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Nothing is always effective for every person and sometimes despite all the assessment and testing a prescribed treatment just may not work for some people. Perhaps you are curious if couples counseling will work for you or wondering if the therapy you’ve been in for a while is actually helping. There could be many reasons the treatment isn’t leading to benefits; following are some of the most likely.
Domestic Violence/Abuse
When you meet with a therapist for couples therapy something they will screen for is domestic violence or abuse in your relationship. Research shows that abuse can get worse when a couple is engaged in therapy (Exline et al. 2014, Cheng et al., 2021). The perpetrator could use manipulation and create a power imbalance. If they think the therapist is targeting them they may also take this out on the victim. If therapists find you have active domestic violence or abuse, they will typically refer you out for individual therapy for these reasons. Sometimes this may be missed in screening because the victim may be too fearful to disclose it or does not realize it’s happening. The abuse may also start after the screening process has been completed.
Commitment or openness to therapy
John Gottman’s research found that therapy only works if both partners are open to therapy and committed to the relationship. If one is forcing the other to come in, therapy isn’t likely to be effective. When someone doesn’t want to be in therapy, they don’t engage much or follow through with the changes discussed in sessions. Some people have a stigma about therapy and don’t believe talking about their issues will be helpful. People may also believe that personal issues should stay in the relationship and not be told to others. Sometimes the unopen partner will agree to go but are checking it off the list to just say they tried. If your partner is not committed to the relationship then they probably won’t be motivated to work on things in therapy. A big part of screening and assessment is determining the client’s motivation to be there and change. Sometimes people are able to grow their commitment once starting therapy but that is not always a guarantee.
Personal issues
If one or both partners are having personal mental health, substance abuse, or existential issues, these individual issues may need to be addressed before starting couples therapy as the goal for couples work does not focus on one person’s issues. Sometimes couples don’t realize the underlying individual issues are the problem and seek couples therapy because they don’t feel connected. A 2019 study by Mokoena et al. found that mental health issues like mood disorders can cause a lower relationship satisfaction self-rating.
Infidelity or betrayal
This can be resolved in therapy but not for everyone. If the betrayal is too much to come back from and re-develop trust, then couples therapy will be unsuccessful. Many people try therapy to save a relationship but find they can’t forgive their partner for what happened. If the offending partner continues the infidelity during therapy or continues to keep secrets then couples therapy cannot be effective. Honesty is a important part of healing from infidelity or a betrayal. (Marin 2014)
The therapist
If a therapist isn’t trained in couples therapy or the couple does not connect with the therapist couples therapy can be ineffective. (Simpson et al. 2020) Counselors do not need to have a special training or certification to see couples outside of their regular degree and training but some couples may need a therapist trained in an evidenced based couples treatment. In many research studies, a major factor in the effectiveness of therapy is the relationship between client and therapist. In couples therapy, the relationship involves an extra person. All three need to be able to connect and have a trusting relationshipm, but not all people connect with the same therapeutic approach and so sometimes a shift to a different practitioner may be beneficial. (Kysely 2021)
Conclusion
There could be many other reasons couples therapy might not be effective. It’s always important to identify your expectations and communicate those with your therapist. Goal setting and treatment planning is an important part of the process in identifying effectiveness and a good way to measure progress during therapy. If you feel stuck in the process try discussing this with your therapist so you can all determine what the next step is.
To find a therapist, visit the Psychology Today Therapy Directory.
References
Marín, R. A., Christensen, A., & Atkins, D. C. (2014). Infidelity and behavioral couple therapy: Relationship outcomes over 5 years following therapy. Couple and Family Psychology: Research and Practice, 3(1), 1–12. https://doi.org/10.1037/cfp0000012
Andrea Kysely, Brian Bishop, Robert Thomas Kane, Maryanne McDevitt, Mia De Palma, Rosanna Rooney
Mokoena AG, Poggenpoel M, Myburgh C, Temane A. Lived experiences of couples in a relationship where one partner is diagnosed with a mental illness. Curationis. 2019 Sep 19;42(1):e1-e7. doi: 10.4102/curationis.v42i1.2015. PMID: 31588763; PMCID: PMC6779990.
"Common Reasons Why Clients Discontinue Couples Therapy" by John Gottman and Julie Gottman (1984): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037577/ - This research by prominent couples therapy experts identifies factors like lack of motivation, power imbalances, and unmet expectations as contributing to therapy discontinuation.
"Therapist and couple characteristics as predictors of treatment outcome in couples therapy: A meta-analysis" by Christopher S. Simpson et al. (2020): https://psycnet.apa.org/record/2020-43103-001 - This meta-analysis examines the role of therapist's skills and compatibility with the couple in influencing therapy outcomes.
