Does Couples Counseling Work? A Therapist Explains

The honest answer: Yes, it works but not automatically, and not for every couple the same way

Santos Counseling has served the Winston-Salem and Greensboro, NC, community since 2014. We actively work with couples, families, adults, and kids in varying areas of mental health and wellness. You’re thinking about investing time, money, and a significant amount of emotional vulnerability into couples counseling. You want to know if it’s actually going to help.

As a licensed counselor who has worked with couples for over a decade, here’s what I can tell you honestly: couples counseling works, and the research backs that up.

The truth is that how well it works, and how quickly, depends on a few things worth understanding before you go in.

What to Expect in Your First Couples Session

Here is something important to keep in mind: your first couples session is primarily an assessment. As such, use this time to slow down and get to know your counselor. The couples counselor during the first session will ask questions about your relationship history, what’s been most difficult, and what you each hope to get out of the process.

You’ll likely leave the first couples session with a clearer sense of what you’re working toward and how the therapist plans to approach the work.

After the first session, we find that most couples meet weekly or every other week to work on their treatment goals. The length of treatment varies depending on the severity of the challenge, counselor and client relationship, and the couple’s commitment to the process.

At Santos Counseling, we have found that some couples see meaningful progress in 8–12 sessions while others benefit from longer-term work, especially after major betrayals or years of unhealthy patterns.

What the Research Shows About Couples Counseling

Counselors at Santos Counseling utilize varying research- and evidence-based approaches when working with couples. Thoroughly studied approaches to couples therapy include the Gottman Method and Emotionally Focused Therapy (EFT). Both have strong outcome data and are utilized by counselors at Santos Counseling.

Did you know that EFT was developed by Dr. Sue Johnson? Research on the approach shows that it helps couples move from relationship distress to recovery. The Gottman Method, as another example, is built on four decades of relationship research by Dr. John and Dr. Julie Gottman. Their approach focuses heavily on identifying specific patterns that predict relationship breakdown with remarkable accuracy. As well as helping couples learn how to reverse those patterns.

Common Fears About Couples Counseling

Couples counseling sometimes holds worries, concerns, and fears for people. We find it helpful to talk about what they are so that you can get ahead of them early. Below are common fears that one can experience about couples counseling:

• “We’ve been married 20 years, is it too late to try couples counseling?”

The answer is no. Your length of time in the relationship doesn’t predict whether couples therapy will help. We have conducted thousands of sessions and learned that some of the most meaningful progress seen has happened with couples who had been stuck for a very long time. What matters more than length of time is whether both partners still have some investment in the relationship.

• “My partner won’t go to couples therapy.”

This is actually more common than you might think. We find that at first, one or even both partners can hold a level of resistance. Sometimes the resistance simply means that they are worried, concerned, or even protecting themselves.

If your partner is resistant to couples therapy, we encourage first starting with individual therapy. Working on your own communication patterns and responses often changes the dynamic in the relationship. 

• “We’ve already tried therapy, and it didn’t help.”

Remember, therapists are different, just like people. At Santos Counseling, we have numerous couples therapists, and each shows up in their unique way. Sometimes this means that the fit is great, and other times a referral is the better option.

If a previous couples therapy experience wasn’t helpful, it may say more about the counseling approach or the fit than about whether therapy itself can work for you. A couples therapist with specific training in couples methods is different from a general therapist who also does couples sessions.

• “Our problems are too serious.”

Seeking couples counseling can happen in all sorts of ways. Some couples seek couples therapy when things are great, while others seek it when the relationship has hit a major roadblock. Sometimes the challenge can be so big that you may feel uncertain about whether couples therapy will help.

We encourage you to consider therapy as a space for multiple outcomes. The outcomes can include healing, reconnecting, or even acceptance. Healing after infidelity, rebuilding trust after a major rupture in the relationship, and recovering from years of conflict are all things that couples do with the right support.

When Couples Counseling Works Best

With over a decade of practice in the counseling community, we collectively at Santos Counseling have found that couples counseling tends to be most effective when:

• You start before things get critical.
• Both partners are willing to try, to be present, and willing to do the work.
• The therapist uses evidence-based methods.
• You’re honest in the room. 
• You give it time.
• Both commit to goals and the work.

When Couples Counseling Is More Difficult

A reality about couples counseling is that there are hard moments and truly beautiful ones. Couples counseling can be challenging yet not impossible. At Santos Counseling, we find that couples counseling can be difficult when:

• One partner has already decided to leave and is attending to manage the end of the relationship, not to try to save it.
• There is active domestic violence or abuse in the relationship (in this case, individual therapy is typically the safer and more appropriate starting point)
• One or both partners are unwilling to take any responsibility for the relationship’s difficulties
• There is active, ongoing betrayal that isn’t disclosed during therapy

Remember, none of these situations mean therapy is useless. Instead, they mean that it’s time for a different action plan of treatment. 

Couples Counseling in Winston-Salem, NC

Did you know that Santos Counseling offers couples and marriage counseling in Winston-Salem, NC? Our couples counselors are trained in the Gottman Method and Emotionally Focused Therapy. We accept Blue Cross Blue Shield and other major insurance plans, and we offer telehealth sessions throughout Winston-Salem and Forsyth County right now, with in-person appointments coming soon.

If you’re considering couples counseling and want to talk through whether it’s the right fit for your situation, call or text 336-663-6570. We respond within one business day.

You might also find these resources helpful:

• Communication exercises for couples: click here for the link 
• Exercises for couples healing after infidelity: click here for the link 
• Premarital counseling at Santos Counseling: click here for the link