Stuart Bradford
Does your marriage need therapy? If you’re like most people, the correct answer may well be yes, but your answer is probably no.
In most marriages, one or both partners resist the idea of counseling. Some can’t afford it, or find it inconvenient. And many view therapy as a last resort — something only desperate couples need. Only 19 percent of currently married couples have taken part in marriage counseling; a recent study of divorcing couples found that nearly two-thirds never sought counseling before deciding to end the relationship.
“It seems like we’re even more resistant to thinking about getting help for our relationship than we are for depression or anxiety,” said Brian D. Doss, an assistant psychology professor at the University of Miami. “There’s a strong disincentive to think about your relationship as being in trouble — that’s almost admitting failure by admitting that something isn’t right.”
Marriage counseling does not always work, of course — perhaps because it is so often delayed past the point of no return. One recent study of two types of therapy found that only about half the couples reported long-lasting improvements in their marriages.
So researchers have begun looking for ways (some of them online) to reach couples before a marriage goes off the rails.
One federally financed study is tracking 217 couples taking part in an annual “marriage checkup” that essentially offers preventive care, like an annual physical or a dental exam.
“You don’t wait to see the dentist until something hurts — you go for checkups on a regular basis,” said James V. Córdova, an associate professor of psychology at Clark University in Worcester, Mass., who wrote “The Marriage Checkup” (Jason Aronson, 2009). “That’s the model we’re testing. If people were to bring their marriages in for a checkup on an annual basis, would that provide the same sort of benefit that a physical health checkup would provide?”
Although Dr. Córdova and colleagues are still tallying the data, preliminary findings show that couples who take part in the program do experience improvements in marital quality. By working with couples before they are unhappy, the checkup identifies potentially “corrosive” behaviors and helps couples make small changes in communication style before their problems spiral out of control. (Typical problems include lack of time for sex and blaming a partner for the stresses of child rearing.)
“Couples won’t go to marital therapy with just the one thing that they are struggling with,” Dr. Córdova said. “So they end up struggling in places where the fix might be simple, it’s just that they themselves are blind to it.”
Not surprisingly, some therapists are creating online self-help programs to reach couples before serious problems set in. Dr. Doss and Andrew Christensen, a psychology professor at the University of California, Los Angeles, are recruiting couples at www.OurRelationship.com to study such a program.
The online study, financed by a five-year $1.2 million grant from the National Institute of Child Health and Human Development, will deliver online therapy to 500 couples. It is based on “acceptance therapy,” which focuses on better understanding of a partner’s flaws — a technique described in “Reconcilable Differences” (Guilford Press, 2002), by Dr. Christensen and Neil S. Jacobson.
The method, formally called integrative behavioral therapy, was the subject of one of the largest and longest clinical trials of couples therapy. Over a year, 134 highly distressed married couples in Los Angeles and Seattle received 26 therapy sessions, with follow-up sessions every six months for the next five years.
Half the couples received traditional therapy that focused on better communication and problem solving, while the others took part in a similar program that included acceptance therapy. Five years after treatment, about half the marriages in both groups were significantly improved, according to the study, which appeared in the April issue of The Journal of Consulting and Clinical Psychology. Dr. Christensen says about a third of the subjects could be described as “normal, happy couples,” a significant improvement considering how distressed they were at the start. (The couples who received acceptance therapy had better results after two years, but both types of therapy were about equal by the end of the study.)
The hope is that an online version of the program could reach couples sooner, and also offer booster sessions to improve results. Even so, Dr. Christensen notes that the disadvantage of online therapy is that it won’t give couples a third party to referee their discussion.
“Nobody thinks it’s going to replace individual therapy or couples therapy,” he said. “There’s generally a sense that the intervention might be less powerful, but if it’s less powerful but is easily administered to many more people, then it’s still a very helpful treatment.”
Researchers at Brigham Young University offer an extensive online marital assessment, called Relate, for couples and individuals. The detailed questionnaire, at www.relate-institute.org, takes about 35 minutes to complete and generates a lengthy report with color-coded graphs depicting a couple’s communication and conflict style, how much effort each partner puts into the relationship, and other things. The fee is $20 to $40.
Australian researchers are using the same assessment, along with a DVD and telephone education program called Couple Care, found at www.couplecare.info, to reach families in remote areas who don’t have access to traditional therapy. The Utah and Australia researchers have begun a randomized, controlled trial of about 300 couples to determine the effectiveness of the approach.
Preliminary data show that couples reported improvement, but Kim Halford, a professor of clinical psychology at the University of Queensland, St. Lucia, in Australia, said more study of long-term effects was needed.
Dr. Halford notes that as more couples meet through Web dating services, the appeal of online couples counseling may increase. “If information technology is integral to how you began your relationship,” he said, “then if therapy is required it’s not surprising that they would look to online technology.”
A version of this article appeared in print on June 29, 2010, on page D1 of the New York edition.
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From 1 to 25 of 108 Comments
I think everything should be done online. Meet, date, marry, have kids, virtual travel, separation, divorce, remarry, etc – all online! Life will be so much easier and more convenient! It’s the wave of the future!
— seasoned therapy veteranWhy don’t marriage counselors ever want to address the elephant in the room? People are afraid to go to counseling because they are afraid the counselor will cause them to lose their marriage. Most people have heard stories of a couple goes into counseling moderately unhappy and coming out with the belief that their marriage is over an they need to divorce. I think marriage counseling in the 70’s and 80’s was used as a divorce-permission system, people were essentially paying 100 bucks a session to have someone tell them to go ahead and break up their families. Couples in their high pressure marriage years right now remember their parents going to “talk to a nice man who is going to help us not argue so much”, soon followed by the “we’re divorcing” talk. Is it any wonder people don’t see counselors until it’s too late? Would you put your most precious possession in the hands of a stranger with a poor track record?
— LizI took the relationship survey mentioned in the article, didn’t inspire much confidence that online couples therapy will benefit many. Twenty plus years of marriage, doesn’t work well with a pull down menu of options.
Who wants to be a chat room with other people?
I guess if i lived in a rural part of the country, it might help, but it made me laugh to think about us sitting facing a computer for hours on couples therapy.
— AS – CaliforniaMy experience is that the unhappy partner often won’t get traction from the contented partner who likes the status quo, even when confronted with the reality of live therapy. It’s hard to imagine that, in the highly defensive contented partner scenario, anything meaningful can be accomplished through online therapy. They ought to first develop a screening tool to establish whether a higher level of intervention is needed. Otherwise, it sounds like an option that will only delay the confrontation with reality that some of us require to acknowledge the unhappy partner’s reality.
— been there…There is no proof that marital counseling improves marriages. Amen to Liz #2 – such counseling can even increase the risk of divorce. In that study that showed that counseling improves marriages only 50% of the time: how do we know that these marriages wouldn’t have improved anyway, even if the couples had no counseling?
No point in throwing one’s money away on something that has no proven benefit.
— ShanaThis weekend, my husband of nearly 19 years told me things I wish we had discussed before. I suggested therapy nearly ten years ago. Now he says it is too late. So sad.
— Almost thereI tried marriage counseling. For two sessions. In the first session, we were told to list three things that would lead us to believe we were loved by the other. I did my assignment; I don’t know if my wife did. When the therapist asked who wanted to go first, I agreed to begin. Item #1 on my list elicited an hour of abusive screaming at me by my wife. We never got to my numbers 2 and 3, or to any of my wife’s. I asked the therapist what I was supposed to do. His answer: Just sit there and take it. I told him I was not a masochist and left–after he took my $100.
Why pay for more of exactly the abuse I was getting regularly at home for free?
— Frank GadoThese comments are really extremely interesting.
I think they are right, that the main reason lots of people do not want to go to therapy is they are afraid it will cause them to lose their marriage.
Another main reason, though, is that it may be suggested that they change their behavior. If a person has behavior that they are “getting away with” just fine, they don’t want to change.
Also, I wonder how qualified some marriage counselors are. Frank Gado, above, tells of his wife screaming abusively at him. That probably means she needs a medical check-up. Or maybe she needs her own therapy. Or maybe his expectations really are that unfair that she should be screaming. I have no idea, since I don’t know what it is that he wants.
I was married once, years ago. My husband was a liar, a cheater, unfaithful, irresponsible, unreliable, arrogant, violent, unloving, ungrateful, goofy, lazy, selfish. He also sexually molested my young teen sister.
It was was horrific and dangerous to be near him. I later found out he had bipolar illness and I think that illness largely was what cause his terrible behavior. He is remarried, has children, and teaches teen children. I hope his illness is treated.
The thing is — we went to marriage counseling – and the counselor never pinpointed my husband’s illness.
I wonder how qualified a marriage counselor is to recognize depression, bipolar illness, and any other such illness. I think in marriage counseling, I was the one who looked out of control. I was extremely stressed out from dealing with a man who was basically an evil, violent monster.
I think that women and men who are in such horrific situations may be unable to communicate how bad it is. I know I was, and I am very communicative. When a spouse has been so routinely put through hell, there can be a real cover-up and attempt to make it seem less than it is.
I guess I would recommend that spouses each be given a questionnaire that is guaranteed it will be kept private. Try to assess: Have you ever been hit by the spouse? Have you been raped by the spouse? Has the spouse ever had sex with one of your friends? with a child?
Take my word for it – if a couple is “good-looking”, it can be hard to spot the horrors that may lie below the surface.
— Once MarriedThe problem is that in far too many cases, its a matter of trying to improve the compatibility of the incompatible.
Today, few singles, especially women look for the important things, when they are dating. Its all about status and impressing their girlfriends. Men also have a propensity to be shallow too but now days but the downside of divorce has warned many of them to at least doing some homework. Unfortunately, women now have all the tools at their disposal to attract, keep and entrap many men, despite their best intentions.
Most marriages will be on the rocks until a balance is restored and therapy to fix this is a false hope.
— SteveI wanted to go to counselling ten years or so ago but my husband refused. I was reading self help books at the time and one thing resonated with me. It was “You can’t change the other person, but you can change yourself and how you relate to the other person.” So I changed my response to the behavior I didn’t like, and things improved a whole lot. This is the sort of advice that could be easily given online. I agree that having a referee or intervention might be preferable, but some partners feel very threatened by having another person in their marriage. Bravo for this innovative idea.
— PatriciaMy best friend has been married with a ?????? for 27 years. This man has been verbally abusive , a cheater, used drugs and who knows what else. I live in a differnet state has she does. This whatever you would like to call him, I believe is missing some screws. he domestric violence shelters are full with a 3 year lag. in the state of arizonat=if you make ten dollars an hour you qualify for no medical assistance, no rent assistance (this is closed to budget short falls) and so on. One therapist said get out she just forgot to tell her how she could feed and house her children. She dodges him at every turn
— susyshe is between a rock and where can i go ,
This reminds me of an old bit on Letterman that advised “don’t wait till light bulbs burn out to change them.” There’s a reason for the DSM codes, as shaky or faulty as they often seem. It’s because when someone says you need healthcare based on their subjective opinion and they profit from it, well, that might be seen as conflict of interest. Psychologists deciding most people need marriage counseling and that the reason it often leads to divorce is because the couple waited too long? There is at least some self-serving going on there, in an age when counseling is out and drugs are in–at least according to the insurance companies.
— TalbotWhy stop at annual prophylactic checkups for marriage? Why not START with annual prophylactic checkups for everyone? Surely your mental health is as important as your dental health?
Most people grew up in dysfunctional families, so most people would benefit from therapy.
Trying to make marriage work between healthy people is hard enough; trying to make it work when both parties are unhealthy is pretty much impossible, with or without counseling.
— BrendaHmm. The concept of accepting your spouse’s flaws is intriguing. How do they do that? Prefrontal lobotomy? Didn’t know you could do that online.
— Wasting TimeWe have such high expectations of marriage. I have been married 18 years, not long. I am still muddling through it. People change, people grow. We grow together, we grow apart. I guess as long as we are headed in the same direction and feel good about it, then it is okay.
My parents were married 58 years before my mom died. before she died, at their 50th wedding anniversary party, I asked her how they kept it together all of those years. She said that it was not easy, you have to learn to let some things go, let the other person be a person, not an extension of you. Sometimes it is best to just be quiet—turn a “deaf ear” as she would say. Every little thing does not have to elicit a comment. It is not all about you.
And never let anyone make you feel bad about yourself. If they do, leave. Some marriages are not meant to be.
Good advice.
Sometimes the question is not why is he/she doing this to me. Sometimes the question is why am I doing this to myself.
— Janice Badger Nelson, RNReading all of these sad stories and dire predictions makes me think I should throw my happy one into the mix. My husband and I went to couples therapy when we’d only been together for a short time — maybe a year. We were in a painful cycle of arguing and resentment. We loved each other, but didn’t know how to make the arguing stop. So we decided to try therapy. Our therapist was not a perfect person, but somehow he created an atmosphere in which our defensiveness shrank away and we were able to talk out our problems (our styles of confrontation, etc). In the end, the therapist actually validated our relationship and that made us feel good too. Perhaps we would have been fine anyway, but therapy honestly helped us and we’ve been a happier pair ever since.
— SIt is difficult to develop trust one-on-one in therapy, and for a couple to be able to do this at the same pace is difficult. By the time most couples reach this stage, too, they are very often seeking a referee, not someone to make them examine how their own behaviors have created the world as they know it.
And individual assessment is needed, for many reasons, including to ferret out who is pushing for therapy and why ( to save the marriage? to change the dynamics? to save face in breaking up? to have their worst opinions validated?), and what are the other partner’s perceptions? It could be that marriage counseling is totally inappropriate, and mediation or guidance toward a gentler parting of the ways is really more appropos.
Plus the obvious — all therapists are not highly skilled, and some, possibly like the one in Frank Gado’s comments above,may have no clue what they are opening up, nor do they have skills in moderating the sessions to prevent attacks. And as mentioned in “once married’s” post many do not recognize dangerous behaviors in people under ther care.
Still, in some ways, IF a couple is committed to staying in the marriage and getting to a better place together, they may actually benefit from the neutrality of the computer approach. Not much transference ( and counter-) to work though… And we do know that there are some concrete things that individuals can be told to do that can improve a relationship, such as simply taking more effort to praise and celebrate the other. In addition to targeting “corrosive” behaviors for elimination, adding some specific positive techniques might well work better than some therapy sessions.
— CGThat humans are at once foolish and optimistic is the news that 2nd marriages fail just slightly more often than 1st marriages. Lots of telling reasons for that which is a study in itself.
— caHow it goes wrong:
1) Marry someone just like your parent. Or not.
2) Have unclear expectations or unexpected changes — disease, disillusionment, demise before death of the relationship.
3) Never come to a happy peace of settling issues whether than is screaming at the top of your lungs or reluctantly going to a therapist.
4) Laugh at one another’s jokes.
5) Love the way your partner smells bathed or not.
6) Share a history textured with meaningful experiences, losses, friends and triumphs.
The list works for gays and straights. Kind simple, kinda stupid. Kinda like what you have tried and disagree with or to chicken to try.
Some of these things above you can’t really know until you live under the same roof for a while. The pedestals or need for one fade away behind home doors.
It’s pretty obvious from all of our artistic expressions that in some mutant way we were meant to love one another. We use every possible piece of pretzel logic to avoid it, but it stares us in the face. Today it’s wearing lipstick.
The war between men and women and men and women etc will cease not just when we can stay married — though that might be a marker — but when the guns stop in the distance from the drones invisible but with deadly cargo in our own bedrooms and living rooms.
When we can finally say I do.
I agree with Steve in #9. Many resist counseling because they fear it will confirm what they already suspect – they married the wrong person. Marriage counseling might reveal that they have issues they aren’t prepared to deal with. The familiar misery is more manageable than the frightening unknown.
“Success” in marriage counseling shouldn’t be measured by “saving” a marriage, but by both partners living more fulfilling lives – together or apart.
J
— JordanCounseling for everything… My guess is that those couples who “make it” would have made it with or without a counselor. We’ll never know though, will we?
I am aware of too many marriage and family therapists or counselors who have major issues of their own- yet they are going to tell others how to make it all better? An acquaintance of mine became a marriage and family therapist — divorced, with an out-of-control, chemically addicted teenager. Yep, that’s who I want to go to for help! Seriously, I’d rather enlist the help of my neighbors, married for over 50 years, who have the equanimity, maturity, and humility to implement the serenity prayer to their marriage.
— lkwobgnOne way to hold a marriage together is a deal requiring the departing spouse to take the children.
— MARK KLEIN, M.D.I tried couples therapy twice in my 8 years with my ex (I’m two plus years out of that now). The first therapist presupposed I was the monster. By the time he realized she was the monster she “happened” to get pregnant and had no time for therapy. We got married. The second time, the therapist kept saying that he was treating the couple, not the individuals (which means we should have hired two more therapists!). He knew I should have escaped (she’s a sociopath), but he kept us on the lost-cause-course of trying to get us on an even keel.
Both times I felt that couples therapy did us a disservice. But before I dismiss it out-of-hand, I have to admit that my case is probably not usual (or is it?).
— RichardMarriage counceling helped us, both before we were married and afterwards. We have used both one-on-one and a weekend session with hundreds of other couples. People should consider using this possible improvement in their marriage before things get super rough. Just like the lifecycle of a child (or aduld) when we have faced different new stressors in the relationship, we have had to get a tune-up; this has been very helpful.
— MKFPerhaps we are comforted by the fact that we have made a definite commitment, and renew it periodically in our discussions. If we are “stuck” in the marriage, might as well improve it as much as possible, is our general point of view. BTW, we met on the internet but I don’t necessarily think internet counceling would be helpful or appealing. It is such a personal thing, to talk about your marriage. Best done with another human being whom you trust.
Sometimes I think the only solution is to make it harder to get married in the first place.
— HeronSometimes, people tell the therapist things that simply aren’t true. And, sometimes, they try to win over the therapist, so that he/she likes them better than the spouse. Often, the system that is set up in the marriage continues into the therapist’s office, and the therapist spends loads of time trying to analyze the dynamic as if it’s all new exciting stuff, when it’s old hat. Silly.
I’ve come to think that people are sometimes better off sitting on their own couches, with their own selves, realizing they know themselves best. The two separate times in my life that I sat on someone else’s couch, I emerged newly empowered, yes, to make two very wrong decisions.
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— Pamela Gwyn Kripke