Every relationship has difficult patches. Misunderstandings, conflicts, distance—these are universal experiences, not signs of failure. But sometimes the problems become entrenched. The same arguments repeat without resolution. Connection fades. What once felt effortless now requires constant effort, or worse, has simply stopped happening.

Couples therapy offers a structured space to address what's gone wrong, rebuild connection, and either repair the relationship or separate with clarity. This guide explains everything you need to know about seeking professional support for your partnership.

What Is Couples Therapy?

Couples therapy brings partners together with a trained therapist to work on their relationship. The therapist doesn't take sides or tell you what to do. Instead, they create conditions where you can communicate more effectively, understand each other better, and make conscious choices about your future together.

Various terms describe this work: couples therapy, couples counselling, marriage counselling, relationship therapy. These are essentially interchangeable, though "couples therapy" and "couples counselling" apply to any committed relationship, not just marriages.

When Should Couples Seek Therapy?

Common Reasons Couples Seek Help

Communication breakdown: You talk past each other, avoid difficult topics, or can't discuss differences without fighting.

Repetitive conflict: The same arguments happen repeatedly without resolution. You know each other's scripts by heart.

Emotional distance: The closeness has faded. You live parallel lives rather than a shared one. Intimacy has diminished.

Trust issues: Past hurts, lies, or breaches of trust continue to affect the relationship.

Infidelity: Whether recovering from an affair or addressing its aftermath.

Life transitions: Major changes—children, job loss, illness, retirement—strain the relationship.

Sexual difficulties: Desire discrepancy, physical problems, or loss of connection in the bedroom.

Different values or goals: Fundamental disagreements about children, money, lifestyle, or the future.

Pre-commitment exploration: Some couples seek therapy before marriage or major commitment to ensure they're on solid ground.

Considering separation: Wanting help to decide whether to stay or leave, or to separate well if that's the decision.

The Right Time

There's no perfect moment to seek couples therapy. Common timings include:

Early: Addressing problems before they become entrenched. This is actually ideal—couples who seek help early often respond better than those who wait.

In crisis: When a specific event (affair discovery, major conflict, ultimatum) forces the issue.

At crossroads: When facing decisions about commitment, children, or the relationship's future.

As a last resort: When you've tried everything and this is the final attempt.

The only "wrong" time is never. Many couples report wishing they'd sought help earlier.

What Happens in Couples Therapy?

Initial Sessions

The therapist will want to understand:

What brings you to therapy now
Your relationship history
Current patterns and problems
What you each hope to achieve

Some therapists meet with each partner individually early on to hear perspectives without the other present. Others work only jointly. Both approaches have merits.

The first session is also about assessing fit—do you both feel comfortable enough with this therapist to do the vulnerable work ahead?

Ongoing Work

Sessions typically involve:

Structured conversation: The therapist guides discussion of difficult topics, ensuring both partners are heard and preventing escalation into unproductive conflict.

Pattern identification: Recognising repetitive dynamics. Maybe one partner pursues while the other withdraws. Maybe criticism triggers defensiveness triggers stonewalling. Seeing patterns clearly is the first step to changing them.

Communication skills: Learning to speak and listen more effectively. How to express needs without attacking. How to hear criticism without becoming defensive.

Understanding roots: Exploring how each person's history—family background, past relationships, individual psychology—shapes current patterns.

Rebuilding connection: Exercises and practices to restore intimacy, appreciation, and positive experiences.

Working through specific issues: Addressing infidelity, sexual difficulties, parenting disagreements, or whatever specific challenges exist.

Making decisions: If the relationship's viability is in question, the therapist helps you explore options honestly.

Session Structure

Sessions typically last 50-90 minutes (longer than individual therapy to allow both partners time). Frequency varies—weekly is common initially, with sessions spacing out as progress is made.

Homework between sessions—communication exercises, date nights, specific conversations—often supports the work.

Approaches to Couples Therapy

Several evidence-based models exist:

Emotionally Focused Therapy (EFT)

Developed by Sue Johnson, EFT focuses on emotional bonds and attachment patterns. It helps couples understand how underlying attachment needs drive conflict and teaches new ways of connecting that create secure bonds.

EFT views negative cycles (pursue-withdraw, attack-defend) as symptoms of unmet attachment needs rather than character flaws.

The Gottman Method

Based on John Gottman's extensive research on what makes relationships succeed or fail, this approach focuses on:

Building friendship and fondness
Managing conflict constructively
Creating shared meaning
Avoiding "four horsemen" (criticism, contempt, defensiveness, stonewalling)

Gottman therapy is structured and research-informed, with specific interventions targeting identified weaknesses.

Psychodynamic Couples Therapy

Explores how unconscious patterns and early experiences shape the relationship. May focus on how each partner's family history creates expectations and reactions in the current relationship.

Integrative Approaches

Many couples therapists draw on multiple models, tailoring their approach to what each couple needs.

Individual Modalities Applied to Couples

Some approaches developed for individual therapy (CBT, person-centred, transactional analysis) have been adapted for couples work.

What Makes Couples Therapy Work?

Research identifies factors that improve outcomes:

Both Partners Engaged

Therapy works best when both people are genuinely invested. If one partner is already mentally checked out, or attending only to say they tried, progress is limited.

Willingness to Look at Yourself

It's easy to focus on what your partner does wrong. Real progress requires examining your own contributions to problems—not just blame, but honest self-reflection.

A Good Therapeutic Alliance

Both partners need to feel the therapist is fair and trustworthy. If one person feels ganged up on, therapy stalls.

Adequate Time

Entrenched patterns don't change overnight. Couples who commit to adequate sessions (typically 12-20, sometimes more) fare better than those who give up quickly.

Work Between Sessions

What happens in the therapist's office is only part of the work. Practice in daily life—new communication, scheduled connection time, specific exercises—matters enormously.

Realistic Expectations

Therapy won't create a conflict-free relationship. All couples disagree. The goal is managing conflict constructively and maintaining connection through differences.

When Couples Therapy May Not Help

Certain situations limit therapy's effectiveness:

Active Abuse

Couples therapy isn't appropriate when there's ongoing domestic abuse. Abusive dynamics require individual safety planning first, not joint work that could increase danger.

Secret Affairs

If one partner is actively involved with someone else and hiding it, honest couples work isn't possible. The affair needs to end (or be disclosed) first.

One Partner Completely Checked Out

If someone has firmly decided to leave but is attending to appear willing, therapy cannot create change. However, therapy can still help with separation if that's the outcome.

Severe Untreated Mental Illness

Active addiction, severe depression, or other conditions may need individual treatment before or alongside couples work.

Expecting the Therapist to Fix Your Partner

If you're hoping the therapist will tell your partner how wrong they are, you'll be disappointed. Therapy requires both people to change.

What to Expect Emotionally

Couples therapy is often harder than expected. Be prepared for:

Discomfort

You'll discuss things you've avoided. Hear feedback you'd rather not. See yourself through your partner's eyes. This is uncomfortable but necessary.

Things Getting Worse Before Better

As suppressed issues surface, conflict may initially increase. This isn't failure—it's necessary processing.

Unexpected Revelations

You may learn things about your partner's experience you didn't know. Some revelations are painful.

Vulnerability

Real connection requires vulnerability. Letting down defences is scary but essential.

Grief

Sometimes therapy involves grieving what you'd hoped the relationship would be, or accepting painful truths about each other.

Hope and Connection

Despite the difficulty, many couples experience renewed hope, deeper understanding, and genuine reconnection through therapy.

Finding a Couples Therapist

Qualifications

Look for:

Training specifically in couples therapy (not just individual therapy)
Registration with a professional body (BACP, UKCP, or Relate)
Experience with your particular concerns

Questions to Ask

When contacting potential therapists:

"What training do you have in couples therapy specifically?"
"What approach do you use?"
"Do you meet with individuals as well as the couple?"
"How do you handle one partner wanting to leave and one wanting to stay?"
"What experience do you have with [your specific issue]?"

The Consultation

Most couples therapists offer an initial meeting (sometimes free, sometimes charged). Use this to:

See if you both feel comfortable
Assess whether the therapist seems fair
Ask questions about how they work
Discuss goals and expectations

Finding Agreement

Ideally, both partners agree on the chosen therapist. If you disagree, consider meeting one potential therapist each, then choosing together.

Frequently Asked Questions

How long does couples therapy take?

Varies widely. Some couples address specific issues in 6-12 sessions. Others work for a year or more on deep-seated patterns. A typical course might be 12-20 sessions.

How much does couples therapy cost?

In London, expect £80-£150 per session. Sessions are often longer than individual therapy. Some therapists offer sliding scales. Relate offers lower-cost options.

Does couples therapy work?

Research shows 70% of couples report improvement. Success depends on the factors discussed above—engagement, willingness to change, adequate time.

What if my partner won't come?

You can work on relationship dynamics in individual therapy, though it's less effective than couples work. Sometimes one partner starting prompts the other to join.

Can couples therapy save our relationship?

Sometimes yes, sometimes no. Therapy can facilitate repair, but it can also help couples recognise when separation is the healthier choice.

Should we see individual therapists as well?

This depends on the situation. Some couples benefit from individual alongside couples work. Discuss with your therapist.

What about online couples therapy?

Video couples therapy works well for many. Both partners need to be in the same room with a good connection and privacy.

Is what we say confidential?

Yes, with standard exceptions (safeguarding, legal requirements). The therapist won't share what one partner says with others outside the session—but may encourage disclosure within sessions.

Starting Your Journey

Taking the step toward couples therapy requires courage. It means acknowledging problems, being vulnerable with a stranger, and committing to uncomfortable work. But couples who engage with therapy often report it as transformative—whether they repair their relationship or separate with clarity and respect.

Your relationship matters. Seeking help to improve it isn't admitting defeat—it's investing in something important.

While my primary focus is individual therapy, I work with relationship dynamics as they affect individuals, and I can recommend specialist couples therapists for joint work. If you're unsure what kind of support your relationship needs, I'm happy to discuss options in an initial consultation.

Whatever you're facing together, you don't have to figure it out alone.

Couples Therapy: A Complete Guide to Strengthening Your Relationship