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How Does Couples Therapy Work?

“The single biggest problem in communication is the illusion that it has taken place.” -George Bernard Shaw

Getting started in couples therapy…

With so many demands on the marital relationship/ long-term partnerships, many couples struggle to maintain a satisfying sense of connection over the long-term.

Ongoing conflict regarding communication, intimacy, affection, personal fulfillment, family, career concerns, etc., can quickly erode the quality of  a relationship if left unaddressed.

In my experience as a relationship therapist, I have seen many couples improve their ability to successfully navigate difficult issues by developing a deeper sense of empathy for their partner’s experience and transforming problematic patterns of interaction.

Many couples are interested in couples therapy at various times in their relationship (which is completely normal), but often there might be some uncertainty around whether it’s the right service at the right time. To help bring some clarity, this article is all about couples therapy at Modern MFT, its purpose, and the typical course of treatment.

How can therapy help?

Therapy can help couples to discuss difficult topics more easily by getting to the heart of the matter and offering guidance, support, and encouragement while creating a more sustainable path forward.

It is sometimes helpful to view couples therapy as an important investment in the overall emotional health of a couple or family’s well-being. Relationship counseling, while relatively short-term in duration, is designed to have a lasting positive impact on the quality of an individual’s most valued intimate connections.

What’s involved in couples therapy? 

When getting started in couples therapy, I like to meet with a couple at least once per week. This helps to establish a high quality working relationship and allows me the opportunity to get to know each person in a meaningful way. Through our consistent meetings, we are able to build trust, a sense of safety, and momentum toward the desired outcomes.

In developing a deeper understanding of the many factors influencing the distress, we can effectively work through the blocks, the hurts, and any trust ruptures related to the presenting concerns. We can sort out the source of the distress and determine the best route toward a more optimal intimacy.

The process of therapy typically includes four phases: an assessment period, a collaborative working phase in which the areas of concern are addressed in-depth, a maintenance phase, and a termination phase.

How long will it last?

It is difficult to say how many sessions are required in order to address particular issues or concerns since there are many factors that can influence the process of therapy. It is a collaborative process between the client(s) and therapist. Ongoing communication and trust are essential. In my work, I have noticed that when partners are committed to their unique work in therapy, they often start feeling better in their relationship very early on in the therapy.

Sometimes the reasons for coming in might seem like they require a relatively superficial fix, but in order to create meaningful and lasting results, a more in-depth exploration and understanding of the issues is necessary.

In therapy, we are not merely bandaging a wound, rather we are tending to the damage and examining how it happened in the first place. The goal is optimal functionality and flexibility.

It’s important that each partner feels comfortable with the therapist and the commitment to therapy so that there are minimal impediments to the process. Couples who are curious and open to self-discovery often have the best outcomes in therapy.

Course of treatment:

In the assessment phase, we work to develop a deeper understanding of the presenting issue(s) which provides an important foundation for the work ahead. Significant information can also be provided through the intake form which helps to facilitate and expedite the process.

Once I have an understanding of each person’s perspective, history, and the present relationship dynamics, I can then customize a way of facilitating the necessary growth. This might also include collaborating with any other treatment providers involved.


In the initial stage, we often visit a variety of relationship concerns or topics regarding a couple’s overall sense of satisfaction. This might include discussing  interactional patterns, communication, issues pertaining to affection, trust, desire, etc. We may also construct a family genogram for each partner in order to better understand interactional patterns and any intergenerational trauma that may be impacting the felt experience in the present relationship.

Working through the struggles

The next phase of treatment often involves a series of tailored interventions and conversations designed to address the the specific areas of concern for a particular couple. This may include a blend of intimate conversations, homework assignments, in-session activities, and exercises designed to access the underlying dynamics and transform the problematic cycle of interaction.

Oftentimes, couples experience a significant shift in their relationship during this point in treatment as their relationship begins to feel less rigid and stifled. Couples often report feeling as though a “weight has been lifted.”

Growth often involves helping the partners to heal a present or past emotional hurt, re-establish a sense of trust and togetherness, or work through difficulties related to communication, intimacy or affection. It is necessary to stay committed to the work as it takes some time to establish new ways of operating as a couple. Sometimes, there are deep and profound individual changes that have resulted from the work in therapy–which may require partners some time and space to readjust to the new landscape. This is normal and expected.

Maintaining the progress

In the maintenance and termination phase, we have brought about important changes in the functionally of the relationship and the progress is sustainable. We have been able to address the inevitable setbacks and frustrations and have created stability in the quality of the relationship.

During this phase, we sometimes transition to another important aspect of the work that was not as initially pressing as the original reason(s) for seeking treatment. Other times, a couple may decide that they have reached and maintained a great place and feel comfortable winding down treatment.


The termination phase allows us the opportunity to look back at the growth and provides time to anticipate barriers and plan ahead for the inevitable ups and downs in the future. This period also enables the couple to solidify their progress and a chance to end therapy with a sense of dignity.


When we are struggling or hurting in some way, it’s only natural to want the discomfort to stop immediately. During these painful moments of life, we can be vulnerable and seek to resolve important interpersonal matters through a quick fix. A commitment to the process of therapy can provide the appropriate guidance, in-depth healing, and repair of difficult intimate relationship struggles.

As an aside, there are times when couples therapy may be premature–meaning that there are potentially significant barriers to treatment which may require partners to seek individual therapy first for a period of time to address certain personal issues. However, this is dependent on many factors and is evaluated on a case by case basis. It’s important that partners are in a place to be able to receive the benefits of therapy for their relationship.

Building a more optimal intimacy…

In therapy, there is sometimes a tendency to focus on resolving here and now conflicts rather than on addressing a big picture sense of fulfillment. However, in focusing on optimal intimacy and the underlying causes of distress, couples therapy can bring about much more meaningful and lasting change. Ideally, we are not just fixing a set of issues, but rather, we are creating a deeper sense of fulfillment between partners and in their individual lives.

“The real voyage of discovery consists not in seeking new landscapes but in having new eyes.”