When to Seek Couples Therapy
- Communication has broken down
- Same arguments repeat without resolution
- Emotional or physical intimacy has declined
- Trust has been broken (infidelity, dishonesty)
- Major life transitions (baby, move, job change)
- Considering separation but unsure
- Everything is fine but you want to strengthen the relationship
Don't wait until you're in crisis. Earlier intervention typically leads to better outcomes.
Major Approaches
Emotionally Focused Therapy (EFT)
Based on attachment theory. Focuses on the emotional bond between partners and helps couples understand the negative cycles they get stuck in. Strong research support.
Gottman Method
Based on decades of research by Drs. John and Julie Gottman. Focuses on building friendship, managing conflict, and creating shared meaning. Uses assessments to identify specific problem areas.
Cognitive Behavioral Couples Therapy
Applies CBT principles to relationships. Focuses on changing negative thought patterns about the partner and teaching communication and problem-solving skills.
What to Expect
- First sessions: Assessment of the relationship, history, goals
- Individual sessions: Many therapists meet with each partner individually
- Joint sessions: Working together on communication, patterns, issues
- Homework: Practice new skills between sessions
The therapist is neutral—not taking sides. Both partners need to be willing participants for therapy to work.
Insurance Reality
Most insurance doesn't cover couples therapy because it uses relationship codes (Z-codes) rather than individual mental health diagnoses. Expect to pay out-of-pocket. Some couples qualify if one partner has a diagnosable condition like depression.
Online Couples Therapy Options
Does Couples Therapy Work?
Research shows about 70% of couples improve with therapy. Success depends on both partners being motivated, starting before problems become too severe, and finding a good fit with the therapist.
Give it at least 8-12 sessions before evaluating. Relationship patterns took years to form and won't change overnight.