Can Couples Counseling Help?

Medically Reviewed by Brunilda Nazario, MD on January 08, 2014
4 min read

You know to see a doctor for an ache or cough that won't go away. But where can you turn if your relationship needs a shot in the arm?

For some couples, professional counseling is the answer.

"Studies show that, in the hands of a good counselor, marriage counseling is successful 70- 80% of the time," says William Doherty, PhD, LCSW. Doherty is a professor of family social science at the University of Minnesota.

"We don't see our relationships and ourselves objectively," he says. "Most people are far more aware of how their partner is contributing to the problems in the relationship than they are. When we can't ‘fix’ ourselves, sometimes we need a third party's perspective."

The main complaints couples bring to therapy are "losing connection and high levels of conflict," Doherty says. "My research shows that 'growing apart' is the single biggest reason people give for divorce. Or maybe there is a lot of conflict that is depleting your marriage and you just can't resolve it on your own."

Major life changes or high levels of stress can put pressure on a relationship, too.

Whatever the cause, it's best to treat relationship problems sooner rather than later -- just as you would an illness, says Michael McNulty, PhD, LCSW. He's a psychotherapist who trains couples counselors for The Gottman Institute.

McNulty says on average, couples wait 6 years after problems develop to seek counseling. And he says that's unfortunate, because the sooner you get help, the better your chances of success.

The goal of therapy is to give couples problem-solving tools. Studies show that most newlyweds expect to agree with their spouse far more often than they actually will.

"We aren't taught how to be in relationships or deal with the conflicts that come up," McNulty says. "There are very basic things people can learn about friendship and conflict that make total sense, are easy to do, and can really help. And that is where counseling helps."

Over the first few sessions, expect the therapist to interview both of you -- together and sometimes separately. After that, the therapist should give you feedback and a plan for treatment.

The average length of counseling is 12 sessions, but it can be different for each couple.

After four or five sessions, you should be able to tell if the therapy is working. By this time, you and your partner should feel you're communicating with each other in a more positive and effective manner, McNulty says. "[You] should look for small changes week in and week out."

"You can tell that couples counseling is working," Doherty says, "when you feel that there is some learning going on about the other partner. Maybe you are feeling more hope or seeing changes at home. If you were distant, maybe you feel closer. Maybe there is less conflict, or arguments are not so bad when you have them."

"I encourage people to see someone who specializes in marriage counseling -- at least 30% of their practice,” Doherty says. “They have seen it all, and they will roll up their sleeves and help you."

Ask your friends, doctors, or clergy for names of counselors they know and recommend. Some hospitals and social service organizations have referral services. Local chapters of the American Association of Marriage and Family Therapy, the National Association of Social Workers, or the American Psychological Association may be able to help, too.

Look for someone who has a background in couples therapy and advanced certification in couples work. Licensed marriage and family therapists (LMFTs) are likely to have more training as well.

Also look for a therapist who is caring and compassionate to both of you and doesn't take sides. A therapist should keep control of sessions and not allow you to interrupt each other, talk over each other, speak for each other, or have heated exchanges.

McNulty says a good therapist will encourage couples to decide early on whether he or she is a good fit for them, and will offer a referral if not.

Couples counseling is not always covered by health insurance, although it may be if one partner is being treated for a mental health condition such as depression.

If you want to try counseling and your partner doesn't, experts say don't give up.

"Tell them you are worried for the relationship, that you love them and want their help in making it succeed," Doherty says. "You don't have the conversation once. You have it over and over, and you don't take no for an answer."

If all else fails, try therapy alone, McNulty says. The counselor may have ideas about how to change your partner's mind.