Psychological therapies
Couples & Marital Therapy
Structured relationship-focused therapy for couples experiencing persistent conflict, communication difficulties or emotional distress that affects wellbeing.
Couples therapy provides a structured space to understand recurring patterns between partners, improve communication and work on specific relationship difficulties. It is not about deciding who is “right”; the therapist helps both partners identify patterns, clarify goals and develop more constructive ways of responding.
Communication breakdown
Repeated misunderstandings, withdrawal, criticism, escalation or difficulty discussing important issues safely.
Relationship strain
Loss of trust, emotional distance, role changes, parenting stress, illness, grief or major life transitions.
Mental-health impact
Relationship difficulties may worsen depression, anxiety, sleep problems or coping, and mental-health symptoms can also strain the relationship.
Shared recovery
Where clinically appropriate, involving a partner can support treatment goals, relapse prevention and healthier routines.
When there is coercive control, serious violence, immediate safety risk or fear about speaking openly, the first priority is safety and individual assessment. The therapist may recommend a different pathway rather than joint sessions.
What happens in couples therapy?
Assessment and goals
The therapist explores the main difficulties, how each partner understands them, relationship strengths, mental-health factors, safety concerns and what both people hope to change.
Understanding patterns
Sessions identify recurring cycles such as criticism and withdrawal, escalating arguments, avoidance, reassurance seeking or difficulties expressing needs.
Practising new responses
Depending on the approach, therapy may include communication work, behavioural tasks, problem-solving, emotional understanding and structured practice between sessions.
Reviewing progress
Goals and progress should be reviewed openly. If one or both partners need individual psychiatric or psychological treatment, this can be coordinated separately.
Couples therapy and depression
NICE recommends considering behavioural couples therapy for people with depression when relationship problems may be contributing to the depression or when involving the partner may help treatment. Suitability depends on the clinical situation and both partners’ willingness to participate.
Preparing for the first session
- Think about the two or three patterns you most want to change.
- Consider what improvement would look like for each partner.
- Bring relevant mental-health or treatment information if it affects the relationship.
- Be prepared to discuss concerns respectfully; therapy works best when both partners can participate safely.
Frequently asked questions
Does the therapist take sides?
The aim is to understand the interaction between partners and work towards agreed goals, not to act as a judge or decide who is at fault.
Can couples therapy be used alongside individual treatment?
Yes. Depending on clinical need, couples work may occur alongside individual psychological therapy, psychiatric care or medication treatment.
Is everything discussed confidential?
The therapist should explain confidentiality and its limits at the outset, including how information is handled when safety or safeguarding concerns arise.
Clinical sources
NICE NG222: Depression in adults — behavioural couples therapy
NICE CG136: Service user experience in adult mental health
Editorial Policy · How We Review Health Information
This information is for general education and does not replace an individual clinical assessment.
Would relationship-focused therapy be appropriate?
Ahana’s team can help you identify whether couples therapy, individual therapy or another pathway best fits the concern.