Marriage Counseling and Couples Therapy

What Is Marriage Counseling?

Marriage counseling is talk therapy for two people in a committed relationship, whether they are married, engaged or dating. Instead of focusing on one person, the therapist works with the relationship itself: the patterns of conflict, distance or mistrust that keep repeating between partners. Most couples therapy is short term. The American Association for Marriage and Family Therapy (AAMFT) reports that couples therapy averages about 11.5 sessions (AAMFT, n.d.).

Several approaches have strong research support. Emotionally focused therapy (EFT) helps partners understand the needs and fears underneath their arguments, and a review of the research found that it meets or exceeds the guidelines for an evidence-based couple therapy (Wiebe & Johnson, 2016). Integrative behavioral couple therapy (IBCT) combines communication skills with acceptance of differences that are unlikely to change. In a large clinical trial, about half of the couples were still significantly improved five years after therapy ended (Christensen et al., 2010). Some therapists also use cognitive behavioral therapy (CBT) techniques or the Gottman Method.

What are relationship issues?

Personal and family relationships can be both fulfilling and challenging. The more you understand yourself (your emotions and behaviors), the better you can communicate with loved ones (including your spouse), manage your stress, and effectively function in your daily life. Marriage is one of the most important relationships in your life, but it’s important to be realistic. Every marriage will have its “highs and lows.” That is normal.

During the “highs,” you and your partner will feel connected, in love, and passionate about each other. However, during the “lows,” one or both of you may feel cold, indifferent, distant or hostile towards the other. You may argue so much that you contemplate separating or divorcing. For some, this stage only lasts a few weeks, but for others, it can last for years.

What Happens in Couples Therapy?

Marriage counseling, couples therapy and marriage therapy are all types of psychotherapy that focus on improving your communication and conflict-resolution skills.

Here are answers to common questions:

Do We Have to Attend Marriage Counseling Together?

It depends. Typically both partners attend sessions together, but your therapist may ask to see each of you separately at times.

Does Couples Therapy Work?

In most cases, yes, but both partners must be fully committed to the therapy process for it to work. A 2020 analysis of 58 studies found that couples in therapy improved far more in relationship satisfaction than couples on a waitlist, and most kept those gains at follow-up (Roddy et al., 2020).

What Is the Success Rate?

There is no single success rate, but in one large trial about half of couples were still significantly improved five years after therapy ended (Christensen et al., 2010). Keep in mind that your specific treatment plan will depend on your unique situation. Marriage counseling can also help with issues beyond marital problems, such as the death of a loved one, a tragedy in the family or a chronic illness (e.g., substance abuse and depression).

What is the Purpose of Marriage Counseling?

The purpose of marriage counseling is to help you learn the tools you need to strengthen your marriage.

Is a Marriage and Family Therapist the Same as a Marriage Counselor?

Often, yes. Marriage and family therapist (MFT or LMFT) is a type of mental health license, and many MFTs specialize in couples work. MFTs are trained to look at problems in the context of a person’s relationships (AAMFT, n.d.). Family therapy, which brings children or other relatives into sessions, is a related but separate service. To learn more, see family therapy.

What Happens During a Typical Couples Therapy Session?

During a typical couples therapy session, you and your partner may be given roleplay tasks and assignments to work on at home. You will also be encouraged to share your true feelings with your counselor and spouse. Communication and conflict-resolution skills are a big focus of couples therapy. Your therapist will expect you to complete all tasks and assignments. For example, during a session, you and your spouse may be given communication exercises to practice at home with the expectation that you will share your experiences during the next session.

What Happens in the First Session?

A first session usually includes both partners together. The therapist asks each of you what brought you in, what you hope will change, and what is still working between you. Some therapists also schedule one short individual session with each partner, so both of you can share your history openly. Before the second session, you may be asked to notice one moment each day when you felt close and one moment when a conversation went off track. Those small observations give you and your therapist a clear place to start.

The Different Stages of a Relationship

Relationships are not static. Most relationships go through various phases. Couples move through these stages at different times. Issues can come up during any of these stages, and if you understand them, you can handle issues when they arise.

Listed below are the different stages of being in a relationship:

These seven stages are a general guide drawn from clinical work with couples, not a formal research model. Not every couple goes through all of them, and many move back and forth between stages. 

Stage #1: Passion

The first stage, often called the “honeymoon stage,” is when you meet and fall in love. Sparks fly, and you begin to build respect, intimacy and admiration for each other. For most couples this stage is temporary, so it helps to keep reigniting the passion by trying something new together.

Stage #2: Realization

Once the initial passion fades, you begin to see each other as real people, flaws and all, and to decide whether marriage may be in your future. You also start to respect each other on a deeper level and share parts of yourself you kept hidden during the honeymoon stage. This stage can bring disappointment and disagreements, but good communication and conflict-resolution skills help you work through them together.

Stage #3: Rebellion

During this stage, the focus shifts back to your own interests, from “all about us” to “all about me.” A power struggle is common, with each partner sure their way is best. How you argue matters: blaming, talking over each other and letting resentment build can cause a rift that is hard to repair.

Stage #4: Cooperation

With careers, children, household duties and bills, many couples settle into cooperating to get through daily life. This stage can feel like a business arrangement, with passion, romance and intimacy put on the back burner, and it can last 20 years or more if you have children.

Stage #5: Reunion

Once your children have grown up and left home, you have a chance to get reacquainted and enjoy the quiet and security of fewer responsibilities. This is the time to become friends and lovers again, and to rediscover why you chose each other.

Stage #6: Explosion

This stage brings serious life events, such as a death in the family, a job loss, financial strain or a major health problem. Facing them together can bring you closer, but without good communication and conflict-resolution skills, it can also push you apart and spark resentment and frustration. The explosion stage can happen at any point in a relationship.

Stage #7: Completion

In the last stage, your children are adults and you are preparing for retirement. Couples who have weathered the storms of a long relationship often feel close, relaxed and at peace, and the goal is simply to enjoy each other’s company.

When Should You Go to Marriage Counseling?

As marriages move through the various stages and experience challenges together, conflict can occur. And, although some minor arguments are to be expected, more complex and deeper ones can drive a wedge between you and your partner. In fact, the more troubling conflicts can cause you to question if a resolution is even possible, or if you really want one.

As you start to drift apart, you may realize that you and your partner want different things in life. In addition, infidelity may enter the mix or you or your partner may feel “stuck” in a relationship with no way out. Before seeking couples counseling, you or your partner must acknowledge that your marriage is in trouble. Then, you must decide together, if you want to try to “fix” your broken relationship.

In this scenario, couples therapy can help. A marriage counselor can help the two of you communicate better and begin to resolve deep-seated emotional hurt.

Types of Marriage/Couples Counseling

Marriage counseling is not just for unhappy or struggling couples. Rather, it also involves couples therapy for non-married couples. Regardless of your relationship status, marriage counseling, or couples counseling, can be used to strengthen bonds and gain a better understanding of one another. It can also be used to help couples, who are about to be married and those who are thinking of getting married. This is called premarital counseling. The goal of this type of counseling is to help couples learn how to communicate and resolve issues more effectively and to “iron out differences” before the wedding day.

If you are interested in marriage counseling because you are having relationship issues, some of the issues that can be addressed during sessions include:

• Poor Communication: arguing, belittling, criticizing and misunderstanding
• Financial Problems: debt, poor budgeting and overspending
• Sexual Differences and Dysfunctions: erectile dysfunction, different sexual preferences, low libido or premature ejaculation
• Parenting Challenges: defiance, learning disabilities, behavioral problems, and children’s mental and physical health issues
• Substance Use and Addiction: drinking, drug use or gambling that strains the relationship
• Anger: frequent blowups, yelling or resentment that won’t let up
• Infidelity: an affair or emotional betrayal, and rebuilding trust afterward
• Separation or Divorce: deciding whether to stay together, or how to part with less conflict

Family therapy, which brings children or other relatives into sessions, is a related but separate service. If parenting stress is straining your relationship, parenting counseling can help, and family therapy looks at how the whole family works together.

If faith is central to your marriage, Christian marriage counseling brings your shared beliefs into sessions, often with a licensed therapist who also uses evidence-based couples methods.

What are the Goals of Marriage Counseling?

For many couples, the primary goal of marriage counseling is to save the marriage and stay together. For others, seeking therapy may be attributed to unresolved issues in the marriage. It’s important to understand that marriage counseling isn’t a quick fix. Rather, it takes dedication and effort to accomplish goals and repair the relationship.

A marriage counselor can help you in the following ways:

Infidelity & Adultery

If either you or your partner is unfaithful, it can seem like your relationship is doomed. However, if both you and your partner are committed to the relationship and willing to try to work it out, there is a chance your relationship can be repaired. A marriage counselor can help you rebuild trust in your relationship. This relationship specialist can also help you understand why the infidelity or adultery occurred.

Poor Communication

It’s common for couples to communicate differently and to struggle to say how they feel. You may assume your partner knows what you are thinking or needing, but they may have no idea unless you tell them. That silence can leave one or both of you feeling ignored or dismissed, and you may even mistake poor communication for a sign that your partner no longer loves you. A marriage counselor can help you say what you need clearly and listen to each other.

Substance Use and Addiction

Sometimes one or both partners have a substance abuse problem or full-blown addiction. Addiction comes in many forms, such as drugs, alcohol, gambling, pornography, overeating, and even shopping. This is a serious issue that must be addressed as soon as possible. But, first the abuser or addict has to admit there is a problem and he/she needs help. Couples counselors can help you address these challenges individually and within your relationship.

Child-Rearing Issues

Raising children can be hard, really hard. There is no instruction manual on how to raise children or how to combat child-rearing problems when they arise. Most of us simply have to “wing it.” Still, children can put a strain on a relationship, especially when the child has behavioral problems, learning difficulties, a chronic illness or disability, or mental health issues. When child-rearing issues pop up, the focus usually goes towards the child, leaving the relationship to flounder.

Passion & Romance

Every couple wants passion and romance in their relationship, especially if they have been together for a long time. So, it is common for couples to seek marriage counseling as a way to become closer to one another. A benefit of marriage counseling is that it can help you and your partner see the value in reconnecting with one another. The end result? More passion, romance, and a re-emergence of the “honeymoon stage.”

Conflicts & Resentment

It’s normal to have conflict and even resentment from time to time. You are human after all. Marriage therapists teach conflict-resolution skills, in other words, how to “fight fair.” When conflict and resentment are left to simmer, especially when partners can’t say how they feel, anger and bitterness build and the relationship may not survive.

Marriage Counseling FAQs

How long does marriage counseling take?

It varies, but most couples therapy is short term. AAMFT reports that couples therapy averages about 11.5 sessions (AAMFT, n.d.), and Mayo Clinic notes that some couples need only a few sessions while others continue for several months (Mayo Clinic, 2019).

Can marriage counseling help after infidelity?

Often, yes, when both partners want to repair the relationship. In one clinical trial, couples dealing with an affair that had been disclosed started therapy more distressed than other couples but improved more over the course of treatment (Atkins et al., 2005).

What if my partner won’t go to couples therapy?

You can still go on your own. Mayo Clinic notes that you can attend counseling even if your partner refuses, although repairing the relationship is harder when only one person takes part (Mayo Clinic, 2019). Individual therapy can help you understand your side of the pattern and decide on next steps.

How do we prepare for couples therapy?

Before the first session, each of you can think about what you want to change and what is still working between you. Come ready to listen and understand, not to win an argument or prove who is right. Early sessions can feel uncomfortable, which often means you are talking about what matters. If there is any abuse in the relationship, talk with a therapist on your own first.

Is online couples therapy effective?

Early research is encouraging. In a small randomized trial, couples who completed a relationship program by video call improved as much in relationship satisfaction and mental health as couples who met in person, and they rated their bond with the therapist just as highly (Kysely et al., 2022).

How much does couples counseling cost, and does insurance cover it?

Fees vary by location and by the therapist’s training. Many health plans do not cover couples counseling on its own, because insurers usually pay to treat a diagnosed mental health condition rather than relationship problems. Coverage may apply when the therapy also treats a partner’s diagnosed condition, such as depression. Ask the therapist whether their services are covered by your plan before you start (Mayo Clinic, 2019).

Should we try couples therapy if there is abuse in the relationship?

Usually not while abuse is ongoing. The National Domestic Violence Hotline explains that abuse is not a relationship problem, so couples counseling cannot fix it, and a partner may use what is said in session against you later (National Domestic Violence Hotline, 2022). Individual support from an advocate or therapist is a safer first step. You can call the Hotline at 800-799-7233.

How Can I Find a Marriage Counselor?

You can seek marriage counseling from a trained and licensed marriage and family therapist (MFT), clinical social worker, or marriage/couples counselor.

If you feel that you and your partner could benefit from couples therapy, check out the TherapyTribe Directory and connect with licensed therapists near you. You can also use Get Matched to describe what you want to work on and see therapists who fit. Get the support you need and remember, select a counselor that you are both satisfied with. For tips, see how to choose a therapist.

If you are being hurt, threatened or controlled by a partner, couples counseling is usually not recommended while the abuse is ongoing (National Domestic Violence Hotline, 2022). You can call the National Domestic Violence Hotline at 800-799-7233 or text START to 88788, any time. If you are in immediate danger, call 911. For more options, see our list of crisis helplines.

Ready to take the first step? Get Matched with a couples therapist who fits what you and your partner need.

This article is for general information only and is not a substitute for advice from a licensed mental health professional.

References

American Association for Marriage and Family Therapy. (n.d.). About marriage and family therapists. AAMFT website

Atkins, D. C., Eldridge, K. A., Baucom, D. H., & Christensen, A. (2005). Infidelity and behavioral couple therapy: Optimism in the face of betrayal. Journal of Consulting and Clinical Psychology, 73(1), 144–150. https://doi.org/10.1037/0022-006X.73.1.144

Christensen, A., Atkins, D. C., Baucom, B., & Yi, J. (2010). Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology, 78(2), 225–235. https://doi.org/10.1037/a0018132

Kysely, A., Bishop, B., Kane, R. T., McDevitt, M., De Palma, M., & Rooney, R. (2022). Couples therapy delivered through videoconferencing: Effects on relationship outcomes, mental health and the therapeutic alliance. Frontiers in Psychology, 12, Article 773030. https://doi.org/10.3389/fpsyg.2021.773030

Mayo Clinic. (2019). Marriage counseling. https://www.mayoclinic.org/tests-procedures/marriage-counseling/about/pac-20385249

National Domestic Violence Hotline. (2022). Should I go to couples therapy with my abusive partner? https://www.thehotline.org/resources/should-i-go-to-couples-therapy-with-my-abusive-partner/

Roddy, M. K., Walsh, L. M., Rothman, K., Hatch, S. G., & Doss, B. D. (2020). Meta-analysis of couple therapy: Effects across outcomes, designs, timeframes, and other moderators. Journal of Consulting and Clinical Psychology, 88(7), 583–596. https://doi.org/10.1037/ccp0000514

Wiebe, S. A., & Johnson, S. M. (2016). A review of the research in emotionally focused therapy for couples. Family Process, 55(3), 390–407. https://doi.org/10.1111/famp.12229