How Does Couples Therapy Work? A Guide to Marriage Counseling

If you're considering couples therapy, you might be wondering what actually happens in those sessions and whether it could help your relationship. Couples therapy typically involves meeting with a licensed therapist who can help partners work through challenges by facilitating communication, identifying patterns, and teaching new skills. The process can vary depending on your specific concerns and the therapist's approach, but the goal is generally to help you and your partner understand each other better and develop healthier ways of relating. Below, explore how couples therapy works, what to expect in sessions, common therapeutic approaches, and how to know if it might be right for you.

What is couples therapy?

Couples therapy, also called marriage counseling or relationship counseling, is a form of psychotherapy designed to help partners improve communication and resolve conflicts. Licensed therapists, often marriage and family therapists, can guide couples through structured conversations and exercises aimed at strengthening their connection. Unlike individual therapy, which typically focuses on one person's experiences and growth, couples therapy often addresses the relationship itself as the focus of treatment.

This type of therapy can benefit both struggling relationships and healthy ones seeking improvement. Some couples seek help during a crisis, while others attend sessions to maintain their connection or navigate life transitions together. Couples therapy can take place in person at a therapist's office or through online platforms, making it accessible to partners with varying schedules and preferences.

Why couples seek therapy

Relationship challenges can be a normal part of sharing your life with another person. Couples therapy can help partners build trust, overcome communication issues, foster emotional connection, and build hope for the future. From disagreements about finances to navigating family dynamics, many obstacles can impact a relationship. A couples counselor can provide clarity and a compassionate perspective, offering both an opportunity to overcome challenges and a chance to strengthen bonds.

Common reasons couples seek counseling

Partners may seek therapy for many different reasons. Some of the most common issues that bring couples to counseling include:

• Money and financial disagreements
• Fair distribution of housework
• Physical intimacy concerns or sexual difficulties
• Extended family obligations and issues
• Children or parenting challenges
• Career-related stress
• Sleeping habits
• Past relationships
• Substance use
• Unhealthy behavioral patterns
• Increased stress
• Health challenges impacting the relationship
• Conflict with a partner's family

Understanding what brings couples to therapy can help normalize the decision to seek support. Whatever your specific relationship concerns, a therapist can work with you to address them in a structured, supportive environment.

How does couples therapy work?

During the therapeutic process, a therapist may observe and discuss the interactions between partners and work with them to employ various techniques that support the relationship. Cognitive behavioral therapy and a range of other approaches may be used to foster emotional connection, hope, and happiness. These methods can take place in person or online, depending on your preferences.

The initial assessment

The first session or two typically focus on gathering information about your relationship. Your therapist may ask about your history as a couple, what brought you to therapy, and what each partner may hope to achieve. This assessment phase can help the therapist understand your unique dynamics and identify patterns that may be contributing to challenges. Some therapists may also meet with each partner individually to hear perspectives that might be difficult to share in front of the other person.

Setting goals for therapy

After the initial assessment, you, your partner, and your therapist will typically collaborate on setting treatment goals. These goals might include improving communication during disagreements, rebuilding trust after a breach, or learning to navigate a specific life transition together. Having clear goals may help guide your sessions and may give you a way to measure progress over time.

What happens during couples therapy sessions

Regular sessions usually last between 50 and 90 minutes and may follow a general structure. Your therapist may begin with a check-in to see how things have been going since the last session. From there, you might discuss a specific issue, practice new communication techniques, or work through an exercise designed to build understanding. Sessions may often end with the therapist summarizing key points and assigning homework to practice between appointments.

Working on your relationship between sessions

Therapists may often assign exercises or homework to help couples practice skills at home. These might include communication exercises, journaling prompts, or specific activities designed to strengthen your connection. Practicing what you learn in therapy between sessions can help reinforce new patterns and may support your progress.

How long does couples therapy take?

The duration of couples therapy varies based on your specific needs, goals, and progress. One study suggests that couples may see meaningful improvement in around 16 sessions, though some may notice positive changes in fewer sessions while others benefit from longer-term work. Sessions are typically held weekly, particularly at the beginning of treatment, though frequency may decrease as you make progress.

Some couples choose to return for periodic "tune-up" sessions after completing an initial course of therapy. These check-ins can help maintain gains and may be useful for addressing new challenges as they arise. Your therapist may be able to help you determine an appropriate timeline based on your unique situation.

Types of couples therapy approaches

Therapists may use various evidence-based approaches when working with couples. The right approach may depend on your specific challenges, preferences, and the therapist's training.

Emotionally focused therapy (EFT)

Emotionally focused couples therapy uses adult attachment and bonding theories to guide clients. By recognizing how each partner's attachment needs may influence their behavior, couples can learn to respond to each other in ways that may create greater security and connection.

The Gottman Method

This approach, developed by Drs. John and Julie Gottman, may help partners increase their overall closeness, respect, and affection through "love maps" and other research-based interventions. The method may focus on building friendship, managing conflict constructively, and creating shared meaning in the relationship. It draws on decades of research into factors that may contribute to relationship success or challenges.

Other therapeutic approaches

Several other methods may be effective for couples seeking support. In narrative therapy, partners might identify and name their internalized concerns, which may be viewed from multiple angles and worked with constructively. Imago therapy combines behavioral and spiritual techniques, posing questions such as "Why did you choose your partner?" Positive psychology may emphasize the positive aspects of relationships, using optimism practices to strengthen connection. Your therapist may draw from multiple approaches based on how couples therapy works best for your specific situation.

Does couples therapy work?

Couples therapy may reduce relationship distress and improve relationship quality for many partners.

Many couples may leave therapy feeling more connected, with better problem-solving skills and a stronger emotional bond. However, outcomes can vary based on several factors, and therapy may not be the right fit for every couple in every situation.

Factors that influence success in marriage counseling

Research indicates that relationship therapy can often work when both partners are present, willing to try in-person or online couples therapy, and ready to make changes. Several factors can influence whether couples therapy leads to positive outcomes, such as:

• Both partners' commitment to the process and willingness to do the work
• Openness to being vulnerable and honest in sessions
• Completing homework and practicing skills between appointments
• Finding a therapist who feels like a good fit for both partners
• Willingness to each examine your own contributions to relationship challenges

When therapy may not lead to desired results

Couples therapy may not lead to desired outcomes in certain circumstances. If one partner is unwilling to participate or has already decided to end the relationship, progress can be limited. In situations involving active abuse, individual safety may need to be addressed before couples work can proceed. Being honest with yourselves and your therapist about your readiness for the process may help set realistic expectations.

Tips for getting the most out of couples therapy

Couples therapy may require active participation from both partners to be effective in addressing relationship concerns. The following tips may help you make the most of your sessions.

Be aware of relationship patterns

Part of couples therapy may include identifying unhealthy patterns in your interactions with each other. Relationship therapy can help both partners recognize these and work together to address them. It may help to consider your own role in these patterns and be open to working toward change.

Focus on current concerns

When a disagreement arises, consider the current situation and its underlying cause instead of bringing in irrelevant information, other people's relationships, or past hurts. If you wish to discuss past hurts, consider doing so in a separate therapy session. It may help to take each problem one at a time so that you and your partner can fully focus on the concerns.

Practice empathy for your partner

During therapy, consider why your partner is upset, temporarily disregarding what caused you to feel your emotions. Do they feel unheard, unloved, or disrespected? By stepping into your partner's shoes and understanding their behavior patterns, you may gain new insights into their perspective.

How much does couples therapy cost?

In-person couples counseling can cost $100-$200+ per session depending on the therapist, their approach, your location, and other factors. For example, a therapist may charge more per session in areas where the cost of living is higher. If you aren't sure you can afford therapy, you may be able to find free online therapy for couples or explore sliding-scale options.

Also, online platforms may reduce some of the overhead fees associated with therapy, potentially offering more affordable options. Online couples therapy via Regain ranges from $70 to $100 per week, billed weekly or monthly, with costs based on your location, referral source, preferences, any applicable non-insurance discounts, and therapist availability. When considering cost, it may help to think about the investment in your relationship's long-term health and your own well-being.

Benefits of online couples therapy

Online therapy may offer several advantages for couples seeking support. The accessibility of online sessions may mean that there's no commuting required. Flexible scheduling can make it easier to coordinate two busy people's schedules, potentially removing one common barrier to seeking help. For couples juggling work, children, or other responsibilities, online therapy may provide a practical, convenient path to getting support.

How effective can online couples therapy be?

A 2022 study published in Frontiers in Psychology suggests that virtual couples therapy delivered via video can often help improve relationship satisfaction and mental health. Discreet appointments that can take place remotely from anywhere may help couples feel safer opening up, allowing them to get the maximum benefit from therapy.