Does Couples Therapy Work?
Though those first few years of marriage were good, lately they have become a slog. You have the same fight over and over and neither of you know how to stop it or who to turn to. You’ve thought about couples therapy, but you have concerns. How do you go about finding the right therapist? Won’t the therapist take sides? Is your marriage really that bad that we need this? Will it even help? As a Licensed Marriage and Family Therapist (LMFT), these are just a few of the concerns I’ve come across in couples and to be frank, they are not without merit. Despite research supporting the effectiveness of couples therapy1, clients tend to walk away from it less happy than from individual therapy2.
The Problems with Couples
Generally, when an individual shows up for therapy, it’s understood they will put in the necessary effort to improve their mental health. If they get stuck blaming everyone else for their problems, without trying to make changes, they won’t get very far. This is where couples struggle. It’s easy to blame the other party for the problems in the relationship (and to have your friends and family confirm it), while assuming they are the ones who need to fix it. Couples won’t make progress in therapy if they maintain this mindset. Instead, each partner needs to focus less on what the other is doing wrong, and more on what they can improve. This includes looking at your contribution to the problem, and make changes accordingly – whether be more kind, biting your tongue when you want to get defensive, or learning to forgive.
Along those lines, many couples mistakenly assuming the therapist will be the one to do all the work. However, you shouldn’t think of your therapist as a doctor (or a magician) who will give you a pill to take away your problems, but rather as a personal trainer who will show you actively teach you techniques, that you should be implementing both in session and beyond. Without the work outside of session, your time in therapy will be much less effective3.
Finally, one of the bigger mistakes couples make when it comes to therapy, is waiting too long to attend4. Perhaps one or both of you came from homes where fighting and dysfunctional behaviors were the common, and so living in a certain level of chaos feels normal. Or perhaps your experience some of the fears of couples therapy I mentioned above. But if your engine starts making a weird noise, you probably know from experience it’s best not to put that off. Waiting allows the more hurt feelings and dysfunctional patterns to take hold in your marriage – which will be that much harder for a therapist to undo.
The Problem with Couples Therapists (and What to Do About it)
A major challenge of couples therapy is that any clinician can claim to work with couples, regardless of their level of training or experience5, whether they spent multiple semesters studying couple dynamics or just watched a TikTok video. One study found eighty percent of psychotherapists practice couples therapy without any specific training in couples work6. Therefore, it’s important to have a good pre-session chat with your counselor where you get a feel for them. After you explain a little bit about your problem, they should be able to articulate their approach for tackling it. You can also ask about their training (generally MFTs have more couple training), and how extensively they’ve worked with couples. It’s very important that you are able to connect with the therapist, a big predictor of therapeutic effectiveness7.
Be leery of a therapist who takes sides. Early in my career I had a woman who convinced me how “horrible” her husband was. Imagine my surprise when I met with this horrible guy, only to find out the wife wasn’t the innocent victim I was led to believe. This was particularly egregious of me, because as an MFT I was trained to look at couples through a systemic lens - an understanding that all parties play a role in maintaining the dysfunction. A good clinician understands the importance of making both parties feel heard, understood and valued8. Although some confrontation may be necessary, you should feel that the therapist has your back. If they don’t, it’s time to look elsewhere. Though some individual work way be warranted in the course of therapy, but even then, the therapist should be careful to not those sessions devolve into a diatribe, lest they create a deeper wedge in the marriage. Of course, a much different tact should be taken when violence is present in the relationship.
Couples therapy works best, when the clinician creates safety in the session. This can only be done when both parties are able to discuss their issues in a productive manner. Though some fighting may be permitted, particularly to help the clinician understand your dynamics, it should only be temporary. Additionally, some arguing may be allowed so both of you can be shown how to have conflict in a more effective manner, but you will get a sense of that fairly quickly.
Finally, a number of therapists are too quick to advocate for divorce – particularly if a couple is in high distress. As an MFT, I understand it’s tempting to pull the trigger on what appears to be a painful condition, but divorce is anything but a simple solution. I’ve had a number of divorced clients tell me it was just as painful as having someone die, not to mention the accompanying heart ache that may happen to the children. Don’t get me wrong, sometimes divorce is the appropriate solution, so I never leave that off the table but ideally a clinician see divorce as a last choice. You want to have a sense that the therapist is fighting for you as a couple, and believes in you. When these qualities are present, couples therapy is more likely to work.
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