Therapy101 / Relationships
Couple work
Couple therapy can take different forms, shaped by the people involved, their aims and the approach.
Working together
Couples may bring questions about communication, trust, intimacy or changes in their relationship. Some work takes place entirely in joint sessions, while some practitioners include one or two individual meetings during an initial assessment. How information from any individual meeting is handled should be agreed in advance.
Different approaches
Couple therapists draw on different traditions. Emotionally focused couple therapy pays particular attention to emotion, attachment needs and recurring cycles of interaction. Behavioural and cognitive behavioural approaches may focus on communication, actions and interpretations; integrative behavioural couple therapy also emphasises emotional acceptance alongside change. Psychodynamic and systemic practitioners also work with couples. Practitioners often combine ideas, and an approach’s name alone does not tell you what a particular therapist will do.
Balancing more than one perspective
Unlike one-to-one therapy, couple work involves each partner’s alliance with the practitioner as well as the couple’s shared sense of purpose. Research on alliances in couple and family therapy describes a split alliance when one partner feels much more understood or aligned with the practitioner than the other.
A constructed example
Constructed for learning. Not a real case.
Two partners attend a first appointment saying they keep having the same argument about household responsibilities and time together. Rather than deciding who is right, the practitioner asks each partner what happens just before the argument escalates, what each person feels at that point, and what they each hope the sessions will help them change.
Safety and choice
Couple work is not always appropriate. When abuse or coercive control is present, joint sessions can expose a partner to further harm, including retaliation for what is said. The National Domestic Violence Hotline advises against attending couple counselling with an abusive partner. Specialist domestic abuse services can offer confidential support and help a person consider their options.
Sources and inspection notes
British Association for Counselling and Psychotherapy. Couples: how counselling can help.
Supports: Topics brought to couples counselling and discussion of confidentiality when individual meetings take place.
Supports: Overview of contemporary couple therapy approaches and differences in their emphasis; this review is not a guarantee of outcome for an individual couple.
Supports: Abstract describes within-system and split alliances across 48 studies (1,545 couples and 2,568 families) and reports that more unbalanced or split alliances are associated with poorer outcomes.
The National Domestic Violence Hotline. Should I Go To Couples Therapy With My Abusive Partner?
Supports: The organisation advises against couple counselling with an abusive partner and describes the risk of retaliation.