Ask a Psychologist: Five Tips for Couples Counseling


The Who, When, How, and Why of Therapy Together

by Shara M. Brofman, Psy.D.

Couples Therapy is for everyone

As a culture, we seem to talk a lot about how marriage is hard work. When people get divorced, we shake our heads. If they’d just worked harder, or gone to therapy, maybe they could’ve worked it out? At the same time—possibly because we associate couples therapy with crisis or divorce—there can also be a lot of stigma about going to therapy as a duo.

First things first: going to couples therapy does not have to mean that your relationship is headed for trouble. If you are married, it is not a sign that you are going to get divorced. In fact, the opposite may be true. Going to couples therapy before you get to crisis mode can strengthen your relationship tremendously and help to avoid future conflict. To help answer the smart questions you asked me on APW’s Facebook page, I spoke to another New York City psychologist and colleague, Eugenia Cherkasskaya, M.Phil, about when couples therapy can be helpful. She suggested that therapy is a good option “any time you want to discuss an issue together, at any point in your relationship.” In particular, “loaded issues,” says Cherkasskaya, can be much easier to discuss and explore with an objective professional. Remember the ten topics in Meg’s book that she suggests discussing before getting married? (A refresher: the questions are under the general headers of faith, money, goals, family, location, sex, household responsibilities, fighting, skeletons in the closet, and end of life.) As much as we might wish we could discuss these topics once and then move on, they continue to come up and evolve throughout marriage. Read: it is totally okay for any couple to go to couples therapy at any time.

Good Reasons to try therapy

New York City psychotherapist Traci Maynigo, M.Ed. considers any of the following scenarios good times to start couples therapy:

  • You’re going through a big life transition (e.g. marriage!, a new job, moving, illness, infertility, birth, or adoption, death of a loved one, living with family members, or becoming a stepparent, to name a few).
  • You keep having the same fight over and over again and it’s hard to understand why.
  • You feel like you can’t effectively communicate with each other. No matter how you try to communicate, what you each have to say is somehow not getting through.

No matter what you want to focus on, couples therapy is about learning how to communicate with each other in a safe, healthy way. A couples therapist can help you to understand: What is the pattern you keep falling into that gets you stuck? How can you fight together effectively? You’re going to fight. You’ve probably read elsewhere that it’s not that happy, healthy couples don’t fight—it’s how they fight. So, Maynigo points out, the emphasis in couples therapy is not on stopping the fighting, but rather: How can you learn to fight in a different way, and, importantly, repair the fight in a healthy way? A couples therapist works with you to break unhealthy patterns, maybe even practicing healthier patterns in session, and capitalizes on your strengths as a couple.

1. What if only one of us wants to try therapy? Maybe your current fight is about whether to go to couples therapy. Perhaps one of you has already been to therapy and has had a negative experience. Maybe one of you has heard that couples therapy could be helpful, but the other partner doesn’t want to go. Here’s a possible solution: Discuss attending an initial consultation with a therapist (or more than one—see below), just to learn about it. Agree to a test run, and see how it goes.

Keep in mind that couples therapy is different from individual therapy. Going to therapy with a partner is different from going alone. Plus, therapists vary significantly in personality, style, age, and how those variables interact with you as a couple. So, don’t necessarily let a previous bad experience cloud your judgment this time around. If an initial couples therapy consult still doesn’t seem like an option for you, the partner more interested in therapy can begin individual therapy, which can be helpful with or without concurrent couples therapy.

2. Where do you find a couples therapist? Your primary care provider or OB/GYN can be a great resource. Or, start with Psychology Today’s comprehensive Find a Therapist directory. If you can’t find a therapist close to home, you can even search by which therapists work via Skype (or other confidential video platforms). Clarify with the therapist, however, that his/her license allows him/her to provide therapy to patients in your state (working with someone in-state often fixes this issue). And at the end of the day, word of mouth is often a great way to go. It can be hard to talk to friends and family about needing help, but you might be surprised, when you ask around, how many people have been to therapy or know of a good referral. As APW contributor Aly Windsor wrote in “Secrets of a Gay Marriage,” if you ask your happily married couple friends their secrets, “One or two of them may even be able to refer you to their secret, heroic therapists.”

3. How do you find a qualified therapist who is a good fit? Most importantly, both you and your partner need to like your couples therapist. Feel free to consult with more than one therapist before beginning therapy. There are also various types of therapists and therapies, and it’s absolutely your right to have a good understanding of a therapist’s training and approach. Discuss with your partner what’s important to you, and just ask the therapist directly if he/she can work with that in mind. It’s completely normal to be anxious before starting, so be honest about your concerns. Ask the therapist about his/her specialized training in couples therapy, professional organizations he/she belongs to, what proportion of his/her practice includes couples, or if he/she has helped people with your particular needs before.

4. What are the different kinds of credentials, a.k.a. all of those letters after therapists’ names? In general, master’s level therapists have focused their training (approximately two to three years) on therapy, while doctoral level therapists have training (approximately five to seven years) in therapy, as well as psychological assessment and research. Counselors who are clergy may not necessarily be trained therapists, but may still have significant counseling experience. Clergy may approach relationships through a religious lens (they don’t always!), which may or may not be a good fit for you and your partner. Some therapists’ styles are practical/skills-oriented, some are more interpersonally oriented, and some are more emotion-focused. Some therapists have been working for many years, and some are new to the field, but both can be great. Some might see you for several sessions or a few months, and some might work more long-term. Again, just ask. Also: for a more feasible way to schedule couples therapy into your busy life, or to just brush up on skills, consider attending a weekend couples workshop.

5. How do I afford this? See if your health insurance includes mental health benefits, or if it offers out-of-network mental health coverage. Because even if they don’t take your insurance, most therapists are happy to help you obtain out-of-network reimbursement. Many therapists also work on a sliding scale fee. Last, therapy training institutes, clinics, and graduate schools often provide terrific opportunities for affordable therapy, usually with a therapist who is pursuing advanced training under expert supervision.

I hope that this information is helpful and that the future brings happy times for you and your partner—even with the inevitable, but with the right tools, survivable, bumps in the road. 

Disclaimer: The information provided in Ask a Psychologist is intended by Dr. Brofman and APW to serve as general advice and guidance for all readers. It does not constitute or serve in place of confidential clinical consultation with a mental health professional.

Shara M. Brofman, Psy.D.

Shara Marrero Brofman, Psy.D., is a psychologist who values all things practical. She studied Child Development at Tufts University and worked in case management and clinical research before earning her master’s and doctoral degrees in Clinical Psychology from Rutgers University. Dr. Brofman practices in New York City and has special interests in women’s and reproductive mental health. She can be contacted at drsharabrofman at gmail dot com. Photo by Smitten Chickens.

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  • Amy March

    Don’t forget re: number 5, many large employers offer an Employee Assistance Program. Mine covers 3 sessions of therapy, couples or individual, fully, without any of the co-pays or deductibles I’d pay if going through my regular insurance.

  • Mariah

    As a woman married to a man, who recently went though about 8 months of couples therapy, I was surprised (and a bit disappointed) to find out that our therapist’s gender actually mattered. We saw a woman, and although I felt really supported by her, my husband (who was initially resistant to therapy) felt ganged up on a lot – by two women. Maybe she wasn’t a good enough therapist to appear neutral and objective, or help him work through that, but it definitely caused a lot of delays in an otherwise great process.

    I hate that this happened, but the last thing you want to do when you’re trying to work on tough stuff and communication with your partner is be side-tracked by the way male privilege has creeped into the therapeutic process. When we have to do this again (because let’s face it, we WILL go through tough stuff again), I honestly think that we’ll see a man, which makes me feel like a terrible feminist and sell-out. Sigh.

    • macrain

      I see a therapist on my own, who I trust tremendously, and when I told her we wanted to do pre-marital counseling she suggested finding a man. It did make sense to me, especially since my fiance is the more reluctant of the two of us.

      • Violet

        You bring up a really important point- many health care providers would consider it unethical to do couple’s counseling when one party in the couple has been their long-term client. The issue is objectivity- most counselors realize they could not possibly be objective when they’ve known one person intimately via individual counseling. If it’s sort of a one-off thing and it would be helpful to bring your partner into your therapy, that’s one situation. But if the idea is “and now we’re doing couple’s counseling,” many providers should offer an alternative person to do the couples work.

    • ElisabethJoanne

      For the same reason, I’d give my husband an opportunity to get referrals instead of just going with someone recommended by my gynecologist. I mean, great to get a referral from another healthcare provider, but I like to trade off decisions about the relationship. If I decide we should go to therapy, he gets major input in the therapist.

  • Anon

    I also encourage you to look towards resources that may seem more geared towards low-income folks, especially if you think you are middle class but can’t afford therapy. In the DC/MD/VA area, I thought that The Women’s Center provided help only to people who qualified as very poor, which I’m not. Not only was I wrong, but they’ve provided me with both individual and couples counseling at a price I can afford. (OK, I know this sounds like I’m paid to shill for them. If only.) My point is simply that there may be resources in your town or city that have a broader definition of need than you expect, and it’s worth a call to find out.

    • CH

      I’ll second this. The Women’s Center is great and I only had to pay my insurance’s copay for the sessions.

  • MC

    Love this post! Has anyone had couples/pre-marital therapy with a grad student? We have a counseling grad school in our city that has affordable therapy and I’m considering that for a few pre-marital sessions. My partner and I don’t have any big issues, conflicts, or particular things we need to figure out – but I like the idea of having a professional third-party give us tips on communication and best practices for keeping our relationship awesome. I also like the idea of giving a student practice (which is why I get my hair cut at a hair school and get acupuncture at an acupuncture school). So I think it would be a good option…

    • C

      My husband and I saw a grad student while we were in a rough patch (and I still continue to see her, though she’s now licensed). Our friends referred her to us; they found her by calling the practice and inquiring about affordable options, Her sessions were only $10 while she was in school!

      I think her style was a better fit for me than for my husband, but I definitely gained a lot from her. At times her inexperience shows a bit, but that’s not really a problem for me, particularly since we weren’t dealing with any major mental-health issues or other really complicated things, just the everyday challenges.

      Another affordability tip that I got from my EAP: my insurance has good coverage for individual counseling, but not couples. However, some providers will be willing to code/bill sessions as individual therapy if the premise is, “I’m having a problem, and I’m bringing my partner with me for support” or something along those lines. It’s worth looking into.

      Also, in the US, most insurance providers now have to cover mental-health care at the same coverage level as other kinds of medical specialists.

      • Amy March

        Mental health, yes. But counseling to talk through a difficult transition or figure out a new way of communicating won’t necessarily be considered mental health care by your insurance company. In most of the examples in this article there’s no problem with mental health.

        • Meg Keene

          Yeah. I’ve never had therapy covered unless it was a mental health emergency. And, uh, I’d rather be paying out of pocket than having a mental health emergency, much as I hate paying out of pocket. Those are NOT FUN.

          I mean, I wish it was covered, but at least for me it never has been.

          • Ann

            More should be covered now, thanks to Obamacare. I’m not sure exactly what’s covered, but I do know that certain things have to be.

          • Meg Keene

            As someone who’s was dealing with the system as it changed, I can tell you more things are covered, but it’s still not a ton. Namely, it’s mental health care that’s had some expansion in coverage, and as Amy points out, couples counseling almost never falls under a mental health emergency. Mental health emergencies are things like depression with suicidal ideation. Mental health problems are things like Generalized Anxiety Disorder.

      • ElisabethJoanne

        My husband has diagnoses of severe depression, attention-deficit/hyperactivity disorder, and sometimes anxiety, and his psychiatrist appointments (monthly or quarterly) and occupational therapist appointments (twice a month) have been covered by 4 different insurance plans in the last 4 years, with no crises during that time.

        Our present health insurer has a list of behavioral healthcare professionals who accept our insurance. The list is on a different website than for other providers, but that’s another way to look. The website shows credentials (PhD, MSW, MFT, etc.), areas of expertise (depression, trauma, finances, infertility, etc.), and what kinds of patients the provider accepts (children, adults, couples, families). A provider who accepts your insurance will usually do everything they can to get paid by your insurer in terms of how they bill for the appointment and what diagnosis codes they use, but you can totally ask about that before the appointment. [For insurance, diagnosis codes aren’t necessarily a medical/psychological diagnosis. There are preventive care and worried/well and screen for X diagnoses.]

        What really encourages me about the ACA is that you can no longer be denied coverage for seeking mental health treatment. Before, I heard stories of people being turned away or paying very high premiums because they asked to be assessed for depression or whatever in the last year.

        • Lauren from NH

          Hey ElisabethJoanne,
          Not to treat you like the expert on all things, but we recently realized my partner may have undiagnosed ADD or ADHD. Any suggestions on good places to start understanding what this means and tools to address some of the challenges? We picked up a copy of “You Mean I Am Not Lazy, Stupid, or Crazy” but with his difficulty focusing, reading it is slow going. As best I understand, this isn’t really something I can do for him, he needs to try to understand himself a little better to know what symptoms he experiences and how to handle them (which then I can help with). It is difficult for me as a proactive person to be patient as he takes his time sorting this through.
          Thanks in advance!

          • ElisabethJoanne

            There’s a book for couples “Is it You, Me or Adult ADD?” That helped me.

            Here’s the biological understanding I have of the disorder, based on a couple books for patients/family members and talking to my husband: It’s like his brain is scotch-guarded against the hormone that says, “focus on this task” and “now switch to the next task.” If you think of untreated cotton: Just a few drops of water on the fabric, and you get a dark spot. Likewise, with a normal or average brain, just a normal amount of this hormone, and we can be productive. But if the fabric is treated, you really have to soak it to get the water to penetrate. That’s what ADHD meds do: They flood the brain with the “focus/switch” hormone. Doctors don’t yet know how to actually make the brain better at receiving the hormone (eg, remove the scotch guard).

            The “scotch guarding” makes it hard for him to focus on unpleasant things, and hard to stop focusing on pleasant things. “Pleasant” of course is different person-to-person. He can spend hours taking notes from a philosophy book, but has to work hard to take the time to pay the monthly bills. For us, it’s not a moving around v. sitting still issue, though for some ADHD patients, it is.

            Day-to-day, every family will be different, of course. A big thing with us is his day timer. He has an appointment book, and each morning I help him plan his day in 15-minute increments. He likes being able to physically cross things off, and I think seeing time as space on the page helps. As in “apply for jobs” may be fewer letters than “go to post office,” but the post office is allotted 15 minutes/1 line in the schedule, but job applications need at least an hour/4 lines.

            ADHD patients often have trouble recognizing that something’s literally out of place. I’ve learned to break household chores down into parts. We don’t write on our to-do list, “take out trash” but “take out trash” AND “replace trash can liner” or “mop kitchen” AND “put back kitchen mat and chairs.” Almost everything he uses daily, like his toothbrush or sandwich bread, we just leave on the counter, where he can see it.

            I also make sure I have his attention before I say anything he needs to react to. Not just, “Please put your dirty T-shirt in the hamper” but always, “Can I talk to you?” then when we’re literally eye-to-eye, “Please…” On weekends, I often ask, “How much longer do you want to read that magazine [or whatever], and then we can talk about what errands we need to do today?”

            [This is hard to say nicely, but I honestly also think of ADHD as kind of typical masculine behavior in terms of the sitcom dad always obsessed with the game on TV and never scrubbing the corners of the bathtub. ADHD is ten times more common in men than women, and I think the stereotypes might have developed out of observing ADHD behaviors before society had the diagnosis. If you’re trying to understand what ADHD might look like in a home (and probably how NOT to react), imagine if Tim Allen of “Home Improvement” or the uncles of “Full House” truly couldn’t help it.]

            For schedule and household maintenance issues, there’s a book that might be helpful called something like “Organizing the Sensitive Child.” It was written by a mother of a son with autism, but addresses ADHD issues as well. I found we either already did what she recommended, or didn’t have the space, but it might be helpful.

            As for professional treatment, my husband had to ask his psychiatrists for assessment and treatment for years before he finally got it. (He was already being treated for depression.) By the time we met, he had been evaluated, diagnosed, and was on meds. His advice would be to get to a psychologist and psychiatrist, and keep looking for a healthcare team that will take you seriously. Then ask for a referral to an occupational therapist who will help with things like organizing your day and home (A therapist will also help with career advice and any emotional or other mental health issues and other life-coaching stuff).

            For partners, there’s resources in the first book, “Is it You…?” I go to a support group through the National Alliance on Mental Illness. ADHD isn’t considered a mental illness, and my first NAMI support group wasn’t very helpful. I switched groups when I switched jobs, and my new group has more expertise on ADHD.

          • Shara Marrero Brofman, Psy.D.

            Thanks for this response, ElisabethJoanne! Great to hear about ADHD experiences, resources and support groups. It’s true that it’s really hard to find good information about ADHD out there, especially for adults with ADHD. As for medications, ADHD is often treated with psychostimulants (or sometimes anti-depressants), which are understood to affect the activity of neurotransmitters (similar to hormones in that they are chemical messengers, but neurotransmitters communicate within the nervous system, vs. the blood stream/glands), including dopamine and norepinephrine. For anyone interested, here’s some more general info from the NIMH: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/index.shtml?utm_source=REFERENCES_R7#pub11 And this psychologist is a well-known expert on ADHD, including in adults: http://www.russellbarkley.org/index.html

          • Emily

            This is a really helpful comment! Thank you! The timing is fascinating; today I was thinking “I wish APW would do a post called ‘So You Think Your Partner has ADD . . . ‘ ”

            My partner isn’t diagnosed; we’ve been together over four years, but I’m still stunned by the difficulty he has organizing events in the day. I am a detailed planner and one day rarely looks like the next for me. He cannot do that; having a general routine is really important to him and I’ve realized that more than one change to the routine is too much. I do the things with deadlines: pay bills, etc, and I send him text messages an hour or so before a change in the routine to remind him. They say things like “I hope that your dentist appointment goes well!”

            Interestingly, he is able to get it together much better than I am to have food in the house and get a meal on the table at about the same time every night.

          • Violet

            You may want to check out Mary Solanto’s book, Cognitive-Behavioral Therapy for Adult ADHD. It’s based on her evidence-based psychosocial treatment, which is is a group program for adults with ADHD that specifically focuses on issues regarding organization. Planners, watches, etc. The idea is not just to use the tools, but how to address barriers and negative thoughts when using these tools proves difficult (which, it inevitably will).

    • Laura

      I currently am a grad student (Ph.D. program in clinical psychology). Obviously I’m biased, but I think this is a great idea depending on the resources in your area. Depending on the graduate program, students are more likely to be trained in empirically-supported interventions. For example, I’m being trained in Integrative Behavioral Couples Therapy, which has a lot of research support. Plus, grad students are continually supervised by a licensed psychologist, so there’s quality control in that regard. And, as mentioned below, it’s typically pretty inexpensive. Our clinic’s sliding scale goes down to $10/session, although we’ve been known to make exceptions and go even lower than that.

      Like I said, I’m biased, but it’s worth shopping around to see what student training options are available in your area. As with any other therapist, I’d be sure to ask questions about the trainee’s level of experience, experience working with other couples, theoretical approach and general style, etc.

      • laurasmash

        What are the different types/approaches to couples therapy? You mentioned you are being trained in Integrative Behavioral Couples Therapy, what is that? Are there certain key words or qualifications I should look for when finding a couples therapist? I would definitely prefer something backed by research and it’s kind of overwhelming to look at the long lists of therapists in my area!

        • Laura

          Ha, I just wrote a final exam about this topic, so I’ll try not to talk your face off. My training program is generally cognitive-behaviorally oriented, which means it’s focused on looking at the relationships between thoughts, feelings, and patterns of behavior. Following are a few types of couples therapy that have empirical support:

          1) Traditional Behavioral Couples Therapy (TBCT): focuses on communication training, problem solving skills, behavioral exchange (basically, focusing on doing things that your partner experiences as being positive), emotional expressiveness training (learning how to vocalize inner thoughts/feelings to one’s partner to help that person understand your inner world). It’s sometimes also called just behavioral couples therapy or cognitive-behavioral couples therapy.

          2) Integrative Behavioral Couples Therapy (IBCT): some of the same elements as TBCT above, but an increased focus on emotional acceptance. Basically, the idea is that all relationships have some incompatibilities — we’re never going to find somebody who perfectly matches every little criterion we have. When we push back against our partner’s problem behaviors (could be big things like lack of ambition when job hunting or smaller things like leaving dirty laundry all over the place), conflict tends to increase. IBCT focuses on acceptance and managing emotional reactions to those difficulties. The idea is that you’ll learn skills to communicate with each other, reveal how you feel about the problem, and try to develop empathy for the other person’s point of view. By becoming more tolerant and aware of the effects of your actions on your partner (and vice versa), you’ll be mindful of your own annoying/difficult behaviors and be more empathetic when your partner displays those behaviors.

          3) Emotion-focused couple’s therapy: the idea behind this therapy is that emotions can be agents of change. Basically, you’ll work with the therapist to learn how to articular unacknowledged emotions that might be fueling problematic interactions. This might be expressing deeply held fears, needs that are unmet, etc. Then, there will be work surrounding becoming more emotionally responsive to what your partner needs, and vice versa. It boils down to less of a direct emphasis on behavior (like the above approaches) and more of an emphasis on emotional reactions.

          4) Insight-oriented couples therapy (IOCT): This takes a developmental perspective, meaning that you’re thinking about the ways that past relationships (including romantic relationships, friendships, familiar relationships, etc.) have shaped you. The therapist will help you understand patterns of emotions and behaviors that might be linked to prior relationships. You’ll identify themes and learn ways to change your patterns of emotions/behavior to fulfill your needs and decrease relationship anxieties. There’s often more of an emphasis on unconscious patterns that drive your activities, defensive strategies you may have developed, etc.

          *These are the four flavors of therapy that I’m aware of that have significant research evidence backing them up. It kind of depends on what you and your partner are looking for. If you’re action-oriented and looking to work on some concrete skills, TBCT or IBCT might be a good fit. If you’re looking to better understand your subconscious emotional reactions or how your relationship history affects your current conflicts, #3 or #4 may be better. However, any good couples therapist will touch on both of those aspects (concrete skills as well as developing insight about patterns and emotions). It’s just the emphasis that differs between these forms of therapy.

          There you have it — more than you ever wanted to know about empirically-supported interventions for couples therapy :)

          • laurasmash

            THIS IS SO HELPFUL!!! Thank you so much for posting!

          • Shara Marrero Brofman, Psy.D.

            This is terrific, Laura! Thanks for contributing to the discussion. We didn’t have the space to include this amount of detail in the post itself.

          • Shara Marrero Brofman, Psy.D.

            Thanks for contributing to the discussion, Laura! This is terrific. We didn’t have the space to include these details in the post itself.

  • Peekayla

    This is so great! Thanks so much for this post! Now I have a few starting points when I bring up couples therapy with my fiancee, who is very resistant to the idea!

  • Mama to Be

    YES YES YES, everything you said, YES. The three reasons you cited are EXACTLY why I brought my husband to my therapist with me (different from seeking out a couples therapist) this past week. We are expecting our first child this summer and were experiencing some conflict in discussing division of responsibilities regarding her care. We were having the same discussion over and over and feeling frustrated and confused by the other’s position. Since my therapist knows my background and issues so well, she was very good at reframing things for my husband and also of course for me. The result of our therapy session isn’t that I know exactly how parenting will go for us but it reassured me that my husband wants wholeheartedly to be a good dad. He is the person I love and married and trust to do what is best for me and for our family. So anyway, I just wanted to tell you that this article really rang true with me. Thank you for writing it!

  • Aly Windsor

    This should be required reading for all married or to-be-marrieds.

    • Shara Marrero Brofman, Psy.D.

      Thank you, Aly! As should yours! For anyone. Fantastic piece.

      • Aly Windsor

        Thank you, Shara! :)

  • Kayjayoh

    We had the extremely odd experience of our pre-marital therapist poofing on us. We had an appointment and she called to reschedule for the next week. We did that, and then when we got there for the appointment (which always took some rearranging of our schedules, the office was locked and no one was there. We left a few messages for her, but she never called back. It was really, really weird.

    It wasn’t a solo practice or anything. I could see her thinking “I’ve had several sessions with this couple and I don’t want to deal with them for X reason” but you’d think she’d refer us to one of the many other therapists in the practice. (Maybe a Prepare/Enrich person.) But not showing up and not returning calls is just weird. Granted, we were probably on our last or second to last session, but still…

    (I never did call or email the general practice to complain. It was a year ago, so it seems a little late now.)

  • Caroline

    Yes! We mostly go for a session or a few when we’ve been having the same fight over and over again. It’s very helpful.

  • laurasmash

    Yay! Thanks for this, it’s exactly what I needed this week! I know I want to go to pre-marriage counseling with my fiance, but I wasn’t sure where to start :)

  • Having the same fight over and over is what drove us to seek couple’s therapy. We weren’t able to find someone we could see regularly, but during the short period of time we were going, it really helped. Because we both felt accountable (i.e. if we had a bad fight, we’d have to tell our therapist we had a bad fight), we both put more effort into keeping fights from getting out of hand. And, wouldn’t you know it: fights got shorter, less intense, and easier to resolve with fewer residual hurt feelings.

    I recommend asking about sliding scale, and being upfront about insurance concerns. Our therapist managed to secure us an inexpensive copay because we volunteered to have our sessions recorded for a research project.

  • Guest

    I wanted to comment and say a good place to start is to call your insurance and find

  • unknown

    I wanted to comment and say a good place to start is to call your insurance and find out if its covered. If it is the can give you a list of covered providers in your area. I know a lot of people say its not, but its worth checking. I found I do have coverage for unlimited counseling for any reason (either couples or solo) and we only pay $20 a session, after we pay $500 annually in co-pays its 100% covered. I would never have known and would have wasted a ton of money if I hadnt asked first.

  • My boyfriend and I live in a small(ish), rural(ish), conservative town and I cannot for the life of me find a therapist who offers premarital counseling that’s not bible-based. By any chance, have any non-Christians taken bible-based premarital counseling, and if so, did you find it helpful? I imagine there would be at least some overlap between bible-based and secular counseling.

    • Anon

      I’m not sure if it is the type if thing you’re looking for, but my husband and I did the Catholic Pre-Cana marriage preparation. We are Christian but not Catholic, so our situation is not the same as yours.

      Still, I can say that we found the marriage preparation to be useful and applicable, despite its specific religious elements that do not apply to us. Basically, we spent a weekend listening to a couple talk about a given issue in their marriage nd then working through a time of guided writing and talking about tht issue ourselves. It was very self-directed. That said, it definitely had religious qualities (a prayer service, religios language, a discussion of NFP). Good luck!

      • Thanks! After hearing the term “Pre-Cana” several times on here, your comment finally inspired me to look it up. Wikipedia says “The name is derived from John 2:1–12, the wedding feast at Cana in Galilee, where Jesus performed the miracle of turning water into wine.” So cool! All this time, I thought that “Cana” was short for something!

    • Violet

      My partner and I attended pre-marital counseling sessions with a priest. My husband is Catholic-turned-Episcopalian and I am religiously tone-deaf. We didn’t have any particular issues we wanted addressed; pre-marital counseling was just part of the church wedding deal. So I didn’t have any particular needs. But the counseling itself was not “religious” at all. Nothing really rooted in the Bible. Exploring communication styles, introversion/extroversion, openness to new experience spectrum, that type of thing.
      In terms of overlap, the thing I’ve found when reading things written by people who are Bible-based is that there’s sort of a Non-religious to Religious Dictionary. That is, where a non-religious person would say “Do everything you can do, after that, accept,” a religious person would say (as far as I can tell) “Do everything you can do, after that, you just gotta pray about it.” Maybe this is my tone-deafness, but those two concepts seem very similar to me. I still doubt I’d feel comfortable seeing someone who was Bible-based when we have a real issue we want outside help with, but if you’re asking about run-of-the-mill premarital counseling, I found our religious one perfectly acceptable.

      • “‘Do everything you can do, after that, accept,’a religious person would say (as far as I can tell) ‘Do everything you can do, after that, you just gotta pray about it.’Maybe this is my tone-deafness, but those two concepts seem very similar to me.”

        Totally agree. Thanks for the reply. It’s cliche, but I am “spiritual, but not religious,” and I often find that if I mentally substitute the word “God” with the “the Universe”, that traditional religious texts/teachings/principles often ring very true for me. In that sense, I have been hopeful that Bible-based premarital counseling would be beneficial. And yep, we are looking for run-of-the-mill counseling :)

    • Annie

      Just want to mention that there can be significant differences between Bible-based counseling and counseling offered by a religious leader.

      Many mainstream Protestant clergy (Episcopal, Presbyterian – PCUSA, Lutheran – ELCA) use curricula like Prepare/Enrich, which focus more on communication styles, conflict, personality traits, etc. We just did ours and there was no mention of the Bible, but there is a section on how you want to approach religion in your family. Almost every Episcopal church I know of offers this type of premarital counseling, but they’re not going to advertise it on their website. You would probably need to have coffee with the priest and explain your situation.

      In my experience in our small, rural, conservative area, “Bible-based counseling” is something completely different, and the content can vary widely depending on whether the person is using an established curriculum. Many of the curricula I’ve seen focuses on scripture passages and how you’re going to adhere to certain faith tenets in your marriage. Which can be wonderful for many people who are seeking that kind of counseling, but may not super helpful if you interpret the Bible in a different way than your counselor.

      Anyway, I would do a little digging to see what curriculum the counselors use and if you can get a list of sample questions. That should give you a good idea of whether it would be a good fit for you or not.

      • Thanks so much for pointing out the distinction. Very helpful! Looks like there are 2 Episcopal churches where I live. Perhaps I will inquire about Prepare/Enrich-type premarital counseling.

    • E

      Another option may be finding someone from afar and doing pre-marital counseling over Skype. That’s what we did because we lived several states away from the rabbi who was our officiant. It worked pretty well.

      • I’ve considered that! We are also going to see if we can find a weekend intensive in Seattle, which is about 3 hours from where we live.

  • Shara Marrero Brofman, Psy.D.

    Thanks to all of you for your sharing your experiences and terrific insights on this topic. Awesome discussion/appendix here.

  • Shara Marrero Brofman, Psy.D.

    Thanks to all of you for sharing your experiences and terrific insights on this topic (and related topics)! Great discussion/appendix of resources here.

  • Me

    Thanks for this post. We started out doing couple’s counseling as a pre-marital thing, but have decided to continue with it for a bit longer. I think it has been and will continue to be a really good thing for us. As we dug in, there was enough for us to talk about that we didn’t just want to cut off because our wedding date was approaching.

    One thing that we learned in terms of having it covered by insurance is that, at least for our insurance, which is pretty good and through state employment, while mental health services can be covered, the primary insured person has to have an official diagnosis for it to be covered after we exhausted our certain number of free sessions. That just didn’t feel great for us, especially when we are both agreeing to do this together and working on our joint issues. We didn’t want to carry that with us. We are going to figure out how to pay out-of-pocket.

  • Eh

    It is super important that you find someone who you are both comfortable with. My ex and I went to therapy at the end of our relationship. We did one session of couple’s therapy after we broke up and then we both continued with individual therapy (he continued with the therapist we saw and I found a new therapist). He had picked the therapist (his insurance was paying for the couple’s session). This was the weirdest thing ever – not even close to what I expected, especially since I had been in therapy before. The therapist talked at me and made me very defensive and uncomfortable. She had some background from my ex about us and started using that to attack me. For example, based on what he told her about me, she assumed that I had been suffering from major depression for over five years (I had recovered from major depression five years earlier and had struggled with it but had not had another episode in those five years). He had also mentioned that I wanted to get married (every time I brought up marriage he would make a comment like “a piece of paper isn’t going to make me any more committed to you” or “I’m here with you now and I have no plans on leaving” or “you just want a day”). The therapist told me that I should date ten people a year and I shouldn’t even consider marriage until I am 30 years old. And then she said that if I wanted to get married young I should move to a small town. The whole session was more or less between me and the therapist while my ex just sat there. Every once and awhile the therapist would say something that my ex had told her and that wasn’t true. I would point out that he lied and she didn’t care (this is one of the reasons he liked her, he didn’t have to be accountable). For example, she started talking about our breakup. She mentioned that we had talked about why we broke up after we broke up. I said we didn’t. (I came home one evening and he was in a good mood after being in a bad mood for two months. He said he didn’t want to talk about things between us. I said, so I guess it’s over and he agreed to move into the spare room.) She insisted that we had talked about things since he told her we did and in the session he even said we did. When I explained how we broke up she turned to my ex and asked if my story was accurate and he said it was. And then she started attacking me again and saying that I just wanted a reason why we broke up so I had something to hold onto or something that I could “fix” so that we could reconcile and that I couldn’t deal with the fact that the relationship just wasn’t working out and that sometimes there isn’t a reason relationships end (my ex had feelings for a coworker, I knew that – the therapist told my ex that the feelings were just a sign that the relationship wasn’t working out so he should end it with me, that was in the consultation). Since I had been in therapy before I knew that this wasn’t normal. I found a therapist that was a better fit; though it took a couple of tries. One therapist I met with told me that I should start dating right away since I hadn’t been out of practice and that if I didn’t get back on the horse right away then I would have a hard time. I found a therapist who understood that I wanted some “me time” and needed to get used to my new life (I had been with my ex for five and a half years) before letting someone else in.

  • Alyssa M

    So very excited, thanks to some of the comments on here I think I finally found a way to get pre-marital counseling! I had no clue, and I doubt he did either, but the University he works for actually provides a counseling center (with marriage counseling) for benefits eligible employees! Now I’m just crossing my fingers we aren’t disqualified because I’m not covered by his benefits pre-wedding…