How to Choose a Good Couples Therapist

Do you know how to choose a good Couples Therapist or Marriage Counselor? Knowing how to pick could mean the difference between staying happily married, and staying together at all…. Learn what to look for.

Why the Warning About Couples Counseling?

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?

How to Choose a Good Couples Therapist in Four Steps:

Step One - Choose a marriage counselor with a practice devoted to couples.

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.


"Marriages drive you "crazy," but getting help for a marriage problem isn't a treatment for "mental illness."



Step Two - Chooses a marriage counselor who is a member of professional organizations devoted to couples.

Professional Organizations Devoted to Couples

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.


Seeking help for marital problems is always a decision point.

How Therapists Think about Couples Therapy

In a recent article in the NY Times, therapists talk about what it takes to be a couples therapist because “couples therapy stresses out therapists.”

"You have to be very active in structuring the session, or the system can blow you away . . . The passive uh-huh, uh-huh is useless...

"[It's] like piloting a helicopter in a hurricane..."

"You have to like action. To manage marital combat, a therapist needs to get in there, mix it up with the client, be a ninja.  This is intimidating..."

Couples Therapy is most challenging. The stakes are high. You're dealing with volatility. There are often secrets."

"With individuals, a therapist can stall. You can always say, 'Tell me more about that,' and take a few minutes to figure out what to do next. In couples therapy, the emotional intensity of the couple's dynamics doesn't give you that luxury.




Professional Organizations for Marriage and Family Therapists

AAMFT is the preeminent international organization for couples therapists, and the field of marriage and family therapy. Its membership is over 50,000 marriage and family therapists. AAMFT Clinical Members meet rigorous training and educational requirements that qualify them for the independent practice of marriage and family therapy. AAMFT requires Clinical Members to abide by the AAMFT Code of Ethics, the most stringent ethical code in the marriage and family therapy profession. This code delineates specific ethical behaviors and guidelines for members to follow to ensure the ethical treatment of clients. Clinical Membership in AAMFT signifies that a couples therapist is dedication to his or her ongoing professional development.

Professional Organizations for Sex Therapists

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. Shaping the professional image of sexual health practitioners is a task that only a strong professional association can undertake.

AASECT’s Code of Ethics describes the exemplary standards of ethical conduct required of all AASECT members and stands as a pledge of trust between the Association and the public.

Expect a professional to demonstrate their interests by investing in professional organizations who cater to helping couples with their sexual and intimacy needs.

Step Three - Look for someone who studied evidence-based couples therapy and taken trainings as a couples therapist.

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). You can ask not only if the couples counselor is 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.

Others are clinically effective and are taught world-wide, but not research oriented models. We have four Couples Therapists with additional advanced training in models of this type, in addition to evidence-based models.

Dr. McMahon, Dr. Meunier, Dr. Wolfe, Rev. Ramsey and Ms. Voegele at Couples Therapy Inc. are Gottman Certified Couples Therapist approved worldwide.

We also have certified Sex Therapists.  

All of our therapists are trained Gottman Method.  Five are among the few who are certified. Two of these are Master Trainers for the Gottman Institute, teaching these methods to therapists across the globe.

If you aren’t familiar with the orientation of the approach, be sure to research the methods these therapists have adopted.

In addition, all professionals in the USA holding a license are required to complete continuing education for re-certification.  Ask to see a list of the courses, workshops or supervisors they have attended. This list will help you decide if they have kept up with the vast accumulating literature and progressive advances that has been made in couples therapy and marriage counseling each year.

Why choose a scientifically-based model?

 Because the evidence is in.
It works.  Period.

Step Four - Choose a therapist who has the right attitude to be a skilled couples therapist.

Two-thirds of Marriage Counselors are "neutral" on divorce.

Really?

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 may be fashionable to try to stay “neutral,” but it is hardly a good attitude for effective couples therapy.

Marriage Counselors should be the last one in the room encouraging divorce.

The reasons are many, but here are a few:

  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, not fluctuating over time. 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 [3] 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 Overridedemonstrates 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 over a week’s time.

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.

Warning to those in Individual Therapy:

The other danger is when an individual goes to see a therapist alone, and complains about unhappiness in their marriage. Too often the individual therapist sees it as their job to encourage a “relationship-dectomy” as a fast-track to individual fulfillment and a cure-all to individual malaise.

It becomes a refrain of the song that goes:

I have to be me, without you..."

Other therapists might encourage a "trial separation" without mentioning the statistics that 75% of couples who separate end up divorcing.

Individual psychotherapists can powerfully promote relationship break-ups, advocating "individual growth."

Be Aware that a Highly Skilled Couples Therapist is UNLIKELY to Accept Health Insurance


Why? Because to be accepted into an insurance panel, a psychotherapist must demonstrate a willingness to see a broad range of diagnosable mental disorders.  In contrast, very few insurance companies reimburse for what are called "V-codes, or problems that arise from interpersonal distress, but are not actually mental illness.

Marriages may MAKE you “crazy,” but getting help for a marital or relationship problem is not a “treatment” of a mental disorder. It is a treatment for relationship distress. If you've received treatment for a marital problem, one of you had to be labeled as having a mental disorder which was the focus of the work.  Anything else is insurance fraud. Learn more about this here.

The Marriage Counseling Associates and trained Sex Therapists at Couples Therapy Inc. have had 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.

Want to learn more about good marriage therapy? Use the links below.

• What are “Fights About Nothing” and why are they so common in marriage?
• What are the costs of living in a bad marriage?
• What is Online Couples Therapy?
• What is International Couples Therapy?
• Or for a variety of articles on sex and couples therapy, read our BLOG.