How To Find Effective Intensive Marriage Counseling:
8 Things to Look For
by Jay S. Lindsay, Ph.D.
Your marriage or relationship is in serious trouble, so you’re looking for a therapist who works with couples, and he or she had better be good.
However, you’re wary because you’ve read that many therapists are poorly qualified to work with couples and as a result are not very effective. Also, several of your friends have been to couple therapy and they said it didn’t help.
Certainly, you don’t want to waste your money on a therapist who can’t help you and who might even make matters worse.
So how does one go about finding a highly qualified and maximally effective couples therapist?
The answer is, by knowing what to look for.
Here are 8 important criteria that will help you find a therapist who is truly skilled at helping couples. The more criteria met, the more likely it is that a therapist will provide top-notch help to you and your partner.
1. A license in marriage and family therapy.
Almost all therapists do some work with couples, but less than 20% have had adequate graduate-level training and supervision specifically in marriage and family therapy.
The rest were taught to do therapy primarily with individuals. Some of them are even trying to “wing it” with couples, using individual approaches to treat couple problems. This doesn’t work!
That’s why every state in the nation now has a license for marriage and family therapists that is separate from the licenses for other kinds of therapists, such as psychologists, psychiatrists, social workers, and professional counselors.
The license in marriage and family therapy is your guarantee that a therapist has had adequate graduate-level training and supervision in how to work effectively with couples and families.
2. A high percentage of practice time devoted to couple therapy.
Many licensed marriage and family therapists see mostly families in which an adolescent is the focus. So find out how much of a therapist’s practice is devoted to working with couples.
Obviously, the more the better. The higher the percentage, the more specialized is a therapist in couple therapy.
If a therapist lists couple therapy as only one of a large number of services offered that are not couple-oriented, this may be a bad sign.
The reason is that couple therapy is one of the most complicated kinds of therapy to do. Therefore you really don’t want to see someone for whom couple therapy is one of a number of different things he or she is dabbling in.
Instead, you want to see a therapist who specializes in couple therapy, devoting at least half of his professional time to it.
3. Many years of experience treating couples.
The principle of “the more the better” applies here as well.
This is because it takes more than training and a specialization to become a highly skilled couple therapist. It also takes many years of experience to develop the kind of finesse that is needed to do couple therapy really well.
4. In addition to a license in marriage and family therapy, a second license in a mental health discipline that focuses on the assessment and treatment of individuals.
The fact is that all effective couples therapy requires careful attention to individual issues as well as couple dynamics. This is particularly true if one or both partners have an undiagnosed mood disturbance, anxiety problem, personality disorder, or addiction.
For example, many times a person who is described by his or her mate as irritable, distant, and disinterested in sex is clinically depressed and needs to be treated.
In fact, research shows that in 50% of couple therapy cases a partner is clinically depressed and may not know it. Without treatment of that individual’s depression, the couple therapy is likely to fail.
A good bet is to see a therapist with “dual licensure,” that is, one who is trained and licensed both in marriage and family therapy and in an allied mental health discipline that focuses on the assessment and treatment of individuals.
An excellent example would be a therapist who is both a licensed marriage and family therapist and a licensed clinical psychologist.
5. A doctoral degree.
Many therapists have just a master’s degree, which means they have studied at the graduate level for only about two years.
It stands to reason that a therapist who has gone the extra mile and spent two or three years going beyond the master’s degree to earn a doctorate is likely to be more effective. This is simply because that therapist has had a lot more training. So look for a Ph.D., Psy.D., M.D., or other doctoral degree in the therapy field.
6. Training and certification in a specific approach to couple therapy that has been proven by research to be highly effective.
All graduate programs in marriage and family therapy give therapists a survey of the best-known approaches (sometimes called “models”) to working with couples, and this is good. However, few graduate programs provide intensive training in any one approach.
The best couple therapists go beyond their graduate education and become thoroughly trained and fully certified in at least one approach to couple therapy that has been scientifically validated. Usually this training is best found at an institute.
An excellent example is the The International Center for Excellence in Emotionally Focused Therapy in Ottawa, Canada, directed by Dr. Susan Johnson. This institute offers therapists complete training and full certification in Emotionally Focused Couple Therapy (EFT), a proven approach.
EFT is based on twenty years of research which shows that it brings 70–75% of distressed couples to recovery and 90% to significant improvement. In addition, EFT has a very low relapse rate. It is perhaps the most effective help for couples available today.
So try to find a therapist who is fully trained and certified in an approach to couple therapy that has been proven by research to be highly effective.
7. Clinical membership in the American Association for Marriage and Family Therapy (AAMFT).
If a therapist is a clinical member of AAMFT, he or she meets important professional standards established by leaders in the field of marriage and family therapy.
A clinical member of AAMFT also subscribes to a stringent code of ethics and has agreed to be accountable to his or her professional peers for adherence to that code.
In addition, a clinical member is given opportunities to attend professional conferences and training events that help keep him or her abreast of the latest developments in the field.
8. A fee that is commensurate with the therapist’s training, experience, and specialization.
Couple therapists at the doctoral level generally charge between $150 and $300 for a full hour. As a general rule, the more training, experience, and specialization a therapist has, the higher will be the fee.
When it comes to purchasing products and services, everyone wants the best value at the lowest price. Unfortunately, we rarely can get both at the same time.
An important question to ask yourself, then, is, “Which do I want, the lowest price or the best value?” You don’t need an accountant to help you figure out the right answer.
The fact is that it simply does not make good economic sense to choose a therapist whose fees are low if that therapist takes a lot more sessions to do less than quality work.
In the final analysis, it’s a lot more about value than it is about price. So concentrate on finding a therapist who can give you optimal value in the form of a high level of training, experience, and specialization.
To sum up, couples therapy is one of the most difficult kinds of therapy to do and an unqualified or under-qualified therapist can definitely do more harm than good. If your marriage or relationship is on the line, you have a lot at stake.
For this reason, finding a highly qualified and maximally effective couple therapist should be your top priority. The 8 criteria discussed above will help you narrow the field.