Couples Therapy FAQ with Kelsee Costanza, LCPC

You’re going in circles in arguments and nothing ever feels resolved. Your frustrations are piling up. You want to talk about things but you hold back because you just know it will turn into another fight. You feel like you’re the one making all the changes just to keep the peace. You’re feeling more like roommates or friends than romantic partners. You’ve been hoping that things will change. You care about each other and you’re really trying, but things keep getting lost in translation and you’re stuck.

Couples therapy can help. It provides an opportunity for you and your partner to meet in a safe and supportive space to address your relationship concerns. A couples therapist is a neutral party to support you with skills and insights to communicate openly, disrupt unhealthy patterns, and create a more meaningful and satisfying relationship.

There can be stigma around couples therapy that makes people wait until a crisis point, and sometimes this is too late. Therapy doesn’t have to be a last resort, and in fact it can be most effective when you start early. It doesn’t mean your relationship is failing; it just means you’re being proactive.

As you consider couples therapy, you probably have some questions… 

What can we expect a couples therapy session to look like? How is it different from individual therapy?

Couples therapy, like individual therapy, starts out with an intake, where the therapist gets to know you by asking questions about both your present and past experiences. Intake appointments differ a little in couples therapy, where there is the added piece of getting to know the relationship as well as each person individually. For the intake you will meet with the therapist together to talk about the relationship and then have separate individual sessions to cover more of your individual background. The intake can feel like a slow process, and it’s so fundamental to therapy being successful, because it’s such a key time in building a trusting relationship with your therapist as they strive to understand your unique relationship.

Couples sessions typically involve more guidance and structure than individual therapy as your therapist supports you with skills in real-time. Your therapist will often take a direct approach to slow moments down, guide you in use of tools, and offer insights in order to improve communication, connection, and perspective-taking. This might look like the therapist saying: “Let me pause you there, can you turn to face your partner?”, “Person A, can you please reflect what you just heard your partner say?”, “Let me jump in for a moment. It seems like something just shifted for Person B when Person A said that. What are you feeling?”

What types of concerns can we address in couples therapy? 

Broadly, anything that impacts your relationship! Some common concerns are:

• Communication

• Emotional disconnect

• Trust issues, betrayal

• Division of labor and role imbalances

• Finances

• Sex

• Future-planning and shared goals

• Parenting challenges

• Relationships with family of origin

• Life transitions 

• Changes in relationship structure, like opening the relationship or polyamory

• Navigating sexuality / gender identity changes

• Differences in cultural/familial background

• Differences in values/beliefs, e.g., political views, religious beliefs

• Differences in neurotype  

How will we know if couples therapy is helping?

This partly depends on your particular goals and needs, but what progress in couples therapy can look like is: improved communication, reduced intensity in conflict and/or less frequent conflict, improved understanding of relationship patterns, increased trust, more emotional connection, and/or improved quality of sexual relationship.

We have tried couples therapy before and it wasn’t helpful. What would be different this time?

Every couple and every therapist is different. There are many reasons why therapy may not have been helpful in the past. For example, perhaps the therapist was not the right fit for you, or maybe you and your partner had different levels of investment in the process. Your therapist will talk to you about your past experience(s) in couples therapy and work to understand what was helpful and what was not helpful so that they can best support you both.

My partner has not committed to doing couples therapy with me. Can I begin on my own and they can join me later?

Your couples therapist will meet with you for an individual session during the intake process, but apart from that it is important for both partners to be present at all appointments. Forming an individual relationship with your couples therapist could lead to therapist bias or perceived bias. 

If you are ready for therapy and your partner is not, this is a tough spot to be in. Individual therapy could be a helpful starting point to get some support for yourself. While working on a relationship is difficult with only one side, from individual therapy you can explore your feelings about the relationship, get a better understanding of how you show up in the relationship, and make some changes that might impact the overall relationship dynamic. Sometimes a reluctant partner may become more open to therapy when they see the benefits it’s having for you. Down the line, if your partner becomes ready for therapy, your individual therapist can support you with referrals to a couples therapist.

If you’re able to have an open conversation with your partner, it may be helpful to approach them with curiosity and try to understand why they are hesitant to do couples therapy. Have they had a bad experience with therapy before? Do they have worries or fears about doing therapy? If they become open to it, try searching for a therapist together so you’re on the same page about who you would feel comfortable with. 

Do you accept insurance for couples therapy?

Yes, we are in-network with BCBS PPO and Aetna plans. Relationship issues alone are not covered by insurance as there must be a diagnosable mental health condition to bill insurance. Claims will be submitted under one partner’s insurance plan and they will include a diagnosable mental health condition.

What is the cost of couples therapy?

If you are using insurance, the financial cost to you will either be your copay or paying toward your deductible until that is met. Your therapist can provide you with a more specific estimate by looking at your particular plan. If you are paying out-of-pocket, fees range from $170-250 depending on your therapist and their experience. 

Couples therapy is certainly an investment. In addition to finances, it also requires the commitment of your time and emotional energy. On the flip side, the cost of not doing couples therapy can be substantial both financially and emotionally.

How long does couples therapy take?

It depends on why you are seeking therapy and what your goals are. Some couples may be in therapy for several months while others may be in therapy for years. Your therapist will talk to you about expectations and regularly review goals and progress with you.

How often will we have sessions?

Typically, session frequency is weekly and appointments are about 50 minutes. After some time, you and your therapist may talk about a different frequency, like biweekly, depending on progress made, current treatment goals, and your therapist’s availability.

Will sessions be in-person or virtual?

This is dependent on your schedule, your therapist’s schedule, and location. If you have the flexibility to do either in-person or virtual appointments, consider these pros and cons:

In-person therapy:

• Pros

  • Awareness of non-verbal cues

  • Neutral, contained space of the therapist’s office

  • Commute time to/from the office can offer a buffer between daily life

• Cons

  • Limits therapist options based on location

  • Requires more time commitment with commute to/from office

Online therapy:

• Pros

  • Convenience of no commute

  • Comfort of home and personal space

  • Opens up more therapist options when proximity is not a factor

  • May be easier to schedule a time when both partners are available 

• Cons

  • Technology glitches 

  • Reduced access to non-verbal cues

  • Beginning and ending of sessions can feel more abrupt without a commute as a buffer

  • If you and your partner are joining from separate locations, you are not able to offer physical touch for affection or comfort

Curious about getting started?

Let’s connect! We’d love to hear more about what you’re looking for from therapy and answer any other questions you may have about the process. Complete the form on this page so that you and your partner can set up a consultation phone call with a therapist.