How Does Couples Therapy Work?

Couples therapy, like other forms of talk therapy, attempts to alleviate people's suffering and improve their functioning in a key area of life. In contrast to other types of therapists, however, psychotherapy often involves a third participant. There are both individuals in the pair and the couple itself. The couple's therapist does a delicate balancing act, keeping both parties' needs and desires in mind while remaining objective.

Couples often seek help from therapists when arguments arise over shared experiences, and when one or both spouses are experiencing significant discomfort. It's common for one spouse to feel more hopeful about treatment or to want it more than their partner.

What happens in couples therapy?

The vast majority of couples therapy sessions have both partners actively participating. It may be necessary to meet with or communicate with one partner individually on occasion, but this should only be done if doing so will yield information useful to the partnership and with the consent of the other. When one member in a pair is unwilling to engage in treatment, the other may decide to seek couples counselling as a means of reviving the relationship.

The therapist will probably ask a lot of probing questions, some of which will pertain to the backgrounds of the two people in the relationship. Despite not taking sides, therapists who work with couples may point out how each partner's actions are contributing to the couple's issues. According to studies conducted in the field of relationships, each partner contributes to the majority of relationship issues.

In most cases, therapists try to help a couple grow closer together or gracefully split ways. While working through challenges together, couples develop empathy for one another and for themselves, discover effective strategies for dealing with negative emotions, and rediscover the positive aspects of their relationship.

Couples in therapy are often given homework assignments between sessions to reinforce their newfound understandings, patterns of interaction, and approaches to conflict resolution.

A range of approaches for couples in distress

Several couples counselling methods have been subjected to at least some level of scientific scrutiny. They all aim to improve pair functioning and make partnerships a source of deep meaning and satisfaction for both partners, even if they draw on various theories of relational behaviour. Most therapists who specialise in working with couples have training in several different approaches, allowing them to pick and choose from a variety of methods. Among these are:

The Gottman Method: 

Developed by psychologists John Gottman (a pioneer in the field of measuring interaction processes) and his wife Julie Gottman, the Gottman Method stresses the importance of frequent bids for connection or response, the critical need to repair the damage done by missing those bids, and the value of sharing their inner worlds; it also emphasises the outsized power of negative emotion to harm a relationship. In order to get closer to one another, couples work on "love maps" that depict each other's inner mental landscape as a means of practising mutual understanding and appreciation.

Emotion-Focused Therapy

When working with a troubled couple, Emotion-Focused Therapy prioritises helping them mend their emotional and physical connection. Using concepts from attachment theory, the therapist helps partners get to the root of their resentment and isolation. That's because admitting weakness is a potent way to get a spouse to respond. If communication between partners is restored, they can draw on a never-ending well of support while they work through their issues.

Imago Relationship Therapy 

The goal of Imago Relationship Therapy is to help you achieve "getting the love you want." Its purpose is to help spouses realise the ideal of love they imagined as children when they were attached to their carers. Partners take turns talking and listening, and they show they've understood each other by repeating or mirroring what the other has said.

How does couples therapy differ from couples counseling?

Clinicians and patients often use the phrases interchangeably because they are so similar: both types of care attempt to help couples overcome relationship challenges and handle conflict. However, they are not the same thing at all. Couples therapy typically lasts no more than six sessions and is narrowly tailored to address a specific, pressing issue.

Couples therapy is a more in-depth approach that looks into the origins of current issues between partners with the goal of mending unhealthy habits of interaction. Often times, it must repair the hurt feelings that have been caused by the partners' previous interactions. As a result, partners may better communicate their wants and requirements to one another and provide meaningful emotional and practical assistance.

However, interpersonal dynamics are complex, and the number of treatment sessions needed to achieve the couple's goals might vary widely. Rebuilding trust after infidelity can take time and a lot of effort from both parties (and the therapist!).

Infidelity, intimate partner violence, and sexual dysfunction are just some of the relationship issues that have inspired specialised forms of couples therapy. Individuals who suffer from depression, chronic pain, cardiovascular illness, substance misuse, or post-traumatic stress disorder (PTSD) may benefit from couple-based treatment.

How do I find a good couples therapist?

Finding a couples therapist with whom you feel comfortable talking about your issues, but who is also prepared to confront either partner's ideas or behaviour when necessary, is as crucial in couples therapy as it is in individual therapy. Consultation interviews with multiple potential therapists, all of whom should be willing to answer any questions you have about therapy and discuss any concerns you have, are a good idea before settling on one to work with.

Therapists that specialise in working with couples typically have advanced degrees in fields such as medicine, psychology, counselling, social work, or marriage and family therapy. In addition to extensive instruction in a variety of psychotherapeutic modalities, these professionals have also received intensive, supervised clinical training in interpersonal dynamics, as well as formal academic training in the study of relationships and families. The Association for Marriage and Family Therapists (AAMFT) offers training and certification for some therapists. In order to find help for sexuality-related issues in a relationship, some couples may wish to consult a therapist who has completed extra training through the American Association of Sexuality Educators, Counsellors, and Therapists (AASECT). It's important to choose a therapist who has experience working with couples going through similar issues as you are, so don't be afraid to ask potential candidates about their background and approach.

How much does couples therapy cost?

Couples therapy, much like individual therapy, is often provided by a private practitioner once a week for an hour at a cost of $150 to $400. It's always a good idea to inquire about a sliding cost scale if you're looking for a therapist, as some may be prepared to work with you on pricing. Some couples therapists charge more to complete a full course of therapy in just two or three days, usually over the weekend.

Unfortunately, insurance companies rarely consider couples therapy to be medically necessary, therefore it is typically not covered. However, there are options for low-cost, high-quality treatment. One option is to visit a university-affiliated or independent facility specialising in couples counselling. You receive therapy from students, but they are under constant supervision from experienced professionals who are coaching them while they work. Couples counselling is also available from several nonprofits in the local community. Therapy professionals who see both individuals and couples, and who specify their area of expertise, can be found in Psychology Today's Therapy Directory.

Therapists who work with couples are unanimous in their belief that it is worth every penny to invest in the process. They argue that it is a more economical option than getting a divorce.