When the health of your relationship is at stake, you want the right therapist. That means one who is qualified to help you address the issues you are facing and one with whom you and your partner feel comfortable. That means doing more than just Googling "marriage counselor" on the internet and picking the first name that pops up. There are all sorts of therapists, counselors, and coaches out there willing to work on relationship issues, but important differences do exist—and you need to pay attention to them.
Here, we share 10 questions to ask before scheduling an office visit. (Some answers might be found on the therapist’s website; feel free to call about the rest.)
1. What is your state license and professional affiliation? Various mental health professionals—from psychologists to counselors to social workers to marriage and family therapists—offer therapy services to couples, and their qualifications can vary greatly.
You should not work with a therapist unless he or she is licensed by your state. Beyond that, ask if the professional is a member of a leading professional organization. Membership in a professional organization indicates that the therapist is more aware of recent developments in their field of study.
2. What approach do you use in couple therapy? Numerous approaches to couple therapy exist. Some therapists use a specific approach like emotionally focused therapy (EFT) or cognitive behavioral therapy. Others describe their approach as "eclectic," which can mean integrating more than one approach or using techniques from a variety of approaches.
We believe that if you’re going to put your relationship and your money in the hands of a professional, you should know that the therapist is working from a clinical approach that has been research tested and has demonstrated positive results. Three couple therapy approaches that have achieved strong research support are emotionally focused couple therapy, behavioral marital therapy, and integrated behavioral couple therapy.
3. What kind of training have you had in couple therapy? Some therapists may mention specific conferences or workshops they’ve attended. Others may point to certification programs they’ve completed post-graduation. A therapist’s response to this question will tell you whether their work with couples is something they have invested time and energy in developing, or simply something they offer as a general part of their overall practice.
Be wary of therapists who are still practicing what they learned in graduate school 10 years ago. When you ask a therapist about training, they may mention where they went to grad school, what degree they earned, but they should also talk about other training they have received in the years since.
4. What percentage of your practice is working with couples? This is very important. The answer to this question will tell you whether a counselor specializes in treating couples or does it as a part of their overall general practice. It gives you a clear way of gauging the amount of current experience the therapist has with couple therapy.
Look for a counselor whose weekly caseload is at least 50 percent couple therapy. Experience is important, particularly in EFT, where therapists actively learn from the couples they serve.
5. Do you mainly meet with partners as a couple or as individuals? Contemporary scholars don’t recommend treating couples by working with individual partners in isolation. Without the relationship in the room—meaning both of you present—it’s more difficult for partners to know or experience what’s changing at a personal level, or in the dynamic between the partners.
You want a counselor who sees both of you in-session at the same time almost all of the time over the course of counseling. They may see you each for an individual session early on as part of the assessment, but this should not be the norm.
6. Do you focus more on strengthening the couple or on each partner individually? The answer to this question tells you something about how the counselor sees change happening in therapy. Does change happen through helping individuals to revisit childhood and family of origin relationships primarily? Or does the therapist use sessions to focus on the couple’s relationship as the basis of change?
“It’s okay to let the therapist know that you plan to have an initial session with several professionals in order to find the best fit.”
A stronger relationship brings resilience to both partners individually and to the couple. When Brad feels emotionally connected with Becca, for example, he is "set free" in a sense to be a better employee, friend, and lover as well. He is a better person in and out of his marriage because of the increased positive sense of himself gained through his connection with Becca.
7. What do you focus on most when working with couples? Some counselors may be surprised by this question, but that’s okay—you should know what to expect, and this question helps get you there.
Some approaches focus on communication skills and behavior change. Other approaches emphasize new understanding and insights. You know, things like this is how you felt with your dad, or this is how you felt at home, etc., but that’s not where you find yourself now—gaining that insight.
But a newer way of creating change is by focusing on and working with lively emotion. This helps couples make explicit that which is rarely, if ever, spoken between them. When Charles, for example, sees and feels how much his disapproval really hurts Sophia, her emotion is a powerful agent of change for him. He wasn’t aware that it hurt her so. These "underbelly" emotions are powerful if you know how to uncover and use them for a stronger bond.
8. What do you do if a couple isn’t sure they should stay together? Some therapists are more "marriage friendly." Other therapists are more "divorce friendly." William Doherty, a professor and marriage and family therapist, warns couples that couple therapy can be hazardous to your marriage if your therapist doesn’t view marriage in the same way that you do. He encourages couples to pay attention to the values a counselor has about couple therapy before beginning therapy.
Ask yourself, "Do I want a counselor who will help us fight for this marriage?" If so, listen carefully to the therapist’s response to this question. The decision about your relationship is your own, but so is the decision to choose a therapist who will work with you for what you desire. If you tell the counselor you want to make the relationship work, and can they help you two do this, and the counselor is neutral about this, why pay for counseling with them?! Yes, they may do their best and later say they can’t help you beyond a certain point. That’s fine. But up-front if they can’t join with you in doing all they can to make it work—go elsewhere for goodness’ sake!
9. When should couples stay together or break up? Typically, a counselor will say, "It depends on the couple." This isn’t a bad response, because, ethically, therapists don’t make decisions for their couples. But see if you can push the counselor to talk about when a couple should break up.
For example, if a relationship involves domestic violence, which is harmful to victims and children who are exposed to violence, divorce may be the best option. If a partner refuses to address destructive patterns of addiction or engages in repeated affairs that destroy trust, again, divorce may be best. On the other hand, though, beware of therapists who see divorce as a solution unto itself. More often the issues behind a breakup are more important than the decision to stay or go.
10. Of the couples you’ve seen, what percentage would say you helped them improve their relationship? This may seem like an obvious question, but few clients actually ask counselors about their success rates.
Granted, judging success in counseling is often difficult, and many factors can influence treatment outcomes. However, two-thirds of people show improvement in psychotherapy, so you should be looking for a percentage at least this high.
Once you decide to schedule an appointment, be aware that having one session with a couple counselor isn’t a commitment to continue with that therapist. It’s okay to let the therapist know that you plan to have an initial session with several professionals in order to find the best fit. This approach is standard; plus, it just makes good sense.
Lastly, feel free to think about each session for several days after the fact. A counselor who’s truly focused on helping couples won’t be offended when you tell him or her that you’ll call back if you want to continue therapy.
Brent Bradley, PhD, and James Furrow, PhD, are co-authors of "Emotionally Focused Couple Therapy For Dummies." Dr. Bradley is president of The Couple Zone (www.couplezone.org), a center for counseling, counselor training, and research in Houston. He is a former tenured associate professor of family therapy and a published scholar/researcher in emotionally focused couple therapy. Dr. Furrow is professor of marital and family therapy at the Fuller Graduate School of Psychology. He is executive director of the Los Angeles Center for EFT and a certified emotionally focused couple therapist, supervisor, and trainer.