Relationship Therapy: What to Expect

Jennie Lannette, MSW, LCSW
Updated on February 4, 2021

In the early months of a relationship, it can seem like nothing can go wrong. Why wouldn’t you both be head over heels for each other forever? No matter what comes up, there’s nothing you can’t get through, right? While that may indeed be true, however that head over heels part isn’t meant to last forever. In this early phase, both partners are usually bathed in attraction and bonding hormones. These are meant to help you connect with a mate, and can make you feel as if you are experiencing like “love at first sight.”

couple holding hands

Once these chemicals begin to wear off, and normal conflict crops up, it can feel like a punch to the gut. Both partners may chase the original feeling for years, not understanding what happened to that early connection. Why are there now disagreements, disconnection, and criticism?

Working Through Relationship Issues

The reality is that relationships involve quite a bit of work. Both partners will likely need to work through childhood traumas, self-acceptance issues, acceptance of each other, and communication patterns to maintain a healthy relationship.

Sometimes these struggles can devolve into more serious issues like extramarital affairs, or turning away from your partner in other ways. Changes in yourselves, your careers, and adding children or stepchildren into your lives can also complicate matters.

You may simply feel like you’ve lost your connection, or you can’t stop fighting.

Often couples turn to a professional to better understand what’s going on, or to address communication problems or betrayals that have come up in the relationship. So how exactly does relationship therapy work? What can you expect? Here’s a look at the most commonly recommended couples therapies, and how they work.

Starting Relationship Therapy

Once you have chosen a therapist and made an appointment, you will meet your counselor (usually with your partner) for the first time.

Many therapists utilize an initial assessment process. This can vary widely, depending on the approach and the therapist. It could be as simple as an open conversation where the two of you and the therapist discuss problems that often come up. In other cases, it may be highly structured, with forms to fill out ahead of time and interactions (such as discussing a key conflict) that your therapist will observe early on.

While these approaches may seem intimidating, they are a key part of the therapist beginning to understand the dynamics of your relationship.

After the assessment, you and your therapist will decide if you want to go forward in relationship therapy. After this step, the therapy approach will depend on the training and preferred model of the therapist. Here’s a look at some possible approaches you might expect.

Emotionally Focused Couple’s Therapy

Emotionally Focused Couples Therapy, often referred to as EFT, is one proven intervention. Studies repeatedly show that it is helpful for couples struggling with multiple issues.

EFT is based on the premise that our attachment and bonding needs are a major factor in how a relationship progresses. In EFT, a therapist will help you both learn how to better understand and manage your own emotions. They’ll also teach you how to interact more effectively, and how to foster a closer bond with each other.

EFT is a highly-recommended, time-tested therapy. Other well-known approaches are similar, but each has a unique perspective.

Gottman Method

The Gottman Method was developed by experts John a Julie Gottman, therapists and a couple themselves. They utilized years of research on couples who thrive versus those who continue to struggle or break up. They used this understanding of what effective couples did better, and created a therapy around their findings.

Like EFT, Gottman therapy is also found to be effective for couples. The Gottman approach begins with reconnecting the couple as friends, and building from there. They use the “Sound Relationship House” to build on the foundations of healthy partnerships. These stages include the following:

  • Building love maps (learning about each other)
  • Sharing fondness and admiration
  • Turning towards each other instead of away
  • Building a positive perspective
  • Managing conflict
  • Making life dreams come true
  • Creating shared meaning

By working through all levels of the house, the couple builds a strong foundation and a variety of relationship skills. They can use these to repair problems and begin to move forward.

Imago Therapy

Imago therapy is an older approach, but these ideas have integrated into mainstream therapy over a matter of decades. Imago therapy was made famous by Oprah, who promoted the book Getting the Love You Want, written by the founders of the therapy.

The idea of this therapy is that all couples are influenced by their childhood experiences which directly link to how they interact with each other. Many people strongly identify with this idea, because they’ve experienced it. Often couples come to therapy confused about this, only to learn that most couples encounter these childhood triggers at some point.

In Imago therapy, you learn to better understand your own triggers as well as your partner’s, and how to work through these together. Therapists teach couples how to communicate more openly, and how to identify and support each other’s struggles.

The ideas of Imago have integrated into many areas of modern therapy. Therapists often reference these ideas in individual therapy as well, and they have been integrated into approaches for PTSD, complex PTSD, and other difficulties.

Integrated Approaches

Many therapists are not trained in one specific, evidence-based therapy, but still offer couples therapy. Such therapists use their years of experience in their own relationships, and in observations they’ve had with other clients, to tailor their approach.

There is some disagreement about this eclectic approach. Developers of the formal therapies mentioned typically point to their own research, and stress that the more structured approaches are found to be the most effective. However, other therapists believe these approaches may be too structured, and focus less on the key aspect of the relationship with the therapist.

Choosing a Relationship Therapist

If you are looking for a relationship therapist, consider checking out multiple options. If possible, you and your partner can discuss which type of therapy and therapist seems to fit you best.

In some cases, you may have limited options available to you when it comes to choosing a therapist. In that case, don’t be afraid to as for an interview. Ask them what approach they use, how much training they’ve had in this area, and what guides their work with couples.

Also get a feel for how you connect with the therapist. Do you both feel heard, accepted and supported by the therapist? If not, it may be a difficult road forward. After all, you are investing your time and money and have a right to decide on the therapy approach that’s best for you.

Jennie Lannette, MSW, LCSW

Jennie Lannette is a licensed therapist who specializes in trauma, PTSD, and related issues. She has trained extensively in multiple evidence-based treatments. She has a decade of experience in inpatient, community, and private practice settings.