Couples Therapy In Canada For Mental Health & Marriage Health

If you and your partner are facing a challenge, navigating a transition, or trying to improve your emotional connection and ability to share how either partner is feeling, you might benefit from couples therapy—but what does that entail? What options do Canadian couples have for getting the relationship support they need? In this article, we’ll explore couples therapy in more detail, including what it can look like, where to find it, how to choose a counsellor with knowledge and training relevant to the challenges in your lives, and other considerations to keep in mind if you’re seeking counseling in Canada. Plus, we’ll discuss the potential benefits of attending couples counselling sessions for dealing with relationship issues.

The role of animals in therapy

How couples counselling sessions work

Couples therapy (sometimes called relationship counseling) is a form of therapy designed to help romantic partners improve their relationship. In couples therapy sessions, a mental health provider typically helps partners set goals, explore their emotions, discuss relationship challenges, and find practical ways to improve their connection. The length, type, and format of these sessions can vary, depending on your relationship goals and your therapist’s particular specialty. Couples therapy most often includes both partners, who attend sessions together. However, some therapists may also conduct separate sessions with each partner to gain additional context and perspective. 

This is what usually happens during the first session, though the exact approach may vary based on the therapeutic interventions being used: 

• Both partners will be given the ability to share their perspectives on what brought them to therapy
• The counsellor may ask questions to clarify their understanding of the challenges the couple is facing 
• Typically, by the end of the session, the counsellor will go over the expectations and goals of both partners, helping them understand how therapy might be able to help 

While it may take a while to develop a strong therapeutic alliance, a great therapist is often able to quickly build trust with their clients that supports productive couples counselling. 

Is couples therapy the same as marriage counselling?

You may have heard the terms “couples therapy” and “marriage counselling” used interchangeably. While both aim to improve relationship health, marriage counseling is often considered a specific type of couples therapy focused specifically on marriage and marriage-related challenges. For instance, married couples might choose to work with a marriage counselor (instead of a more general couples therapist) to discuss a potential divorce or navigate infidelity. In situations involving children or parenting, marriage counseling may also overlap with other specialized treatments, like family therapy.

Common relationship issues addressed

There are many relationship issues that can be addressed in therapy, such as: 

• Physical intimacy issues, such as libido mismatch or sexual dysfunction
• Major life events, such as financial stressors, having a child, or changing jobs
• Mental health challenges of one or both partners, such as depression, substance use disorder, trauma, and related behaviour difficulties 
• Breaches of trust, such as affairs or financial infidelity 

Couples can also benefit from therapy even if there are no significant difficulties in the relationship. For example, therapists may be able to help address minor conflicts that could become bigger issues if left unaddressed.

Individual counselling and couples counselling together 

Both individual counselling and couples counselling can be useful for addressing relationship issues, though there are some key differences in how they work: 

• Individual counselling: This approach is often recommended if an individual is struggling with personal challenges, such as traumatic life experiences, depression, or anxiety. Individual counselling may also be recommended if only one partner is interested in counselling. While it focuses on the individual, it can also help rebuild relationship quality for couples and families. 
• Couples counselling: If the relationship is primarily experiencing interpersonal issues like breaches of trust, communication challenges, or conflict, couples therapy is typically recommended as a good first step. 

Some people find that a hybrid approach works best for them, using individual counselling to focus on themselves, and couples counselling to focus on the relationship. 

Why Canadian couples might seek relationship and marriage counselling

Not every couple has specific reasons for seeking couples counselling. Some may attend couples therapy to grow closer, while others might start counseling with specific relationship goals in mind, such as improving their intimacy or preparing for marriage. 

How couples therapists can support emotional and mental health

It can be common to assume that couples therapy is only for improving relationships. However, relationship counseling can also indirectly support individuals’ mental health, emotional health, and general well-being. In addition to strengthening the bond between partners, couples therapy can:

• Help individuals feel heard, explore their emotions, and build an awareness of their needs
• Provide support for individuals and couples living with mental health challenges
• Reduce stress by improving conflict resolution
• Improve communication skills
• Help partners develop healthy coping mechanisms that may translate to other areas of life

Effective interventions in couples therapy

Here are a few types of therapeutic interventions that can help couples: emotionally focused therapy, acceptance and commitment therapy, cognitive-behavioral couples therapy, and the Gottman Method.

Whichever type of therapy you decide to try, it often focuses on: 

• Active listening, like asking questions to clarify information, reduces the risk of miscommunication
• Identifying negative patterns in the relationship, what to do when you feel “stuck” in a conflict, and how to find hope
• Approaching each other with nonjudgmental curiosity 
• Acknowledging the efforts and contributions each other makes in the relationship 
• Strengthening emotional bonding by sharing how each partner is feeling

Couples therapy reminds partners that they only have the ability to change their own behaviour, and they only have knowledge of their own thoughts and feelings. This framing can help couples move away from trying to change each other, and instead toward understanding the impact of their own actions and changing them. 

Rebuilding trust and strengthening bonds

Couples therapy can provide a safe environment to address challenges in the relationship. For example, relationship issues like affairs and repeated conflicts can lead to a lack of emotional and physical intimacy, or even trauma. 

Through therapy, the couple can work to rebuild trust, reaffirm commitment, and grow closer together through strategies like open communication, spending quality time together, and expressing appreciation.

Couples therapy Canada: What to know

Couples therapy is not a one-size-fits-all treatment and can vary significantly across couples and locations. If you live in Canada and are considering working with a therapist, getting familiar with these details can give you a better idea of what to expect. In the following sections, we’ll take a closer look at what couples therapy can look like, qualifications for Canadian couples therapists, and more. 

Registered psychotherapist, counselling therapist, and more: Types of Canadian couples therapists

According to Job Bank, a resource from the Canadian government, the specific titles for marriage therapists (and other related counselors) in Canada can vary by region. For instance, in Ontario, therapists use the designation of Registered Psychotherapist, while in Nova Scotia, they use the designation of Counselling Therapist. Meanwhile, in Quebec, relationship therapists may fall in the category of Marriage and Family Therapist, Sexologist, or Psychoeducator. Each of these designations is governed by a different regulatory body, and therapists must register with the correct one in order to practice.

In addition, Canadian therapists must also fulfill certain educational requirements. These typically include a bachelor’s or master’s degree in counselling, psychology, or a related field, alongside a certain amount of supervised client work. It can be helpful to ask your counselor about their qualifications, licensing, and experience prior to starting therapy. 

Preparing for your first couples session

There are a few tips that can help you prepare for the first session, including: 

• Clarify how you’re feeling in the relationship 
• Identify major relationship issues
• Prepare to share life stressors (like financial hardship) and mental health challenges, like depression 
• Create a list of questions to ask your counsellor, such as how many sessions they recommend and what their approach to therapy is

While these tips can help you prepare for your first couple’s therapy session, they are optional. Just showing up to the first session is a major first step, and you can let your therapist guide the approach if you prefer. 

What types of therapy do couples therapists practice?

Practitioners may use various approaches to couples therapy. The exact type can depend on a couple’s specific challenges and preferences. According to Harvard University, some of the most common techniques used in couples therapy include the following:

• Emotionally focused therapy: Emotionally focused therapy, or EFT, generally focuses on exploring and addressing the underlying emotional needs that may be contributing to relationship challenges. 
• The Gottman method: The Gottman method typically focuses on helping couples improve their communication and conflict resolution skills while building the foundation for a more positive, meaningful relationship. 
• Cognitive behavioral therapy: Also known as CBT, cognitive behavioral therapy usually focuses on helping clients identify and shift unhelpful thought patterns.
• Integrative systemic therapy: This form of therapy normally combines multiple techniques and approaches based on clients’ unique needs and dynamics. 

Couples therapy Canada: Cost and payment options

In Canada, couples counseling can cost anywhere from CAD $150 to $200 or more per hour. It is typically not covered by Canada’s public healthcare program. However, non-public and employer-sponsored healthcare plans may provide additional coverage for therapy, and certain therapists may offer sliding-scale fees based on income level and other factors. Some providers may also offer a free consultation prior to starting treatment. This can be an opportunity to decide whether a specific therapist is the right fit for you, which can keep costs down by minimizing trial-and-error. 

Setting yourself up for success with a registered psychotherapist, counselling therapist, or other relationship therapists 

There are no set requirements couples must fulfill prior to starting therapy. However, taking a few simple actions ahead of time may set you and your partner up for success in your therapy journey.

• Reviewing your health benefits to understand your coverage options and what, if anything, you can expect to pay
• Sitting down with your partner ahead of time to discuss what you want to get out of counseling
• Talking to your therapist beforehand to explore your goals can help you get a sense of whether they’re the right fit for your relationship needs
• Reflecting on your role in the relationship, your dynamic with your partner, and any patterns you’ve noticed in the relationship that you would like to change
• Completing any assigned homework, paperwork, or pre-counseling exercises your therapist sends you in advance

Tips for success after starting therapy

In addition to pre-counseling preparation, you may also find it helpful to be intentional once you’ve started relationship therapy. Being conscientious throughout your journey can promote a more positive and productive experience for you and your partner. 

• In each session, try to be open and honest about your experiences, feelings, and concerns.
• Make an effort to implement your therapist’s suggestions in your everyday life and daily interactions, rather than just during your sessions.
• Actively listen during your sessions when your partner is talking, rather than just waiting for your turn to speak.
• Check in with your partner periodically about how each of you believes your therapy journey is going.
• Focus on solving problems rather than assigning blame.
• Manage your expectations, be patient with the process, and recognize that the goal of couples therapy is to create lasting changes, rather than implement quick fixes.
• Stay mindful of your goals and reasons for seeking therapy, and don’t hesitate to raise any concerns with your therapist.
  

Options for finding an in-person therapist in Canada

If you’re in Canada and you’ve never participated in relationship counseling before, you may wonder where you should search for a couples therapist. There are several resources you can consider, depending on your needs, location, and preferences. 

• Referrals from your doctor: If you’re unsure where to seek support, you can start by bringing up your relationship concerns with your primary care doctor. They may be able to recommend therapy practices targeted to your needs and situation. 
• Professional associations: Consider contacting your province’s or territory’s professional psychology association to learn about in-person counseling options in your area. They may be able to direct you to appropriate providers. 
• Government websites: The Canadian government maintains lists of mental health and wellness resources. Consider using its provincial and territorial resources directory to explore relationship counseling options near you.
• Online directories: Various websites and organizations maintain directories of providers, which you can filter by location, specialty (including couples counseling), and other preferences. 

What other support options are available in Canada?

Beyond in-person therapy, several other options exist to help Canadian couples improve their relationship health. While the options below may not replace professional counseling, they may be a useful supplement to traditional therapy. 

• Support groups: Support groups for couples and romantic partners can supplement formal therapy and provide a safe space to discuss challenges with others. If you’re in search of a couples therapist, attending support group meetings can also be a way to get counselor recommendations and word-of-mouth referrals from other couples.
• Couples education classes: Relationship workshops, classes, and conferences may be available through your school, employer, or other community programs. These can provide short-term education for couples looking to improve specific aspects of their relationships. 

Online therapy for relationships and mental health 

In addition to the options above, working one-on-one with a therapist can be a valuable way to explore your relationship, its effects on your mental health, and any other challenges you’re facing, even without your partner present. However, attending counseling in person may not always be practical for people with busy schedules or long commutes. With online therapy through platforms like BetterHelp for individuals or Regain for couples, you can receive therapy from the comfort of home via voice call, video call, or online chat. You can also message your therapist between sessions, and they will respond as soon as they are able. This may make it easier to stay accountable and address challenges as they arise.

Research shows that online therapy can be as effective as in-person therapy for supporting mental health and well-being. In 2023, researchers studied over 27,000 individuals to compare the effectiveness of in-person cognitive behavioral therapy (CBT) with an internet-based CBT program. They found that online therapy was just as effective at addressing various mental health concerns as face-to-face therapy.