Who Should Consider Couples Therapy?

At a glance — key takeaways

• Couples therapy is not only for relationships in crisis — preventive therapy is equally valid.
• Common reasons include communication breakdown, infidelity, intimacy issues, and major life transitions.
• Unmarried couples, same-sex couples, and couples at any life stage can all benefit.
• The average couple waits six years after problems begin before seeking help — earlier is better.
• Couples therapy is not appropriate as the primary intervention in abusive relationships.

Who Benefits From Couples Therapy?

Any couple — married or unmarried, at any stage of their relationship — can benefit from therapy. The most common groups who seek couples therapy include:

• Couples with recurring, unresolved conflicts that cycle through the same arguments repeatedly
• Couples experiencing emotional distance or feeling like strangers despite living together
• Partners navigating the aftermath of infidelity or a major breach of trust
• Couples facing a significant life transition (new baby, job loss, retirement, relocation, serious illness)
• Engaged couples who want to build a strong foundation before marriage (premarital counseling)
• Couples where one or both partners feel consistently unheard, dismissed, or misunderstood
• Partners with mismatched expectations around sex, money, parenting, or family roles
• Couples where individual mental health issues (depression, anxiety, addiction) are affecting the relationship

Specific Situations Where Couples Therapy Is Particularly Helpful

Who Should Not Start With Couples Therapy?

Couples therapy is contraindicated as the primary intervention when there is ongoing domestic violence, coercive control, or a significant power imbalance in the relationship. The National Domestic Violence Hotline explicitly advises against couples counseling in abusive relationships, because the format can be used by an abusive partner to further manipulate, and can place the victim at greater risk.

If you are experiencing abuse, the right first step is to contact the National Domestic Violence Hotline at 1-800-799-7233 (or text START to 88788) to speak confidentially with a trained advocate.

Couples therapy may also be premature when one partner has an active, untreated substance use disorder or a severe untreated mental health condition. In these cases, individual treatment is usually the appropriate first step, with couples therapy following once stability is achieved.

Does Both Partners' Willingness Matter?

Mutual willingness significantly improves outcomes — but a reluctant partner who engages honestly can still make progress. What matters most is genuine participation once in the room, not the enthusiasm that got them there.

If your partner refuses to attend, "one-person couples therapy" — attending individually with a couples-trained therapist — is still worthwhile. You can change your own patterns, which often shifts the dynamic enough to bring the reluctant partner around.

What Is the Cost of Waiting Too Long?

Research cited by the Gottman Institute suggests the average couple waits six years after serious problems begin before seeking professional help. By that point, negative interaction patterns have often become deeply entrenched, and the level of contempt — the single strongest predictor of relationship failure — has risen significantly.

This does not mean late therapy is pointless; it means earlier intervention is easier and typically faster. If you have been aware of a problem for more than a year and private attempts to resolve it have not worked, that is a meaningful signal that professional support is warranted.