At Toronto Psychology Clinic, we understand the importance of developing and sustaining strong, meaningful connections in relationships. Unhappy couples have a greater likelihood of relationship breakdown or divorce, and lower levels of physical and mental well-being. We have helped many married and unmarried couples improve the quality of their relationships using well-proven counseling techniques and approaches.
- What is Couples Therapy and Marriage Counselling?
- Who Goes to Couples Therapy?
- Why Seek Couples Counseling?
- How Can Couples Therapy Help?
- Premarital Couples Therapy and Premarital Counseling
- How effective is Couples Therapy?
- What types of Couples Therapy are there?
- How do I get started with Couples Counseling?
- How long does Couples Therapy take?
What is Couples Therapy and Marriage Counselling?
The terms ”couples therapy,” “couple therapy” and “marriage counselling” are often used interchangeably to define a type of counseling for two people in a committed, intimate relationship. Couples may seek relationship counselling to address issues such as a lack of connection, love, understanding, trust or communication skills between two partners. Couples therapy can also be a tool to help individuals create healthy boundaries and win/win scenarios within their relationship.
Marriage or couples counseling is often sought during times of conflict, crisis or distress, such as when one partner has had an affair or there is abuse in a relationship. When relationships are in distress, research shows that couples who seek help fare better than those who do not.
Couples therapy can be a path forward to building a mutually beneficial, trusting relationship after such tumultuous or difficult periods. However, your relationship does not need to be going downhill in order to seek couples therapy. Many couples seek relationship therapy to enhance the quality of an already loving and supportive relationship. For instance, they may want to improve their communication skills to prevent potential conflict in the future, providing tools to deal with stressful life events, such as when a couple is thinking of having children, purchasing a home or changing careers.
People who seek couples therapy can refer to married, unmarried, preparing to marry or premarital, common-law or dating partners. Our psychologists, psychotherapists and social workers are experienced in helping both heterosexual and same-sex couples, as well as dyads and polyamorous couples.
Toronto Psychology Clinic offers a wide variety of approaches for couples therapy and marriage counseling in downtown Toronto including the Gottman Method of Couples Therapy and Emotion Focused Therapy or EFT Couples Therapy.
Who Goes to Couples Therapy?
Not all couples who seek therapy are married, although marriage counselling makes up a large part of our client base. Couples can refer to married, unmarried, preparing to marry or premarital, common-law and/or a couple living in a same-sex relationship. It is not uncommon for platonic friends to seek therapy in order to establish healthy boundaries and communication strategies for building a business relationship, such as co-founding a company together.
A couple may want to enhance or improve parts of their relationship, or use counseling as an opportunity to build better communication prior to a major life step such as marriage, children, property ownership or other business dealings. Some couples succeed in certain aspects such as parenting and division of labour, but struggle with talking about more difficult or emotional topics such as intimacy.
Why Seek Couples Counseling?
There are many reasons a couple may seek counselling. Examples of common difficulties that drive individuals to seek couples therapy include:
- Difficulty in communication
- Change to or lack of intimacy (e.g. less physical affection or sex)
- Feeling emotionally disconnected
- Constant arguments, difficulty resolving conflict
- Problems with anger
- Dealing with infidelity or betrayal
- Problems managing division of labour
- Difficulty with parenting
- Managing mixed race, cultural, ethnic or religious differences
- Navigating major life transitions (new baby, retirement, death in family)
At Toronto Psychology Clinic we offer expertise in highly specific challenges couples may face such as:
- Blending an interfaith, interracial and interethnic relationship
- Managing LGBTQ challenges
- Dealing with blended families, joint family and/or in-laws
- Differences in income, spending, power, privilege
- Managing an open or polyamorous relationship
- Navigating major changes in one or both partner’s lives such as:
- Retirement
- Menopause
- Empty nest syndrome
- Substance abuse and recovery
- Pregnancy, miscarriage, adoptions
- Loss of employment, e.g., pandemic job lay-offs
- Learning to live with life-threatening health diagnosis
How Can Couples Therapy Help?
Counseling can help a couple develop stronger relationship skills and navigate conflict more effectively. In relationship therapy, individuals become more aware of their respective patterns of communication and behaviour, and how they each contribute to create misunderstanding or conflict in the relationship.
Without intervention these negative patterns can escalate, leading partners to avoidance, disagreement, constant arguments or other types of conflict. Therapy can facilitate understanding and reconciliation towards a more positive exchange between two people. Successful couples therapy partners report an increase in empathy and understanding, ultimately leading to a closer relationship.
When a relationship is in crisis and a couple is considering a break-up, separation or divorce, communication has all but broken down. It can be difficult to get out from under our own behavioural patterns as well as individual habits and beliefs to see our spouse’s point of view. Marriage counseling can help couples navigate these issues and develop a path forward.
Below we provide a broad overview of some of the issues couples have commonly reached out for help for. Do not hesitate to get in touch for a free phone intake to ask if we can help you with the specific issue you are dealing with.
Improve Communication in a Relationship
The goal of therapy is to improve or enhance communication skills between two individuals and reduce conflict. Benefits of building communication include:
- Understanding relational dynamics
- Learning to recognize habitual patterns and limiting beliefs
- Building greater emotional connection and support from your partner
- Creating opportunities for growth and connectedness
- Learning to communicate in the love language of your partner
- Developing mutually beneficial strategies within a long distance relationship
- Identifying problem resolution
- Learning to manage stressors better such as money, division of labour, children, in-laws, health problems and careers.
Help with sex and intimacy issues
At our clinic in downtown Toronto, we deal with a broad spectrum of issues related to sex and intimacy including problems with sexual functioning (e.g. vaginismus, erectile dysfunction, etc.), infidelity, sexual dynamics, porn addiction, and a desire for an open or polyamorous relationship. Even couples in otherwise strong relationships may seek therapy to reawaken intimacy and sexual connectedness.
We take a bio-psycho-social approach to understanding problems with sexual intimacy. It is important to rule out a physical reason behind an issue first. In any case, even if there is a physical explanation, often the issue can contribute to or be a result of psychological factors.
Support for couples coping with chronic illness
When one partner is dealing with a disease such as cancer, heart disease, autoimmune conditions (e.g., lupus) or has or will have a major medical intervention, it can affect the couple’s relationship in significant ways. Often the partner without the health condition engages in a caretaking and supportive role. Partners may find it difficult to discuss the emotional and psychological impact of such a major stressor, and this impacts the quality of their communication. For instance, the caretaking partner may have difficulty taking care of themselves and feels guilty to say so, as they are not the one with the health condition. The ill partner may feel guilt speaking up about something that bothers them, as they feel like they are a burden on their partner. In some cases, partners have differing opinions on how to manage the health condition.
There is a lot of research on effective dyadic (i.e., the collective “we-based”) coping. Many of the couples therapists at the Toronto Psychology Clinic are trained as clinical health psychologists in addition to general clinical psychologists, and offer specific expertise to help couples effectively navigate the unique challenges associated with chronic illness.
Help couples deal with differences
No two partners are alike and while no one would want to be married to someone exactly like them, the differences that partner’s bring to the relationship can make it interesting while at the same time challenging. This is particularly an issue for interethnic, interracial and interfaith couples. Couples therapy can help partners find ways to accommodate and embrace their respective differences, be it different personality, values, beliefs or religious views as part of the relationship.
Premarital Couples Therapy and Premarital Counseling
There is a common misperception that couples therapy helps only when there are problems. At our downtown Toronto clinic, many couples seek out our services prior to problems occurring, particularly people who are planning on getting married and want to learn more effective relationship communication tools. They may have seen first hand their parents or their friends having problems in their relationship, are starting to notice some cracks in their own relationship, or they are self-aware individuals who appreciate that we are not born with effective relationship skills – these are learned.
Premarital therapy is similar to couples therapy, with exception that the focus is more on anticipating and identifying matters the couple has not yet considered (e.g. how will we raise our children, where do we want to live), identify and discuss each person’s respective values, expectations around important issues like sex, children, money, in-laws, and learning effective communication strategies and skills.
How effective is Couples Therapy?
There are thousands of studies that have examined whether couples therapy is successful or not. Most recently, Roddy and colleagues (2020) conducted a meta-analyses – a study that summarizes data from several studies – of couples therapy outcome research completed over decades. It found that couples who completed a course of couples therapy showed statistically significant and large improvements on measures of various relationship quality indicators compared to couples waiting to seek treatment. Essentially, their research showed couples who completed a course of couples therapy scored on average 80-95% higher on various measures of relationship quality than those who were waiting for treatment. Such large effects are often hard to achieve in psychotherapy outcome research, which speaks to the significant value and positive impact professional help can provide.
They also found that the couples who did not yet complete treatment showed no significant improvement while waiting. Our experience at Toronto Psychology Clinic shows there is little to no benefit to waiting before embarking on couples therapy, particularly for a relationship in crisis. Additionally, many of our therapists have engaged in or continue to engage in couples therapy research in areas that include online couples therapy, sex therapy and cultural diversity, and are very knowledgeable in the key interventions in couples therapy that contribute to positive outcomes.
What types of Couples Therapy are there?
There are many different models of couples therapy including the Gottman Method, EFT and Family Systems. Most of our couples therapists are trained in multiple types of couples therapy. We like to take the most effective tools from each model in order to best serve our clients. Here are the major models of therapy we typically work with at Toronto Psychology Clinic:
What is the Gottman Method of Couples Therapy?
The Gottman Method of Couples therapy is based on a longstanding program of research on the factors that improve versus deteriorate a relationship. This intervention involves assisting couples in reducing negative interactions and improving positive interactions in three main areas – friendship, conflict management and creation of shared meaning. This form of therapy strives to help a couple find meaning as well as gain better conflict resolution strategies.
The Gottman Method is based on the Sound Relationship House Theory that is comprised of nine components of healthy relationships. A Gottman trained couples therapist will guide couples through these components using a series of exercises to facilitate improvement in their respect, love, trust and affection with each other. To learn more visit The Gottman Institute.
What is Emotion Focused Couples Therapy?
Emotion Focused Therapy for Couples (EFT-C) is a form of couples therapy based on the idea that our relationship dynamics, both positive and negative, are fueled by the way we feel and express our emotions, and these emotions and consequent behaviour patterns are rooted in our identity and attachment histories. In Emotion Focused Therapy, the therapist helps the couple identify and become more aware of emotions, negative relationship interaction patterns, and understand how their respective attachment histories, needs and behaviours contribute to this cycle. We help couples identify alternative, healthier emotions and ways of meeting their individual needs while engaging with each other in ways that are more empathic.
Family Systems, Social Constructivist and Other Approaches
Family Systems based therapy is a longer-standing model of therapy for individuals, couples and families that understands people in the context of their relationships. Family Systems came out of the work of therapists such as Murray Bowen and Salvador Minuchin, among others. This approach is particularly helpful when trying to understand the couple in their relationship with their children, parents and other extended family. A family systems-trained therapist will often use this framework to understand relationship issues related to power, race, ethnicity, culture, belief systems, meanings, values and intergenerational conflict.
How do I get started with Couples Counseling?
How do I choose a therapist?
Not all psychologists are specifically trained in couples therapy. At Toronto Psychology Clinic, in addition to regular training to become a clinical psychologist, our clinicians have significant training and applied research in couples therapy, particularly EFT, the Gottman technique and Family Systems. If a clinician is stuck with a couple’s case, they benefit from peer consultation within the group.
When you contact our clinic, our clinic coordinator can answer any questions and will determine which associate would be right for you and your partner based on your needs.
Should I see a psychologist, psychotherapist or social worker for couples therapy?
All three designations – psychologist, social worker and psychotherapist – can provide couples therapy provided they have engaged in substantial supervised training delivering couples therapy in addition to taking courses. The College of Psychologists of Ontario requires psychologists to have acquired a certain number of hours and cases of supervised work in couples therapy, in addition to couples therapy coursework, in order to be able to provide this service.
It is important to ask your therapist how long they have been providing couples therapy and what type of training they have completed. Our therapists at Toronto Psychology Clinic have substantial training in individual psychology as well as couples therapy and its specific models (Gottman, EFT and Family Systems), and we are continually training new clinicians in couples counselling. Some of our therapists are providing couples therapy under the close supervision of a more experienced couples therapist in order to declare this as an area of competency.
How long does Couples Therapy take?
The length of time a couple will seek counseling varies depending on the goals, the type of issue and the severity of the relationship issue. Each partner’s personality plays a role in determining length of therapy, as well as their commitment to participating in each session. We can provide an assessment to advise how long we think therapy will last. The first few appointments are used as a consultation to understand you, the problem, your respective histories, and answer your questions about the process.
Do both partners need to be willing?
Generally speaking, yes, as the problem we are trying to address is your relationship and without both present, it is often not effective. Our role is not to attribute blame. We strive to create a balanced environment where both partners feel heard and understood, not judged.
Is couples counseling covered?
Our couples therapy services in downtown Toronto are covered by most extended health benefits and other third party insurers. Rates depend on the licensing level and years of experience of the therapist, and are consistent with OPA recommended rates.
Is virtual couples counseling available?
Yes we offer virtual couples therapy. Toronto Psychology Clinic uses a secure encrypted online platform to provide services including partners not living together.
References
Roddy, M. K., Walsh, L. M., Rothman, K., Hatch, S. G., & Doss, B. D. (2020). Meta-analysis of couple therapy: Effects across outcomes, designs, timeframes, and other moderators. Journal of Consulting and Clinical Psychology, 88(7), 583–596. https://doi.org/10.1037/ccp0000514