared with the other partner?
4. How do you work with issues such as infidelity, sex or parenting?
5. How long does therapy typically take, and how will we know it’s helping?
6. What are your fees and cancellation policies?

Safety first: when joint sessions may not be appropriate

Couples therapy is generally not recommended when there is abuse, coercion or fear of a partner. Joint sessions can put the victim at risk, and a therapist trained in domestic violence will screen for this and may recommend individual support first. If you are afraid of your partner, contact a domestic violence hotline or see Get Help Now. Online sessions should only take place when you are in a private, safe space.

Making the most of therapy

• Agree on goals together and revisit them.
• Be honest and curious rather than trying to win.
• Practice skills between sessions.
• Commit to a realistic period — several sessions at least — before judging.
• Don’t be discouraged if sessions feel difficult early on; surfacing hard topics is part of the process.

If one partner is unwilling to attend, individual therapy can still help you think about your own role and options. Our guide to how to set healthy boundaries and our section on relationships offer more.

Bottom line

Therapist training matters more than the platform. Choose a licensed professional with couples experience, a format both partners can commit to, and a price you can sustain. Use the options above as a starting point, and prioritize safety, fit and a clear plan for how you’ll know whether it’s working.