The terms marriage counseling, relationship counseling and couples therapy are interchangeable. All require training beyond a bachelor degree and a degree in mental health. They can be a licensed clinical social worker (LCSW), a marriage and family therapist (LMFT), or licensed professional mental health counselor. What's important to remember is that couples therapy is distinctly different from individual therapy. And it should be a good fit for the types of problems you're facing. Learn what to look for.
Do you know how to pick?
A recent national survey revealed that 81 percent of all private practice therapists in the United States say that they offer marital therapy. But only about 12 percent of the nation’s licensed therapists are in a profession that requires any course work or supervised clinical experience in marital therapy. How can the average consumer find a good marriage counselor when faced with so many choices?
Of course you want to feel comfortable with your relationship counselor. You may also want them to know about child development to help you deal with the kids. But in addition there are now science-based practices from skilled clinicians who have completed advanced training from reputable institutes of marriage counseling training.
These are researchers who have studied real couples over 40 years, and done pre- and post- comparisons of couples before and after treatment. These studies even include MRI research and other biological markers of reduced physiological arousal after marriage counseling. Marriage counseling now is sophisticated science with practitioners who are expected to demonstrate measurable skills before becoming certified. They're not your grandmother's marriage counselor.
Ask the counselor what percentage of their practice is devoted to seeing couples each week. Seek someone specifically trained in couples therapy, and who does it exclusively, or primarily. Couples work is a very different way of working than individual work. If you want to know how to choose a good couples therapist, choose someone with a lot of daily practice in working this way.
A true professional spends his/her time and money with professional associations that reflect their interests, training aspirations, and specializations. Being a clinical member of The American Association for Marriage and Family Therapists (AAMFT) designates that a therapist has been supervised by another marriage therapist and completed adequate coursework and training, at least in family therapy. AAMFT Clinical Members meet rigorous training and educational requirements. AAMFT requires Clinical Members to abide by the AAMFT Code of Ethics, the most stringent ethical code in the marriage and family therapy profession. Clinical Membership in AAMFT signifies that a couples therapist is dedication to his or her ongoing professional development.
The American Association for Sex Educators, Counselors and Therapists (AASECT) is an organization for those practicing sex therapy, and board certification also requires experience and supervision. With its history of impeccable standards for training, experience and ethical behavior, AASECT is recognized as the guardian of professional standards in sexual health. AASECT also has a Code of Ethics outlining conduct required of all members. Expect a professional to demonstrate their interests by investing in professional organizations who cater to helping couples with their sexual and intimacy needs.
The two most well-known scientifically based or evidence based treatments for couples are those designed by John and Julie Gottman, (The Gottman Institute and Gottman Method Couples Therapy) and Emotionally-Focused Couples Therapy created by Susan Johnson (The International Centre for Excellence in Emotionally Focused Therapy and Emotionally Focused Couples Therapy) and Les Greenberg (The International Society of Emotionally Focused Couples Therapy).
Ask the marriage therapist near you not only if they are familiar with these theories, but if they hold credentialing in these models. There are many other very skilled couples therapists who have a great deal of training in couples work and sex therapy. Some of these models do not offer certifications, the way Gottman, Johnson and Greenberg do.
If you aren’t familiar with the orientation of the approach, be sure to research the methods these therapists have adopted. Better yet, find a therapist who has training & certification in several methods for a more thorough tool box.
Others are clinically effective and are taught world-wide, but not research-oriented models.
It works. Period.
A survey of clinical members of the American Association for Marriage and Family Therapy found that nearly two-thirds said that they are “neutral” on the subject of marriage and divorce.
It is a bad sign when a professional psychotherapist has no opinion about whether or not a couple should make an all-out effort to remains married, especially if they are parents.
Marriage Counselors should be the last one in the room encouraging divorce.
1. Divorce dramatically impacts everyone in a family.
While it was once a popular cliche to argue that “if the parents are happily divorced, the kids will do fine…” this turns out to be a more self-serving notion than fact. Research tells us that it takes two years before children adjust to their parents divorce, and some percentage of children never do. The average household with children lose half of their incomes after divorce. This, alone, should give a reason to pause.
2. Marital unhappiness can fluctuate over time.
It also assumes that marital unhappiness is a permanent state. Research tells a different tale:
Our study found that unhappily married adults who divorced were no more likely to report emotional or psychological improvement than those who stayed married. In addition, the most unhappy marriages reported the most dramatic turnarounds. Among those who rated their marriages as "very unhappy"  almost eight out of ten, who avoided divorce, were happily married five years later."
Gottman’s work also supports this fact. Couples are often miserable and hopeless, believing nothing can change. However, the research on the state of “Negative Sentiment Override” demonstrates that when the couple completes evidence-based training, this feeling not only changes, but it “switches” suddenly, like a light switch. It doesn't gradually modify like a ‘dimmer switch.’ We’ve seen this sort of dramatic switch during our intensive couples retreats.
It may be fashionable to try to stay “neutral,” but it is hardly a good attitude for effective couples therapy.
Other therapists might encourage a "trial separation" without mentioning the statistics that 75% of couples who separate end up divorcing.
Be aware that a highly skilled couples therapist is unlikely to accept health Insurance
Getting help for a marital or relationship problem is not a “treatment” of a mental disorder. It is a treatment for relationship distress.
If it was billed as mental illness and it was actually was marriage counseling, that is insurance fraud: a crime in the USA. Learn more about this here.
At Couples Therapy Inc., our Marriage Counseling Associates and trained Sex Therapists have coursework and training in at least two clinical approaches to couples therapy, one of which has to be evidence-based. They are active in their professional organizations related to marriage counseling or sex therapy. They are highly skilled professionals that are here to help you function more effectively in your relationship. And they have certifications to demonstrate their competence. We have 7 certified Gottman Therapists out of the 300 worldwide. We also have sex therapists. All of our therapists are trained Gottman Method. Seven are among the few who are certified in either of two evidence-based treatment models. Four are "Master Trainers" meaning they train other clinicians for the Gottman Institute.