Online Couples Therapy: How It Works, Cost, And Effectiveness

Online couples therapy can connect partners with a licensed therapist through video, phone, or live chat, often from the comfort of home. Many couples turn to online services when in-person counseling is difficult to access due to cost or scheduling barriers. Whether you're navigating conflict, hoping to improve communication, or simply looking to grow closer, online couples counseling can offer tools and support for a variety of relationship needs.

How online couples therapy works

When you think of couples counseling, you may envision partners in a traditional in-person clinic discussing concerns in front of a therapist. However, online therapy offers a viable alternative that many couples find convenient and approachable. Getting started is often simpler than people expect, and much of the process happens from the comfort of your home.

Here are the general steps you might encounter when beginning virtual couples therapy:

1. Choose an online therapy platform or provider that fits your needs.

2. Register for an account and complete an intake questionnaire.

3. Get matched with a licensed therapist suited to your relationship goals.

4. Attend your first session to discuss goals and begin a treatment plan.

5. Continue with ongoing sessions and in-app messaging between appointments.

Signing up and getting matched

After selecting an online therapy platform, you and your partner can begin by registering for an account. You may then be prompted to complete an intake questionnaire, which is one of the tools that mental health professionals may use to tailor their services to each partner. This questionnaire may ask what you hope to discuss, whether you'd like a therapist with specific cultural or spiritual understanding, and any notes you have before sessions begin.

What to expect in your first session

Your therapist can create an assessment unique to your relationship based on the answers in your questionnaire. In your initial intake session, the therapist might ask you and your partner what you hope to get from therapy and start developing a treatment plan personalized to your needs. From there, you can begin working through concerns together in a supportive environment. If you're ready to explore this option, you can get started with online therapy when the time feels right.

Session formats and flexibility

Online therapy can be conducted through video sessions, live chat, or voice calls. Live video sessions provide an interactive, face-to-face environment for clients to engage with their therapist in real time. Scheduling tends to be flexible, and it is often easier to create or modify appointments through a website than through an office. Virtual therapy sessions can also be used from different locations, which may be helpful for partners who aren't in the same place. Alternatively, couples in the same physical location can attend from their shared home. Because these online therapists offer telehealth options, support can be available from anywhere with an internet connection.

How effective is online couples therapy?

Research suggests that online couples counseling can be as effective as in-person sessions for many relationships. A 2022 study found that couples therapy delivered via videoconference was a viable alternative to face-to-face interventions, improving relationship satisfaction and mental health. This may be reflected in real-world experiences, as BetterHelp reports a 4.9 out of five average rating for a live session, from over 1.7 million client ratings. The benefits of online couples counseling often include a more flexible and accessible structure compared to traditional face-to-face services.

As with other forms of therapy, the effectiveness of online relationship counseling may hinge on the willingness and engagement of each partner. The benefits largely depend on both participants' commitment to the process and openness to change and growth within the relationship.

Types of online couples therapy

There are several types of couples counseling, and understanding the differences can help you find the approach that fits your situation. It's worth noting that partners don't need to be married to seek relationship or marriage counseling. Below are some of the main options available online:

• Relationship counseling for dating or committed partners
• Marriage counseling for married couples
• Premarital counseling for engaged partners
• LGBTQIA-affirming couples therapy

Relationship counseling vs. marriage counseling

While these terms are sometimes used interchangeably, marriage counseling tends to focus on issues that arise within a marriage, while relationship counseling can support partners at any stage. You do not need to be married to seek support, and many dating or long-term partners use online marriage therapy to work through communication challenges and grow together.

Premarital counseling online

For couples planning to get married, premarital counseling can be highly beneficial. Professionals who offer premarital counseling may specialize in helping partners prepare for marriage by addressing expectations, communication, financial planning, and other key aspects of married life. Doing this work early may prevent future conflicts and misunderstandings.

LGBTQIA-affirming couples therapy

Finding a therapist who understands your relationship can make a meaningful difference. During the intake process, many platforms allow you to request an LGBTQIA+ therapist so you and your partner can feel seen and supported. Affirming online couples therapy can create a safe space to discuss your unique experiences and goals.

Common therapy approaches for couples

The professional you work with may draw from several modalities, depending on the type of support you're seeking. Learning a little about these approaches can help you understand how couples therapy works. Below are three common approaches, though your therapist can help determine the best fit for your relationship.

Emotionally focused therapy (EFT)

Emotionally focused therapy usually centers on the emotional bond between partners and aims to strengthen attachment and connection. It's one of the most commonly used approaches in couples work and may help partners better understand each other's emotional needs.

Cognitive behavioral therapy (CBT) for couples

Cognitive behavioral therapy typically focuses on the connection between thoughts, feelings, and behaviors. In a relationship context, it can help partners develop skills to improve communication and manage conflicts more constructively.

The Gottman method

The Gottman method is a research-based approach that focuses on building friendship, managing conflict, and creating shared meaning. It offers practical tools couples can use to deepen their connection and navigate disagreements.

Benefits of online couples therapy

Consistently participating in couples counseling may lead to several long-term benefits, including improved intimacy, connection, communication, and mutual respect. Couples who participate in online couples therapy services may find it convenient to address these challenges without the need for in-person appointments. Below are a few benefits you and your partner may experience.

Improved communication and conflict resolution

Partners may learn new techniques for constructively handling conflict and criticism through couples therapy. Participating in joint sessions can enhance a couple's ability to work through challenges together, such as disagreements over finances, feelings of blame, or family conflict. Many couples also find they can re-engage in their relationship and rekindle the "spark" they first felt by fostering a deeper connection. Healthy communication can be a cornerstone of a strong relationship and may increase rates of relationship satisfaction.

Flexibility and accessibility

One of the clearest advantages of virtual therapy is the ability to schedule sessions around busy lives. With the convenience of online therapy platforms, clients can find support from home or anywhere with an internet connection, without the hassle of commuting. Online options can also be more cost-effective than traditional in-person services, which may reduce a common barrier to care.

When using insurance, certain BetterHelp features may be limited or unavailable, including chat-based sessions, groups/classes, and select self-help tools.

Comfort and reduced barriers

Attending sessions from a familiar environment may feel less stressful for some couples. Being able to talk openly in a space where you feel safe can make it easier to discuss sensitive topics. For partners who feel hesitant about walking into an office, the discreet nature of online therapy may make taking the first step more approachable.

Online vs. in-person couples therapy

Both online and in-person couples therapy can offer meaningful support, and the right choice often comes down to personal preference. Some couples prefer the face-to-face presence of an office setting, while others value the flexibility of online therapy. The table below compares a few key factors to help you decide.

Virtual therapy services also tend to offer an individualized approach. If one method isn't working, your therapist can adjust their approach, and you can request a new therapist if needed. Changing providers in an in-person setting may be more complicated.

How much does online couples therapy cost?

The cost of online couples counseling can vary based on the platform, session length, frequency, and the therapist's qualifications. Understanding couples counseling cost can help you plan for the type of support you need. Some platforms charge a monthly fee, while others charge per session.

Prospective clients can research different services, compare prices, and inquire about the specific costs associated with the type of therapy in which they are interested. It may also be helpful to ask about financial assistance or the option to use health savings accounts (HSAs) to pay for therapy.

Does insurance cover online couples therapy?

Some providers on BetterHelp may be in-network with certain health plans, which can also be the case for some in-person counseling. For eligible members, co-pays average about $23 per session when covered. Coverage varies by plan, provider, and therapist availability, so it can help to enter your information during signup to check in-network status and view available options and estimated costs. Where in-network coverage isn't available, BetterHelp's flexible subscription model continues to be an option to receive quality care from the platform's extensive therapist network.

Tips for getting the most out of online couples therapy

Preparing for remote couples therapy can help you both get the most out of the experience. When considering virtual marriage counseling, it can be essential to find a platform that meets both of your needs and provides a comfortable space for open communication. Below are several tips for making the most of online couples counseling:

• Agree on a therapist you both feel comfortable with
• Practice healthy, open communication
• Consider combining couples and individual therapy
• Communicate your relationship goals early
• Approach sessions with an open mind

Agreeing on a therapist together

Finding a marriage counselor or couples therapist you both feel comfortable with can take a little time. A skilled therapist should not value one partner over the other and can balance each partner's perspective while creating a safe environment for open communication. If one partner doesn't feel a connection with the marriage therapist, it may be worth considering a few other candidates. Through virtual therapy, you and your partner can switch therapists if needed at no extra cost, often more efficiently than with in-person therapy.

Combining couples and individual therapy

Many couples pursue online individual counseling while also participating in joint counseling. In individual talk therapy, each partner can focus on personal growth, which can positively impact the relationship. As marriage therapists serve the relationship as a whole, an individual therapist can focus primarily on you and your concerns. For example, during individual therapy, you may address a mental health concern that contributes to conflict in your relationship.

For some individuals, additional support may be helpful alongside therapy. BetterHelp now offers psychiatry services through UpLift, which provide access to licensed psychiatric providers for those ages 18 and older. When clinically appropriate, these services may include medication management as part of a holistic mental health care experience. All treatment decisions are made by a licensed psychiatric provider, and not everyone needs or benefits from medication. If you'd like to learn more, you can get started with psychiatry services.

*Based on finalized paid psychiatry visits with a copay. Insurance availability, coverage, and costs vary by state, plan, provider network, and provider availability.