Marriage Counseling: How Couples Can Improve Mental Health Through Therapy

Marriage can come with challenges, which marriage counseling can help with. Even if you love your spouse, feelings of infatuation may fade over time with the passage through various stages of love. As relationships change, the behavioral patterns within them can too. If you think your marriage as a couple could improve or you find yourself experiencing frequent arguments and disagreements, you may consider marriage counseling. However, you may find yourself wondering “does marriage counseling work?” Understanding the challenges that marriage counseling addresses, what tools a therapist can offer, and how relationship satisfaction can impact mental health as well as physical health can help you make a more informed choice.  If you’ve ever considered marriage counseling, read on to learn more about how motivated couples can work with a professional to navigate the minor and major challenges that arise in any long term relationship.

Even in a healthy relationship, some couples reach out for support from a marriage and family therapist before conflict or relationship troubles occur to create a plan for the future. Therapy offers a safe environment to work on things like conflict resolution, building intimacy, and emotional regulation using evidence-based frameworks such as family systems and attachment theory. You do not need a mental illness or a diagnosis to go to therapy. However, your insurance company might require it if you seek in-person therapy with a couples therapist.  

The success rate of couples seeking therapy according to AAMFT

So how does marriage counseling work? Many couples use counseling as a strategy for problem-solving. Often, these couples wait until serious issues have arisen and they’re in dire need of relationship help. Marriage counseling works best when used as a proactive solution, addressing minor challenges before they cause greater rifts in relationship dynamics. If you're still unsure whether marriage counseling is for you, the American Association for Marriage and Family Therapy states that over 90% of couples seeking support feel they receive the desired results. In general, it can be said that marriage counseling helps improve relationship satisfaction and that it works to address issues in a couple’s relationship. Professional marriage and family therapy is often highly effective and can help you achieve long-term results in the health of your marriage as a couple.

Popular approaches and methods in marriage counseling

There are many forms of marriage counseling that are effective and evidence-based, each offering specific tools to address different relationship challenges. Some are particularly suited to short term support, while others work best for long-standing issues. Imago relationship therapy works on re-establishing communication and bonds through examining childhood experiences, while Gottman method focuses on current interactions and building foundational practices to strengthen relationship ties. Family systems theory practitioners treat the family as a unit, viewing it through the lens of generational, societal, community, and cultural factors, and work on establishing balance to all parts. Attachment theory connects current styles of communication and intimacy to learned behaviors from initial caregivers and seeks to heal the past to move forward. Some therapists lean more heavily on one theory or another, and some others will use a combination. All of these professionals have at least a master’s degree, and many a doctoral degree in their chosen field. 

What to expect in couples therapy and marriage counseling

What does a couples counselor do? You may find yourself asking a lot of questions about what it might be like to start marriage counseling. Before you seek couples therapy, it’s important to review how counseling works, as well as what it can and cannot do. Couples relationship therapy works better with both partners present to recognize and work through any negative patterns that may have been established. Both you and your partner should be willing to make changes and learn lessons. When couples choose talk therapy together, it can signify they value their marriage and wish to preserve it and it may not be effective if only one member is a willing participant or if one partner refuses to go at all. However, couples therapy and counseling might only benefit clients when they consistently attend therapy sessions and enter a therapeutic alliance with the counselor and one another simultaneously.

Couples therapy offers a safe environment to address emotional disconnection, examine how childhood experiences may have affected the relationship, and learn tools to help improve communication and build intimacy. A couples therapist may recommend one-on-one time with each partner to work on individual issues, as well. For couples with children, therapy may be a whole family process, and seeking a family therapist may be beneficial. Below are a few tips to bear in mind when considering marriage or couples counseling:

• The therapist or marriage counselor cannot "fix" you
• Marriage therapy is not individual therapy for one partner
• The therapist or counselor is not a referee
• The therapist or counselor does not take sides
• Therapy does not rewrite the past
• Marriage and family therapy may not work if one person isn’t willing to commit to the time it takes to work through life challenges
• Therapy does not necessarily right wrongs
• Your therapist may not tell you to divorce or separate without you bringing up the subject or asking for advice

Every relationship and couples therapists can be different, so ask questions to learn more about their approach to treating relationships. 

Marriage and family benefits of marriage counseling

Many couples seek marriage counseling because they want to strengthen their relationship, improve their communication skills, or address typical relationship challenges in the presence of a mental health professional. Couples may also experience conflict and face challenges to keeping a relationship healthy, such as infidelity (for example, an extramarital affair), disagreements over parenting styles and how to raise their children, or constant arguing, which may lead them to seek counseling, either on its own or in addition to individual therapy. If you’ve encountered the same argument over and over as a couple, it can indicate that you and your partner may have poor communication and active listening skills. Challenges like these can be navigated in couples therapy and counseling.

Relationship therapy provides support, guidance, and education for couples

Challenges with communication or making healthy choices can lead to these conflicts among couples. Past experiences, family concerns, or past relationship issues could also impact a couple's decision to see a therapist. Regardless of the couple's concerns, relationship therapy and couples counseling can provide a space of support, education, and guidance as the couple works to resolve conflicts, come to their own conclusions, and practice new ways of relating to each other. Some common marital problems that therapy supports include:

• Substance abuse
• Emotional disconnection over time
• Difficulties with emotional regulation
• Lack of conflict resolution
• Infidelity
• Disregulation of family systems
• Sexual dysfunction

When a couple chooses to attend couples therapy, sessions are overseen by licensed professionals, such as marriage and family therapists, who are versed in clinical psychology and the dynamics between partners or couples. A licensed therapist can teach couples communication techniques and offer advice for intimacy and emotional closeness. This can help with the couple’s sexual chemistry and overall relationship status. It can also be a jumping-off point for individual self-improvement.

What can happen during a marriage counseling session?

During marriage counseling sessions, participants may discuss relationship problems with their couple, as well as each individual's feelings, thoughts, and behavioral patterns. Like in individual therapy, many couples therapists offer specific therapy modalities or specialties. Some couples therapists might specialize in sexual intimacy, while others might specialize in a specific type of therapy, like discernment counseling, dialectical behavior therapy (DBT), solution-focused therapy (SFBT), or emotionally focused therapy (EFT).

How to prepare for marriage counseling sessions

Whether you're already living together before marriage or not yet, the decision to seek marriage counseling as a couple can be a positive one. Some couples might feel excited about the prospect of taking the step to talk to a relationship counselor, which could temporarily unify them. This excitement could lead to couples mistaking these positive feelings for a sign that their relationship as a couple has improved. The decision to see a couples counselor might lift stress from the couple's shoulders, and they may feel they no longer need relationship counseling. 

List the subjects you’d like to discuss for marriage counseling

To support your decision to see the positive impacts of counseling, try to list the subjects you'd like to discuss in your first marriage counseling session and remember why you're attending counseling. Some couples notice a difference after just a few sessions of marital therapy and counseling. However, even if you see results after the first session, continue going to couples counseling sessions to see how it impacts you. Studies reveal that couples who completed couples therapy are better than 70-80% of those who do not.

Cost of marriage counseling

The costs for marriage counseling, couples counseling, and marital and family therapy can vary based on a number of factors. These may include your the area where you live as a couple, the kind of therapist you see, and the number of sessions you'll need. According to Forbes, couples therapy can cost $175 to $250 per session. 

You may pay around $700 to $980 monthly for four sessions of couples counseling. Your insurance policy might cover some of the costs. However, you could be responsible for co-pays. If you opt for an online version of marriage counseling, you may find it more cost-effective, with an average cost of $70 to $90 per counseling session. 

Approaches to marriage counseling

There are several approaches to marriage counseling, including but not limited to the following:

• Emotionally focused therapy (EFT)
• The Adlerian approach
• The therapeutic model for marriage counseling
• The pragmatic approach
• The Gottman method by John Gottman

American Association for Marriage and Family Therapy (AAMFT)

Many of these approaches are endorsed by the American Association for Marriage and Family Therapy (AAMFT). The American Association for Marriage and Family Therapy certifies marriage and family therapists in providing these modalities and others, whether a therapist specializes in in-person or online therapy. Below are further descriptions of these methods. 

The Adlerian approach in marriage counseling for lasting relationships

The Adlerian model of marriage counseling was devised by Alfred Adler, a pioneer in individual therapy. He believed each partner should be treated individually before being treated as a couple. With this approach in counseling, each person receives treatment separately. After individual sessions of counseling, the therapist or clinical psychologist can see both clients simultaneously, as a couple. This approach allows the therapist to provide individual and joint support to couples. 

Therapeutic models in marriage counseling and couples therapy

With the therapeutic marriage counseling model, the counselor may treat the relationship like a mental health condition. The couple can work with the counselor to figure out the challenges impacting the relationship and how to fix them. This model of counseling may involve creating a strict treatment plan for the couple, focusing on communication issues, practicing trust exercises, or partaking in a specific therapy modality like debt. 

How counseling helps in strengthening marriage and family bonds

The pragmatic approach to couples counseling can help encourage couples to face their sources of conflict head-on, whether from disagreements about the children, intimacy, communication, or another topic they disagree with as a couple. The process of this counseling approach may include self-examination, finding causes of distress, and remaining solution-oriented as you work to resolve conflicts effectively. Couples can learn to reduce blaming behaviors and cognitive distortions and learn how their partner is feeling by partaking in couples exercises to see the world from their lens.

Gottman method for couples

Developed by John and Julie Gottman, Gottman therapy has been a successful therapeutic model for over 40 years. According to the Gottman Institute, several of the steps to this method include:

• Learning to believe in commitment
• Building trust
• Telling dreams and visions
• Talking about hopes, values, and aspirations
• Managing rather than fixing conflicts
• Gaining positive perspectives
• Stating your needs
• Expressing your fondness and admiration for each other
• Building love maps

There are other forms of marriage counseling than these, and a therapist may also use a combination of techniques in their approach. Any of them can be effective for motivated couples, depending on the specific tools they need. Average individuated treatment can vary based on a number of factors, but addressing challenges can be beneficial to emotional health as well as physical health. 

How long does marriage counseling for couples take to improve marriage relationships? 

There may not be an overnight solution to a relationship concern. In addition, every couple has a different reason for seeking counseling, so counseling can be a personal experience. It can also be important to find the right counselor and to address any underlying mental health challenges, such as substance use. Regardless of the time it takes to receive support from therapy and counseling, the American Psychological Association clinical evidence shows that counseling can decrease the chance of divorce by about half (40% to 50%). Let your therapist know if you're concerned about the number of sessions you might commit to as a couple. They can help you develop a treatment plan and give you a potential estimate of how long it might take. 

If you are struggling with substance use, contact the SAMHSA National Helpline at 1-800-662-HELP (4357) to receive support and resources. Support is available 24/7.

Lifestyle changes to improve your marriage without a marriage counselor

If you're still not decided on marriage counseling, you may decide to make other efforts at repairing your marriage as a couple. Below are a few lifestyle changes you can try to increase your connection with your partner. 

Go on regular date nights

Many married couples may feel that romance falls to the wayside in their relationship after marriage. Consider making it a habit to go on a scheduled regular date night and continue communicating with each other. If you want inspiration for dates as a couple, you can print out a date idea list from the internet, cut up the ideas into small papers, fold them, and add them to a jar to pull out when you're ready for a date. 

Communicating about mental health during marriage counseling

Focusing on your communication may allow you and your partner to reduce conflict and improve emotional health. Actively listen by listening to hear and understand, not to respond. Engaging in conversation frequently can help you understand your partner and their needs. Some couples do weekly or monthly check-ins to see how each partner feels about the relationship. 

Practice gratitude

Find areas of your relationship to be thankful for. For example, smiling and thanking your spouse when they go out of their way to do the chores, give you some time off, or buy you a small present can show them you appreciate their efforts. If you feel your spouse doesn't pull their weight in the relationship, showing gratitude can also encourage them to continue positive behaviors in the relationship. 

Focus on the "minor" aspects of life

Living day in and day out with someone may lead you to forget what you once thought was significant. Focus on the "minor" things that make your partner feel loved. For example, hold their hand, hug them at the store, send them a cute text, or do the chores while they're at work. These actions might increase feelings of love and appreciation in your relationship. 

Marriage counseling options for improved mental health

Evidence shows that motivated couples can gain a lot from marriage therapy: improve communication, emotional regulation, and conflict resolution skills. A therapist can help couples to identify negative patterns of behavior that lead to emotional disconnection, and offer tools for change. There are various forms of counseling and mental health services available for couples. However, some couples may feel unable to get one-on-one practice therapy in person due to insurance costs, session rates, or a lack of availability. In these cases, online marriage counseling may prove effective. Online therapists have the same education (masters or doctoral degree), training, and licensure as in-person therapists, and offer the same safe environment for navigating issues like emotional disconnection and building relationship satisfaction and you and your partner’s relationship.

Online marriage counseling

Because online counseling can be done from anywhere with an internet connection, it is often more affordable than traditional face-to-face marriage counseling for couples. The therapist or counselor saves money because they do not have to pay for purchasing or renting an office, staff, utilities, upkeep, and transportation. With online marriage counseling, you can use video, phone, or live chat sessions to talk to your therapist. In addition, partners can attend from two different locations or rooms. For both short term therapy or ongoing counseling, it offers a convenient way to schedule and attend sessions for busy couples. 

Efficacy of online couples therapy according to research

Research shows online therapy can also be a powerful tool for strengthening relationships and improving men’s and women’s health overall. In a systematic meta-content review conducted in 2021, researchers found that online couple relationship therapy was effective in improving relationship satisfaction, quality, confidence, commitment, and communication. Additionally, the study results yielded reduced instances of conflict and aggression.

If you're interested in partaking in online individual or couples therapy, consider platforms like BetterHelp for individuals and Regain for couples. Both options offer over 30,000 therapists specializing in various symptoms and areas of support. 

"My partner and I are in a long-distance engagement and Shunda is guiding us through premarital counseling. We have nothing but positive things to say about her! She makes counseling fun and we look forward to our appointments with her. It's been great to have her as we navigate getting married and moving in together, especially when we weren't sure we wanted to do premarital counseling at all! We are so glad we did and would recommend Shunda to any couple!"

— BetterHelp member’s review of their therapist

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