Couples Therapy

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What is couples therapy?

Couples therapy is a form of psychotherapy (or talk therapy) in which romantic partners have sessions together with a therapist to support them with some aspect of their relationship. Couples therapy stands in contrast to other forms of therapy, such as individual therapy, family therapy, and group therapy, which involve an individual, family members, or a group of people, respectively. 

What couples therapy can help with

Couples therapy can help couples with a wide range of concerns that affect the relationship in some way. Concerns addressed in couples therapy can be individual concerns that affect the dynamics of the relationship or joint concerns that both partners are grappling with. For instance, some couples might seek couples therapy if one individual is grappling with new questions regarding their sexual orientation that are impacting sexual intimacy, while others might seek couples therapy if both partners are having difficulty resolving conflicts in a healthy way.  

Common areas in which couples therapy may be helpful include the following: 

• Improving communication skills 
• Addressing unhealthy relationship patterns 
• Learning how to navigate conflict more effectively 
• Deepening emotional or sexual intimacy 
• Rebuilding trust after betrayal, such as cheating 
• Navigating major life changes, such as moving, changing careers, getting married, or having kids
• Establishing new expectations and boundaries amid a change in the relationship, such as becoming long-distance or exploring ethical non-monogamy 
• Learning how to navigate mental health concerns that one or both partners are experiencing 
• Moving forward after a traumatic event or major loss, such as a natural disaster or the death of a loved one
• Working through disagreements regarding parenting, finances, or other key topics 
• Developing a deeper understanding of each other, such as learning more about each partner’s love language or communication style 
• Learning more about what a healthy relationship entails and how to infuse the relationship with greater respect, empathy, affection, and gratitude
• Improving relationship satisfaction and building a stronger connection 
  

Ultimately, couples therapy can be helpful for many different concerns facing couples, including many other challenges and situations not listed here. 

Approaches used in couples therapy

In couples therapy sessions, a therapist may draw on a wide range of therapeutic approaches and techniques to help a couple achieve their goals. The exact approaches used in sessions can depend on the couple’s unique concerns and preferences, as well as the therapist’s specialties and areas of expertise. 

Couples therapy approaches 

Some of the common therapeutic approaches used in couples therapy include:

• Cognitive behavioral therapy (CBT): In CBT for couples, partners can identify and modify negative thought patterns and behaviors that are harming the relationship. Couples can also learn healthier communication skills and more effective ways to navigate conflict.
• Integrative behavioral couples therapy (IBCT): A newer therapeutic approach, IBCT encourages partners to accept each other’s differences and to address unhealthy relationship patterns, allowing for greater emotional closeness.
• Emotionally focused therapy (EFT): EFT for couples is rooted in attachment theory and social neuroscience, and it focuses on improving emotional intimacy and closeness between partners.
• The Gottman Method: Developed by John and Julie Gottman, the Gottman Method incorporates research-backed strategies to help couples strengthen their relationship in three key areas: friendship, conflict management, and the creation of shared meaning.

Throughout sessions, a couples therapist may utilize techniques from one or more therapeutic approaches. If you and/or your partner prefer a particular approach, it may be helpful to either prioritize therapists specializing in that approach when trying to find the right therapist for you or communicate that preference to your therapist when you start your therapy journey.

The effectiveness of couples therapy

For many couples, there may be hesitation or skepticism around couples therapy—does it actually work? While each couple’s experience in therapy will be unique to them, a large body of research has demonstrated the effectiveness of couples therapy. 

A number of research reviews and meta-analyses have established the effectiveness of couples therapy for reducing relationship distress, and several clinical trials have found evidence that couples therapy can also be beneficial for coexisting emotional, behavioral, and physical health concerns. In addition, research has demonstrated online couples therapy and in-person couples therapy to be similarly effective.

Beyond this evidence of its efficacy, there are also various factors and steps you can take that can help make couples therapy a more positive and beneficial experience. 

Finding the right couples therapist 

In couples therapy, as with other types of therapy, the therapeutic relationship can significantly impact the overall effectiveness and experience of therapy. Finding a couples therapist who is a good fit for both you and your partner can be an important part of having a successful therapy experience. 

To find a qualified therapist who can best support you and your partner in couples therapy, some of the tips below may help:

1. Ensure that the therapist holds a recognized professional license in your state or jurisdiction to offer therapy services. Couples therapy can be offered by licensed therapists holding various credentials, such as Licensed Marriage and Family Therapists (LMFTs), Licensed Clinical Social Workers (LCSWs), Licensed Professional Counselors, and more.
2. Consider whether you and/or your partner have any particular preferences regarding your therapist’s approach, experience, or background. For instance, for some couples, finding a therapist experienced in LGBTQIA+ relationships may be a priority, while for others, finding a therapist skilled in the Gottman Method may be important.
3. During your therapy sessions, you and your partner can assess whether you both feel comfortable with your therapist and confident in their approach. If one or both of you do not quite gel with the therapist, it may be best to find a new provider.

Making the most of couples therapy

In addition to finding the right therapist, you and your partner can also take a number of steps both before and during the therapy process to make the most out of the experience. 

Before embarking on therapy, some of the following strategies may help you and your partner prepare for the journey:

• Reflecting individually and together on both the negative and positive aspects of your relationship
• Considering your goals for couples therapy 
• Defining what a strong, happy, and fulfilling relationship looks like for you
• Reflecting on the individual, relationship, and external dynamics that may be impacting you and your partner 
  

During therapy, some of the following steps may help you and your partner make the most out of your sessions: 

• Practicing active listening to really hear and internalize your partner’s thoughts, ideas, and opinions 
• Using “I” statements to express your perspective 
• Being as honest, authentic, and vulnerable as possible 
• Staying open to what your partner has to say and to the new topics and dynamics that couples therapy unlocks 
• Having patience with yourself, your partner, and the therapeutic process 
• Practicing the skills you learn in therapy outside of sessions

Seeking couples therapy online or in person

Couples therapy can take place either online or in person, so you can seek support in whichever way you prefer. Different options may appeal to different couples, but both can be effective forms of support. 

Some couples may not be comfortable using technology or may prefer an in-person connection, in which case opting for traditional, in-person couples therapy or marriage counseling may make the most sense. Meanwhile, other couples may find that meeting with a therapist in a therapy office feels too clinical, and they would feel more comfortable having sessions in their own space, in which case online couples therapy may be more fitting. And for other couples, having to be in the same room for therapy sessions may not be appealing or feasible, which may make online couples therapy a convenient solution, as it allows partners to join therapy sessions from separate locations. 

Whether you decide to seek couples therapy online or in person, taking the leap to seek help with your relationship can be a brave step toward a better life. 

Frequently Asked Questions (FAQs) 

What is the success rate of couples therapy? 

The success rate of couples therapy can vary, but some research has found that 60-80% of distressed couples benefit from couples therapy. 

What usually happens in couples therapy?

The exact structure, topics, and dynamics in couples therapy sessions will depend on you and your partner, the issues you are experiencing, and the approach or approaches your therapist employs. Broadly speaking, though, couples therapy typically involves identifying and addressing particular areas of concern that one or both partners have in the relationship, with the aim of improving the relationship in some way. 

What kind of therapy is best for couples?

The best form of therapy for couples can vary from one couple to the next, but some common forms of couples therapy include cognitive behavioral therapy for couples, integrative behavioral couples therapy, emotionally-focused therapy, and the Gottman Method.

Is couples therapy usually covered by insurance? 

In many cases, health insurance plans may only cover couples therapy if one partner has a diagnosed mental health condition. To determine if your insurance plan covers couples therapy, contact your insurance provider directly to understand the details of your plan.

BetterHelp currently accepts HSA/FSA cards and is recognized as an eligible expense by most HSA/FSA providers. 

Is it worth it to go to couples therapy? 

Whether or not going to couples therapy may be “worth it” is something only you and your partner can determine. However, couples therapy can be helpful for a wide range of concerns, and research has demonstrated its effectiveness. If you and your partner are interested in working on your relationship and are committed to the process, couples therapy can be a powerful tool.