Working with a Couples Therapist: Warning Signs and Red Flags

Last week I wrote about a list of questions you should ask as you're interviewing couples therapists.  This post delves into the deeper problems in the field of couples therapy: lack of training, lack of experience, and individual bias.

This is information I wish I'd had before starting our disastrous couples therapy.  If I'd known what I know now, I would have realized as of our first session that our counselor had no idea what he was doing.  But I fell pray to the most common assumption about couples therapy: that anyone with a Marriage and Family Therapy degree has received training in couples work, and that they are therefore qualified to work with couples.

As it turns out, having that "MFT" after their name tells you nothing about a so-called "couples therapist".  In spite of the name, "marriage and family therapy" programs usually require only superficial coursework and training in couples' issues.  As for other therapists who provide couples counseling, including psychiatrists, psychologists, social workers, and others, receive no coursework or training at all.

Nonetheless, about 80% of therapists do some form of couples therapy.  To put it another way, an overwhelming majority of therapists work with couples, and the overwhelming majority of those do so without any real training.  



Most therapists are trained to have an individual therapeutic orientation, not a relationship or community orientation, and they fall back on this when attempting couples therapy.  Don't get me wrong, individual therapy is great when you need to talk about your own problems.  A good therapist can help you see where you might be sabotaging your own goals.  They can help you elucidate your needs, see the places in your life where they're not being met, and support you in making the changes to your life that will ultimately help you meet these needs.

When one of these counselors tries to do couples therapy, their instinct is to focus on each partner as an individual, what those individual's needs are, and how they're not being met in the marriage.  Even if the couple comes to them saying that both are committed to staying in the marriage, this individual may lead the therapist to give up on the relationship -- and tell the couple, sometimes after only a few sessions, that they should divorce.

Does that sound like a viable way to save a relationship?  Didn't think so.


Fortunately, there are ways to determine whether your therapist knows what they're doing.  Again, thanks to Dr. William Doherty, here is a list of red flags that indicate that your couples' therapist may be incompetent:

1.  The sessions lack structure.  If you're going to therapy and having the same fights you are at home, with no interventions from your therapist, that therapist doesn't know what they're doing.  At the end of the session, after you're both worn out and emotionally bruised, the therapist might say something inane like "we've gotten some important issues out into the open here!".  Both members of the couple leave feeling hurt, drained, and pessimistic about their relationship.  Been there, done that.

2.  The therapist fails to recommend any day-to-day changes that the couple can make.  You're in therapy because something in your relationship isn't working, right?  Which means you want to change something, right?  For instance, if Dick and Jane's therapist explains to them that they handle conflict by Jane losing her temper and Dick retreating into silence to punish her, but fails to tell them how to change this dynamic, Dick and Jane's therapist lacks the necessary experience to them.  Been there, done that.

3.  The therapist feels overwhelmed by the couple's problems and recommends divorce.  Seriously.  In these cases, the therapist fails to realize that the overwhelm is caused by their own lack of knowledge and experience, not by the couple's "emotionality" or "irreconcilable differences".  It's not your therapist's job to recommend that you split up.  If they do, they're not competent to help you, and you should seek help elsewhere.  This is actually one mistake our therapist didn't make.


Dr. Doherty says that there are other mistakes that are more common in more experienced therapists.  A therapist may have worked with dozens, even hundreds of couples over the years.  They know how to provide structured sessions, how to give meaningful feedback, and how to contain the difficult feelings that come up during couples therapy.

Listen up, dear audience, because this one relates directly to you.  Even an experienced therapist may lack experience in your particular area of need.  Doherty relates several examples of this, but to me, the most important one involves a story of mental illness.  Out of the blue, Doherty's friend came home and announced to his wife that he was having an affair and that he wanted an open marriage.  The next day he was found in a confused state, wandering around in the woods.  He was diagnosed with psychotic depression (a fellow sufferer!) and spent to weeks in the hospital.

While his own therapist cautioned him not to make any major decisions in his current state, his wife's therapist urged her to divorce.  Remember that "sickness-and-health" promise that's part of the standard wedding vows in this country?  Yeah.  Her therapist wanted her to up and abandon it.  She, however, was not ready to give up on a long-term relationship when her husband was clearly not himself, and found another therapist.

This was yet another area in which our therapist couldn't help us.  He gave me half of one session to talk about my issues with disability.  He provided no insight, let alone concrete suggestions, as to how my partner could come to a more empathetic understanding.  He didn't deal with my mental illness at all.  These issues are fundamental to our marital problems.  Yet we barely even mentioned them.  I suppose I should be grateful that he didn't recommend divorce because this was clearly a problem that would never go away.

For Doherty's full article on the hazards of marriage therapy, click here.  For a more compact list of what to look for in a therapist, and what warning signs you should heed, click here.


individual therapy hazardous