Tips for Recognizing Effective Couples Therapy

Tips for recognizing effective couples therapy

On a personal note, I believe that effective couples therapy is invaluable given the many economic and human costs associated with divorce. With this in mind, I often tell my clients, “If you think couples therapy is expensive, just wait until you see how expensive divorce is.”

My point in making this comment is to convince those who are struggling in their relationship that effective couples therapy, even if it seems expensive at the time, can turn out to be one of the best investments they will ever make.

Even if your marriage fails, the things you will learn in good couples therapy will help improve future relationships.

At the same time, I believe good couples therapy can be invaluable, I also believe it can be harmful if it’s not done correctly. In fact, if your therapist doesn’t know what they’re doing, they can actually hurt your relationship through the counseling process. This typically happens when they guide you toward focussing mostly on the problems in your relationship.

If they do this, you can be certain that they’re not in touch with the research around what it takes to develop and sustain a strong relationship. A

Maintaining a 5 to 1 ratio of positive to negative interactions

Researchers like John Gottman ( have empirically demonstrated that to build and sustain healthy relationships, couples must consistently maintain a 5 to 1 ratio of positive to negative interactions to keep the “good feelings” or, what researchers call “positive sentiment,” in a relationship.

With this in mind, any negative things that take place in front of a therapist–-like back and forth “he said she said” bashing during a session–-can do harm to a relationship.

During your sessions, an effective therapist won’t simply set back and watch you fight with your partner.

You can do this on your own time.

At a minimum, a good couples therapist will

  • Identify core problems, unhealthy relationship dynamics, levels of commitment, and your goals
  • Call attention to and get all the unwanted “elephants out of the room” by making sure both you and your partner are emotionally healthy, free of addiction, do not abuse each other, and are not participating in an affair
  • Teach or review the principles of successful relationships, including the characteristics of a healthy, romantic relationship
  • Help you create a “Relationship Vision
  • Guide you toward developing “Relationship Agreements” that spell out the specific things you will think and do to solve your problems, reach your goals, and realize your Relationship Vision.

To clarify what I mean by these characteristics of effective couples therapy, I will discuss each of the five areas as follows:

  • Identify core problems, unhealthy relationship dynamics, levels of commitment, and your goals.

The old saying “Seek to Understand Before You Seek to Be Understood” is applicable here. If your therapist starts “helping you” before they really understand what is going on, they may take you down the wrong path. This can be both a waste of time and money and, may cause harm to your relationship.

There are many different effective tools that therapists can use to systematically identify the core problems in your relationship, including the process I use which is known as the Prepare-Enrich Assessments or P/E (

The P/E provides personalized insights into relationship dynamics, commitment levels, personality, spiritual beliefs, and family systems.

Because a comprehensive assessment like what is included in the P/E takes time and costs money, your therapist should start the process by asking each of you what your reasons are for seeking help.

I do this by asking each person which of the following scenarios is most like what they want at this point in their relationship.

  • Do you want to separate/divorce
  • Accept each other unconditionally—while working on yourself
  • Negotiate some changes while continuing working on yourself?

If one or both clients pick the first option I explain that couples therapy won’t be necessary and, in turn, help them begin the process of consciously disconnecting without the anger, resentment, and bitterness that often takes place near the end of a relationship.

If both clients pick any of the latter, I explain the process that is outlined in this article, including the need to conduct a comprehensive assessment of their situation using the P/E assessment.

Considerable effort is required in rebooting a relationship

Maintaining a healthy relationship is hard work that requires focus and dedication

To my point above regarding the “value” of couples therapy, a good therapist will explain early on in the process that the considerable effort, patience, and dedication required to reboot and rebuild a relationship is worth the investment.

Although telling a couple that the therapeutic process will be easy may convince them to invest in a few sessions, my experience has been that clients who are lead to believe that couples therapy requires just a few hours and very little effort on their part will cause disappointment in both the therapeutic process and the outcomes.

This is because building and maintaining a healthy, happy romantic relationship is hard work that requires focus and dedication. I know this first hand given that my wife and I have been happily married for 40+ years.

  • Call attention to and get all the unwanted “elephants out of the room” by making sure both and your partner are emotionally healthy, free of addiction, do not abuse each other, and are not participating in an affair.

Effective couples therapy cannot happen if either partner has an untreated mental illness, is addicted to a substance like alcohol, is abusing their partner, or is involved in an affair.

With this in mind, a good therapist will insist that both clients agree to come to terms with and address such compelling issues before starting couples therapy.

At a minimum, if both clients agree that there is a serious problem that needs to be addressed with one or the other partner and, at the same time, they are desperate for help with their relationship, the therapist (at least I will) may agree to start couples therapy as long as the issue is being addressed at the same time.

For example, because I treat many clients who have a trauma-related diagnosis like PTSD, I will agree to do couples therapy as long as the client with the trauma diagnosis is, at the same time, engaging in an appropriate treatment.

Locus of control

A less obvious issue that should be addressed before or during effective couples therapy, is the case where one or both of the individual in the relationship does not have an “internal locus of control.”

In 1954 a personality psychologist, Julian B. Rotter, promoted a concept called locus of control. This construct refers to the extent to which individuals believe they can control events affecting them.

More specifically, the word “locus” (Latin for “location” or “place”) is conceptualized as either external locus of control (meaning individuals believe their decisions and life are controlled by chance or fate) or internal locus of control (individuals believe they can control their lives and how they respond to people, places, and things that are outside their control).

Individuals with a mostly “external locus of control” tend to blame things outside their control (the actions of other people or events in their environment) on how they think and decide to behave.

In relationships, individuals with “external locus of control” will not take responsibility for the problems in the relationship and their own happiness.

Until they are willing to do this they will find themselves demanding that their partner make all the changes and, agree to change in ways that make them happier.

Because this attitude (external locus of control) is a death knell to most relationships and, is most likely the reason the couple is struggling in the first place, it must be changed before the couple can experience significant progress.

The point here is that if either partner is unwilling to adopt an attitude of “internal locus of control” and accept responsibility for the problems they have some control over in the relationship, including their own happiness, there is very little chance that couples therapy will result in significant long-term improvements in the relationship.

To this end I explain to my clients that for couples therapy to be effective, they must accept that they both have some responsibility for the problems in the relationship and, believe that it’s not what your partner says or does that makes you happy or sad, it’s how you choose to think about and react to what they say and do that determines your sense of wellbeing.

Competencies to build and sustain a healthy relationship

To be effective and efficient, both clients enrolled in couples therapy need to have some understanding regarding what it takes to build and maintain a healthy relationship.

This means that, early on, the therapist should conduct a “relationship competency assessment” to determine whether or not each individual in the relationship has the minimum knowledge, skills, and abilities required to be successful.

Once again, I use the P/E assessment to help with this process. Another good example of a tool that can be used here is the Epstein Love Competencies Inventory (ELCI) which is used to measures seven relationship competencies that various researchers suggest are important in the maintenance of long-term romantic relationships: (a) communication, (b) conflict resolution, (c) knowledge of partner, (d) life skills, (e) self management, (f) sex and romance, and (g) stress management.  

The point here is that whatever the process they use because there are certain competencies that a person must possess to build and sustain a healthy relationship, your therapist should help you systematically identify and rectify any “relationship competency deficiencies” as a part of the therapeutic process.

Some examples of the principles related to essential relationship competencies I’m referring to are included here.

Create a relationship vision

In his book “Getting the Love You Want: A Guide for Couples,” Harville Hendrix emphasized the importance of a “Relationship Vision.” Frankly, I have no idea how couples can succeed without “getting on the same page” by creating a common vision.

Whether written down or simply discussed and agreed upon in some other informal way, the idea here is that successful couples somehow create a shared and agreed upon vision of what they consider to be a deeply satisfying, romantic relationship.

In other words, they are “on the same page” when it comes to their mutual aspirations for how they want to relate to each other, the things they want to do together and separately, the things they want to acquire, and those things they want to associate with.

Some examples of things you may want are as follows: we live a life of meaning and purpose, we have an enjoyable sex life, we have lots of fun together, we have children and raise them to be secure and happy, we live close to our grown-up children.

We attend a variety of activities together, we support each other in everything we do, we are faithful and committed to each other, we are loyal and never speak badly about each other, we resolve our conflicts peacefully, we are best friends, we stay physically fit and healthy, we talk through our disagreements and do not share them with anyone outside our relationship.

If we are struggling to get along we will seek help from a relationship counselor, we spend time alone, we go out together (date night, just the two of us) at least one day/night per week, we both have fulfilling careers, one of us stays home to raise our children while the other works, we share household responsibilities.

we are good stewards of our finances—and save for retirement, we pray together, we attend church or synagogue or temple or mosque together, we plan fun dates and vacations, we always tell the truth, we trust each other, we make important decisions together.

We are there for each other when things are hard, we pay it forward and serve our community, we are close to our family and friends, we always think and do things that make us feel closer, we end each day by asking what we did or said during the day that made us feel closer together (we use this information to improve our relationship).

We are good listeners, we make each other a priority, etc. Once you decide on the elements in this vision (the things you want to do, get, become) you can use these as standards against which you determine whether what you are thinking, saying, or doing will help you achieve your goals and realize your vision.

If not, you can make course corrections that help both of you stay on the same page towards a happy, fulfilling relationship

Develop “Relationship Agreements”

Spell out the specific things you will think and do to solve your problems, reach your goals, and realize your Relationship Vision.

During the entire therapeutic process, your therapist should help you decide and agree upon some things you can do to repair and improve your relationship. For example, I help my clients develop what I refer to as “Relationship Agreements.”

I tell my clients that these agreements are designed to clarify all the changes and improvements they plan to make in their relationship.

A Chinese proverb that captures the idea behind this part of the process says “The faintest ink is more powerful than the strongest memory.” My point here is that it’s just as important to develop and capture, in writing, the Relationship Agreements you have decided on as it is to write down your Relationship Vision.

In effect, these agreements will spell out the specific things you will think and do to solve your problems, reach your goals, and realize your Relationship Vision. For example, like many couples, my wife and I had a serious problem come up shortly after we got married.

That is, when we disagreed on something and started arguing about who was right and who was wrong, we would start to say things that were hurtful and that we did not mean. In light of this problem we came up with an agreement that says the following:

“It’s ok to disagree but it is never ok to be unkind. In the future, when we start getting angry, we agree to stop talking. One of us will call a “time-out” to think things through.”

“Once either one of us has signaled a time-out we agree that it means we will 1) separate for up to 30 minutes, 2) try to calm down, 3) come back together and resume the discussion in a civil tone. During our break, we will remind ourselves that this is just an emotion. It doesn’t have to control you. It’s like a wave on the ocean—no matter how high and fast, it always passes.”

After reading this over you can see that we are very detailed in our agreements. This way, we both know what’s going to happen when we start arguing. Although we have not perfected this agreement, we at least know it’s there and can reach for it when we need a “lifeline!”

The agreements I have helped couples make over the years are endless and include agreements on telling the truth (honesty), communication, date night, parenting, household chores, relationships with others outside the marriage, finances, retirement, commitments to a church or synagogue, vacations and holidays, and the frequency of sex, to mention a few.  

The point here is simple, if you are serious about solving your problems and reaching your goals, you can increase the likelihood that you will succeed if you make formal agreements and specify your plans in writing.

What I have just outlined above is important to understand when trying to identify a good couples therapist.

Although, effective couples therapy requires a significant cost in terms of time and money; if you find a good therapist and agree to do the work, the benefits will far outweigh the cost of divorce.

I also made the point here that not all couples therapy is good therapy. If, at a minimum, your therapist doesn’t do the things I have outlined here the process can sometimes do more harm than good. This can be avoided by asking a prospective therapist about their approach and what therapeutic process will entail.

If they can’t articulate a good plan that makes sense to you, you should probably move on to a therapist who can at least clearly explain how the do what they do and, how it works.

All said, the main point here is that if you need help with your relationship, it’s important to find a therapist who has a process that can help systematically understand and address the unique problems and relationship dynamics that are undermining your ability to flourish as a couple.

Ideally, you will seek help sooner rather than later as it is often the case when couples seek therapy after years of unbridled conflict it is nearly impossible to salvage the relationship.

Galen Cole
Psychologist,  PhD, MPH, LPC, WCP
Galen Cole, PhD, MPH, LPC, WCP, is a master of public health, licensed professional counselor, American board certified psychotherapist, internationally certified psychotherapist, and a nationally certified hypnotherapist. Dr Cole’s private practice consists largely of treating high conflict couples and adult clients referred with a history of trauma, mood problems and/or anxiety conditions.

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