Family life

What parents need to know about couples therapy—including if it actually works

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Here are two things we know for sure: Marriage is hard, and kids make it harder. So what happens when you throw a global pandemic into the mix?

With all the extra stress in parents’ lives, it’s no surprise that marriage therapists report seeing an uptick in couples looking for help. Multiple surveys suggest that many couples started arguing more with their partner when the COVID-19 pandemic began. The fights can be about anything—childrearing and domestic duties, intimacy, money—because, really, any number of topics can serve as a proxy for worries about an uncertain future, precarious employment and social isolation. “Couples are in close quarters, working from home, parenting from home—and without the same outlets like work, friends and hobbies,” says Elana Sures, a psychotherapist in Vancouver. “There are pent-up emotions that don’t get processed, whether that’s anger or anxiety.”

The threat of a breakup is extra stressful when you have kids because you’re so keenly aware of how deeply affected they’ll be. This often becomes the motivation for troubled parents to seek outside help.

“Therapy? No way”

The stigma associated with therapy has long been a deterrent for getting help, but thankfully it’s fading as society’s compassion around mental health issues has grown. But even if you’ve done individual therapy and think therapy’s no big deal, you or your partner may still feel reluctant to seek out a stranger and spill your relationship dirt—the things you’re perhaps not proud of saying or the behaviour you never imagined you would tolerate from a partner.

Some couples might worry that seeing a therapist conflicts with the sunny version of their #relationshipgoals being posted on Instagram. Heather Kohlmann, 38, who lives in Toronto with her husband and infant daughter, says that she and her now-husband were on the verge of a breakup before getting married, but they were still reluctant to seek out help. “Part of the reason we put it off for so long was that I didn’t want to admit we weren’t the perfect couple I thought all our friends saw us as,” she says. “I definitely felt that if there was something so wrong with our relationship that we needed therapy, then surely it wasn’t strong enough to last.” And that was a fact she didn’t want to face.

Unsurprisingly, it’s better to not let things fester. “Couples usually wait until they’re in crisis instead of focusing on relationship maintenance,” says Ornella Harris, a psychotherapist in Mississauga, Ont. “So when you’re faced with other compounding issues, it really intensifies the need for support.”

The tendency to rationalize struggles in the context of a relationship, says Sures, is another factor that keeps people away from the therapist’s office. “They think, ‘Every couple with kids goes through this.’”

It’s true that conflict is both normal and expected in relationships. But feeling unhappy, bored, frustrated or unappreciated in your relationship shouldn’t be anyone’s status quo—and couples therapy can help unpack those feelings.

How to find a couples therapist you can trust

Trusted friends, family members or your healthcare provider are great places to start looking for a therapist recommendation.

Ruth Neustifter, who teaches the couples therapy program in the Department of Family Relations and Applied Nutrition at the University of Guelph, recommends interviewing a therapist before you commit to a session. Request a brief phone call (about 15 to 20 minutes, and you usually won’t be charged for it) to ask where they’re registered or licensed, how much experience they have, how they might approach someone with your concerns, and, if this applies to you, if they’re trained to do work with a particular community, sexuality, ethnicity or religion.

Black, Indigenous or persons of colour, as well as transgender or non-monogamous individuals, might want to make the extra effort to find a therapist with similar lived experience. “Social location is really important in terms of creating a safe environment you can feel vulnerable in,” says Harris.

Finally, ask what type of therapy they use. Sures says there are two particularly popular forms: the Gottman Method, based on the research of clinical psychologists (and married couple) John and Julie Gottman, and Emotionally Focused Therapy (EFT), based on what’s called attachment theory and pioneered by Canadian therapist Sue Johnson. There are many styles out there, but it’s most important to make sure the therapist has training and experience in couples therapy specifically.

Couples therapy in the age of physical distancing

As long as COVID-19 is lingering around, expect that your sessions—which are typically just shy of an hour—could be held over Zoom, Skype or telephone. Some in-person sessions might be available, but you should likely anticipate the new normal of physical distancing, masks and hand sanitizer.

Sures for one has found that remote sessions are just as effective as in-person, although she’s experienced her share of tech glitches, so prepare yourself for accidental muting or the odd frozen screen. Do what you can to minimize distractions. “Put the kids in front of a movie or plan it for nap time,” says Sures. Post-bedtime might be best for parents with small kids—if that’s the case for you, ask your therapist if they have any evening availability.

What to expect during couples therapy

During your first appointment, it’s standard to be asked to sign a consent form and a contract for services and to also provide a little background on your relationship.

While what happens in therapy depends on the style of therapy you’ve chosen and the issues you would like to explore, Neustifter says it’s common to explore exercises related to how you hear and respond to each other’s needs, how to negotiate when your needs conflict, how to de-escalate if you experience intense conflict, and even how to structure your day in order to prioritize the relationship. You can also likely expect to spend time talking about your upbringing, with a specific focus on how love was modelled. “It’s important to look at subconscious programming when it comes to how you see the world,” says Harris.

Couples often see a therapist for eight to 12 sessions, but others go periodically; still others might see a therapist for the entire duration of their relationship. The amount of progress you make and how fast you make it will depend on your individual situation. “If it’s mostly stress and you’re otherwise getting along fine, you can often see some real progress in just the first few sessions,” says Neustifter. Harris says that couples aiming for 10 sessions should start to feel a “shift in perspective” by around the halfway mark.

How much does couples therapy cost?

There’s no way around it: Couples therapy is expensive—prohibitively, for many. Sures says you can expect to pay between $120 and $160 per hour for a master’s level therapist (a social worker, registered psychotherapist or clinical counsellor) and more than $200 for a registered psychologist. Workplace benefits sometimes cover the cost, but often for a limited number of sessions. Some therapists offer a sliding scale based on your income, and university training programs are a good place to find lower-cost options. Unfortunately, it can be difficult to find a couples therapist who is covered by a provincial healthcare plan.

A photo of two hands holding onto one another

Photo: Carmen Cheung

Does couples therapy work?

Before trying therapy, Kohlmann and her husband were defensive and unable to communicate, suppressing their needs to avoid conflict. Tension would build until someone exploded. “And then it would be so accusatory,” she says. Kohlmann wanted to go to therapy, but they were both concerned about cost. Eventually, they reached a crossroads. She remembers lying in bed together, both tearful, trying to figure out whether to stay together when they were both so unhappy but unable to fix it.

They ultimately did begin therapy, nudged by (of all things) a coupon that landed in Kohlmann’s inbox—and it took fewer than 10 sessions for things to really turn around. One key epiphany? Kohlmann says therapy helped her realize that, in previous conversations, she wasn’t really listening to her husband; rather, she was using the time he was talking to think about what she was going to say next to prove her point.

Sures says couples can expect to improve their communication skills quickly. “It’s also fair to expect a better, deeper connection and appreciation for each other,” she says. One 2016 study from the University of Ottawa found that couples who tried EFT enjoyed increased relationship satisfaction and attachment, even two years after their sessions.

A big part of making therapy work for you is taking responsibility for your role in the relationship dynamic. “It’s really important—no matter how ticked off you are,” says Sures. Blaming all your problems on your partner won’t get you anywhere.

Getting buy-in from your partner

While it might be common for one partner to lead the charge to therapy—yes, usually the woman in a heterosexual coupling—both partners are going to have to buy in to the process, and fully commit to the work, if you want to see any results.

For Andrew Stoneman*, a dad of one in Toronto, couples therapy felt doomed from the start. When he and his now-ex-wife tried it when their daughter was 12—initiated when Stoneman was unnerved by his wife’s close relationship with a male friend—his wife refused to return after two sessions because she felt the counsellor was taking her husband’s side. Her position masked a lack of commitment, something Stoneman finally accepted as his wife’s infidelities added up. “The old light bulb joke has wisdom in it,” says Stoneman. “It takes only one therapist to change a light bulb, but the light bulb has to want to change.”

If your partner won’t entertain the thought of couples therapy, consider individual therapy, which will help you see your issues more clearly. “I see a relationship as three relationships: each individual’s relationship with themselves, and then with each other,” says Harris. “All three need to function well for everyone’s health and well-being.” It might not be what you hoped for, but it’s a start.

Should I stay or should I go?

If your relationship is already in serious crisis, you might want to consider discernment counselling, which is designed to help a couple figure out whether to work on the relationship or to split up.

In discernment counselling, there’s typically “a ‘leaning in’ partner, who wants to stay, and a ‘leaning out’ partner, who wants to leave,” says Amanda Bacchus, director of the Vaughan Relationship Centre. The number of sessions is usually limited to a handful, with the aim of making a firm decision on how to proceed. “We figure out whether there’s a chance to save the relationship,” says Bacchus, who says she asks couples about motivation, family preservation considerations, respective responsibility in relationship breakdown, and what a future might look like.

Jennifer Ellison, a certified discernment counsellor in Oakville, Ont., notes that she commonly sees couples who are new parents who have not yet reoriented their relationship to their new normal. “We know that the first few years after having a child are some of the most stressful for relationships,” says Ellison, who adds that it’s rare to see couples whose issues didn’t precede the new baby.

Studies show that more than half of couples who try discernment counselling decide to stay together for good or, at the very least, stay together and partake in couples therapy for six months without bringing up divorce. But even those who decide to split report more amicable breakups and co-parenting arrangements, thanks to a process that ensures steps aren’t taken with an angrily packed suitcase in the middle of the night, but with a thoughtful and deliberate process.

DIY couples therapy

If therapy just can’t happen right now, try one of these books or workbooks recommended by couples therapists.

1. Hold Me Tight: Seven Conversations for a Lifetime of Love by Sue Johnson

This book offers an outline of Johnson’s wildly successful Emotionally Focused Therapy, with an emphasis on building emotional connection between partners.

2. The Seven Principles for Making Marriage Work by John M. Gottman

Gottman’s book offers practical strategies for building a happy, long-lasting relationship.

3. Marriage Rules: A Manual for the Married and The Coupled Up by Harriet Lerner

In this workbook, Lerner offers solution-based rules (particularly when it comes to self-regulation) to improve relationship quality.

4. Unf#ck Your Intimacy Workbook by Faith Harper

The exercises in this workbook—which range from communication templates to boundary setting—are designed to help users get in touch with their own needs.

5. Mating in Captivity: Unlocking Erotic Intelligence by Esther Perel

This book explores the complications of sustaining desire in a long-term relationship, including the issue of divergent sexual appetite. (While you’re at it, listen to Perel’s podcast, Where Should We Begin, where real couples anonymously work through their relationship challenges, from infidelity to sexlessness.)

*Name has been changed