Research-Backed Advice

How Couples Therapy Works


  • Couples therapy can help you identify unhelpful patterns and hone the skill of “relationship mindfulness.”
  • Consider a free consultation call with a therapist before an initial session to get a better sense of what to expect.
  • Couples therapy will involve hard, uncomfortable moments and happy, playful moments.
  • A good therapist will guide you, maintain a rhythm throughout your session, and uphold boundaries, so you don’t have to worry about doing it “wrong.”

Relationships aren’t always easy breezy. They sometimes require hard work, especially when conflict arises. Whether or not you’re butting heads, you might benefit from talking things out and learning new interpersonal skills. 

Couples therapy may help you and your partner break unhelpful patterns and improve communication.

According to the American Association for Marriage and Family Therapy (AAMFT), most couples therapy clients report relationship improvements. 

But unless you’re in the know, the idea of going to couples therapy may seem intimidating. 

Below, we outline why you might consider couples therapy, common myths, cost considerations, and what to expect from sessions.

What is couples therapy?

“The reasons why people say they come to couples therapy are often different than what [they] later discover – through therapy – to be the real reasons,” says Erin Davidson, a registered clinical counselor and sex therapist specializing in couples therapy in Vancouver, BC. 

According to Davidson, some of the most common reasons people start couples therapy include:

  • communication challenges
  • wanting to better understand and support each other
  • infidelity
  • navigating different levels of desire for sex
  • having the same fights over and over again
  • wanting to open the relationship 

All of these are great reasons to embark on couples therapy. But remember, the real, root reason you’re there will take some time to uncover.

You must be willing to open up and do the work to have a successful couples therapy experience.

What outcomes do people get from couples therapy?

Davidson notes two main outcomes you can expect to achieve from couples therapy. 

Couples therapy can help you achieve an awareness of your unhelpful relationship patterns. For example, your unhelpful pattern might be that you tend to be too critical of your partner. Couples therapy will help you identify this pattern, examine how it interacts with your partner’s unhelpful patterns, and help you both to see how your patterns are causing relationship roadblocks.

Another potential outcome is the cultivation of “relationship mindfulness,” says Davidson. In practice, this involves being able to pause during tricky situations and react in thoughtful ways. 

What are common myths about couples therapy?

Davidson outlines three common myths about couples therapy:

Myth 1: It will be hard the whole time. 

This isn’t true! Your sessions will have many light, enjoyable, playful, happy, and reassuring moments.

Myth 2: You can “fix” your relationship in one session. 

This won’t happen. But you can expect to have big epiphanies right away, says Davidson.

Myth 3: Your therapist will act as a completely impartial mediator.

Davidson notes that while some therapists try to be entirely “fair” throughout the entire session, it’s more common for therapists to initially focus on the partner with “explicit” behavior. 

For example, if one partner tends to yell and one partner tends to withdraw, the therapist will address the loud person first. This may not feel equal, but it will ultimately be the most productive in reaching your goals as a couple.

How much does couples therapy cost?

The cost of couples therapy ranges widely, from $50 to $250 per hour, with the average cost being about $95 per hour. 

It’s essential to make sure your therapist is available to meet your support and budget needs. 

Some things to keep in mind when shopping around for the right therapist include:

  • Some therapists offer sliding scale fees based on income.
  • Some therapists accept insurance.
  • Some therapists charge per hour, and some charge per session — be mindful of session length when determining the overall cost.  
  • Some therapists are booked months in advance, so you have to wait a while to see them again after your first session, which isn’t ideal.
  • Some therapists may only accept clients who can attend weekly sessions, which may not be within your budget.

How Couples therapy works

Your first couples therapy session will look different depending on the therapist. 

Most therapists offer a free consultation to help you figure out if you click. This consultation is also an excellent opportunity to ask the therapist questions about their philosophy and methods, giving you a better idea of what to expect from sessions. 

Questions to consider asking:

  • How much do you expect me to talk? 
  • Will we do role-playing exercises? 
  • What kinds of questions do you ask to get conversations started?

This free call can help you feel much more comfortable moving into your first session.

During an initial session, your therapist will usually focus on gathering information. They may ask about your goals and potential relationship pain points.

Will I have to talk about sex?

Your therapist may not ask you about sex, particularly if they don’t have training in therapeutic conversations about sexuality. 

But, no matter how taboo or uncomfortable the topic might be, it’s likely you won’t get what you want and need out of couples therapy if you’re unwilling to talk about your sex life. 

Experts note that neglecting conversations about sexuality ignores an important form of intimacy within your relationship. As much as you might not want to go there, you’ll probably end up happy that you dove right in.

Tip: Another good question to ask in a free consultation: Are you trained to talk about sex? 

How to prepare for your first session

Asking questions during a free consultation is a good place to start.  

Before attending your first session, Davidson recommends asking yourself the following questions:

  • What would your relationship look like if you could magically delete all of your relationship problems?
  • What are your top three points of tension within your relationship?

Going into your first session feeling like you have some clarity with your goals will help tremendously, says Davidson.

Dos and don’ts in couples therapy

You might feel nervous that you’re going to do something “wrong” in couples therapy. But there isn’t a right or wrong way to go through couples therapy. 

“It’s actually the therapist’s job to teach you how to be in the session and corral you and your partner into a good rhythm and hold boundaries,” says Davidson. 

“It’s like the therapist is a conductor, and you and your partner are playing instruments. Of course, there will be some wrong notes, but the conductor is there to set the tone and bring you back into harmony.” 

Don’t worry too much about doing the wrong thing. As long as you’re brave, open, and honest, you’re doing it right.

The final word

Couples therapy isn’t a quick fix for your relationship problems, and it will involve some hard and uncomfortable moments for you and your partner. 

Take the time to clearly outline your relationship goals and commit to uncovering points of tension and unhelpful patterns. This will help you both learn skills that can help you strengthen your relationship.

Olivia Kelava
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