# Couples therapy and counselling

> Couples therapy tends to help the average couple, though some gain little, so it's worth asking how progress will be checked. Getting help early, when the same argument keeps coming back, is the usual advice. It isn't the right route where there's abuse or fear, and a good fit with the therapist matters.

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- **On average, couples therapy helps:** many couples improve, though some gain little and a few get worse.
- **Rough patches are normal,** but arguments that never get resolved are a good reason to look for outside help.
- **Earlier is usually easier** than waiting until things feel too far gone.
- **Where there is abuse or fear, couples counselling isn't the place to start:** confidential support for the person at risk comes first.
- **Fit matters:** you should both feel heard, not judged, and able to speak your mind.

## Does couples therapy work?

On average, yes. Couple therapy tends to bring a large improvement in relationship satisfaction, couples left on a waiting list don't improve much, and the gains generally hold up over short- and long-term follow-up [1]. A pooled analysis of behavioural and emotionally focused couples therapy found a medium improvement, with no clear difference between the two [2]. That analysis comes with a warning: publication bias may make the results look rosier than they are [2].

Real life is a bit less tidy than the lab. Reviews put it at 60–80% of distressed couples benefiting from behavioural and emotion-focused approaches. Effects are weaker in everyday clinical practice, though, and they fade after treatment for about half of couples [3]. A sizeable share of couples gain little from therapy, or get worse afterwards [4].

So treat those percentages as rough averages, not a forecast for the two of you. Two things help:

- **Ask how progress will be checked,** and agree when you'll review it together.
- **If it isn't helping after a reasonable time,** say so to the therapist and consider other approaches.

## When is it time to get help with your relationship?

When the same problems keep coming back and you can't sort them out between you. Rough patches are a normal part of sharing a life, so a bad month isn't a verdict [5]. But some patterns are worth noticing: recurring arguments that never get resolved, feeling dissatisfied and unhappy, or rows about parenting, family or money that go round in circles [5]. Concerns you can't resolve, communication breaking down and feeling unsupported are also signs a relationship needs attention [6].

The usual advice is to act early. If you can't seem to improve communication on your own, consider talking with a relationship counsellor, because it's better to act early than to wait for things to get worse [7]. You don't have to wait until things are "bad enough".

Many couples hold off anyway. Cost is a common hurdle, and plenty of people feel their relationship is either not bad enough to deserve help or too far gone to benefit from it [8]. If cost or not knowing where to start is the snag, a doctor or a local relationship service can point you to options.

You can also begin small: pick a calm moment and say, "I've noticed we keep having the same argument. Could we try something different?"

> **Try this together:** Set aside 10 minutes. Each of you writes down the one pattern you'd most like to change, and one question you'd want to ask a therapist, such as "How will we know it's working?" Swap notes and agree whether getting some outside help is worth a try.

## When is couples therapy not the right choice?

Where there is abuse or fear. Couples counselling isn't recommended where one partner is abusive or controlling, or where either partner is afraid. Confidential support for the person at risk is the safer first step.

Constant jealousy, controlling who you see or how money is spent, put-downs and ridicule, and cruel or shouting words are signs of an unhealthy or abusive relationship [5]. They are not communication problems for the two of you to fix together. Couple therapists treat safety as the first question when violence comes up, and see little point in joint sessions where fear stops partners speaking freely [9].

If you're unsure whether fear or control is part of your relationship, talk it through with a trusted professional on your own before any joint sessions. A partner may be able to see a shared phone, app or browser history, so look for help on a device you trust.

Joint sessions can also be a poor fit when one partner has already decided to leave. That's rarely clear-cut, though, and mixed feelings are common [9]. If you're unsure about staying together, say so openly.

## How do you find a good couples therapist?

Start with credentials. Many kinds of professionals offer therapy, including psychiatrists, psychologists, social workers, counsellors and psychiatric nurses [10]. Check that yours belongs to a recognised professional body or an accredited register where you live [11][12].

Then ask a few questions, ideally before you book:

- **What approach do you use, and what's the evidence behind it?** Integrative behavioural couples therapy and emotion-focused therapy are two approaches with especially promising results [13].
- **How will we know it's working,** and what happens if we aren't improving? [10]
- **How does confidentiality work,** and what are its limits? [10]

Then there's chemistry. Rapport and trust are essential, because therapy gets personal [10]. After a few sessions you should know whether you're comfortable: not judged or criticised, and able to speak your mind. If not, say so to the counsellor, or change to someone else [11]. Finding the right fit can take a try or two, and that's fine.

If one of you came along reluctantly, say so early so the therapist can address it. It's much easier to work with than a quiet "I'd rather be anywhere else."

## When to get more help

Which of these fits depends on where you are.

If you're afraid of your partner, or they hurt, threaten, watch or control you, you don't have to deal with it alone: contact a local family or domestic violence service for confidential support, or call your local emergency number if you're in danger now.

If things feel stuck, or the same hurt keeps coming back, a qualified couples counsellor can help, and a relationship counselling service near you can help you find one.


## Common questions

### What if only one of us wants to go?

It's common for one partner to be keener than the other. If you're the reluctant one, say so early, so the therapist can address it. If you're the keen one, explain what you hope will change rather than what's wrong with your partner. A first session can simply be a chance to see what it's like.

### How much does couples counselling cost?

Prices vary by place and provider, so ask before you book. Cost is one of the most common reasons couples put help off. If it's the obstacle for you, a doctor or a local relationship service can point you to options, and asking about costs upfront is perfectly reasonable.


## Sources

1. Meta-analysis of couple therapy: Effects across outcomes, designs, timeframes, and other moderators. Roddy and others · Journal of Consulting and Clinical Psychology · 2020 https://doi.org/10.1037/ccp0000514
2. The Efficacy of Emotionally Focused Couples Therapy and Behavioral Couples Therapy: A Meta-Analysis. Rathgeber and others · Journal of Marital and Family Therapy · 2019 https://doi.org/10.1111/jmft.12336
3. Interventions for Couples. Bradbury and Bodenmann · Annual Review of Clinical Psychology · 2020 https://doi.org/10.1146/annurev-clinpsy-071519-020546
4. Current status and future directions in couple therapy. Snyder, Castellani and Whisman · Annual Review of Psychology · 2006 https://doi.org/10.1146/annurev.psych.56.091103.070154
5. Relationship support services. Better Health Channel https://www.betterhealth.vic.gov.au/health/HealthyLiving/relationship-support-services
6. Building and maintaining healthy relationships. Healthdirect Australia · 2026 https://www.healthdirect.gov.au/building-and-maintaining-healthy-relationships
7. Relationships and communication. Better Health Channel · 2001 https://www.betterhealth.vic.gov.au/health/healthyliving/relationships-and-communication
8. The marriage checkup: increasing access to marital health care. Morrill and others · Family Process · 2011 https://doi.org/10.1111/j.1545-5300.2011.01372.x
9. Is It Safe Enough? An IPA Study of How Couple Therapists Make Sense of Their Decision to Either Stop or Continue with Couple Therapy When Violence Becomes the Issue. Snellingen, Carlin and Vetere · Behavioral Sciences (Basel, Switzerland) · 2024 https://doi.org/10.3390/bs14010037
10. Psychotherapies. National Institutes of Health https://www.nimh.nih.gov/health/topics/psychotherapies
11. Counsellors and counselling - what is it and how it can help. Healthdirect Australia https://www.healthdirect.gov.au/healthcare-and-services/roles-and-specialties/counsellors-and-counselling
12. Counselling. NHS https://www.nhs.uk/tests-and-treatments/counselling/
13. Research on the treatment of couple distress. Lebow and others · Journal of Marital and Family Therapy · 2012 https://doi.org/10.1111/j.1752-0606.2011.00249.x

Source: https://coupletools.com/learn/couples-therapy-and-counselling