Popular types of couples therapy and what to know when choosing a therapist
- There are a wide variety of approaches to
couples therapy, and choosing the right one for your relationship depends on your goals.
- Many therapists are trained in multiple modalities and can integrate different approaches depending on the couple.
- The therapist you choose to work with may be more important than the type of couples therapy they use.
Couples therapy can be a powerful tool, whether you're looking to increase intimacy, improve communication, build trust after a betrayal, or learn to navigate your differences as individuals.
Couples therapy has been around since the 1930s, but it didn't gain popularity until the 1980s when different approaches described below came to life.
There are a wide variety of approaches to couples counseling, and experts say choosing the right one for you will ultimately depend on your goals for the relationship. Here are some common types of couples therapy and how to determine which is right for you.
The Gottman method
Gottman Method Couples Therapy, which was created by husband and wife psychologists John Gottman and Julie Gottman, was built based on the findings from 40 years of scientific research about patterns of behavior in successful and unsuccessful partnerships.
The Gottman method entails honing in on destructive behaviors such as "the four horsemen":
Areas of focus include:
- Sharing relationship histories
- Exploring areas of disagreement
- Identifying various triggers
- Discovering shared values
- Gaining specific tools to help manage conflict
A 2018 study showed that couples scored significantly higher in regards to intimacy and overall relationship quality after receiving 10 sessions of Gottman's couples therapy.
Cognitive-behavioral therapy (CBT), which was originally designed for individual use to treat such issues as anxiety, depression, substance abuse, and eating disorders, centers around the notion that your thoughts influence your behaviors.
"A CBT therapist will initially focus on identifying what each partner is thinking about the conflicts that have brought them to couples counseling," says Gary Brown, PhD, a licensed family and marriage therapist based in Los Angeles. "One's beliefs may be challenged in order to help each partner develop better methods of communicating."
Discernment counseling was developed around 2008 for cases of conflicted couples in which one partner wants to save the relationship and the other is leaning towards ending it.
This short-term approach is meant to bring clarity for both partners when ambivalence is preventing them from fully engaging in and reaping the benefits of couples therapy, says Angele Close, PhD, a clinical psychologist and emotion-focused therapist based in Skokie, Illinois.
One of the primary goals of discernment counseling, according to Brown, is to help the couple discover all of their options to consider before they make the ultimate decision about the fate of their relationship.
Emotion-focused therapy, developed in the 1980s, is one of the most researched and tested types of couples therapy, according to Brown.
With this method, the therapist will typically have each partner share specific, problematic events in the relationship, and then work with them to identify, explore, and make sense of the underlying emotions that are contributing to those situations.
"It can be difficult for people to address their more vulnerable emotions when they get stuck in anger, resentment, or apathy," says Brown. "It is when they can access deeper emotions such as sadness, hurt, or fear that they can then understand the unmet needs that these deeper emotions help to reveal.What research says: A 2019 systematic review of nine studies concluded that emotion-focused therapy is effective at improving marital satisfaction. Additionally, a 2015 study of 30 infertile couples revealed that EFT significantly improved their physical, emotional, and sexual satisfaction from their spouses.
Imago relationship therapy
The Imago method views a couple's problems as a result of unmet childhood needs and unhealed wounds that later become sensitivities, conflicts, or pain points in adult
"The premise of Imago therapy is that each partner experienced certain images in their childhood that formed their own perspectives about what a relationship looks like," says Brown. "The goal is to bring these images into consciousness so that you can identify negative thoughts, feelings, and behaviors in order to help you understand the childhood experiences that impact how you behave towards your partner."
Brown says Imago relationship therapy involves a three-step process of mirroring, validating concerns, and expressing empathy. A 2017 study found that couples experienced "statistically significant" increases in marital satisfaction after completing 12 sessions of this therapy method
The philosophy behind Narrative therapy is that the stories you and your partner tell yourself shape your decisions and behavior toward each other. True to its name, this technique revolves around correcting self-defeating or otherwise negative narratives that may be sabotaging the relationship dynamic.
"The therapist helps the couple see what erroneous beliefs and themes from their lives are contributing to the deterioration of their bond," says Close. "The couple is guided to create a new and healthier narrative that honors and addresses the needs of each partner while fostering greater intimacy and connection in the process."
Solution-focused therapy is better suited to couples who are exclusively looking to resolve a specific problem, as opposed to those experiencing a wider range of conflicts, says Brown.
Results from a small 2018 study revealed that brief solution-focused couple therapy can significantly reduce "couple burnout" - a physical, mental, and emotional condition that involves a lack of interest and attachment to one's spouse.
"A solution-focused style is to invite the couple to envision the positive changes they aspire for," says Close. "From this imagined circumstance, the therapist and clients concretize and delineate actionable steps designed to achieve these goals together."
Most therapists are trained in more than one modality and can integrate different approaches as needed depending on the specific challenges you're facing in the relationship.
In addition to considering all options for types of couple's counseling, experts emphasize that it's just as important to find a professional you feel comfortable with and can build a good rapport with - someone who validates your problems and effectively addresses them.
"Since you are going to share some of your most intimate thoughts and emotions, I believe the therapist you choose to work with is more important than the methodology that they use," adds Brown.
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