The Evolution of Marriage Counseling – Does It Work?

Historically, marriage counseling and couples therapy got a bad rap. The old joke was that when you started therapy, you knew your relationship was over. However, this tired trope couldn’t be farther from the truth!

Marriage Counseling in the Past

It often consisted of one therapist, whether they were an actual, trained psychoanalyst or not, working independently with a husband and wife to determine what went wrong, who was to blame, and offering a mix of analysis and advice. In the past, these therapists did not offer much support in ways to improve or save the relationship and it was common in the field to remain detached on the matter. This has led to many flawed, preconcieved notions about what modern couples therapy is like and how effective it is now.

Modern Couples Therapy and Marriage Counseling

Modern couples therapy has emerged as an integrative, important, and verifiable field, although it is still constantly evolving. Specialized therapists now, like ours at Well Marriage, draw from many couples therapy techniques to create a catered approach that works to address each couple’s unique obstacles. With a focus on the original strengths of the relationship, we work on building trust and fostering a sense of teamwork so that the deeper issues can be tackled together. Deeper issues often include individual disorders, past trauma, affairs and broken communication systems. By using integrative techniques and pulling from science-backed, clinically-proven methods, we’re able to see and track real success in partner’s emotional well-being and quality of life.

Additionally, compared to the static, older practice of marriage counseling, where what went wrong and who is to blame was the basis for helping a sliver of the population, modern couples therapy is now “a vehicle for helping with intimate relationships across gender, sexual preference, class, culture, race, ethnicity, and other facets of social location” (Fam Process, 2022.)

A Mature Discipline

With more research has come more techniques that therapists can draw from and incorporate into their treatment plans. Since every relationship is unique, every therapeupitic journey has to be adaptable but verifiably sound.

Couples therapy has come to incorporate “a wide array of distinct treatments, and a stronger evidence base both in the efficacy of therapies and in its foundation in the emerging body of relational science. Couples therapy has also broadened its conceptual framework to incorporate feminism, multiculturalism, and a broader view of gender and sexuality. Thus, “couple” now speaks to a much broader diversity of couples.

Indeed, the continuing evolution of couple therapy now incorporates the increased use of social media and technology as well as open discussions about LGBTQ rights, gender equity, racism, social justice, politics, sexuality, individuality, freedom, and gender identity (). This era also includes the flourishing of numerous integrative methods and the development of couple therapy as a format for treating problems of individual partners” (Fam Process, 2022.)

11 Ways Marriage Counseling Has Evolved

Over the past few decades, couples therapy has evolved significantly, adapting to changing societal norms, advancements in research, and emerging therapeutic approaches. Some key ways in which couples therapy has during the history of marriage and family therapy are:

  1. From Blame to Collaboration: Earlier models of couples therapy often focused on assigning blame and identifying one partner as the problem. However, modern couples therapy has shifted towards a more collaborative approach, where both partners are seen as active participants in the relationship dynamics. Therapists now emphasize understanding each partner’s perspective and working together to find solutions.
  2. Inclusion of LGBTQ+ Couples: Historically, couples therapy primarily focused on heterosexual relationships. With the increasing recognition of LGBTQ+ rights and relationships, couples therapy has become more inclusive, providing specialized support and understanding for same-sex couples and those with diverse gender identities.
  3. Diversity and Cultural Sensitivity: Modern couples therapy recognizes and values the importance of cultural, racial, and ethnic diversity. Therapists are now more attuned to cultural differences and the impact of cultural norms on relationships, making efforts to provide culturally sensitive and inclusive counseling.
  4. Integrating New Theoretical Approaches: Over the years, various theoretical approaches to couples therapy have emerged, such as Emotionally Focused Therapy (EFT), Gottman Method Couples Therapy, and Narrative Therapy. Therapists now integrate these evidence-based approaches, tailoring their methods to suit the unique needs of each couple.
  5. Focus on Emotional Connection: Emotions play a vital role in relationships, and modern couples therapy emphasizes the importance of emotional connection and vulnerability. Therapists help couples express and understand their emotions, fostering empathy and closeness.
  6. Online and Virtual Counseling: With advancements in technology, couples therapy has become more accessible through online platforms and digital counseling. Virtual therapy sessions allow couples to seek help from the comfort of their homes, reaching a broader range of clients. At Well Marriage, we found during Covid lockdown that virtual therapy is just as effective as in-person when couples are working with a skilled relationship specialist.
  7. Short-Term and Solution-Focused Therapy: While traditional couples therapy could be long-term, many modern approaches are more short-term and solution-focused. Therapists help couples set specific goals and work towards achieving them within a shorter timeframe. At Well Marriage, we are working to create unique intensives and retreats for couples to support this growing addition to traditional therapy. (More details soon!)
  8. Self-Reflection and Individual Growth: Couples therapy now often involves individual work, encouraging partners to reflect on their personal challenges and growth opportunities. Understanding one’s own needs and triggers can lead to improved communication and relationship dynamics.
  9. Inclusion of Neuroscience: Research in neuroscience has provided valuable insights into how the brain processes emotions and impacts relationship behaviors. Couples therapists now incorporate these findings to enhance their understanding of couple interactions.
  10. Focus on Prevention and Maintenance: Couples therapy is no longer seen solely as a last resort to save failing relationships. Many couples now seek therapy for preventive reasons, to enhance their communication and relationship satisfaction, to achieve long-term goals together, and to maintain a healthy partnership.
  11. Addressing Individual Disorders: The extension of couple‐based treatments to individual disorders, trauma, and prior baggage “reflects one of the most important developments of couple therapy in this century” (Fam Process.)

Couples Therapy and Marriage Counseling – It Works!

Research and analyses agree – modern couples therapy and marriage counseling work when it comes to reducing relationship distress (; ). Many techniques have been show to be effective, although most modern specialists pull from multiple techniques to cater a treatment plan that works: “cognitive‐behavioral couple therapy, integrative behavioral couple therapy, and emotionally focused couple therapy each have sufficient evidence to be considered specific well‐established treatments for relationship distress. Nonetheless, broadly, meta‐analyses show [these] therapies to have similar rates of impact” (

The average person receiving couples therapy is better off at the end of their therapy than 70%–80% of individuals not receiving treatment—an improvement rate that rivals or exceeds the most effective psychosocial and pharmacological interventions for individual mental health disorders.

A Look at the Research

  • A variety of couples therapy treatments have garnered evidence supporting their effectiveness for specific relationship problems including sexual difficulties () and infidelity (.)
  • When it comes to the success of modern couples therapy, especially when the therapist is trained to a specialist degree like ours at Well Marriage Center, evidence supports that modern couples therapy works: “In addition to reducing relationship difficulties, evidence from several clinical trials supports the beneficial impact of couple therapies for coexisting emotional, behavioral, and physical health concerns (; ; ; .) For example, there is evidence in support of couple‐based interventions for depression or anxiety (), posttraumatic stress (), and alcohol problems (.)
  • Couples therapy helps in situations of physical distress, as well: “couple‐based interventions for physical health problems comprise an expanding application—with evidence beginning to emerge supporting the benefits of couple therapy across a broad spectrum of conditions including couples in whom one partner has cancer, chronic pain, cardiovascular disease, anorexia nervosa, or type‐2 diabetes” (Fam Process, 2022.)

Overall, couples therapy has evolved to be more inclusive, evidence-based, collaborative, and sensitive to the unique needs and backgrounds of each couple. These changes have helped make couples therapy a valuable resource for couples seeking to strengthen their relationships and create lasting connections.

You can read more about marriage counseling statistics, our approach, or reach out today to see if our modern, strengths-based approach is a good fit for your relationship.


What Are the Different Kinds of Couples Therapy?

Just like there are many kinds of couples, there are many kinds of couples therapy. Each approach to couples therapy is rooted in its own specific theories about relationships, emotions, and human complexity, and a skilled therapist will often combine these techniques to create a unique program for your unique needs.

Relationships are very complicated–which is why there’s no shame or failure in seeking out couples therapy or marriage counseling as soon as you think you need it. Setting the intention to do better in your relationship means taking action to give yourself and your partner a happier life. Some couples even begin their romantic journey with therapy right off the bat to create a more solid foundation for the future.

There are lots of ideas about how to best restore or preserve the joy in a relationship…which is great news, because it means there are couples therapy techniques best suited for you and your love. 

What Type of Therapy is Best for Relationship Problems

The best type of therapy for relationship problems addresses the unique challenges of the couple’s situation and promotes lasting healing in the relationship. Here are just some of the kinds of couples therapy a therapist may utilize or combine elements of:

  • Dr. Ellyn Bader – Developmental Model of Couples Therapy 

This approach is our personal favorite. It is focused on developing the couple as a team by nurturing skills and strengths in each individual. 

  • Dr. John Gottman – Gottman Institute

Gottman Method couples therapy prioritizes verbal communication, helping the couple reduce conflict in conversations and increase attention and affection throughout the relationship. 

  • Dr. Sue Johnson – Emotionally Focused Therapy (EFT)

Emotionally-focused couples therapy leverages cutting-edge research into the science of emotional attachment styles to make sense of past problems and achieve lasting change for the couple. 

  • Dr. Harville Hendrix – Imago Therapy

Imago Therapy helps get to the root of a couple’s issues by promoting understanding of each others’ childhood experiences and the resulting needs as an adult. 

  • Dr. Esther Perel – Eroticism and Desire

This approach to couples therapy recognizes that our erotic life also comes with inner struggles, tensions, and anxieties. Through improved self-worth and vulnerability, the couple’s desire also recovers. 

  • Dr. Terry Real – Relational Life Institute

Relational Life Therapy is one of the most popular behavioral couples therapy techniques. Each individual is shown by the therapist how their behaviors are harming the relationship, and then those behaviors are addressed and overcome as a team.

 At Well Marriage Center we approach couples therapy with a focus on preserving the relationship and helping partners renew their appreciation of each others’ strengths. Our therapists always prioritize interested continued learning of proven approaches like these and others.

Which Form of Therapy Is Typically Used During a Couples Therapy Session?

In cases like Relational Life Therapy or Imago Therapy, the couple will likely know going in that these specific forms of therapy are being used. They may even seek out or be matched with a specialist, especially if other approaches to couples therapy have not worked in the past. If one of the above approaches sounds appealing to you and your partner, that’s a great direction to start your search.

But remember, the outcomes achieved are always more important than using a specific method. As the expert, a therapist may use techniques from a few complimentary schools of therapy. It all depends on the needs of the couple. And, just like with other forms of medicine, the treatment which works at first may need to be adjusted or supplemented as you enter new and healthier phases of life. Your therapist will learn about you as individuals and the complex issues your relationship faces to create a customized approach, pulling from these different approaches.

What Is Couples Therapy Like?

There are some universal things you can expect from good couples therapy. Whether you try EFT, Gottman Method, the Developmental Model, or something else, make sure the therapist is working in favor of your relationship with these main points:

  • You will start the conversation focused on the positives and why you want to keep choosing the relationship. 
  • The therapist will ask questions and help each partner speak equally in the conversation. 
  • You should always feel encouraged, not judged. But you may not always feel comfortable as wounds are discussed and behaviors are addressed. Change is hard, and your therapist should be a coach along that path.
  • Homework between sessions will help you and your partner apply what you have learned and develop new daily patterns of love and appreciation. 

Well Marriage Center: Not Just for Married Couples

Though we are called Well Marriage Center, we celebrate all couples and their desire to improve their intimacy. Whether it’s couples therapy for boyfriend and girlfriend, boyfriend and boyfriend, girlfriend and girlfriend, theyfriend and theyfriend–your gender, sexuality, and the legal status of your relationship are not what matters to us. We even help people have better relationships with themselves or other family members! The world is built on relationships of all sorts and we’re here to help people connect better.

We are more interested in the journey that has brought you to our door and how we can help you leave happier and healthier! You don’t have to have that answer ready for us. We will help you figure out what you need and how to move forward. Please connect with our intake coordinator Melinda by phone or email to learn more about how we match you with a therapist that is uniquely suited to support the restoration of your relationship. We can’t wait to meet you!