What to Expect From Couples Therapy [Video]

What to Expect From Couples Therapy [Transcript]

A recent study found that, once a couple begins facing serious problems, they often wait roughly 2.5 years on average before seeking counseling help.  One of the main causes of this hesitancy can be the fear of the unknown.  This post is going to try to help make the idea of couples therapy a lot less mysterious by sharing what to expect from couples therapy.

What Is Couples Therapy?                                

Couples therapy is a subcategory of psychotherapy. It can help couples better relate to one another, improve understanding of their relationship, and navigate various other challenges. Often couples seek therapy when they are in crises mode, facing substantial difficulties, or considering divorce.  Couples therapy can also help a couple simply strengthen their relationship and communicate better.  Alternatively, some couples come to therapy for help ending their relationship and working through the separation.

Who Attends Couples Therapy?                                  

This may seem like an obvious question. The first part of the answer is: romantic couples attend couples therapy.  Whether dating, married, or separated, romantic couples make up the bulk of couples therapy.  However, other types of couples can also benefit from the process.  Sometimes friends may be facing an issue that they struggle to overcome. Rather than choosing to end the friendship or ignore the situation, they may choose to attend couples therapy.  Also, sometimes two members of a family may attend therapy to work on their relationship. This technically makes it couples therapy.  Many couples therapists are also open to working with alternative romantic partnerships, including polyamorous relationships.  

Additionally, if one partner wants to attend couples therapy, but the other doesn’t, it can be okay to go alone and still get insight into ways to improve the relationship. Maybe the other partner might be willing to join in eventually.  And,  even if both partners are willing to attend, some sessions may be individual sessions.  While most sessions are usually joint sessions with both partners in attendance, individual sessions may be helpful at different times. Only one partner attends a session, and then the other partner attends the next session.  This is often the case in the first few sessions of the intake process at the start of therapy. Both partners attend the first session, then the next two sessions being individual ones with each partner, and then both coming back together for the fourth session.  

What Should You Look For In a Therapist?                        

Finding a therapist who is a good fit is an important part of successful therapy.  Couples counseling is no different, so you should dedicate time to researching and comparing your options.  Some therapists post introductory videos or offer free consultations so you can get a sense of who they are.  As you search, and into your first few sessions, you want to determine whether you feel understood and connected. You’ll also want to start to build a therapeutic alliance.  It is important to feel that the therapist isn’t taking sides or keeping secrets between partners.  You may need to try a few therapists before feeling you have a good fit. This means you shouldn’t give up in the first one doesn’t seem right.  However, before switching, it can be helpful to raise your concerns with your therapist and possibly reassess your goals or shift the approach you all are taking.

How Long and How Frequent Are Sessions?                      

Different therapists may have different session lengths, with sessions ranging from 45 to 90 minutes. The majority are around an hour.  Many therapists believe that weekly sessions are the most successful approach allowing for consistent work and accumulated progress, but some therapists will meet less frequently. Most will also offer multiple sessions in a week if a couple feels that would be most helpful. 

The overall length of treatment can vary based on the type and number of issues and goals the couple wants to work on and how committed to the process and willing to work the couple is.  Some couples may only need a few sessions to work through an issue. Others may remain in therapy for years working through particularly challenging issues or appreciate the continued support and maintenance therapy provides.  

How Much Do Sessions Cost?

The cost of sessions can vary widely based on the location, education, and experience level of the therapist. Session rates range, on average, between $75 and $400 per session.  Insurance coverage can vary, so you should reach out to your insurance provider and to different therapists for more information.  Coverage may be more likely if one or both partners has a mental-disorder diagnosis.  This could include depression, anxiety, or chronic stress.

What Do You Do In Couples Therapy?

First, you will likely be supplied with a variety of forms to review, complete, and sign.  Some of these will outline the policies of the therapist or practice. Others may connect to insurance and payment, and others may provide an opportunity to give your therapist a little background before the first session.  It is important to set aside enough time to complete these forms before your first session.

The first few sessions will then be dedicated to the couple and the therapist getting to know each other and establishing rapport.  The therapist will ask a wide variety of questions in an effort to learn about the couple and to have the information necessary to best understand and help them.  The questions can include information about the various stages of the couple’s relationship together, other early relationships, family background, vocational and educational background, and more.  Some of the questions may not seem relevant, and some couples may feel frustrated and eager to begin what they view as the actual work. However, it is important to remember that this history collection is an essential part of the work and is crucial to the success of the therapeutic process. 

Along with the questions, therapists may include a variety of assessments to gain additional insight into the personalities and behaviors.  As mentioned earlier, this is one phase of therapy when each member of the couple will likely meet with the therapist individually so they have the opportunity and space to discuss the couple’s issues without filtering what they think. This solo time is not designed to have the partners share secrets with the therapist, but it does help the continued building of the relationship with the therapist.

During this early period in the counseling, therapists will often share the strengths they have noticed in the couple.  The couple and therapist will also explore the issues bringing the couple to therapy and then work together to establish goals and timelines for the couple’s work.  The goals and timelines look different for every couple, and often, through the course of therapy, the goals established at the beginning will evolve or expand.

After the initial sessions, the couple and therapist will likely move toward one of the most important parts of couples therapy: learning and developing new skills to strengthen and improve the relationship.  These skills can fall into a variety of categories including better communication, closeness and connection, patience and forgiveness, trust and honesty, selflessness, stress-management, and conflict repair.

At the end of some sessions, therapists may give the couple homework to complete between sessions so they can practice and strengthen their new skills.  Dedication to these activities can greatly influence a couple’s success in the therapy process.  Some common types of homework can include engaging in specific activities as a couple, reading relationship-focused materials, reflecting on specific topics individually or as a couple, practicing specific skills or techniques outlined in a session, and more.

Read more about starting couples therapy here.

What Might You Feel During Couples Therapy?

A wide variety of challenging feelings may come up during couples therapy.  You may find yourself feeling angry, confused, embarrassed, guilty, uneasy, sad, suspicious, and many other uncomfortable emotions.  Of course, you may also find yourself feeling happy, hopeful, and relieved.  The important thing to keep in mind is that these emotions are all perfectly natural and acceptable to feel and explore.  You may leave some sessions feeling worse than when you walked in. But that can all be part of the work.  Try to keep in mind that it is work and it can be challenging, but if you stay focused on your goals, it will likely all be worthwhile.

What Do You Need for Couples Therapy to Be Successful?

First, as discussed above, success in couples therapy can look different for each couple.  Some couples want to improve their relationships and learn new skills. Others want to solve a specific problem, and others may want help ending a relationship.  However, no matter your goal, some qualities will greatly improve your likelihood of finding success.  A willingness to work is an important ingredient to success. In couples therapy you will need to be open to exploring issues, adopting new perspectives, taking the work home, committing to the work, and possibly changing.  

Similarly, you will need to bring an openness, honesty, and vulnerability to your sessions.  Feeling comfortable sharing with your therapist will likely take time. But try to be open to sharing your thoughts and feelings.  Your therapist is not there to pass judgment.  As mentioned before, keep in mind that the situation you are in may seem to get worse before it gets better.  Opening up about difficult issues may challenge a couple in ways they have never experienced.  The perception that things are not improving and may be getting worse is a normal part of the process and no reason to lose hope.  

Finally, the success of therapy can be greatly assisted if the couple is able to call on their existing support systems.  If you are comfortable, lean on friends and family during your challenging time.  Also, consider starting individual therapy if you are not already in it; having a space that is dedicated to only you in which you can process your thoughts about feelings can be incredibly helpful.

Overall, couples therapy can an incredibly helpful tool for couples to use to strengthen their relationships, grow as partners, and overcome a variety of issues.  It can be challenging, but immensely rewarding, and it is common for it to bring a degree of trepidation.  I hope this post was able to answer some of your questions and to make the process a little easier by helping you know what to expect from couples therapy. 

Read more about common fears related to starting therapy here.