You should get outside help for your relationship when the same problems keep repeating despite real effort, when contempt, shutting down or hopelessness has become normal, or when you face something big such as an affair, addiction or depression. Couples therapy has good evidence behind it. But if you feel afraid of your partner, couples work is not the right tool. Start with a domestic violence advocate instead.
This guide covers the whole path to getting help. It explains how to tell when it's time, what self-help and apps can and can't do, and what the research says about couples therapy. It also covers how to find a good therapist, how to afford one, and what to do if your partner won't go. It links to a deeper article on each topic. It is written for married and unmarried couples of any gender.
This guide is for education and is not a substitute for professional help. If you're struggling, a licensed couples therapist can help. If you're unsafe, visit Help Now.
What does "getting help" for a relationship actually mean?
Getting help is any step that brings in support, structure or skills from outside the two of you. It is a range, not a single choice. On one end is learning and practicing on your own. On the other is weekly sessions with a licensed couples therapist.
| Level of help | What it looks like | Best for |
|---|---|---|
| Self-guided learning | Books, articles, worksheets, couples apps | Everyday friction, drifting apart, building habits |
| Structured programs | Evidence-based online or workshop programs | Moderate distress, couples who want a guided plan |
| Individual therapy | One partner sees a therapist alone | When your partner won't go, or your own stress, depression or history is part of the picture |
| Couples therapy | Both partners meet with a trained couples therapist | Repeating conflict, betrayal, gridlock, serious distance |
| Discernment counseling | A short process for when one partner is leaning out | "I'm not sure I want to stay" situations |
| Safety support | Domestic violence advocates and hotlines | Any fear, threats, control or violence |
You can combine levels. Many couples read and practice at home while seeing a therapist. Others start with self-help and move up if it isn't enough. For an honest look at how the options compare, read our guide to couples therapy vs. a couples app.
When is it time to get professional help?
It is time to see a professional when a problem is lasting, painful and not improving with your own efforts. You also need help when it involves something that outside expertise is built for. You don't need to wait for a crisis.
Consider a licensed couples therapist if any of these are true:
- The same fight keeps repeating. You've tried to talk it through many times and end up in the same place.
- Contempt or withdrawal has become normal. Eye-rolling, mockery, the silent treatment or one partner shutting down has become the default. You can read more in our guide to the Four Horsemen.
- There has been an affair or a serious breach of trust. Recovery is possible, but it is hard to manage alone. See our overview of recovering from infidelity.
- Addiction is involved. Alcohol, drugs, gambling or compulsive behaviors affecting the relationship usually need their own treatment.
- Depression or anxiety is affecting daily life for either of you. Researchers who reviewed many kinds of studies concluded that relationship distress is a causal risk factor for depression [1]. That means the two problems can feed each other.
- One of you is thinking about leaving. If you're unsure, a structured process such as discernment counseling can help.
- You feel hopeless, numb or lonely in the relationship most of the time.
Some situations need a different kind of help, and fast:
- Any fear of your partner, including threats, intimidation, control over money or contacts, or physical or sexual harm. Contact the National Domestic Violence Hotline: call 1-800-799-7233, text START to 88788, or chat at thehotline.org.
- Thoughts of suicide or self-harm, yours or your partner's. Call or text 988, or chat at 988lifeline.org. In an emergency, call 911.
Our article on why couples wait too long to get help goes deeper on timing and the signs it's time.
When couples therapy is not the right tool
Couples therapy is designed for two people who both feel safe to speak honestly. It is not recommended when one partner is abusive, controlling or frightening to the other.
The National Domestic Violence Hotline states its position plainly. It does not encourage anyone in an abusive relationship to seek counseling with their partner. In its words, "Abuse is not a relationship problem." [2] The Hotline explains that relationship counseling cannot fix the unequal power that marks an abusive relationship. An abusive partner may later use what was said in therapy against their partner. And a therapist who doesn't know about the abuse may end up believing the abusive partner's version of events [2].
The same logic applies to communication techniques, conflict tools and couples apps. They assume both partners feel safe. If you are afraid, they are not the right tool.
How do you tell ordinary conflict from abuse? Ordinary conflict, even painful conflict, happens between equals. Each of you can disagree, say no and leave the room without fear. Abuse is a pattern of behaviors used to gain or keep power and control over a partner [3]. Relationships sit on a spectrum from healthy to unhealthy to abusive [4]. These two guides walk through it carefully:
- Healthy, unhealthy or abusive? How to tell the difference
- Signs of emotional abuse in a relationship
You can also read Is this abuse? on our Help Now page. If any of it sounds familiar, a confidential advocate can help you think through your options and make a safety plan. You don't have to be sure it's abuse before you reach out.
What self-help and couples apps can do
Self-help works best for couples who feel safe and are still on the same team, even if they are tired, distant or arguing more than they'd like. It can teach skills, build better daily habits and give you a regular time to talk.
The evidence for structured self-help is better than many people expect. In a randomized trial with 300 couples, the web-based OurRelationship program improved relationship satisfaction compared with a waitlist [5]. The program combines about eight hours of online activities with four short calls with staff. Couples also reported fewer depressive and anxious symptoms. A later review of research from 2010 to 2019 found substantial support for several less-intensive programs, including the Marriage Checkup, OurRelationship and Hold Me Tight [6].
That evidence is about those specific, tested programs. It does not prove that any app works. Stronger Couple has not been tested in a clinical trial. We built it to make well-researched habits easier to keep up: weekly check-ins, appreciations, conversation prompts and a structured conflict tool. We think of it as practice, not treatment.
Self-help is a good fit when:
- You are both willing to try.
- The problems are mostly about distance, routine, stress or communication habits.
- Neither of you feels afraid.
- You want something to do between therapy sessions.
Self-help is not enough when:
- You've tried for months and things are getting worse.
- There has been an affair, addiction or ongoing contempt.
- One of you is depressed, very anxious or thinking of leaving.
- Conversations reliably turn into shouting or shutdown.
Our comparison of couples therapy vs. a couples app lays out who each option suits, and how to use both together.
Does couples therapy work?
Yes, on average, and by a meaningful margin. Couples therapy is one of the better-studied forms of talk therapy.
- A 2020 meta-analysis pooled 58 studies with 2,092 couples. It found that couple therapy had a large effect on relationship satisfaction. Couples on waitlists did not significantly improve over the same period [7]. Therapy also improved communication, emotional intimacy and partner behaviors, and gains generally held up at follow-up.
- An earlier review reported that couple therapy positively affects about 70% of couples who receive it. Its effectiveness is comparable to individual therapy for individual problems [8].
- Four approaches meet criteria as "well-established" treatments for relationship distress [6]: Behavioral Couple Therapy, Cognitive Behavioral Couple Therapy, Emotionally Focused Therapy (EFT) and Integrative Behavioral Couple Therapy (IBCT).
There are honest limits. The studies in the 2020 meta-analysis included only opposite-sex couples [7]. Not every couple improves, and some couples who improve still decide to separate. Therapy is not a promise that you'll stay together. It is a structured way to understand what's happening and give the relationship its best chance.
One encouraging finding speaks to couples who feel they've left it too late. In the 2020 meta-analysis, couples who started therapy with more distress tended to show larger gains [7].
For the full picture, including what predicts success and how to get the most from sessions, read Does couples therapy work? What the evidence says.
What kind of therapist and approach should you look for?
Look for a licensed mental health professional with specific training in couples work. Then look for an approach with research behind it. A therapist who mostly sees individuals and "also does couples" may not have the specialized skills couples therapy needs.
Licenses to look for (US):
- LMFT: Licensed Marriage and Family Therapist
- LPC or LPCC: Licensed Professional Counselor or Licensed Professional Clinical Counselor
- LCSW: Licensed Clinical Social Worker
- Licensed psychologist (PhD or PsyD)
Marriage and family therapists are trained in both psychotherapy and family systems. They focus on how problems show up within relationships, and they work with individuals, couples and families [9]. Other licensed clinicians can be excellent couples therapists too. Ask about their couples-specific training. You can check any license on your state licensing board's website.
Common evidence-based approaches:
- Emotionally Focused Therapy (EFT) draws on attachment research. It helps partners understand the emotional cycle beneath their fights. Read more in Emotionally Focused Therapy, explained.
- The Gottman Method begins with a thorough assessment of the relationship. It then uses interventions built on the Sound Relationship House theory. See the Gottman Method explained.
- Integrative Behavioral Couple Therapy (IBCT) combines behavior change with acceptance of differences that won't fully go away.
- Cognitive behavioral couple therapy focuses on patterns of thinking and behaving that keep conflict going.
Directories that list couples therapists:
- Psychology Today's therapist finder (external site) lets you search by location, issue and insurance.
- ICEEFT's find-a-therapist directory (external site) lists EFT-trained therapists. ICEEFT is the International Centre for Excellence in Emotionally Focused Therapy.
- The Gottman Referral Network (external site) lists Gottman-trained therapists.
- The AAMFT's Find a Therapist page (external site) points to marriage and family therapists. AAMFT is the American Association for Marriage and Family Therapy.
Our step-by-step guide on how to find a good couples therapist includes questions to ask on a first call and red flags to watch for.
How to afford couples therapy
Cost is one of the most common reasons couples don't get help. In a study of 231 newlywed couples in lower-income neighborhoods, cost and not knowing where to go were the top two barriers [10]. Both have workarounds.
- Check your insurance. Call the number on your card and ask whether couples or family therapy is covered and which providers are in network. Coverage for couples therapy varies, and some plans only cover therapy tied to a diagnosis.
- Check for an employee assistance program (EAP). Many employers offer a few free, confidential counseling sessions. Ask HR or check your benefits portal.
- Ask about sliding-scale fees. Many private therapists keep some lower-fee spots. It is normal to ask.
- Look for university training clinics. Graduate programs in marriage and family therapy, counseling and psychology often run clinics where supervised trainees see clients at reduced fees.
- Try community mental health centers and nonprofits. FindTreatment.gov (external site) lists local services. Open Path Collective (external site) is a nonprofit network of therapists offering reduced-fee sessions.
- Consider telehealth. Online sessions can widen your choices and cut travel time. Therapists usually must be licensed in the state where you are located during the session.
- Use structured self-help in the meantime. An evidence-based program, workbook or regular check-in habit can carry you while you wait for an appointment.
If substance use or mental health is part of the picture, SAMHSA's National Helpline is free, confidential and open 24/7 in English and Spanish. SAMHSA is the Substance Abuse and Mental Health Services Administration. Call 1-800-662-4357 for referrals to local treatment and support [11].
What if your partner won't go to therapy?
You can't make a partner go, and pressure usually backfires. But you still have real options.
Reluctance is common and often uneven. In one study of couples seeking marital therapy, the two partners tended to move at different speeds. They passed through three steps at different times: recognizing the problem, considering treatment and seeking it [12]. In the lower-income newlywed study, women often named their partner not wanting therapy as a barrier. Men more often said individual counseling would be more helpful [10].
Things that tend to help:
- Invite, don't accuse. "I miss us and I want help getting back to how we were" lands better than "You need therapy."
- Lower the stakes. Suggest a single consultation, a time-limited trial of three to four sessions, or a workshop.
- Let them help choose. A partner who picks the therapist, or chooses between in-person and online, has more ownership.
- Go on your own. Individual therapy can help you understand your part, manage your own stress and decide what you want.
Our full guide on what to do when your partner won't go to therapy has scripts for the conversation. If you can't get your partner to engage in check-ins either, see what to do when your partner won't do check-ins.
When one of you is leaning out: discernment counseling
Discernment counseling is a short, structured process for "mixed-agenda" couples. In these couples, one partner is leaning toward ending the relationship and the other wants to try. It is not traditional couples therapy. The aim is clarity and confidence about what to do next, not fixing the problems yet.
Sessions focus mostly on separate conversations with each partner [13]. In an analysis of 100 consecutive cases, about half of couples chose to start couples therapy to try to reconcile. Most of the rest chose to divorce [13]. Either outcome can be a good one if it is made with clear eyes. Like couples therapy, it is not a fit where there is abuse or fear.
Learn more in discernment counseling: when one partner is unsure. If you are weighing staying against leaving on your own, our guide to should I stay or leave? offers careful questions to ask yourself.
Books and learning that are worth your time
Reading together can be a low-pressure first step, especially for a partner who isn't ready for therapy. Choose books written by the researchers or clinicians who built the approaches, not books that promise quick fixes. Our list of evidence-based relationship books explains what each book is best for and who should read it.
The free Library guides and exercises on this site are designed the same way. They are built on primary research and written to be practiced, not just read.
Why couples wait, and why it matters
Many couples hold off on getting help until their problems are severe. Researchers studying couples who were seeking therapy described this reluctance as a key reason therapy reaches fewer couples than it could [12]. Common reasons include cost, not knowing where to go, doubts about whether therapy works, stigma, and one partner not being ready.
Waiting has costs. Patterns harden, resentment builds, and relationship distress is linked to individual problems such as depression [1]. But waiting doesn't automatically mean it's too late. Couples who start with more distress can still make large gains [7].
Read more in why couples wait too long to get help.
Crisis and safety resources
If you or someone else is in immediate danger, call 911.
- National Domestic Violence Hotline: call 1-800-799-7233, text START to 88788, or chat at thehotline.org. Free, confidential and available 24/7.
- 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org.
- SAMHSA National Helpline (mental health and substance use referrals): 1-800-662-4357.
Our Help Now page lists these resources and includes a quick-exit button.
A simple plan for getting started this week
If you've read this far, you're probably ready for a next step. Here's one that fits most couples who feel safe with each other:
- Name what's happening, together if you can. Use one sentence each, without blame: "I feel like we keep missing each other and I miss you."
- Pick the level of help that fits. Use the table at the top of this guide. Choose couples therapy if any professional-help sign applies.
- Make one concrete move in the next seven days. Book a consultation, call your insurer or EAP, or set a first weekly check-in.
- Protect one small daily habit. A real greeting, a specific thank-you or ten minutes of undistracted talk keeps you connected while you get help.
- Review in a month. Ask each other honestly whether things are better, the same or worse, and adjust.
If you're not sure your relationship is safe, skip this plan. Start with Help Now or call 1-800-799-7233.
When to get professional help: the short list
Every guide on this site ends with the same reminder, because it matters. Seek a licensed professional if you notice any of these:
- Ongoing contempt, criticism or withdrawal that you can't shift on your own
- An affair or serious breach of trust
- Addiction affecting the relationship
- Depression or anxiety affecting daily life
- Any fear of your partner. Contact the National Domestic Violence Hotline rather than a couples therapist.
- Thoughts of self-harm. Call or text 988.
Keep going: every article in this guide
Deciding what kind of help you need
- Couples therapy vs. a couples app: which do you need?
- Does couples therapy work? What the evidence says
- Why couples wait too long to get help
Safety first
- Signs of emotional abuse in a relationship
- Healthy, unhealthy or abusive? How to tell the difference
Finding and using professional help
- How to find a good couples therapist
- What to do when your partner won't go to therapy
- Discernment counseling: when one partner is unsure
Learning on your own