What is couples therapy?

The quality of your life ultimately depends on the quality of your relationships.
— Esther Perel

Couples therapy (sometimes called relationship counselling) offers a structured, confidential space for two partners to explore what’s happening in their relationship with the support of a trained therapist. People seek couples therapy for many reasons: recurring conflict, communication breakdown, emotional distance, trust issues, changes in intimacy, major life transitions, or feeling like they’re “stuck in the same loop.”

Couples therapy isn’t about deciding who is right or wrong. It’s about understanding the pattern between you — what happens when you feel hurt, misunderstood, rejected, criticised, or alone — and finding new ways to respond to each other with more clarity and care.

What happens in couples therapy?

Couples therapy usually involves both partners attending together. Sessions may focus on:

  • how you communicate when things are calm and when you’re under stress

  • recurring conflict cycles (e.g., one pursues, the other withdraws)

  • unmet needs, expectations, and the impact of roles you’ve fallen into

  • repair after ruptures (arguments, disconnection, trust injuries)

  • building emotional safety and understanding (without avoiding hard conversations)

  • intimacy and closeness, including sexual communication where relevant

  • navigating life changes (parenthood, fertility, relocation, illness, bereavement, career shifts)

Many couples also benefit from learning practical tools (for example: slowing conflict, listening differently, speaking more clearly about needs, setting boundaries, and making workable agreements). A good therapist will balance depth (what this taps into emotionally) with practical change (what you can do differently between sessions).

Is couples therapy only for relationships in crisis?

Not at all. Some couples come because something feels strained or distant; others come proactively to strengthen communication and connection. Couples therapy can also support you when you’re deciding what happens next — including, where appropriate, exploring how to separate in the least harmful way.

A note on confidentiality and boundaries in couples work

Confidentiality is a core part of therapy and is explained at the start of work, along with the limits of confidentiality, such as where safeguarding or serious risk of harm applies.

Couples therapy also has some additional boundaries that are usually covered in the therapy agreement, for example:

  • how individual contact with the therapist is handled (if at all)

  • how the therapist manages information disclosed separately

  • expectations around respectful communication in sessions

  • how risk, safeguarding, and support are managed if the relationship includes coercion, fear, or harm

An ethical therapist will be clear about these boundaries so you both know what to expect.

What does “integrative” mean in couples therapy?

As an integrative counsellor, I draw from more than one therapeutic approach so the work can match your needs as a couple. This can include:

  • Person-centred principles: creating a respectful, non-judgemental space for both partners

  • Attachment-informed work: understanding how closeness, fear of loss, or disconnection may link to earlier relational experiences

  • Psychodynamic thinking: noticing how past experiences, defences, and “old wounds” can show up in present conflict

  • Skills and strategies: where helpful, using practical tools for communication, emotional regulation, and repair

Integrative couples work aims to be both relationally sensitive and grounded in what helps you function day-to-day.

Common themes couples bring to therapy

Couples therapy can help with many relational challenges, including:

  • communication problems and recurring arguments

  • loss of connection, resentment, or feeling like “roommates”

  • trust difficulties (including recovering from betrayal)

  • differences in needs, values, or future plans

  • intimacy concerns and sexual disconnection (within therapist competence/scope)

  • navigating family pressures, culture, identity, and expectations

  • parenting stress and changes in roles after children

  • conflict around money, mental load, or decision-making

If something is outside a therapist’s competence or isn’t suitable for couples therapy, an ethical practitioner will discuss this openly and explore appropriate support or referral options.

How to choose a couples therapist

It’s reasonable to ask about:

  • the therapist’s training and experience in couples work

  • professional registration (for example, BACP membership/accreditation status)

  • how they structure couples sessions and reviews

  • fees, cancellations, and what happens if one partner stops attending

  • supervision (ethical practice includes ongoing clinical supervision)

Most importantly: you should both feel respected and able to speak, even when sessions are challenging.

What can change through couples therapy?

Progress often looks like:

  • fewer escalations and quicker repair after conflict

  • clearer, kinder communication (even when you disagree)

  • more understanding of each other’s emotional worlds

  • healthier boundaries and fairer relational “contracts”

  • rebuilding trust through consistency and openness

  • renewed intimacy and connection, where possible

Couples therapy isn’t about perfection. It’s about becoming more aware of what happens between you — and building a relationship that is more intentional, honest, and supportive.

Monica C | Integrative Counsellor, MBACP
Therapy with Monica I hello@therapywithmonica.com

This article is for informational purposes only and is not a substitute for mental health care. If you need urgent support, please contact your GP or Samaritans at 116 123.

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Couples Therapy vs Relationship Therapy

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Individual therapy: What it is and what to expect.