Couples therapy – what you need to know
Two out of five marriages in Switzerland end in divorce. Couples therapy helps to prevent a split. How does it work and what does it cost? Comparis explains.
In couples therapy, people find the space and time to deal constructively with their relationship and their common problems.
1. What is couples therapy?
Relationship counselling is joint therapy for couples having difficulties in their relationship. The couple’s typical communication behaviours are identified with the aim of improving how they interact with each other.
A therapist looks after the couple in joint sessions. Their interactions are analyzed. This reveals any harmful patterns when dealing with each other. Good communication is as important in a relationship as trust and acceptance.
Couples therapy is often referred to as relationship counselling. However, couples therapy is usually carried out in a psychotherapist’s office. Relationship counselling, on the other hand, often takes place in institutional counselling centres.
2. How does couples therapy work?
This is usually a conversation between the two partners moderated by a (psycho)therapist. It begins by clarifying the couple’s goals. Existing conflicts are then investigated.
The therapist takes a neutral role in the process. The procedure can examine past and present behaviour or emotional experience. Solutions can then be sought together.
The focus is on strengths and positive traits rather than difficulties. Solutions are suggested and tested. The couple can receive “homework” between therapy sessions where the solutions are tried out in everyday life before being discussed in the following session.
3. What are the different types of couples therapy?
There are four procedures in use.
Psychodynamic therapy focuses on the personal history of each partner. How do current conflicts in the relationship relate to each partner’s childhood? Have life issues and fundamental conflicts been transferred from family history to the present? It’s about drawing out unconscious conflicts and unspoken thoughts and feelings.
Behavioural therapy for couples focuses more on the couple’s current behaviour. The aim is to recognize disruptive behaviour and replace it with more functional patterns. Exercises help the couple create new, positive experiences together. This strengthens new interaction patterns and experiences, replacing old, negative behaviours.
Systemic couples therapy treats relationships as systems with defined rules. These rules can be rewritten in favour of a healthier relationship. Systemic therapists consider problems that arise to be a result of how the couple treats each other. Their interaction is analyzed and amended.
Emotion-focused therapy (EFT) for couples assumes that emotions drive all our activities. Therapy thus addresses the couple’s emotional security and sense of connection.
4. When does couples therapy make sense?
Therapy can address the following problems:
Escalating conflicts and crises that prevent constructive solutions
Stressful situations affecting the relationship (such as professional problems, moving house or children leaving home)
Infidelity of one or both partners
Mental or physical illnesses of a partner putting strain on the relationship
Emotional distance
5. How successful is relationship counselling?
Therapy is *more effective in treating problems in the relationship than the treatment of one partner alone. **Couples who work on the relationship together have lower rates of separation and divorce. More than 70% of couples report a significant improvement in their relationship after therapy. However, the effect doesn’t always last. After five years, improvements are reported by only 40% of couples.
6. How long does couples therapy take?
Professional help depends on the type of procedure as well as the couple’s concerns and starting point. A session usually lasts 60 or 90 minutes.
You should expect eight to 20 sessions if you follow EFT. Fifteen sessions is the most frequent.
The following applies to all approaches: initial changes should be visible after the first five sessions. The time between sessions is flexible. Couples often agree on an interval of two to four weeks.
7. How much does couples therapy cost?
Costs are charged per session. Freelance psychological psychotherapists who are not employed by a psychiatrist usually follow the recommendations of the Federation of Swiss Psychologists (FSP). This is CHF 160–180 per hour.
The hourly rate is usually somewhat higher for couples therapy. As two people are present, a marriage counselling session often lasts 90 minutes. In certain cases, it may be helpful to arrange sessions with one partner alone. Ten sessions of couples therapy of 90 minutes each at an hourly rate of CHF 160 would thus total CHF 2,400. The price depends on the therapist’s location, training and experience.
8. Is couples therapy covered by health insurance?
A new regulation, the prescription model, has applied since July 2022. Psychotherapy is covered by basic insurance if it is prescribed by a doctor.
9. How can I find a reputable couples therapist?
“Couples therapist” is not a protected profession. It is therefore important to check a provider’s qualifications.
The profession of “psychotherapist” is, in contrast, protected. These specialists have completed a degree in psychology and have several years of training in psychotherapy. Many psychotherapists also offer marriage counselling.
To be able to offer serious therapy, the provider should have at least a degree in psychology or social work, with additional qualifications in couples therapy. Couples therapy deals with sensitive topics.
Sources (some links not available in English)
*Christensen et al., 2006.
Gerrig, R. J. & Zimbardo, P. G. (2016). Psychologie (20th edition). Hallbergmoos: Pearson.
**Roesler, C. (2019). Die Wirksamkeit von Paartherapie. Familiendynamik.
