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  • Writer's pictureJordan Conrad, PhD, LCSW

Couples Therapy


It was once thought that people came to couples therapy “too late” – that the relationship dynamic that caused negative attitudes toward one another were too entrenched by the time couples came to therapy. However, therapists today have more reason to be optimistic. Perhaps because the stigma around therapy is waning (particularly among those seeking therapy in New York), people are coming to couples therapy earlier[1] which gives the relationship a better chance to address core issues. Indeed, research on couples therapy reveals that it has comparable levels of efficacy to other treatments,[2] with some researchers reporting that “studies continue to show that most couples therapy has an impact, with about 70% of cases showing positive change.”[3] Couples coming to therapy thus have a very good reason to be hopeful that therapy will be beneficial to their relationship.


Couples therapy - or relationship counseling, couples counseling, or marriage therapy, whatever you prefer – differs from individual therapy in a number of ways. Not least of which is that, if you are looking for a couples therapist, your relationship is likely struggling and you need to get started right away. Though it can be immensely helpful to have a mediator for some tough conversations, in general couples counseling isn't about arbitrating who is “right” or “wrong” it is finding out what is preventing the relationship from thriving. Although it is obviously crucial that your therapist understands each of you as individuals, it’s important that you aren’t spending weeks and weeks unpacking your individual histories before you are able to start making progress.


Timeline


For that reason, couples therapy is typically short-term. Good couples therapy isn’t about uncovering in fine-grained detail every aspect of your personalities, but in learning how to calibrate to one another in a sustainable and enjoyable way. Although this will involve examining the content of the issues that are preventing the relationship from growing, there is often less to be gained in relitigating old fissures in the relationship than in focusing on the structure of the relationship. That is, although a specific argument might be a focal issue in your relationship right now, the way the two of you argue is almost always more significant than what you are arguing about. Couples therapy will focus on teaching you how to communicate effectively with one another, how to disagree in ways that don’t cause bad feelings, and how to support each other in ways that lift you both up.


The Relationship Comes First


What makes couples therapy effective is often the same thing that makes therapy in general so uncomfortable: you are inviting a stranger into your most vulnerable moments in a close and intimate way. When a relationship is struggling, its individual members often start to feel resentful, depressed, and hopeless and it is important these feelings are addressed before they calcify. However, in couples therapy your therapist works for the relationship and not any individual within it. It is important that both of you feel comfortable expressing your emotions and that whatever anxiety you feel is in the service of the therapy. For this reason, you can expect couples therapy to involve regular check-ins, both as a group and with individual sessions with your therapist, to make sure you are both working toward your goals in the relationship.


Enhancement vs Treatment


While the majority of people seeking couples therapy are experiencing an acute problem in their relationship, many come to therapy to improve their connection, reaffirm their commitment to one another, or simply for a periodic “check-in.” Within the clinical and bioethics literature, there is a distinction between “treatment” and “enhancement”: treatments focus on correcting something that has gone wrong whereas enhancements attempt to improve something that is going right. Of course, all good couples therapy identifies the strengths in a relationship and builds upon these in the service of repairing the connection, but in some cases – such as premarital counseling – this is the explicit goal. And research shows that it is extremely effective.[4] You don’t need to have a breakdown in the relationship to want to cultivate an already thriving sense of closeness or to figure out how to deepen the trust you already have for one another.



 

[1] Doherty, W. J., Harris, S. M., Hall, E. L., Hubbard, A. K. (2021). How long do people wait before seeking couples therapy? A research note. Journal of Marital and Family Therapy, 47, 882-890. [2] Shadish, W. R., & Baldwin, S. A. (2003). Meta-analysis of MFT interventions. Journal of Marital and Family Therapy, 29(4), 547–570. [3] Lebow, J. L., & Chambers, A. L. (2012). Research on the treatment of couple distress. Journal of Marital and Family Therapy, 38(1), 145-168.; Lebow, J. L., Chambers, A. L., Christensen, A., & Johnson, S. M. (2012). Research on the treatment of couple distress. Journal of Marital and Family Therapy, 38(1), 145–168. [4] Carroll, J. S. & Doherty, W. J. (2003). Evaluating the effectiveness of premarital prevention programs: A meta-analytic review of outcome research. Family Relations, 52(2), 105-118.; Blanchard, V. L., Hawkins, A. J., Baldwin, S. A., & Fawcett, E. B. (2009). Investigating the effects of marriage and relationship education on couples’ communication skills: A meta-analytic study. Journal of Family Psychology, 24, 203-214.

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