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The Evolution of Marriage Counseling – Does It Work?

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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.