“It takes a lot of legwork,” said Lynn Bufka, a clinical psychologist and associate chief for practice transformation at the American Psychological Association.
If you are considering couples therapy, here’s how to determine what qualities to look for in a counsellor and how to make sure they’re the right match for you and your partner.
Start online and check credentials
Going online to find the “right” therapist might feel like searching for a needle in a haystack, but experts say it’s a good jumping-off point.
Vanessa Bradden, a licenced marriage and family therapist and the founder and clinical director of Lakeview Therapy Group in Chicago, recommended searching for “couples therapy” and your location on Google.
Look for therapists with a degree in mental health who focus on couples work, even if they also work with individuals. Checking for certain credentials can help. Consider a psychologist who is board-certified in couple and family psychology, said Anthony Chambers, the chief academic officer at the Family Institute at Northwestern University, or a licenced marriage and family therapist. Those designations mean someone has received many hours of training focused specifically on family and relationship work.
When you search, include keywords that describe your circumstances and concerns, Dr Bufka said. Are you dealing with infidelity? Sex or intimacy issues? Mental health concerns, like depression? Would you like to see someone who identifies as LGBTQ or who regularly works with LGBTQ couples? Therapists know that many people find them online, so they tend to be specific about their areas of focus, Bufka said.
Ask around
Primary care doctors and clergy members can offer recommendations, Bufka said, since they often have experience working with local therapists.
Friends can also be a good resource. Though some therapists will not work with people in the same social circle, that’s less of a concern with couples work, Dr Guralnik said. “It’s a little different. Couples don’t tend to spend their time talking about their friends. They talk about their relationship.” Dr Chambers noted that many couples were referred to him by their friends and that it could be helpful for someone who is wary of starting couples therapy to know the recommendation came from a trusted friend.
Still, it is a “delicate situation”, as Bradden put it. She said she would probably decline to work with friends of a couple she was currently treating, but would be open to referrals from those she had seen in the past.
Be ready with questions
Once you have a shortlist of potential therapists, narrow down your choices by asking questions, either during an initial phone consultation or email exchange or within your first session or two. You don’t need to feel awkward about it. “We, as consumers, are purchasing a service here,” Bufka said. “We can ask questions!”
Here are a few things to bring up:
What will working with you be like, and how long will treatment last?
Most couples therapists see their work as relatively brief and solution-oriented. They help partners navigate specific conflicts around money, sex or parenting, for example, or around broader concerns like communication challenges or feelings of growing apart.
Therapists should tell you how they typically work with couples — for instance, whether you and your partner will always go to sessions together or whether you will have some individual sessions — and offer a potential timeline for treatment.
It helps to talk to therapists about their approach. That could mean asking about the specific theory of psychotherapy they have been trained in (like psychoanalysis) or about their style more broadly, Bradden said. Are they going to talk a lot and collaborate with you? Are they more apt to practise active listening? Those sorts of questions can help you understand what the therapy experience will be like.
Have you dealt with my issue before?
Elizabeth Earnshaw, a licenced marriage and family therapist and author of I Want This to Work, recommended asking counsellors outright whether they have treated couples facing a similar issue.
Ideally it is not the therapist’s first time addressing a problem like yours, and, crucially, you should ask how the therapist dealt with it before to get a sense of what lies ahead and whether that approach feels comfortable and doable.
Every therapist is different, Earnshaw said. “The way I work with couples who are struggling with an affair, for example, might be very different than what colleagues might do.”
How do you handle secrets?
In individual sessions, or even between sessions, one partner might share something with the therapist but not with the other partner. “That might be something like ‘I’m having an affair,’ or ‘I’m thinking of leaving,’ or ‘I’m utilising substances my partner doesn’t know about,’ or ‘I’ve spent all of our life savings, and my partner doesn’t know,’” Earnshaw said. “They can be really big secrets.”
Couples therapists have different ways to handle this. Some have a “no secrets” policy and will ask people to share the information with their partner in order to continue with therapy. Others will allow one partner to divulge private information without requiring that it be shared with the other partner. Those are important distinctions to know upfront, Earnshaw said.
Attend a few sessions and give some feedback
Try a few visits before you conclude that a therapist isn’t right for you. Bufka recommended at least two, and Bradden four to six, unless something was obviously not working. You may not like your therapist equally, but neither of you should feel like the therapist is taking sides. Bufka recommended that both partners ask themselves, Do I feel respected and heard? Chambers suggested asking, Do we both feel confident in our therapist’s ability to help us?
It is also completely appropriate to offer feedback to the therapist, especially if you have concerns after a few sessions, Bradden said. Therapists are not all-knowing, and research shows that feedback can make therapy more effective.
Bradden said: “If somebody came to me and said, ‘Hey, you know what? In that last session I really wanted you to be a little more direct with me,’ I would love that.”
Written by: Catherine Pearson
Illustration by: Bianca Bagnarelli
©2023 THE NEW YORK TIMES
