How to Prepare for Couples Therapy

You do not need to prepare much. The useful steps are to get clear on what you want to change, agree with your partner on why you are going, sort out the practical details, and resist the urge to build a case. Arriving willing to look at your own part matters more than arriving with notes.

Do you need to prepare for couples therapy at all?

Not in the sense of studying for it. A couples therapist expects you to arrive unsure, nervous, and possibly in the middle of an argument. Nobody is graded on the first session.

A little thought beforehand does help, for one reason. Couples usually arrive with two different stories about what is wrong. If each of you has spent ten minutes thinking about what you want, the first session can move from “who is right” to “what are we trying to change” much sooner.

This article covers what to do in the days before you start. For what happens once you are in the room, see what to expect in your first couples therapy session.

What should each of you think about on your own?

Take a few quiet minutes separately. You can write the answers down or keep them in your head. You do not need to show them to each other.

• What would be different if this worked? Try to describe an ordinary Tuesday six months from now. “We would eat dinner without tension” is more useful than “we would communicate better.”
• What is the pattern, not the incident? Most couples can name the fight they keep having. Notice what you tend to do in it: push, go quiet, get sarcastic, leave the room.
• What is my part? This is the hardest question and the most valuable. You are not taking the blame. You are identifying the one thing you actually control.
• What am I afraid to say? There may be something you have not told your partner: a doubt, a resentment, a need. You do not have to say it in the first session, but know that it is there.
• What still works between us? A therapist will ask about strengths as well as problems. It helps to remember them before you walk in.

What should you agree on together before the first session?

Keep this conversation short and low-stakes. Its purpose is to make sure you are both walking into the same thing.

Why you are going

You do not need to agree on what the problem is. You only need a shared sentence such as “we keep getting stuck and we want help getting unstuck.” If one of you sees therapy as a way to fix the relationship and the other is not sure they want to stay, say so honestly. That difference is common and a therapist can work with it. Discernment counseling is designed for couples in that position.

What is off limits outside the session

Some couples agree not to restart session topics in the car on the way home, or not to quote the therapist in later arguments. A simple rule like this protects the work.

Who else knows

Decide together whether family or friends will be told. One partner announcing it without the other’s agreement is a rough way to begin.

Why does the therapist need both of you on board?

Research on couple and family therapy gives a practical reason to care about this. A meta-analysis of 48 studies covering more than 1,500 couples and 2,500 families found that a stronger working relationship with the therapist was associated with better results. It also found that outcomes were poorer when that relationship was “split,” meaning one person felt much more connected to the therapist than the other.

These are associations, so they do not prove that the alliance causes the improvement. They do suggest that it is worth choosing a therapist you both feel reasonably comfortable with, and worth speaking up early if one of you feels the therapist is taking sides. The guide to questions to ask a couples therapist before you book can help with the choosing, as can this post on how to choose a couples therapist in NYC.

What practical details should you sort out?

Loose ends create stress on the day. Settle these in advance.

• Fees and payment. Ask what a session costs and how payment works before you book. For spiral2grow, contact the practice for current fees. A sliding scale is available, so ask about it if cost is a concern.
• Insurance. spiral2grow does not bill insurance directly and works as an out-of-network provider. If you plan to seek reimbursement, call your insurer first and ask whether couples therapy is covered and whether a diagnosis is required. The article on insurance and couples therapy in New York explains the questions to ask.
• Time. Sessions at the practice are 45 minutes. For a first session, the practice asks you to arrive 10 minutes early to complete the standard intake forms.
• Cancellation. Know the policy. At spiral2grow, cancellations need at least 48 hours’ notice.
• Format. Decide whether you are coming to the office or meeting by video. For video, pick a private room and test your connection.
• The hour afterward. Try not to schedule a work meeting or a family dinner straight after. Leave room to decompress.

Some approaches include a structured assessment at the start. The Gottman Institute, for example, describes a joint session followed by individual interviews with each partner, plus questionnaires. Not every therapist works this way, so ask what the first few sessions will involve.

What should you avoid doing before you go?

• Do not build a case. Lists of your partner’s offenses, screenshots and timelines turn the session into a trial. The therapist is not a judge.
• Do not rehearse a speech. A few notes on what matters to you are fine. A prepared argument makes it hard to listen.
• Do not stage a final confrontation the night before. If something hard needs to be said, the session is a safer place for it.
• Do not make it a threat. “Wait until the therapist hears about this” sets your partner up to arrive defensive.
• Do not expect a verdict. The first session is mostly about understanding. Change comes from the weeks that follow.

When is it time to stop preparing and book?

Preparation can become a way of putting things off. If you have been meaning to find a therapist for months, the most useful step is a first conversation with one. You do not need your partner’s full enthusiasm, a perfect description of the problem, or the right moment. You need a time on the calendar.

A short phone call before booking lets you ask how the therapist works and get a feel for whether you would both be comfortable. You can read about the approach to couples counseling at spiral2grow before you call.

One exception: if you are afraid of your partner, or there is physical violence, threats or controlling behavior, joint sessions are not the right first step. The National Domestic Violence Hotline explains why it does not encourage couples counseling with an abusive partner. You can call the hotline at 1-800-799-7233 to talk through your options confidentially.

Start with a short call

spiral2grow offers a free phone consultation with Moshe Ratson, LMFT, who sees couples in Midtown Manhattan and Online by Video. Bring your questions, including the practical ones above. Contact spiral2grow to request a call.

Common questions

Sources

• Meta-analysis of the alliance-outcome relation in couple and family therapy (Friedlander et al., 2018), Psychotherapy, via PubMed
• The Gottman Method, The Gottman Institute
• Should I Go To Couples Therapy With My Abusive Partner?, National Domestic Violence Hotline

This article is part of the Couples Counseling Guide. It is general information, not a substitute for care from a licensed professional who knows your situation.

This article is for general education. It is not a substitute for professional advice, diagnosis or treatment.