Questions to Ask a Couples Therapist Before You Book
Before you book, ask a couples therapist about their license, how much of their work is with couples, the approach they use, how they keep sessions fair to both partners, what it costs and how you will know it is working. A short phone call covering these points tells you a lot about fit, which research links to better outcomes.
Why do the questions matter?
Couples therapy is unusual because the therapist has to build trust with two people who may currently disagree about almost everything. Research suggests that this working relationship counts. A meta-analysis of 48 studies of couple and family therapy found that a stronger alliance with the therapist was associated with better outcomes. It also found that when the alliance is “split,” with one person feeling connected to the therapist and the other not, outcomes tend to be poorer.
You cannot measure that before you start. You can improve your odds by asking a few direct questions and noticing how both of you feel about the answers. The questions below are grouped so you can pick the ones that matter most to you. Most can be covered in a short call.
What should you ask about license and training?
- What is your license, and in which state? In New York, the State Education Department’s licensing rules require a marriage and family therapist to hold a qualifying master’s or doctoral degree, complete at least 1,500 client contact hours of supervised experience and pass an examination. Psychologists, clinical social workers and mental health counselors hold different licenses with their own requirements.
- Can I verify it? Yes. Anyone can look up a New York licensee by name on the Office of the Professions verification search.
- How much of your practice is couples work? Couples therapy is a specialty. A therapist who mostly sees individuals and occasionally sees a couple is working differently from one who sees couples every week.
- What training do you have specifically in couples therapy? Listen for specifics instead of a list of buzzwords.
If you are unsure which type of professional to look for, LMFT, psychologist or social worker explains the differences.
What should you ask about their approach?
- Which approaches do you use with couples, and why? Common ones include the Gottman Method, Emotionally Focused Therapy and Imago. A review of 20 meta-analyses found that differences among kinds of couple interventions tend to be small, so you are listening less for the “right” brand and more for a clear explanation that makes sense to you. This guide’s comparison of Gottman, EFT and Imago gives background.
- What does a typical session look like? Some therapists are active and structured. Others follow where the conversation goes. Neither is wrong, but you may have a preference.
- Do you ever meet with each of us alone? Many therapists do this during assessment. Ask how it works.
- How do you handle secrets? If one partner tells the therapist something privately, will it be kept from the other? Policies differ, and you should both know the rule before it matters.
- Do you give homework? Practice between sessions is often part of the work.
What should you ask about your own situation?
Describe your situation in a sentence or two and ask how the therapist would approach it.
- Have you worked with couples dealing with this? For example an affair, constant arguing, a sexless relationship, blended family conflict or a decision about whether to stay together.
- What if one of us is not sure about staying? A good answer acknowledges that this changes the goals of the work.
- How do you make sure you do not take sides? Every couples therapist is asked this. The answer should be more than “I don’t.”
- Do you have experience with couples like us? This may mean LGBTQ couples, intercultural or interfaith couples, non-monogamous relationships, or working in a language other than English.
- What would make you say couples therapy is not right for us at the moment? A careful therapist screens for safety. If there is violence, coercion, or you are afraid of your partner, couples therapy is not the right first step. The National Domestic Violence Hotline (1-800-799-7233) offers confidential help.
What should you ask about cost, insurance and logistics?
- What is the fee per session, and how long is a session? Ask whether couples sessions cost more than individual sessions.
- Do you take insurance or are you out of network? Many couples therapists do not bill insurers directly. Ask whether they provide a statement you can submit, and call your plan to ask what it reimburses. See does insurance cover couples therapy in New York.
- Can I get the expected cost in writing? Under federal rules, if you are not using insurance, a health care provider generally must give you a good faith estimate of expected charges when you ask for one or schedule at least three business days ahead.
- What is your cancellation policy? Find out the notice required and what you are charged for a missed session.
- Do you offer in-person sessions, video sessions or both? What hours? Two calendars are harder to match than one.
- How often would we meet? Weekly is common at the start.
How will you know it is working?
- How do you set goals with a couple? You should leave the first session or two knowing what you are working toward.
- How will we check progress? Some therapists use brief questionnaires. Others review goals with you at intervals.
- How long do couples usually work with you? An honest answer is a range with the reasons it varies, not a promise.
- What happens if we feel stuck, or one of us feels unheard? You want a therapist who invites that feedback.
Be cautious about anyone who promises to save your relationship, quotes a success rate without saying where it comes from, or seems to side with whoever made the call. A therapist who answers plainly, admits what they cannot know yet and asks you thoughtful questions in return is showing you how they work.
How does spiral2grow answer the practical questions?
For readers considering couples counseling at spiral2grow, here is what the practice states on its site:
- Who you see: Moshe Ratson, LMFT, a licensed marriage and family therapist in solo practice.
- First step: a free 15-minute phone consultation. The first full session is a regular paid session.
- Sessions: 45 minutes, usually weekly, with some clients meeting every other week.
- Where: 260 Madison Ave #8023, New York, NY 10016, near Grand Central Station, or Online by Video.
- Insurance: the practice is out of network and does not bill insurers directly. It provides a statement you can submit for possible reimbursement. HSA and FSA cards are accepted.
- Fees: contact the practice for current fees. The site notes that a sliding scale is available, so ask on the call if cost is a concern.
- Cancellations: at least 48 hours’ notice is required.
Details are on the fees and insurance page. To see how the call itself goes, read what happens on a free phone consultation.
Bring your questions to a free call
Write down the three or four questions that matter most to the two of you and ask them directly. Moshe Ratson, LMFT, offers a free phone consultation for couples considering sessions in Midtown Manhattan or Online by Video. Request a call through the contact page.
Common questions
Start with the basics: your license type, how much of your practice is couples, and whether you have worked with our kind of situation. Then ask how sessions are structured, what the fee and cancellation policy are, and whether you can provide paperwork for out-of-network reimbursement. Ten to fifteen minutes is usually enough.
After the first call or session, both of you should feel the therapist understood your side and did not take sides. You should have a rough idea of how the work will proceed. If one of you feels blamed or unheard, say so early. How the therapist responds is useful information.
It helps. When only one partner chooses the therapist, the other can arrive feeling outnumbered. If you can, be on the consultation call together, or have each partner ask a couple of questions. If your partner is unwilling, you can make the call alone and share what you learned.
Yes. Speaking with two or three therapists is common and no reasonable therapist will be offended. Use the same short list of questions with each so you can compare answers. Pay attention to how clearly they explain their approach and whether both of you felt at ease.
Sources
- Meta-analysis of the alliance-outcome relation in couple and family therapy (Friedlander et al., 2018), Psychotherapy, via PubMed
- Marriage and Family Therapists: License Requirements, New York State Education Department, Office of the Professions
- Verification Search, New York State Education Department, Office of the Professions
- Meta-analysis of MFT interventions (Shadish & Baldwin, 2003), Journal of Marital and Family Therapy, via PubMed
- National Domestic Violence Hotline, National Domestic Violence Hotline
- What is a good faith estimate?, Centers for Medicare & Medicaid Services
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.
