Couples Therapy: Definition, Benefits, & Goals

Couple therapy is psychotherapy with both members of a romantic couple, delivered with the goal of helping them improve their relationship (Johnson, 2019). Most couples come to couple therapy because they recognize that something in their relationship is not working well or is causing one or both partners considerable distress. The therapist works with them to identify the problems, understand each other’s perspectives, and collaborate in resolving the problems.
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Couple therapy does not have the explicit goal of keeping the couple together, although this is typically what the couple themselves want. A couple therapist is not required to try to save a relationship that is especially unhealthy or abusive, and I would argue that a couple therapist should generally not provide an opinion on whether a couple should stay together or not. Rather, the therapist’s goal is to help the couple become aware of the dynamics they are experiencing and their ability and willingness to meet each other’s needs. With this awareness, couples are better able to make decisions regarding their long-term prospects.

There are at least three reasons why couple therapy is important (Snyder et al., 2006). 

1. First, relationship distress – unhappiness, uncertainty, and conflict – is very common among couples, to the extent that for many decades, roughly half of couples that marry in the United States eventually divorce (Kennedy & Ruggles, 2014). 

2. Second, this distress can and does affect the entire family system; when a couple has relationship difficulties, their mental and physical well-being suffers, as does the mental and physical well-being of any children they may be raising, or any other people living in the home with them.
 
3. Third, couple therapy can positively affect more than just relationship problems. Research tells us that resolving issues in the couple relationship can help improve other mental health difficulties, and that couple therapy can be used as a primary intervention for one partner’s psychiatric disorder (Snyder et al., 2006). For example, when one partner’s depression is negatively impacting the romantic relationship, couple therapy can be used to treat the depression. The romantic partner without depression gets to learn about depression with their partner, be involved in enacting a treatment plan, and benefit from the support of the therapist as they deal with their own needs around having a partner with depression.
 
4. Finally, couple therapy is important because people are generally not very proactive about asking for help (Williamson et al., 2018). In fact, some research suggests that couples wait up to several years on average, after behavioral patterns have become very entrenched and distressing, before seeking help from a therapist.
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Benefits of Couple’s Therapy

Coupletherapy has numerous benefits (Roddy et al., 2020). First, couples report substantially greater relationship satisfaction after participating in therapy, compared to couples who do not get treatment. Relatedly, couples also experience improvement in their communication skills, sense of closeness, and levels of conflict. Research tells us that these gains generally last in the long-term.
 
Better yet, couple therapy seems to be more helpful for couples that are really struggling (Roddy et al., 2020). Like I noted above, many couples enter therapy only after years of existing in significant conflict or disconnection; for many of them, therapy means the first time they have put a concerted effort into changing those patterns of interaction, and this time with the help of somebody who is part coach, part cheerleader, and part referee.
 
It is clear that not only couples, but anybody living with them, stands to benefit from their participation in couple therapy (Snyder et al., 2006). The resolution of conflict between parents reduces a significant stressor in the lives of their children. The parents’ own well-being outside of the relationship will likely benefit, too.

As a therapist and a researcher, I can tell you that people in our fields are obsessed with figuring out why things work. Psychotherapy is no exception: we really want to know what changes during therapy that results in better quality of life. In the realm of couple therapy, it seems that changes in communication skills, the frequency of positive and negative relationship behaviors, and emotional acceptance and regulation, are the main drivers of positive outcomes in therapy (Doss et al., 2005).

That said, different kinds of couple therapy may focus on different mechanisms of change. In emotionally-focused therapy (EFT), for example, the focus is on corrective emotional experiences (Johnson, 2019): partners learn to validate and respond effectively to each other’s emotional needs, making interactions that were once painful and disconnecting into moments that strengthen the relationship. In more cognitive-behavioral forms of couple therapy, the emphasis might be more on promoting positive behaviors or challenging partners’ negative interpretations of each other (Benson et al., 2012).

Couple’s Therapy Goals

Some of the most common goals couples have for therapy are to communicate better, re-establish intimacy, fight less, and overcome challenges to their relationship, such as an infidelity or the loss of a child (Snyder et al., 2006). Another goal that couples often have is to better understand how compatible they are. This goal suggests that they may already have their suspicions about their compatibility, and it is perhaps for this reason that couples who enter therapy with this goal seem more likely to separate during or after therapy (Owen et al., 2012).

The primary techniques of couple therapy tend to result in the changes I discussed above. These include (Benson et al., 2012):

(1) Reframing conflicts and key interactions. For example, a couple might work to see how both partners contribute to a problematic dynamic. The fight is not just “one person’s fault” – it is a learned pattern that reflects each of their needs and emotions.

(2) Reducing unhelpful behaviors and increasing helpful ones. A common pattern is for one partner to aggressively pursue engagement, while the other becomes defensive or withdraws (Johnson, 2019). Neither behavior is helpful for safe connection. In place of these patterns, partners learn to state what they need in the moment. One partner might learn to say, “When I say this, I am afraid that you will shut down and hide everything away,” while the other could practice replying, “Your anger does make me want to run and hide. I need reassurance that you still love me even though you’re angry.”

(3) Increasing disclosure of needs and emotions. Couples learn to practice effective self-disclosure. If one partner is frustrated by the other’s lack of sexual interest, for example, both partners need to express their experience fully to the other. Behind the anger and defensiveness might be fears of being unloved, being rejected, or no longer being desired.
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(4) Increasing positive time together. Often, couples are so besieged by the demands of life that they have few chances to spend intentional time together. Couple therapists are frequently advocates for date nights, daily check-ins, and gratitude practices.

One of the most common activities is to practice talking about a difficult topic. This could look like revisiting a recent dispute or starting fresh on something the couple frequently argues about. The couple therapist will help the couple remain emotionally regulated, communicate about and hear each other’s experiences, and identify solutions.
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Couple therapists also provide psychoeducation to their clients. One of my favorite examples is to share the Hidden Issues model from the PREP tools for couples, which helps couples understand how arguments work (Stanley et al., 1999). According to this model, arguments usually arise because of an Event: suppose, for example, that you forgot to call your mother-in-law on her birthday, and your spouse is upset with you. This event serves as reminder of a larger Issue in the relationship. Perhaps you do not like your mother-in-law and your spouse is frustrated by your lack of effort to connect with her. Beneath this is a Hidden Issue, a powerful, emotional response that needs to be dealt with. In this case, it could be that your spouse feels unloved, disrespected, or rejected by your general attitude toward their mother.

Couple’s Therapy Vs. Marriage Counseling

Sometimes the terms couple therapy and marriage counseling are used interchangeably. However, there is a form of relationship education, sometimes called premarital counseling, that is different from couple therapy – it tries to help couples proactively avoid the onset of relationship challenges (Halford & Casey, 2010). It seems that close to half of couples that get married attend some kind of premarital education (Doss et al., 2009).

Couple’s Therapy with a Narcissist

Couple therapy can be done with a couple in which one person has a diagnosis of narcissistic personality disorder, but narcissistic personality traits do make the situation more challenging (Janusz et al., 2021). People with narcissism often have trust issues and diifuclty admitting fault, so the focus on both partners acknowledging their contributions to relationship challenges can cause these partners to resist or leave therapy. However, with careful attention to helping the partner come to trust the therapist, it is possible for couple therapy to help a couple in this situation.

Couple’s Therapy After Infidelity

Couples where one or both partners have been unfaithful experience a lot of conflict and disconnection (Atkins et al., 2005). This is because many key assumptions about relationships are shown to be false when a partner is unfaithful: the relationship no longer seems like a safe place to be. Nevertheless, couple therapy can help these couples, chiefly by helping the betrayed partner(s) move through their negative emotions and by re-establishing a shared, realistic vision for the relationship (Gordon et al., 2008).

• Atkins, D. C., Yi, J., Baucom, D. H., & Christensen, A. (2005). Infidelity in couples seeking marital therapy. Journal of Family Psychology, 19(3), 470–473.
• Benson, L. A., McGinn, M. M., & Christensen, A. (2012). Common principles of couple therapy. Behavior Therapy, 43(1), 25-35.
• Doss, B. D., Rhoades, G. K., Stanley, S. M., Markman, H. J., & Johnson, C. A. (2009). Differential use of premarital education in first and second marriages. Journal of Family Psychology, 23, 268–273.
• Doss, B. D., Thum, Y. M., Sevier, M., Atkins, D. C., & Christensen, A. (2005). Improving relationships: mechanisms of change in couple therapy. Journal of Consulting and Clinical Psychology, 73(4), 624-633.
• Gordon, K. C., Baucom, D. H., & Snyder, D. K. (2008). Optimal strategies in couple therapy: Treating couples dealing with the trauma of infidelity. Journal of Contemporary Psychotherapy, 38, 151-160.
• Halford, W. K., & Casey, L. (2010). Taking it to the people: Using technology to enhance the impact of couple relationship education. In K. Hahlweg, M. Grawe, & D. Baucom (Eds.), Enhancing couples: The shape of couple therapy to come (pp. 111–127). Gottingen, Germany: Hogrefe.
• Hecker, L. (2007). Trauma and couple therapy. Journal of Couple & Relationship Therapy, 6(1-2), 83-93.
• Janusz, B., Bergmann, J. R., Matusiak, F., & Peräkylä, A. (2021). Practices of claiming control and independence in couple therapy with narcissism. Frontiers in Psychology, 11, 596842.
• Johnson, S. (2019). Attachment in action—changing the face of 21st century couple therapy. Current Opinion in Psychology, 25, 101-104.
• Kennedy, S., & Ruggles, S. (2014). Breaking up is hard to count: The rise of divorce in the United States, 1980–2010. Demography, 51(2), 587–598.
• Kuo, F. C. (2009). Secrets or no secrets: Confidentiality in couple therapy. The American Journal of Family Therapy, 37(5), 351-354.
• Mayer, J., Savard, C., Brassard, A., Lussier, Y., & Sabourin, S. (2020). Subclinical psychopathic traits and romantic attachment in treatment‐seeking couples. Journal of Marital and Family Therapy, 46(1), 165-178.
• Owen, J., Duncan, B., Anker, M., & Sparks, J. (2012). Initial relationship goal and couple therapy outcomes at post and six-month follow-up. Journal of Family Psychology, 26(2), 179-186.
• Roddy, M. K., Walsh, L. M., Rothman, K., Hatch, S. G., & Doss, B. D. (2020). Meta-analysis of couple therapy: Effects across outcomes, designs, timeframes, and other moderators. Journal of Consulting and Clinical Psychology, 88(7), 583–596.
• Snyder, D. K., Castellani, A. M., & Whisman, M. A. (2006). Current status and future directions in couple therapy. Annual Review of Psychology, 57, 317-344.
• Stanley, S. M., Blumberg, S. L., & Markman, H. J. (1999). Helping couples fight for their marriages: The PREP approach. In R. Berger & M. T. Hannah (Eds.), Preventive approaches in couples therapy (pp. 279–303). Brunner/Mazel.
• Stith, S. M., Rosen, H., McCollum, E. E., & Thomsen, C. J. (2004). Treating intimate partner violence within intact couple relationships: Outcomes of multi‐couple versus individual couple therapy. Journal of Marital and Family Therapy, 30(3), 305-318.
• Williamson, H. C., Hammett, J. F., Ross, J. M., Karney, B. R., & Bradbury, T. N. (2018). Premarital education and later relationship help-seeking.  Journal of Family Psychology, 32 (2), 276.