Does Marriage Counseling Work?

Marriage counseling is a type of joint counseling in which a couple seeks help, typically due to relationship issues. It differs from other types of therapy because there are two married individuals involved in each session.

Marriage counseling is considered by many therapists as the most difficult therapy to undertake, according to Block, especially with couples who are angry, hurt and treat the therapy as a medium to prove their partner wrong. “They view the process as a court and the therapist a judge who will hopefully straighten out their partner,” he says, stressing that is not the purpose of marriage therapy.

At its core, marriage counseling is meant to help couples understand and resolve conflicts to improve their relationship. It’s intended to give couples the tools to communicate with more compassion and less fear while learning how to problem-solve and deal with conflict in a healthy manner.

You don’t need to be struggling in your relationship to seek marriage counseling. In fact, you may have a better result if you don’t wait until your marriage is unraveling. “Marriage counseling can benefit couples who just want to strengthen their relationship and feel more connected and bonded with one another,” says Jaime Bronstein, licensed relationship therapist and coach and host of Love Talk Live on LA Talk Radio.

Therapists draw from a variety of different theoretical orientations and methodologies when treating couples. Some of the most frequently used techniques include:

• Cognitive behavioral therapy
• The Gottman Method
• Emotionally focused therapy (EFT)
• Positive psychology therapy
• Solution focused therapy (SFT)

“Just as is the case with individual therapy, marriage therapists take differing approaches to treating couples,” says Block. Cognitive behavioral-oriented therapists, he adds, focus on troubling thoughts and attitudes and how to manage them—for example, the “shoulds” that create conflict, such as, “he should be a better earner,” or “she should be more sexual,” negative thoughts about themselves and/or their partner, or attempts to mind read their partner’s wants and needs instead of using direct and assertive communication. The goal is to manage thoughts in a more effective way so they don’t lead to feelings that are difficult to cope with or actions that are not productive for the relationship.

The Gottman Method—developed by Dr. John Gottman and Dr. Julie Schwartz Gottman—on the other hand, focuses on applying findings from the couple’s research. This research includes specific identified behaviors—criticism, contempt, defensiveness and stonewalling/withdrawal—that lead to discord and often, separation.

Other techniques, such as emotionally focused therapy (EFT) focus heavily on emotion and emotional regulation as a means of developing bonds and trust in a relationship. This therapy works to expand a couple’s understanding of their emotions, enabling them to control their emotional responses and foster deeper connection. Positive psychology therapy focuses on enhancing traits and behaviors such as optimism, happiness, creativity, perseverance and hope in a person’s everyday life, while solution focused therapy (SFT) is goal and solution oriented, as the name might suggest.

“What’s important is not so much which ‘theoretical orientation’ is used, however, but whether the methodology and therapist are right for the couple,” says Beatty Cohan, psychotherapist and author of For Better, For Worse, Forever. “It may take several sessions for a couple to assess whether the counseling is helpful and, if you find that you are not seeing improvement or don’t have a good connection with your therapist, remember there are many other therapists who can help you.”

Marriage counseling is for any couple who has tried to resolve their issues on their own without success. Unsure if you and your partner fall into that category? Indicators include the following signs:

• You have poor communication and are unable to agree on anything
• You’re constantly fighting or bickering
• You’re incapable of problem-solving together or experience unequal decision making
• You have trust issues
• You feel a lack of connection, emotionally and physically
• You are experiencing sexual issues, or not having sex at all
• You have lifestyle or life-goal disagreements (i.e. money, kids, where to live, etc.)
• You are reeling from one partner (or both) engaging in infidelity
• You are experiencing more difficult days together than peaceful and joyful days

“The reality is most couples wait until they are emotionally exhausted from the turmoil within their marriage before seeking marriage counseling,” says Bronstein. The good news is, most couples don’t wait so long that the counseling is rendered ineffective.

In fact, the majority of couples enter counseling within two years of the onset of their problems, which gives them a reasonable opportunity to resolve their issues, according to a recent study in the Journal of Marital and Family Therapy^[2]Doherty W, Harris S, Hall E, Hubbard A. How long do people wait before seeking couples therapy? A research note. Journal of Marital and Family Therapy. 2021;47(4):882-890. .

“If you are just surviving and not thriving in your relationship, it’s time to go to marriage counseling,” says Bronstein. “Ideally, a healthy marriage is made up of two people who grow individually and together as a couple.”

What If My Partner Isn’t Open to Marriage Counseling?

While 79% of males think their partner would be open to couples therapy, only 66% of women think their partner would go. However, studies have shown that 52% of people who have never tried marriage counseling say they would consider attending^[3]The State of Marriage Counseling [Study]. MidAmerica Nazarene University. Accessed 1/30/22. .

If you’re nervous about how to approach the topic with your spouse, Cohan recommends setting up the conversation in a way that isn’t putting anyone on the defensive. Instead, share your desire to learn about tools that could benefit the health of your marriage. To get started, she suggests trying something like: “I know how much we still care about each other, and I think we could benefit from some outside input. After all, professional athletes and businesspeople have teams and resources to help them maximize their potential. We don’t need to navigate life’s problems and stressors on our own.”

If you’re trying marriage counseling for the first time, it can be helpful to know what to expect. It’s not unusual for a therapist to do an initial couples evaluation, or to meet with each partner separately to rule out things like ongoing affairs or individual psychological issues. A therapist might also suggest separate meetings to help each partner with their specific concerns, with the goal of resolving those concerns in the couple’s relationship.

“If one or both partners have extramarital affairs that haven’t ended, or serious psychological or psychiatric problems, it’s virtually impossible to do effective marital therapy,” says Cohan. In that case, individual therapy may be recommended before any couples sessions are booked.

If your therapist deems couples counseling to be beneficial, sessions will likely occur on a weekly or biweekly schedule for about an hour at a time, though length can vary per couple. The duration of your marriage counseling will depend on the issues you’re facing. Some couples may have positive results in as few as four sessions, while others may need many more.

What Happens in a Marriage Counseling Session?

During a marriage counseling session, couples work with their therapist to identify and address the problems that need to be acknowledged and resolved.

Skills couples might practice and takeaways they might learn during a session include the following, according to Bronstein:

• Learning more effective ways to communicate with each other
• Learning how to be vulnerable and truthful with each other
• Learning how to control their anger and responses when they feel emotionally charged
• Discovering why they choose to be married and their shared purpose in the marriage
• Reviving romance
• Remembering how to be grateful for one another versus judging and wanting the other person to change

“Whenever you have two willing people in a safe place with a mental health professional, there is bound to be change and growth within the relationship,” says Bronstein. “Marriage counseling is most successful when the couple takes it seriously, and they are cognizant of what they learn and discover in their sessions and take it with them in between sessions.”

What Happens Outside of Marriage Counseling Sessions?

Marriage counseling isn’t limited to the walls of a therapist’s office, however. Additional effort is required from each partner to implement the skills discussed during counseling.

“Couples need to be invested in the process and be mindful of their communication and behavior,” says Cohan. “I routinely give my patients ‘homework’ so they can set time aside to talk about issues and ‘practice’ what they have learned during our sessions.”

Bronstein agrees, and frequently gives couples she’s working with various exercises to do outside of scheduled sessions to keep the momentum going. These include:

• Practicing tools for better communication and reduced misunderstandings and hard to resolve conflicts
• Intentionally setting aside more time for intimacy
• Practicing active listening and validation instead of judging
• Being vulnerable and sharing feelings
• Making time for dates
• Having a weekly check-in to share feelings and express any needs that aren’t being met

“Marriage counseling works when the couple puts their learnings into action between sessions,” says Bronstein.

Costs for marriage counseling depend on the therapist and how long they’ve been practicing.

“Therapists who don’t take insurance on average charge anywhere from $100 to $500 per session,” says Bronstein, adding these rates most commonly end up between $175 to $250 pers session.

When therapists don’t take insurance, they often offer clients a “superbill” to submit to their insurance company for reimbursement of a certain amount for seeing a therapist who is out of network. For therapists that do accept insurance—and many do—the copay is usually $25 to $30 per session.

Cohan adds that as an out-of-network provider, she is also open to negotiating her fee. “I encourage people to ask their therapists if they’re willing to be flexible about fees, since counseling can become very expensive,” says Cohan.

That being said, marriage counseling should be viewed as an investment. “I believe therapy and healing is the best gift you can give yourself, as it truly is life-changing and can enhance your life in ways you can’t even imagine until you experience it,” Bronstein adds.

Indeed, marriage counseling can be effective when both people are willing to learn, grow and heal individually and as a couple, but results are largely predicated on a couple’s dedication to counseling.

“There are two people who are dancing a dance—both functional and dysfunctional—and two people need to be willing to acknowledge their roles and be committed to making some changes in the dynamic of their relationship,” says Cohan. “So, even though they can’t change their history, today is a new day and today they can decide whether they want to resolve their problems and move forward.”

Bronstein also notes the need for willingness in counseling, rather than want. “Willingness’ authentically breeds change, as it’s two people who have the conviction to make it work, and when two people believe in making it work, it can most definitely work,” she says. “Love is why we live, so if there are problems in your relationship, marriage counseling can help you do the best you can to resolve them.”