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Couples therapy: what it is, whether it works, and how to find a therapist

A plain guide to couples therapy: who does it, the main approaches, what research says about results, what it costs, and how to find a good therapist.

Written by the Venna team Updated · 5 min read

A quick note before we start: we make Venna, an app where couples talk with other couples. Venna isn’t couples therapy, and it doesn’t replace it. This guide explains what couples therapy is, how to find a good therapist, and where something like Venna fits.

What couples therapy is

In couples therapy, you and your partner meet with a licensed therapist, usually together, usually once a week. The therapist helps you see what keeps setting off the same fights, or why you’ve drifted apart, and helps you try new ways of talking things through. Couples go for all kinds of reasons: the same argument on repeat, an affair, a new baby, sex, money, or a feeling that you’ve become roommates.

You don’t have to be on the verge of breaking up to go.

Who provides couples therapy

Several kinds of licensed professionals do couples work:

  • Marriage and family therapists (MFTs). They specialize in relationships. They usually have a master’s degree, and every state requires them to be licensed.
  • Psychologists. Clinical and counseling psychologists are licensed in every state and usually have a doctorate.
  • Clinical social workers (LCSWs). They have a master’s degree and a license, and many offer couples therapy.
  • Licensed counselors. Mental health counselors in private practice need a master’s degree and a state license. You’ll often see LPC or LMHC after their names.

A license tells you a therapist is qualified. It doesn’t tell you how much they work with couples. Many therapists who do mostly individual work see the occasional couple. You want someone who sees couples all the time.

The main approaches

Most couples therapists draw on one or more of these:

  • The Gottman Method. Built on research by John and Julie Gottman. It starts with a full check-up of your relationship, then uses exercises drawn from that research.
  • Emotionally Focused Therapy (EFT). Based on attachment theory. It looks at the emotions and needs underneath the fights.
  • Integrative Behavioral Couple Therapy (IBCT). It combines changing specific behaviors with learning to accept differences that won’t go away.

You don’t need to pick an approach before you start. It’s fine to ask a therapist which one they use and why.

Does couples therapy work?

For many couples, yes. A 2012 review of the research found that couples therapy helps about 70% of the couples who get it. That’s on par with individual therapy, and far better than no treatment.

Results aren’t guaranteed, and they don’t always last. In one trial, 134 married couples in serious distress had about eight months of therapy. Five years later, about half were clearly happier in their marriage than before therapy, and about a quarter had separated or divorced.

How much couples therapy costs

With a therapist in private practice, couples therapy usually costs $150 to $400 for a one-hour session, according to Psychology Today. Prices depend a lot on where you live and the therapist’s experience.

Insurance often doesn’t cover it, because relationship problems on their own are rarely seen as medically necessary. Some therapists take insurance, and some offer a sliding scale based on income. Ask your insurer what your plan covers, and ask the therapist about fees on the first call.

How many sessions it takes

It depends on the couple. The American Association for Marriage and Family Therapy puts the average for couples therapy at about 12 sessions. Some couples come for a few months, others for a year or more. Many therapists suggest checking in together every few weeks on whether it’s helping.

How to find a good couples therapist

These directories list therapists by location:

  • AAMFT Therapist Locator: marriage and family therapists.
  • Gottman Referral Network: therapists with Gottman Method training. It’s free to search.
  • ICEEFT directory: therapists trained in EFT.
  • Psychology Today: filter by “couples counseling” and your insurance.

Before you book, ask on the phone:

  • How much of your work is with couples?
  • What approach do you use?
  • What does a session cost, and do you take our insurance?
  • Do you offer video sessions?
  • What do you do if one of us wants to talk to you alone?

Pay attention to how the first session feels. If one of you feels the therapist is taking sides, say so. If that doesn’t change, it’s fine to try someone else.

When couples therapy isn’t the right fit

If one partner is abusing the other, couples therapy isn’t recommended. As the National Domestic Violence Hotline says, “Abuse is not a relationship problem.” In joint sessions, an abusive partner can later use what was said against the other person. If you’re in that situation, call the Hotline at 1⁠-⁠800⁠-⁠799⁠-⁠7233 or text START to 88788. It’s free and confidential.

If one of you is dealing with depression, addiction, or thoughts of suicide, tell the therapist. That person may need individual help too, before or alongside couples therapy. You can call or text 988 at any time.

Where Venna fits

Venna isn’t therapy. Nobody on Venna is a therapist. Couples share what they’ve been through instead of giving advice. Nothing is recorded unless all four of you choose a recorded session with an experienced couple, and no AI listens. On Venna, you and your partner have a one-hour voice call with another couple who’s going through something similar, or has been through it. The app asks the questions and makes sure each of you gets a turn. Nobody uses real names, and the session only happens if all four of you agree.

You can use it while you look for a therapist, or alongside therapy. You can also use it when you just want to hear how another couple got through the same thing.

Venna isn’t for abuse, a crisis, or an affair that’s still going on. For abuse, call the National Domestic Violence Hotline at 1⁠-⁠800⁠-⁠799⁠-⁠7233. In a crisis, call or text 988, and in an emergency, call 911. For an affair, start with a therapist.

Sources

Frequently asked questions

Does couples therapy actually work?

For many couples, yes. A 2012 review found couples therapy helps about 70% of the couples who get it, on par with individual therapy and far better than no treatment. Results don’t always last, though. In one trial of 134 married couples in serious distress, about half were clearly happier five years later, and about a quarter had separated or divorced.

How many sessions of couples therapy do you need?

It depends on the couple. The American Association for Marriage and Family Therapy puts the average at about 12 sessions. Some couples come for a few months, others for a year or more, and many therapists suggest checking in every few weeks on whether it’s helping.

How much does couples therapy cost, and does insurance cover it?

With a therapist in private practice, it usually costs $150 to $400 for a one-hour session, according to Psychology Today. Insurance often doesn’t cover it, because relationship problems on their own are rarely seen as medically necessary. Some therapists take insurance or offer a sliding scale based on income, so ask your insurer and the therapist about fees up front.

What’s the difference between the Gottman Method, EFT, and IBCT?

The Gottman Method starts with a full check-up of your relationship, then uses exercises drawn from John and Julie Gottman’s research. Emotionally Focused Therapy (EFT) is based on attachment theory and looks at the emotions and needs underneath the fights. Integrative Behavioral Couple Therapy (IBCT) combines changing specific behaviors with learning to accept differences that won’t go away. You don’t need to pick one first, and you can ask a therapist which they use and why.

How do I find a good couples therapist near me?

Directories like the AAMFT Therapist Locator, the Gottman Referral Network, the ICEEFT directory, and Psychology Today list therapists by location. A license shows a therapist is qualified but not how much they work with couples, so ask how much of their work is with couples and what approach they use. If one of you feels the therapist is taking sides and that doesn’t change, it’s fine to try someone else.

Should we go to couples therapy if there’s abuse?

Couples therapy isn’t recommended when one partner is abusing the other. As the National Domestic Violence Hotline says, “Abuse is not a relationship problem,” and an abusive partner can later use what was said in joint sessions against the other person. You can call the Hotline at 1⁠-⁠800⁠-⁠799⁠-⁠7233 or text START to 88788; it’s free and confidential.

Is Venna a form of couples therapy?

No. Venna isn’t therapy, and nobody on Venna is a therapist. You and your partner have a one-hour voice call with another couple who’s going through something similar or has been through it, and couples share what they’ve been through instead of giving advice. You can use it while you look for a therapist or alongside therapy.

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