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David Baxter PhD

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Marriage counseling: Working through relationship problems
By Mayo Clinic Staff
Nov 15, 2007

Illness, infidelity, sex, anger, communication problems ? all can contribute to distress in marriages or other relationships. Marriage counseling or couples counseling can help resolve conflicts and heal wounds.

Your partner comes home from work, makes a beeline for the liquor cabinet and then sulks off silently. You haven't had a real conversation for weeks. A few arguments over money or late nights out, sure, but no heart-to-hearts. Sex? What's that?

Your relationship is on the rocks, and you both know it. But you aren't sure how to fix things ? or if you really want to.

It may be time for marriage counseling. Marriage counseling can help you rebuild your relationship. Or decide that you'll both be better off if you split up. Either way, marriage counseling can help you understand your relationship better and make well-thought-out decisions.

What is marriage counseling?
Marriage counseling, also called couples therapy, helps couples ? married or not ? understand and resolve conflicts and improve their relationship. Marriage counseling gives couples the tools to communicate better, negotiate differences, problem solve and even argue in a healthier way.

Marriage counseling is generally provided by licensed therapists including psychologists and marriage & family therapists. Marriage counseling is sometimes short term: You may need only a few sessions to help you weather a crisis. Or you may need marriage counseling for several months, particularly if your relationship has greatly deteriorated. As with individual psychotherapy, you typically see a marriage counselor once a week.

Who can benefit from marriage counseling?
Most marriages and other relationships aren't perfect. Each person brings his or her own ideas, values, opinions and personal history into a relationship, and they don't always match their partner's. Those differences don't necessarily mean your relationship is bound for conflict. To the contrary, differences can be complementary ? you know the saying about opposites attracting. These differences can also help people understand, respect and accept opposing views and cultures.

But relationships can be tested. Differences or habits that you once found endearing may grate on your nerves after time together. Sometimes specific issues, such as an extramarital affair or loss of sexual attraction, trigger problems in a relationship. Other times, there's a gradual disintegration of communication and caring.

No matter the cause, distress in a relationship can create undue stress, tension, sadness, worry, fear and other problems. You may hope your relationship troubles just go away on their own. But left to fester, a bad relationship may only worsen and eventually lead to physical or psychological problems, such as depression. A bad relationship can also create problems on the job and affect other family members or even friendships as people feel compelled to take sides.

Here are typical issues that marriage counseling can help you and a spouse or partner cope with:

  • Infidelity
  • Divorce
  • Substance abuse
  • Physical or mental conditions
  • Same-sex relationship issues
  • Cultural clashes
  • Finances
  • Unemployment
  • Blended families
  • Communication problems
  • Sexual difficulties
  • Conflicts about child rearing
  • Infertility
  • Anger
  • Changing roles, such as retirement
Domestic violence
Marriage counseling may also be of help in cases of domestic violence or abuse. However, if the abuse or violence has escalated to the point that you fear for your safety or that of your children, consider contacting the police or a local shelter or crisis center. Don't rely on marriage counseling alone to resolve these problems.

Strengthening bonds
You don't need to have a troubled relationship to seek therapy. Marriage counseling can also help couples who simply want to strengthen their bonds and gain a better understanding of each other. Marriage counseling can also help couples who plan to get married. This pre-marriage counseling can help you achieve a deeper understanding of each other and iron out differences before a union is sealed.

How does marriage counseling work?
Marriage counseling typically brings couples or partners together for joint therapy sessions. The counselor or therapist helps couples pinpoint and understand the sources of their conflicts and try to resolve them. You and your partner will analyze both the good and bad parts of your relationship.

Marriage counseling can help you learn skills to solidify your relationship. These skills may include communicating openly, problem solving together and discussing differences rationally. In some cases, such as mental illness or substance abuse, your marriage counselor may work with your other health care professionals to provide a complete spectrum of treatment.

Talking about your problems with a marriage counselor may not be easy. Sessions may pass in silence as you and your partner seethe over perceived wrongs. Or you may bring your fights with you, yelling and arguing during sessions. Both are OK. Your therapist can act as mediator or referee and help you cope with the emotions and turmoil. Your marriage counselor shouldn't take sides in these disputes.

You may find your relationship improving after just a few sessions. On the other hand, you may ultimately discover that your differences truly are irreconcilable and that it's best to end your relationship.

What if your partner refuses to attend marriage counseling sessions? You can go by yourself. It may be more challenging to patch up relationships when only one partner is willing to go to therapy. But you can still benefit by learning more about your reactions and behavior in the relationship.

How do you choose a marriage counselor?
Take care when choosing a marriage counselor or therapist. Not all are licensed or certified, or have specialized training in couples counseling.

Look for a marriage counselor who is a licensed mental health professional. Many marriage counselors are specifically designated as licensed marriage and family therapists (LMFTs). Licensing and credentialing requirements can vary by state. But most states require advanced training, including a master's or doctoral degree, graduate training in marriage and family therapy, and training under the supervision of other experts. Many marriage and family therapists choose to become credentialed by the American Association for Marriage and Family Therapy (AAMFT), which sets specific eligibility criteria.

Most marriage counselors work in private practice. They may also work in clinics, mental health centers, hospitals and government agencies. Ask your health care provider for a referral to a marriage counselor. Family and friends also may give you recommendations based on their experiences. Your health insurer, employee assistance program, clergy, or state or local agencies also may offer recommendations. You can also look up marriage counselors in your phone book.

What questions should you ask when choosing a marriage counselor?
Before choosing a new marriage counselor, you can ask lots of questions to see if he or she is the right fit for you. Consider asking questions like these:

  • Are you a licensed Psychologist?
  • Are you a clinical member of the AAMFT or licensed by the state, or both?
  • What is your educational and training background?
  • What is your experience with my type of problem?
  • How much do you charge?
  • Are your services covered by my health insurance?
  • Where is your office, and what are your hours?
  • How long is each session?
  • How often are sessions scheduled?
  • How many sessions should I expect to have?
  • What is your policy on canceled sessions?
  • How can I contact you if I have an emergency?
Making the decision to go to marriage counseling can be tough. But marriage counseling can help you cope better with a troubled relationship ? rather than trying to ignore it or hoping it gets better on its own.

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