- There are a wide variety of approaches to couples therapy, and choosing the right one for your relationship depends on your goals.
- Many therapists are trained in multiple modalities and can integrate different approaches depending on the couple.
- The therapist you choose to work with may be more important than the type of couples therapy they use.
Couples therapy can be a powerful tool, whether you’re looking to increase intimacy, improve communication, build trust after a betrayal, or learn to navigate your differences as individuals.
Couples therapy has been around since the 1930s, but it didn’t gain popularity until the 1980s when different approaches described below came to life.
There are a wide variety of approaches to couples counseling, and experts say choosing the right one for you will ultimately depend on your goals for the relationship. Here are some common types of couples therapy and how to determine which is right for you.
The Gottman method
Gottman Method Couples Therapy, which was created by husband and wife psychologists John Gottman and Julie Gottman, was built based on the findings from 40 years of scientific research about patterns of behavior in successful and unsuccessful partnerships.
The Gottman method entails honing in on destructive behaviors such as “the four horsemen”:
- Criticism
- Contempt
- Defensiveness
- Stonewalling
Areas of focus include:
- Sharing relationship histories
- Exploring areas of disagreement
- Identifying various triggers
- Discovering shared values
- Gaining specific tools to help manage conflict
A 2018 study showed that couples scored significantly higher in regards to intimacy and overall relationship quality after receiving 10 sessions of Gottman’s couples therapy.
Cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT), which was originally designed for individual use to treat such issues as anxiety, depression, substance abuse, and eating disorders, centers around the notion that your thoughts influence your behaviors.
“A CBT therapist will initially focus on identifying what each partner is thinking about the conflicts that have brought them to couples counseling,” says Gary Brown, PhD, a licensed family and marriage therapist based in Los Angeles. “One’s beliefs may be challenged in order to help each partner develop better methods of communicating.”
Research has shown that CBT is effective in treating communication difficulties as well as conflict resolution.
Discernment counseling
Discernment counseling was developed around 2008 for cases of conflicted couples in which one partner wants to save the relationship and the other is leaning towards ending it.
This short-term approach is meant to bring clarity for both partners when ambivalence is preventing them from fully engaging in and reaping the benefits of couples therapy, says Angele Close, PhD, a clinical psychologist and emotion-focused therapist based in Skokie, Illinois.
One of the primary goals of discernment counseling, according to Brown, is to help the couple discover all of their options to consider before they make the ultimate decision about the fate of their relationship.
Emotion-focused therapy
Emotion-focused therapy, developed in the 1980s, is one of the most researched and tested types of couples therapy, according to Brown.
With this method, the therapist will typically have each partner share specific, problematic events in the relationship, and then work with them to identify, explore, and make sense of the underlying emotions that are contributing to those situations.
“It can be difficult for people to address their more vulnerable emotions when they get stuck in anger, resentment, or apathy,” says Brown. “It is when they can access deeper emotions such as sadness, hurt, or fear that they can then understand the unmet needs that these deeper emotions help to reveal.
What research says: A 2019 systematic review of nine studies concluded that emotion-focused therapy is effective at improving marital satisfaction. Additionally, a 2015 study of 30 infertile couples revealed that EFT significantly improved their physical, emotional, and sexual satisfaction from their spouses.
Imago relationship therapy
The Imago method views a couple’s problems as a result of unmet childhood needs and unhealed wounds that later become sensitivities, conflicts, or pain points in adult relationships.
“The premise of Imago therapy is that each partner experienced certain images in their childhood that formed their own perspectives about what a relationship looks like,” says Brown. “The goal is to bring these images into consciousness so that you can identify negative thoughts, feelings, and behaviors in order to help you understand the childhood experiences that impact how you behave towards your partner.”
Brown says Imago relationship therapy involves a three-step process of mirroring, validating concerns, and expressing empathy. A 2017 study found that couples experienced “statistically significant” increases in marital satisfaction after completing 12 sessions of this therapy method
Narrative therapy
The philosophy behind Narrative therapy is that the stories you and your partner tell yourself shape your decisions and behavior toward each other. True to its name, this technique revolves around correcting self-defeating or otherwise negative narratives that may be sabotaging the relationship dynamic.
“The therapist helps the couple see what erroneous beliefs and themes from their lives are contributing to the deterioration of their bond,” says Close. “The couple is guided to create a new and healthier narrative that honors and addresses the needs of each partner while fostering greater intimacy and connection in the process.”
What research says: A small 2016 study found that couples who underwent just eight sessions of narrative therapy reduced their marital conflict as well as improved their sexual relationship.
Solution-focused therapy
Solution-focused therapy is better suited to couples who are exclusively looking to resolve a specific problem, as opposed to those experiencing a wider range of conflicts, says Brown.
Results from a small 2018 study revealed that brief solution-focused couple therapy can significantly reduce “couple burnout” — a physical, mental, and emotional condition that involves a lack of interest and attachment to one’s spouse.
“A solution-focused style is to invite the couple to envision the positive changes they aspire for,” says Close. “From this imagined circumstance, the therapist and clients concretize and delineate actionable steps designed to achieve these goals together.”
Insider’s takeaway
Most therapists are trained in more than one modality and can integrate different approaches as needed depending on the specific challenges you’re facing in the relationship.
In addition to considering all options for types of couple’s counseling, experts emphasize that it’s just as important to find a professional you feel comfortable with and can build a good rapport with — someone who validates your problems and effectively addresses them.
“Since you are going to share some of your most intimate thoughts and emotions, I believe the therapist you choose to work with is more important than the methodology that they use,” adds Brown.
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Rebecca Strong is a Boston-based freelance writer covering health and wellness, food and wine, fitness, and travel. In addition to contributing to the Health Reference and Kitchen verticals at Insider, she has also written for Healthline, Health magazine, Bustle, StyleCaster, PopSugar, AskMen, and Elite Daily. You can follow her work on Twitter
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Pro Tip 3: Remember, it’s not just about finding a good marriage counselor. It’s about avoiding a bad marriage counselor.
At Growing Self, we have “marriage counseling refugees” — couples who have tried “couples counseling” with therapists who did not have the training or expertise to help them…. and it was not a good experience.
I personally, routinely meet couples who have tried “marriage counseling” with a therapist who had no specialized training or experience in Couples and Family Therapy, and it almost cost them their relationship.
Remember: any therapist can offer “marriage counseling,” even if their background is in social work, counseling individuals, or even as a school psychologist with little training or experience in couples therapy.
I’m pleased to report that the couples with past negative experiences in marriage counseling had the courage and wisdom to get a second opinion and try again. This time with productive marriage counseling that works, using evidence-based strategies focused on results. We let our couples know what to expect from good marriage counseling, then we deliver.
These couples often have the positive, life-changing experiences they were hoping for, and that is a victory. Here are more resources if you’d like to learn what to expect in marriage counseling done well.
But, some couples don’t try again. They don’t know what you are learning about right now — that not all “couples counseling” is the same. They just assume they’ve tried everything, but their relationship is unsalvageable. That’s the real tragedy, in my opinion.
But you are here to learn, so I’m going to help you become a super-informed and empowered consumer of counseling services.
I’m In the Business of Finding Good Marriage Counselors
I have a unique perch from which to provide this information. In addition to my own education, training, and experience in marriage counseling, I’m also a clinical supervisor of marriage counselors, and, as the clinical director of Growing Self, heavily involved in vetting therapists, marriage counselors, and coaches interested in joining our practice.
In this role, I am routinely fascinated (and more than a little horrified) with the number of applications and resumes we get from very enthusiastic therapists who “work with couples” …. with absolutely no basis for doing so. We do not invite them to join our practice, in case you’re wondering.
Here’s why we don’t work with them and why you shouldn’t either: Many therapists offering couples counseling without specialized training in this area attempt to help couples by using individual therapy techniques because that is what they know how to do.
This frequently disintegrates into identifying one of the partners as “the person with the problem,” rather than doing what actual couples counselors do: working with the couple as a system.
We have wonderful therapists and marriage counselors here at Growing Self, but we don’t have thousands of them. We have thousands of counselors applying with us and accept almost none of them. I’m not trying to sound elitist: There’s a good reason for this level of caution in the field of mental health and personal growth.
Having read through hundreds of resumes, interviewed hundreds of marriage counselors, and worked closely with dozens of amazing couples therapists (and some that have not been that amazing, and have been released from our practice), I have gained insight into what to look for when you’re trying to find a marriage counselor… and honestly, what to avoid.
In addition to specific advice about finding a marriage counselor, I have formed conclusions about how to find a therapist too, as well as how to avoid bad therapists. (Actually, I did a whole podcast episode on “Signs you have a bad therapist” as a public service, which you’re welcome to check out, too.)
Here’s what I’ve learned over the years…
Radically Honest Advice About Finding a Marriage Counselor
Let’s pretend, for a moment, that I’m not a marriage counselor — let’s imagine I’m your friend. In my personal life, with the people I care about the most, I am “that” friend, the one who will always be honest and straight with you even if it’s hard to hear. So let me be that for you for a minute.
I will tell you, friend to friend here, that in order to find the right marriage counselor, you need to first understand what is on the line — and what can happen to couples who blunder into a bad situation because they didn’t know any better.
You absolutely must make an informed decision. Choosing a marriage counselor because they are photogenic, or they offer online booking, or they can meet with you on Tuesdays at 7 pm, is simply not enough.
Here’s why:
If Your Relationship Is On the Rocks, You Need The Best Marriage Counseling
I am not saying this to be scary or negative. I’m sharing this because I’ve seen what can happen, and I want to help you avoid a bad outcome.
We vet marriage counselors very carefully, and you should too. When our practice building team meets with a marriage counselor who would like to join our practice, but the team is a little on the fence, here is the exact question I ask:
“If your sister, brother, or best friend was at an incredibly fragile make-or-break moment in their marriage and had just one shot to fix this, and if it didn’t work, was going to get divorced (and your little nieces and nephews were going to be living out of suitcases and shuttling between homes, and dealing with their parent’s new partners for the next ten years), would you refer your sibling or best friend to this therapist?”
Nine times out of ten I watch my team have an almost visceral reaction at the idea of referring their loved one to somebody they’re not quite sure about, for help with a serious situation that has severe and lasting consequences.
That is how we make decisions about marriage counselors around here, and I would like to suggest that you use the same level of discernment about the marriage counselor you choose.
Here’s the truth: While smart, successful couples are actually extremely proactive about getting help for their relationship sooner rather than later (which is WHY they are happy and successful), too many couples put off getting expert help for their relationship until things get really bad between them, and their relationship has experienced significant damage.
They stew in a toxic broth of codependency, increasingly intense repetitive and constant arguments, feeling hurt, disrespected and invalidated by their partner, and becoming increasingly hostile or withdrawn over time. They don’t want to touch each other, let alone have sex, and it’s not uncommon for one partner to develop a crush or even an emotional affair with another person. Trust is lost, and people start wondering if it’s time to call it quits.
This can persist for months, sometimes years, before they actually try to get help. In fact, marriage and family therapy researcher Dr. John Gottman has found that the most distressed couples wait an average of six years before getting professional relationship help.
Too many couples erroneously believe couples counseling is only for when things are “really bad,” like after infidelity. This often creates a self-fulfilling prophecy, because they put off getting help for so long they miss the window of opportunity to fix it. They wait until it’s really bad, and sometimes it’s gotten so bad that it may actually be too late for marriage counseling.
The strongest couples have exactly the opposite belief, interestingly. Just like the most emotionally healthy people are the ones in therapy for personal growth, the strongest couples are the first ones in marriage counseling. Sometimes people avoid getting help for too long because they’re worried about the cost of marriage counseling. (Marriage counseling is not expensive. Divorce is expensive.)
Some couples wait so long to get help that by the time they finally do, it feels like a last resort. They are literally on the brink of divorce. (Finally) contacting a marriage counselor is their final attempt to resolve long-standing relationship problems before calling it quits in their relationship. They may be Googling marriage counselors and divorce lawyers and setting up appointments with each, just to cover their bases. It’s bad.
These couples have one chance to fix their relationship, and if they don’t connect with the best marriage counselor, they’re done.
Remember our comparison? The basic therapist with the single class vs. the marriage and family therapist with literally years of intense, relevant training and experience? Are you getting nervous thinking about that poor, vulnerable couple wandering into the basic therapist’s office legitimately seeking help in this make-or-break relationship crisis?? Me too.
Pro Tip 4: Understand the Cost of Choosing an Unqualified Therapist as a Marriage Counselor
So, the basic, well-meaning but unqualified therapist might tell this poor couple to have a date night, and use their “I statements” when communicating. It quickly backfires, disintegrating into an exceptionally tense and unpleasant evening at an overpriced restaurant with one partner predictably saying, “Okay, I’ll use my ‘I statements:’ I HATE YOU!” at some point.
Then they trudge back to the unqualified therapist and say, “Well that didn’t work.” The unqualified therapist that offers marriage counseling may then say, “Wow, gosh, I am not sure how else to help you so… maybe you’re right to separate?”
Some couples have one chance to fix their relationship, and if they don’t connect with the best marriage counselor, they’re done.
Sadly, when couples — especially couples in a vulnerable moment — have a sub-par marriage counseling experience, they don’t always think, “Well that was just a bad marriage counselor.” No. We are socialized to believe the “experts” know more than we do. So, they think, “We went to marriage counseling and it didn’t help, so this means our relationship is doomed.” This is terrible, because again, most practitioners of “couples therapy” are in fact scarily unqualified therapists practicing marriage counseling.
Furthermore, it’s hard to get a re-do. If your spouse refuses marriage counseling, and you’ve had to beg and badger your partner to try couples therapy once, and it was a bad experience, it’s going to be a really tough sell to get them into marriage counseling a second time.
So that is my friendly / big sisterly advice for WHY you need to slow way down and get very serious about finding the right marriage counselor. Not just anyone will do. There’s too much on the line.
How to Find a GOOD Marriage Counselor
Okay, now that I’ve (hopefully) helped you avoid the potential hazards, here are the things that WILL help you find a good marriage counselor — one who can actually help you repair your marriage:
Pro Tip 5: Find a Good Marriage Counselor By… Choosing a Marriage Counselor
This sounds silly, but it’s important: A therapist who is not licensed or credentialed as a “marriage and family therapist” is unlikely to have specialized training and experience in couples therapy.
There are many flavors of mental health professional, and the different types are considered “regulated professions,” meaning they have specific licensing requirements and you cannot legally use the title of “licensed marriage and family therapist,” or “licensed psychologist,” etc., if you haven’t formally acquired that license.
Licensing requirements vary a bit from state to state, but in my home state of Colorado, you could see a Licensed Professional Counselor (LPC), Licensed Psychologist (LP), a Licensed Clinical Social Worker (LCSW), a Psychiatrist (MD), or a Licensed Marriage and Family Therapist (LMFT) or (heaven help you) a “registered psychotherapist” or relationship coach. (The latter two require no formal education or training whatsoever).
None of these professional licenses require specialized education, training, and experience in couples therapy. However, many LPCs, LCSWs, and psychologists practice marriage counseling anyway. More on the different professions and how to find a therapist in Denver, if you’re interested.
Of all these professions, only marriage and family therapists have specialized education, training, and experience in helping couples.
I have more to share on the subject of how to understand various professional credentials and other details about how to find a good marriage counselor. But if you already know you would like to meet with one of our carefully vetted, highly qualified marriage counselors, here’s that link again to schedule a free consultation. Otherwise, we’ll keep going.
