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Moderate Anxiety, Moderate Severe Anxiety, Severe Anxiety, Therapy

Couples Counseling

 September 11, 2020

By  Dom Partridge

Medicinal Mushrooms

What is couples counseling?

A relationship can be exposed to various risks, disappointment, and grief. Even the healthiest relationship experience turbulence, cracks, and result in conflict. Couples counseling can offer psychological support for couples who are going through a rough patch, conflicts, and emotional breakdowns. Some couples choose to do couples counseling even when there are no problems or misunderstandings to create more intimacy and a stronger connection. 

Couples counseling is psychotherapy which can help with anxiety, depression, trauma, intimacy loss, sex issues, conflicts, broken trust, polyamory, addiction, divorce management among other issues that may arise between a couple. Couples counseling can also be used to make a strong relationship even stronger. It offers the opportunity to discuss uncomfortable and/or important topics in a more calm and impartial environment.

What are the different types of couples therapy?

Partners or spouses can choose the type which fits their concerns and the style they are most comfortable with. Today, there are 8 major forms of couples counseling.

Emotionally Focused Therapy (ETF)

Emotionally focused therapy (EFT) was first introduced in the 80’s’ by Canadian psychologists Sue Johnson and Les Greenberg. It is based on John Bowlbly’s theory which explains relationships as a shelter for safety, and protection. People seek their partner’s comfort relying on behavioral patterns formed in childhood. The main goal of EFT is to help understand emotions and emotional triggers that people may not realize they have, and help them break these patterns. EFT couples counseling is usually ongoing and involves regular meetings with the therapist. 

Imago Relationship Therapy (IRT)

Imago Relationship Therapy (IRT) is based on the work of Harville Hendrix and Helen LaKelly, a couple who experienced marital conflicts themselves. Together, the couple wrote a bestselling book called Getting the Love You Want, which explains in detail how to work on a relationship and save a marriage using this therapy. 

IRT follows the theory that everything a couple experiences during adult relationships takes root from “childhood wounds”. Allowing each person to understand their emotional patterns and identify why these were formed based on “childhood wounds” is believed to help each person to become more aware of their own emotions and behaviors, as well as become more empathetic of their partner. 

The Gottman Method

John Gottman, a professor at the University of Washington introduced this method using his knowledge of mathematical and statistical analysis. Using statistical data, the Gottman Method models can predict various outcomes of a relationship, and suggest interventions to help a couple break the negative pattern they are in. This method fits those who are in a long-term relationship or committed to strengthening a marriage or their relationship. It helps to develop intimacy and break barriers between a couple. During the conversations with a therapist, a couple talks about conflicts and the therapist focuses on the process of the conflict, rather than the content, to help break their patterns and achieve more respect, affection, and closeness. This helps the couple resolve conflict, generate greater understandings of each other, and to keep conflict discussions calm. 

Narrative Therapy

Michael White, alongside David Epston, introduced this form of couples counseling to help people view themselves as separate from their problems, instead of being defined by them. In Narrative Therapy, the therapist helps the couple “re-author” their narrative, which helps them to identify and acknowledge their own worth, and helps them develop a skill set to address the problems they face. 

Solution Focused Therapy

Solution Focused Therapy was introduced by psychotherapists Steve de Shazer and Insoo Kim Berg. This form of couples counseling aims to help couples by focusing on their present and future goals, rather than the past. To do this, the therapist discusses the plans and dreams of each partner, alone and together. A therapist helps the couple plan for the future and monitors the progress of each session. The therapist helps encourage the couple to recognize what is working, and encourages them to celebrate successes.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) was pioneered by psychiatrist Aaron T. Beck in the 1960s. CBT is a form of psychotherapy which helps people, or couples, change from a negative mindset into a more positive one. After identifying the root cause and triggers of a couple’s problem(s), or which thoughts dominate, a therapist may assign exercises to the couple to help them change how they perceive or react to these triggers.

Relational Life Therapy

Terry Rail, a family therapist, first introduced this form of couples counseling therapy which aims to address traditional gender stereotypes so that couples can enjoy more well-balanced relationships. Traditional male stereotypes pressure male-identifying individuals to adopt aggressive or defensive attitudes, as these attributes are commonly associated with masculinity. Males who do not conform to this view may be perceived as weak and feel guilt. 

Relational life therapy aims to address and dispel these social constructs as they may negatively impact modern relationships. Addressing these can help bring a sense of balance to the relationship, by helping each partner understand and celebrate the roles each partner plays in the couple without judgment. This therapy encourages partners to express themselves, without fear of blame, anger, retaliation, or condemnation.

Discernment Counseling

Discernment Counseling was introduced by Bill Doherty, a professor of Family Social Science at the University of Minnesota. Discernment counseling is different to traditional couples therapy,  as according to Kristin Sliwicki (Licensed Marriage and Family Therapist and Certified Discernment Counselor), “it is a structured assessment process, not a treatment”.

This style of couples counseling aims to help couples to decide whether they should leave a partner or stay together, regardless of the cause of their problems. A therapist discusses the ongoing problems and helps balance the pros and cons of such a decision.

Why should a couple decide to do couples counseling?

While this is not a complete list, many couples decide to do couples counseling for the following reasons:

  • Learning how to spot the root of the problem in a relationship
  • Learning how to resolve arguments without provoking conflicts
  • Identifying the triggers which lead to conflicts within a relationship
  • Developing communication skills to elevate the positive experience in a relationship
  • Learning how to speak sincerely without hiding the truth from a partner
  • Managing conflicts and restoring positive emotions
  • Boosting the strengths of partners that previously tied them together and inspired them
  • Learning holistic techniques to reach peace of mind such as Meditation, Yoga, and Qigong

What should a couple expect during couples counseling? 

Couples counseling usually starts with a briefing session. A therapist will discuss the couple’s goals, learn the history of their relationship, and find out what brought the couple to counseling. During the first few sessions, a couple is building a mutual understanding and respect with a therapist. If they are unable to do so, the couple can choose another therapist. The first few sessions are also an opportunity for the therapist to see how the couple speak of their plans regarding each other. A therapist may offer individual counseling as well if they see that an individual approach can help the trigger of the conflicts.

It is difficult to predict how long the couple should stay in counseling.  The therapist may or may not be able to give an idea of how often and how long the couple should expect to be in counseling.  

What do experts say about couples counseling?

Anita Chlipala, a licensed marriage, and family therapist says “if you keep having the same fight, a couples’ therapist can teach you to identify which issues are situational and perpetual. For the latter, those are the arguments that are recurring and need to be managed, not solved. We have tools for that!”

When do you know it’s not working?

Couples counseling does not work for every person, and also it may not be fit for some couples. If partners do not feel comfortable with a therapist, and they are uncomfortable to address this concern with the therapist they should consider an alternative therapist or style of therapy. A good therapist is a specialist who should be open to accept criticism and not become defensive. If a couple believes they do not feel able to continue, it is necessary to speak about it to change the direction of therapy or look for another therapist. However, keep an open mind because the root of your dissatisfaction may lie in a lack of motivation to change, or a reason that is not related to the counseling.

How to find a good couples counseling therapist?

You have a choice between working with someone in-person or online. To help make the right decision, contact a few therapists in your area or online. Prepare to dedicate time to this search, as finding the right person for you may take speaking with a few therapists. Ensure you share your thoughts about the counselor with your partner, as they may have other preferences such as gender or a certain cultural mentality.

To find a couples counseling therapist in person:

  • Ask for a referral from friends & family
  • Use Google or Yelp, pay attention to reviews and feedback from clients

To find a couples counseling therapist online:

  1. Review services provided by BetterHelp

BetterHelp is the private e-counseling platform. It accommodates professionals in psychotherapy and couples counseling. They are licensed and accredited psychologists, marriage and family therapists, clinical social workers, and board licensed professional counselors. 

  • 98% of clients reported significant improvements with BetterHelp, 94% admitted it works better than face-to-face therapy, and 70% reported improvements in their depressive symptoms.
  • This platform offers around-the-clock services for people who may require help, even late at night. You can access unlimited sessions by paying a fee.
  • BetterHelp has experienced and licensed marriage and family therapists as well as other psychotherapists that focus on couples counseling
  • BetterHelp couples counseling is not covered by all insurance plans, unlike face-to-face therapies.
  1. ReGain online counseling platform

ReGain is an online platform that focuses on relationship counseling services. All therapists matched to a couple are licensed and accredited specialists in couples counseling.

  • The platform matches the couples to a counselor within 24 hours. A counselor will assess the relationship using a thorough questionnaire.
  • No extra fee if you want to start couples counseling after individual therapy.
  • Some of ReGain’s therapists are focusing and have extensive experience with couples counseling and even more specifically focus on certain issues and/or goals that couples have.  
  • Response from the therapist to messages that come outside of the scheduled session may not come immediately, it may take up to one day.

Disclaimer: This website does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on our Site. If you think you may have a medical emergency, immediately call your doctor or dial 911


Dom is a PhD and Honorary Research Fellow at the University of Aberdeen, Scotland focusing his research in development of nutritional and exercise strategies to increase resilience and improve health outcomes in a target ageing population.

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