Mental Health Therapy How to Know If You Need Marriage Counseling By Ashley Olivine, Ph.D., MPH Ashley Olivine, Ph.D., MPH Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. Learn about our editorial process Published on April 07, 2022 Medically reviewed by Stephanie Hartselle, MD Medically reviewed by Stephanie Hartselle, MD Facebook Twitter Stephanie Hartselle, MD, is a board-certified pediatric and adult psychiatrist and Diplomate of the American Board of Psychiatry and Neurology. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents What Is Marriage Counseling? Do You Need It? How It Works Efficacy What to Expect Online vs. In-Person Counseling Finding a Counselor Frequently Asked Questions Marriage counseling is couples counseling between a licensed mental health provider and married partners. Couples counseling involves working on relationship issues through discussion, advice, and guidance in a supportive environment with a qualified third party. It works by focusing on specific problems and using different approaches to address those problems. The mental health challenges of one or both partners can be addressed in marriage counseling. Counseling has been shown effective in increasing relationship satisfaction, which is an important measure of mental health. Learn more about marriage counseling, when it is needed, how it works, and more. FatCamera / Getty Images What Is Marriage Counseling? Marriage counseling is a process in which married partners attend one or more sessions with a licensed counselor in order to address relationship issues. It is often specific to a problem, issue, or topic and is generally short term. Some topics addressed in marriage counseling include: Communication, arguments, or disagreements Goals and plans for the future Responsibilities such as paying bills, parenting, and household management Intimacy or sexual challenges Addiction or substance use Tragedy, loss, or other hardship Emotional connection Infidelity Family dynamics Mental health conditions that affect the relationship There is some confusion regarding the difference between marriage counseling and marriage therapy, and the terms are sometimes used interchangeably. While they are similar and there is overlap, they are two different fields. However, some techniques may be used in both counseling and therapy. Marriage Counseling vs. Marriage Therapy What are the differences between counseling and therapy? They include:Marriage counseling is more future focused and marriage therapy is more past focused.Counseling is more likely to address specific relationship challenges.Therapy is more likely to address a mental health condition that affects the relationship.Marriage counseling is shorter term and marriage therapy is longer term. Do You Need Marriage Counseling? It is a common belief that couples need to be facing serious problems to go to marriage counseling. This is not the case. Marriage counseling is beneficial at the first sign of conflict or challenge and can even be used as a preventive measure. For example, partners who anticipate a life transition, such as having a baby, adopting a pet, moving, or starting a new job, may seek counseling to help navigate the changes before problems arise. Additionally, short counseling interventions may help to rejuvenate marriages that are going well but may be headed in a less stable direction. Signs you may need marriage counseling include: You sense things may be starting to head in the wrong direction.There is an increase or decrease in arguments or disagreements.One or both partners lie or keep secrets.There is frequent criticism or lack of satisfaction.Spending time together becomes a chore.Blame is involved in conversations or interactions.One or both partners expect the other to change.Arguments or conversations do not seem to progress toward resolution.There is jealousy or resentment.Relationship challenges impact children.You are struggling to communicate effectively, or at all.One or both partners seek the support of someone else before their spouse.There is a feeling of living separate lives.There are major changes in sexual activity.One or both partners begin to care less about interactions or circumstances.Communication leads to negative interactions or fighting.There is a decrease in intimacy, either sexual or nonsexual.There has been infidelity or a violation of trust. Everything You Need to Know About Relationship Counseling How It Works Marriage counseling provides a safe environment to work through challenges with the support of a trained professional. These professionals use techniques to help guide couples as they learn better ways to communicate and solve problems, building stronger relationships and increasing relationship satisfaction. Specific techniques work in different ways. Methods used in marriage counseling include: Emotionally focused therapy (EFT) has a structured format with eight to 20 sessions that focus on emotions, awareness, and change to overcome relationship challenges, improve interactions, reach goals together, and strengthen relationships.The Gottman method focuses on communication, closeness, removing barriers, and increasing intimacy. Efficacy A positive result from marriage counseling partially depends on the couple and their commitment to the process. While counseling for couples and married partners has been studied and found effective in improving relationship dynamics, research is limited. Couples counseling, including marriage counseling, has been shown to: Improve relationship satisfaction Increase commitment in the relationship Build effective communication skills Increase general wellbeing Reduce relationship distress Emotionally focused therapy (EFT) is a method used in both marriage counseling and marriage therapy. This method has been found effective both in the short term and months to years after finishing the program. What to Expect Marriage counseling is conversation based, which means it involves talking between the provider and the couple. It is generally short term and focused on a specific problem. The details of what happens during the sessions will depend on the provider, the married couple, and what is being addressed in the counseling. Counseling sessions can also include practical strategies and tools taught by the provider, which may be practiced during sessions. For example, if the issue being addressed in counseling is related to communication challenges, the provider may teach the couple specific ways to phrase thoughts or feelings. Then, the partners may share those thoughts and feelings with one another during the session, with the support of the provider. In the session(s), couples will: Identify problems, issues, or challenges to be addressedDiscuss possible outcomesSet goals for the counseling processLearn methods, strategies, techniques, or toolsPractice what is learned with the practitionerImplement what is learned outside of the sessionsDiscuss how things are goingMake adjustments as neededCreate a plan for the future after counseling Online vs. In-Person Counseling When most people think of counseling or therapy, they think about sitting in an office with a provider. However, this is not always the case. Marriage counseling can be offered online through video conferencing options. Some providers even offer phone calls, emails, or texting between sessions. People who receive counseling online have been shown to be just as satisfied with the experience as people who receive face-to-face counseling, and the remote option can make it easier to access the services. Some benefits of online counseling include: People may feel more comfortable in their own homes. It can provide a more confidential environment. It can help the attendees avoid stigma, or negative thoughts about counseling. There is a greater choice of providers without distance limitations. It may require less time since it does not require travel. Key Differences Between Online and In-Person Counseling The main differences between online and in-person counseling include:Online requires technology, including Internet.In-person may require traveling to a location.Online can take place anywhere with an Internet connection.Online may feel less personal.In-person provides a unique environment separate from any distractions at home. The choice between online or in-person counseling is a personal decision for the married couple to make together. It is important for both partners to feel comfortable with the format and environment. Some providers offer sessions both in person and online to allow for more flexibility. Finding a Counselor Counselors can be found by searching online databases for qualified and licensed professionals specializing in marriage counseling, getting a referral from a healthcare provider, contacting the insurance company for providers accepted by that plan, and asking friends and family members for recommendations. When starting marriage counseling, it is important to find a provider that is compatible with both partners. If both partners are not comfortable with a provider, it is OK (and recommended) to try a different one. Does Medicare Cover Counseling? Summary Marriage counseling is communication-based support for married couples to work on relationship issues through advice and guidance from a licensed mental health professional. It is usually short term and focused on a specific problem such as communication or intimacy. Signs that marriage counseling is needed include a sense that the relationship is headed in the wrong direction, an increase in arguments, indifference, resentment, infidelity, and more. Some couples choose to attend counseling as a preventive measure. Marriage counselors use techniques and methods to help partners improve relationship interactions, decrease conflict, strengthen bonds, and increase relationship satisfaction. A Word From Verywell Like all relationships, marriage is not always easy. Couples face many challenges in life and in their relationship. If you think you and your spouse may benefit from marriage counseling, contact a marriage counseling provider such as a licensed counselor for support. Choosing the Right Therapist Frequently Asked Questions How much is marriage counseling? The cost of marriage counseling depends on the provider and their credentials, the location, and other factors. It is generally around $100 to $200 per hour, but can range from $75 to over $500 per hour. When should you start marriage counseling? Marriage counseling can start as soon as a couple is married. Counseling before marriage is called premarital counseling and can start when a couple begins to think about or discuss marriage. Since marriage counseling can be preventive, it is never too early to start, but it is best to start as soon as conflict arises. Learn More: 7 Reasons to Try Premarital Counseling When should you stop marriage counseling? Marriage counseling is generally scheduled for a set amount of time or number of sessions to address a specific issue or challenge. It can be stopped when that amount of time or number of sessions has been completed, or when the goals of the counseling have been achieved. Should you try marriage counseling before getting a divorce? It is a good idea to try marriage counseling before getting a divorce. Marriage counseling has helped many couples avoid divorce. Even if the marriage does end in divorce, marriage counseling can still be helpful by making the process easier and preventing future issues with parenting during and after divorce. 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Psychological Association. Marriage counseling. American Psychological Association. Couples counseling. Schofield MJ, Mumford N, Jurkovic D, Jurkovic I, Bickerdike A. Short and long-term effectiveness of couple counseling: A study protocol. BMC Public Health. 2012;12:735. doi:10.1186/1471-2458-12-735 Duba JD, Roseman C. Musical “tune-ups” for couples: Brief treatment interventions. The Family Journal. 2012;20(3):322-326. doi:10.1177/1066480712449604 American Psychological Association. Emotion-focused therapy. The Gottman Institute. The Gottman method. Najafi M, Soleimani AA, Ahmadi K, Javidi N, Kamkar EH. The effectiveness of emotionally focused therapy on enhancing marital adjustment and quality of life among infertile couples with marital conflicts. Int J Fertil Steril. 2015;9(2):238-246. doi:10.22074/ijfs.2015.4245 Zeren ŞG. Face-to-face and online counseling: Client problems and satisfaction. Education & Science/Egitim ve Bilim. 2015;40(182):127-141. doi:10.15390/EB.2015.4696 American Psychological Association. How do I find a good therapist? By Ashley Olivine, Ph.D., MPH Dr. Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. She has also researched a wide variety psychology and public health topics such as the management of health risk factors, chronic illness, maternal and child wellbeing, and child development. 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