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Couples therapy (aka Couples counseling) is a term which is used specifically for therapy provided when the when the partners are not married. the terms marriage counselling, marriage guidance, marital therapy) in the married case. This is perhaps an outmoded distinction given the incidence in many societies of people choosing to live together and not get married. The distinction is not commonly made in practice and is maintained here to reflect the organization of the literature in the APA thesaurus

Couples therapy is a particular form of counselling and involves a couple meeting with the psychologist, social worker or other type of mental health professional for counseling to address the dysfunction in their marriage. Married couples seek therapy for a number of reasons, most notably for sexual problems or difficulties in sustaining the relationship. Although the original purpose of marriage guidance was to attempt to preserve relationships, marriage therapy now also often acts to help couples whose relationship has broken down to extricate themselves from the relationship with as little hurt as possible.

It is commonly observed that many couples who seek counseling dissolve their relationship despite their clear intention to avoid this extreme emotional trauma and expense. The most successful work in counseling involves the study of couples whose relationship has been restored and who have found a counselor capable of creating an appropriate relationship education milieu. There are many studies indicating that troubled couples have great difficulties with a "value neutral" approach, when they are diligently seeking to resolve difficulties in their marriage. The neutrality is seen as therapeutic vacuum. The dearth of table of contents entries pertaining to the restoration of marital health in psychiatric, psychological, social work, and counseling text books and journal articles indicates a specific professional de-emphasis on relationship education, restoration, forgiveness, and healing. A general denial of couples goal to restore the very positive values and experiences that characterized their relationship in the past may represent a significant part in the negative assessment of the Consumer Reports respondents mentioned below.

Occasionally, divorced couples use mediation to resolve the matters of custody, spousal support and the division of property. The use of the same professional to re-build a marriage or to end it might appear incongruous and troublesome to the majority of couples who are seeking help at a very distressed time in their lives. Many individuals refuse to seek counseling because of the feeling that they are admitting that their relationship has failed or that locating a counselor capable of restoration can be accomplished readily. However, many couples in minimally-distressed relationships seek counseling to resolve difficult concerns, to confront problems in the context of couples therapy or to find a neutral location to improve their relationship. The most successful marriage counselors may meet with the partners separately before meeting with them together, or may even have individual counselors who meet with the partners and then have a group session with all the counselors and the partners. In common practice, though, the latter is rare, and it is over-wrought with concerns about confidentiality and cost management. Having one assistant to see each party separately, to assess strengths and weakness, and then to reconvene with both to discuss what each can do for the other to rebuild is a most helpful technique.

The internet has added new dimensions to traditional face to face counseling. It is now possible to engage in counseling sessions with therapists in other states or even other countries via web cams, email and the telephone. Websites can easily outline the service intervention approach and provide free and widely accessible readings that may challenge inappropriate and resentful assumptions about a partner, all the while re-establishing the common ground and reinforcing the strengths that brought the couple together, initially. This step, alone can be very helpful.

Theoretical approaches to couples therapy

Assessment in couples therapy

Main article: Assessment in couples therapy

Therapy settings

Main article: Couples group therapy

Marital therapy research

Most studies purporting to show counseling effectiveness do not provide parallel study of placebo groups and do not track improvement that may come with the mere passage of time, in the absence of treatment. A 1995 study by Consumer Reports, with a sample size of over 15,000, while indicating some value in counseling by the North American consumers of these services, indicates substantial dissatisfaction with marriage counseling. Marriage counseling was seen as the least effective intervention offered. (Many counseling agencies will not provide longer term studies of their work, and have no means of inquiry as to the marital status of couples in subsequent years.) The type of counseling that was reported as the most valuable by consumers was Alcoholic Anonymous, a lay, peer support. The work of the Coalition for Marriage, Family, and Couples Education, also reports substantial improvement for couples by means outside of traditional, pathology-based psychotherapy.

Couple therapy and mental health problems

Counseling or therapy that is reimbursed by health insurance in the United States, requires a diagnosis of mental illness. Psychotherapy methods rarely involve instruction to the couple, or to the husband or wife regarding specific methods to correct behaviors which have led to deterioration in the marriage. This void is being met by the marriage education movement which dates its beginnings to 1995. This movement, while not seeking to supplant therapy or counseling, sees nearly all individuals and couples, including unmarried, dating couples, as capable of learning improved relationship skills, from a variety of means, including self-study. Intensive follow-up at the University of Denver has shown repeatedly, that educational efforts, when presented by lay persons, can often be more efficacious than therapy given by pathology-bound psychotherapists.

Main article: Couple therapy and alcohol abuse
Main article: Couple therapy and drug abuse

Journals in the field

See also

References & Bibliography

Key texts


  • Coché, J. (1995). Group therapy with couples. In N.S. Jacobson & A.S. Gurman (Eds.), Clinical Handbook of Couple Therapy. New York: Guilford.
  • Halford, W. K., & Markman, H. J. (1997). Clinical handbook of marriage and couples interventions (pp. 679-693). Chichester, England UK: John Wiley & Sons, Inc.
  • Jacobson, N.S., & Christensen, A. (1996). Acceptance and Change in Couple Therapy: A Therapist's Guide to Transforming Relationships. New York, NY: W.W. Norton & Co.
  • Jacobson, N.S., & Gurman, A. S. (1995). Clinical Handbook of Couple Therapy. New York, NY: The Guilford Press.


  • Baucom, D.H., Shoham, V., Mueser, K.T., Daiuto, A.D., & Stickle, T.R. (1998). Empirically supported couples and family therapies for adult problems. Journal of Consulting and Clinical Psychology, 66, 53-88.
  • Dardaneau, M. L. & Johnson, S. M. (1994). Facilitating intimacy: Interventions and effects. Journal of Marital and Family Therapy, 20(1), 17-33.
  • Feld, B.G. (1997). An object relations perspective on couples group therapy. International Journal of Group Psychotherapy, 47, 315-332.
  • Feld, B.G. (1998). Initiating a couples group. Group, 22, 245-259.
  • Halford, W.K., Sanders, M. R., & Behrens, B. C. (1995). Self-regulation in behavioral couples therapy. Behavior Therapy, 25(3), 431-452.
  • Hazan, C., & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52(3), 511-524.
  • Lakoff, R.S. & Baggaley, A. (1994). Working with couples in a group: Theoretical and practical issues. Group Analysis, 27, 183-196.
  • Mohr, D. C., Moran, P., Kohn, C., Hart, S., Armstrong, K., Dias, R., Bergsland, E., Folkman, S. (2003). Couples therapy at end-of-life. Psycho-oncology, 12, 620-627.
  • Spanier, G.B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38, 15-28.
  • Spanier, G.B. & Thompson, L. (1982). A confirmatory analysis of the Dyadic Adjustment Scale. Journal of Marriage and the Family, 44, 731-738.
  • Snyder, D. K. (1999). Affective reconstruction in couples therapy. Clinical Psychology: Science and Practice.
  • Whisman, M. A., & Allan, L. E. (1996). Attachment and social cognition theories of romantic relationships: Convergent or complementary perspectives? Journal of Social and Personal Relationships, 13(2), 263-278.

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