Couples Therapy

What is couples therapy?

Couples therapy is a type of psychotherapy that helps partners understand and improve their relationship. It is for couples of any gender, sexual orientation or relationship stage — dating, living together, married or separating.

Common reasons people seek it

• Frequent conflict or communication breakdowns
• Loss of connection or intimacy
• Trust issues, including after infidelity
• Major transitions such as a new baby, relocation or illness
• Disagreements about finances, parenting or family
• Deciding whether to stay together or separate

Approaches

• Emotionally focused therapy (EFT): focuses on emotional bonds and patterns of interaction.
• Integrative behavioral couple therapy (IBCT): combines acceptance and behavior change.
• Gottman method: focuses on friendship, conflict management and shared meaning.

What to expect

Early sessions usually explore each partner’s perspective and the relationship’s history. Therapists often meet with partners together and sometimes individually. Many couples attend weekly or every other week.

Sessions can also happen online: BetterHelp’s sister service Regain offers subscription couples counseling, and Sesame lists single online couples sessions with a therapist you choose.

When couples therapy may not be right

If there is ongoing violence, abuse or coercive control, joint therapy can increase risk. Individual support and safety planning are recommended first.

What a first session usually involves

The first sessions are about understanding your relationship and what you each want. A therapist typically asks about how you met, what’s working well, what brings you in now and what you hope will change. Many therapists meet each partner individually at some point to understand each person’s perspective and to screen for safety. They’ll explain how confidentiality works, which differs between therapists: some keep no “secrets” between partners, while others hold individual sessions in confidence. Ask about this at the start. You’ll usually agree on goals, a rough number of sessions and how you’ll review progress.

Approaches in more detail

• Emotionally focused therapy (EFT) is based on attachment theory. It helps partners identify the emotional cycles beneath conflict, such as pursuing and withdrawing, and respond to each other’s underlying needs. It has strong research support for many couples.
• The Gottman method draws on decades of research on couples. It works on friendship and intimacy, managing conflict and building shared meaning, and uses assessments and exercises.
• Cognitive behavioral couples therapy targets thoughts and behaviors that fuel conflict and teaches communication and problem-solving skills; see CBT.
• Integrative behavioral couples therapy balances accepting what won’t change with working on what can.
• Discernment counseling is a short-term approach for couples uncertain whether to stay together, helping them make a clear decision.

What couples therapy can and can’t do

It can help partners communicate more clearly, reduce the intensity and frequency of conflict, rebuild trust after a breach, navigate transitions such as parenthood and strengthen emotional and physical intimacy. It can’t make a person want to stay, guarantee a relationship will last or fix a problem when one partner is unwilling to take part. Some couples use therapy to separate with less conflict, which is also a valid outcome. Research suggests a majority of couples who complete therapy report improvement, though effectiveness depends on factors such as motivation, therapist skill and the issue involved.

How long does it take?

Many courses run 12 to 20 sessions, but length depends on the model, the issues and how often you meet. Some couples benefit from a short, focused series; others from longer work. Between sessions, you’ll usually be asked to practice new ways of talking, scheduling time together or noticing patterns. Progress often involves a period of discomfort as hard topics surface, which is not a sign that therapy isn’t working.

Preparing for sessions

• Talk beforehand about what each of you wants from therapy.
• Agree to be honest and to avoid using sessions to score points.
• Make time and a private space, particularly for online sessions.
• Be open to individual issues, such as stress, anxiety or depression, that affect the relationship.
• Plan to practice skills between sessions.

Online couples therapy

Online sessions can make it easier to schedule and stay consistent, and some studies suggest comparable results to in-person sessions for many couples, although research is still developing. Both partners need a private space and a stable connection, and online therapy isn’t suitable where there is a risk of abuse. See online therapy and our guide to the best couples therapy options.

When to seek individual help as well

Sometimes an individual issue underlies relationship difficulty, such as depression, trauma, addiction or ADHD. Treating it in individual therapy, alongside or before couples work, can help both of you. If you’re unsure where to start, our guides to relationships and finding a couples therapist can help. If you’re afraid of your partner, see Get Help Now.

Questions to ask a couples therapist

Before committing, it’s reasonable to ask: What training do you have in working with couples, and which approach do you use? How do you handle individual sessions and information shared in them? How will we measure progress, and when will we review the plan? What are your fees, session length and cancellation policy? A therapist who answers these openly is usually a good sign, and you can switch if the fit isn’t right for both of you.