Couples Therapy: Does it Work?

What is Couples Therapy?

Couples therapy is a form of counseling designed to help partners improve their relationship, resolve conflicts, and deepen emotional connection.

Couples therapy can help married or committed partners navigate various challenges, such as infidelity or life transitions. Other reasons why people may seek couples counseling are to improve communication, help each other work through stress, or learn strategies for coping with the mental health concerns of one or both of the individuals.

Different therapy approaches exist for couples including behavioral and emotion focused approaches. In addition, the Gottman method, integrates both approaches, specifically helps couples to develop practical skills for managing their relationships as well as developing insights into their relationship dynamics.

Couples counseling addresses broader concerns and may be used for any dyadic relationship.

Marriage Counseling vs Couples Therapy

Marriage counseling, or premarital counseling, is a bit different from couples therapy. It helps prepare a couple for future marital challenges by teaching communication and conflict resolution skills. It also helps partners work through their differences before they cause major conflict.

In a marriage counseling session, the marriage counselor facilitates healthy discussion and problem solving. Through this process, couples learn productive communication skills that they can continue to use throughout their marriage.

Marriage counseling can help navigate stressors, including wedding planning. Coordinating a wedding involves stress and logistical and interpersonal challenges. It’s also likely that planning a wedding is the first major stressor that couples face. The process can reveal some deeper interpersonal concerns that result in more fighting than the couple has experienced to that point.

Working through the challenges of planning a wedding together can help couples establish a foundation for a stronger and more fulfilling relationship moving forward.

The Gottman Method

The Gottman Method, developed by John and Julie Gottman, is based on more than 30 years of clinical research with over 3,000 couples. It involves learning, understanding, and daily application of core principles designed to promote healthy relationships.

The Gottmans tailored their research findings to each unique couple and their needs with the goal of helping them increase their closeness and approach conflict constructively.

The overall structure of the Gottman method can be placed into 3 main stages:

Establishing a strong foundation. Trust and commitment is fostered at this stage through learning and practicing skills such as understanding each other more deeply and sharing fondness and admiration.
Turning toward each other. During this stage, the two individuals are encouraged to turn toward each other during conflict and work together to manage it. This involves learning new mindsets and conflict management strategies and practicing them.
Creating shared meaning and making life dreams come true. This stage involves recalling important information about one’s partner that was learned in stage 1 and creating formal or informal rituals that celebrate connection and the couple’s values.

Using Love Maps to Understand Your Partner

One common activity done in stage 1 is Love Maps, which takes the couple through an exploration process so that each individual can more deeply understand the other beyond superficial knowledge (e.g. favorite movie genre).

Open ended questions help each individual learn the other’s hopes, dreams, vulnerabilities, and unique needs in certain circumstances.

For example, Love Maps can help someone learn that their partner values a hug when they are sad because they were deprived of physical touch in their family of origin.

One might realize that their partner does not need problem solving advice with a career struggle but a listening ear and empathy. Such a deeper understanding of each other and the ability to productively manage conflict allows for nurturance and connection along with fair fighting that is normal in healthy relationships.

Establishing a loving and trusting foundation and handling conflict fairly and constructively can lead to rituals that celebrate the relationship. Examples are volunteering as a couple for a cause one partner values or taking the time that is needed to help the other reach a life goal.

Other Therapy Approaches

The Gottman method utilizes emotion focused as well as behavioral strategies. Emotionally focused couples therapy (EFCT) works to promote the expression of primary emotions like vulnerability, hurt, sadness and inadequacy rather than secondary emotions that can be more divisive, like contempt, scorn, or anger.

Doing so enhances empathy, reduces insecure attachment to each other and increases healthy and secure attachment.

Behavioral couples therapy (BCT) focuses on restoring positive exchanges between the couple while reducing actions that impede effective problem solving.

Establishing the Best Therapeutic Approach for a Couple

Whether to approach couples therapy with the Gottman method, EFCT or BCT depends on which appeals to both individuals or the couple’s needs at a particular point in time. All three approaches may be beneficial to different couples at different periods.

One couple might find that they consistently share secondary emotions. In such a case it may make sense to start with EFCT and then move into the Gottman structure to strengthen the relationship.

Conversely a couple that has gone through the Gottman approach may find that 10 years later, another issue has arisen in which they have reached an impasse in resolving on their own. BCT may be the best fit in such a case.

Professional consultation from a couples therapist can help determine the best therapeutic approach, whether that be one strategy or a combination of strategies.

Online Treatment Options

Online couples therapy has been on the rise over the past few years and may be just as effective as traditional face to face couples therapy.Both online and in person modalities have pros and cons associated with them.

The pros of online counseling are lower cost, convenience, lack of a commute and a greater sense of privacy because sessions can occur from home versus an office where you may encounter other people you know.

The cons are that online therapy is reliant on technology that may have problems at the time of an appointment. Virtual therapy may also limit communication because the therapist cannot see your full body language.

Finding a qualified therapist for remote counseling is very similar to finding a qualified therapist for in person counseling. You can search online for therapists who offer virtual therapy.

Their online profile should list their credentials including their academic background and professional training, licensures and certifications and length of professional practice.

During your search you may also want to ask what measures the clinicians take to ensure clients’ safety and confidentiality in the virtual office space.

Cost of Couples Therapy

The average cost for a couples therapy session can be between $100 and $200 depending on factors such as working with a private therapist versus one that works in a community counseling center, how long the therapist has been in the field and if the therapist is a generalist versus one that focuses on couples therapy.

Your health insurance may also cover couples therapy; it is best to check your coverage before you decide on a therapist. You can call your insurance carrier or check your plan information online for details such as how many sessions are covered, what percentage of the costs you will be responsible for, and if there needs to be a diagnosable condition in order to be covered.

Alternative options for affordable couples counseling also exist. Employee assistance programs often offer counseling free of charge and this may include couples counseling. Health or flexible spending accounts may also be used to pay for couples counseling; you can check with your plan about any limitations.

Another low cost option for couples counseling includes sliding scale fees based on income that may be offered by community counseling centers or private therapists. University or college counseling centers also offer couples therapy for undergraduate and graduate students and students may qualify for a certain number of free sessions.

FAQs

Does Couples Therapy Work?

Research has found couples therapy to be effective. Couples who receive counseling find their relationship to be functioning better than 80% of couples with similar issues who do not receive couples therapy.

How Much is Couples Therapy?

The cost of couples therapy can vary depending on the setting. On average it may cost between $100 and $200 per session when working with a private therapist. This can be lower if you see someone in a community counseling center or if you have health insurance that covers couples therapy.

Is Couples Therapy Covered by Insurance?

Couples therapy may be covered by insurance depending on your specific insurance plan. Often therapists can bill insurance if one or both of the partners has a diagnosable condition. Often this can be an adjustment disorder or another condition such as a mood disorder or generalized anxiety.

It’s a good idea to first check with your insurance plan on whether or not couples therapy is covered and, if so, how much is covered (e.g. number of sessions at no charge, a percentage of each session, etc.).

What is the Best Type of Couples Therapy?

The best type of couples therapy for you and your partner would depend on your unique situation and needs. The Gottman method may be most effective for couples dealing with infidelity.

For those who have an addiction and seek couples therapy to address how it is affecting their relationship, BCT may be the best fit.

On the other hand those with major depression may find EFCT to be most effective.

Can we Do Couples Counseling Online?

Yes! Couples counseling is available online.

Strengthening Relationships Through Couples Therapy