When Couples Therapy Is Not Recommended

Couples therapy is not recommended when there is ongoing violence, coercive control or fear of a partner. It is also unlikely to help while an addiction is active and untreated, while an affair is continuing in secret, or when one partner has firmly decided to leave. In each case another kind of help should come first.

If you are afraid of your partner, start here

If your partner hurts you, threatens you, controls where you go or who you see, or you find yourself editing what you say out of fear of what will happen later, couples therapy is not the right first step. Your safety comes first.

The National Domestic Violence Hotline is free, confidential and open 24 hours a day: call 1-800-799-7233, text START to 88788, or chat at thehotline.org. In New York, the state Domestic and Sexual Violence Hotline is 800-942-6906 (text 844-997-2121). If you are in immediate danger, call 911.

If your partner checks your phone or computer, consider using a device they cannot access.

Why is couples therapy not recommended when there is abuse?

Couples therapy rests on two assumptions: that both people can speak honestly in the room, and that both share responsibility for the pattern between them. Abuse breaks both assumptions.

The National Domestic Violence Hotline does not encourage anyone in an abusive relationship to seek counseling with their partner. Its reasons are practical. A person who is being abused may not be able to speak freely, what is said in a session can be used against them later, and the safety of the therapy room does not extend to home. Counseling also cannot fix the unequal power that defines an abusive relationship, and treating abuse as a “communication problem” quietly puts part of the blame on the person being harmed.

Abuse is not only physical. The Hotline’s overview of types of abuse includes non-physical behavior meant to control, isolate or frighten: cutting you off from friends and family, monitoring where you go and who you contact, controlling money, and pressuring you into sex. A steady pattern of this kind is often called coercive control, and it is a reason to seek specialized help even if you have never been hit.

This is common. According to the Centers for Disease Control and Prevention, more than 1 in 3 women and more than 1 in 6 men in the United States have experienced contact sexual violence, physical violence or stalking by an intimate partner in their lifetime.

What about the research on couples treatment and violence?

You may read that some studies support joint treatment. That is true in a narrow sense. A 2016 systematic review and meta-analysis pooled six studies and concluded that couples therapy may be viable “in select situations.” The authors limited that conclusion to mild to moderate situational violence between partners who do not want to separate, after careful assessment and with safety precautions in place. They did not apply it to relationships marked by domination and severe abuse, and they noted that the evidence was thin, with few studies, limited diversity and one large study driving the results.

An earlier review of clinical practice reached a similar position: joint treatment may have a place for some couples, but only with careful screening, a format modified for safety, ongoing safety checks and links to other community services. In other words, this is specialized work decided by a trained clinician after separate, private assessment. It is not a reason to bring an abusive partner to ordinary couples counseling and hope for the best.

When one partner has an active, untreated addiction

Couples therapy asks both people to show up, remember what was said and follow through. Heavy, ongoing drinking or drug use, or compulsive gambling that has not been addressed, makes each of those hard. Sessions tend to circle the same broken promises, and the other partner ends up carrying the work.

The research here is more encouraging than many people expect, with a condition. A review of controlled studies of marital and family therapy in alcohol treatment found that once the person with the drinking problem enters treatment, behavioral couples therapy is more effective than individual treatment alone at increasing abstinence and improving the relationship. When the person is unwilling to get help, the same review found that family-focused approaches can help the partner cope and can raise the chance that the drinker enters treatment.

So the order matters. Addiction care usually comes first or alongside, and couples work is built on it. A therapist can help you decide the sequence. For treatment referrals, SAMHSA’s National Helpline is free and confidential at 1-800-662-4357, and New York’s HOPEline covers substance use and gambling at 1-877-846-7369. The practice’s page on alcohol problems explains how drinking affects a relationship.

When an affair is still going on and still a secret

Couples therapy can help after infidelity. What it cannot do is work around an affair that is continuing and hidden. The partner in the dark is making decisions on false information, and the therapy becomes a performance.

There is some research behind this. In an exploratory analysis of 19 couples with infidelity inside a larger trial of 134 couples, those whose affair was revealed before or during therapy started out more distressed but improved more than couples without infidelity. The sample was small, and the study speaks only to affairs that came into the open.

This is also why many couples therapists explain early how they handle secrets shared privately by one partner. If you are the one holding the secret, an individual session is the place to sort out what you want. If the affair is known and over, infidelity counseling is a reasonable next step.

When one of you has already decided to leave

Standard couples therapy assumes two people who want to try. When one partner has privately decided the relationship is over and attends only to say they did, or to hand the other partner to a therapist’s care, the work goes nowhere and the partner who is hoping gets hurt twice.

Being unsure is a different matter. If one of you is leaning out and the other is leaning in, discernment counseling is designed for exactly that. Its goal is a clear decision about the next step, not repair. In the paper describing the approach, an analysis of 100 consecutive cases found that about half of the couples chose to start couples therapy to reconcile, and most of the rest chose the path toward divorce. Those were couples seen by the model’s developers, so the figures describe that group, not all couples.

If the decision really is final, a therapist can still help with a respectful separation and with co-parenting.

Other times to pause joint sessions

• Thoughts of suicide or self-harm. Call or text 988, the Suicide and Crisis Lifeline, or call 911. Individual care comes first.
• A mental health crisis that is not yet stabilized. Symptoms that make it hard to take part in a conversation need individual treatment before joint sessions will help.
• One partner is attending under threat. Therapy works by consent. If “come or else” is the only reason someone is in the room, say so to the therapist.

What can you do instead?

“Not recommended” rarely means “nothing can be done.” It usually means a different door first.

• If you are afraid, talk with a domestic violence advocate about a safety plan.
• If addiction is driving things, start with addiction treatment or a helpline, and add couples work when treatment is underway.
• If you are unsure whether you want the relationship, consider discernment counseling or sessions on your own.
• If your partner will not come, or it is not safe to come together, see a therapist yourself. The article on couples therapy versus individual therapy covers how to choose.

When is it worth getting professional help?

Almost always, even when joint sessions are not the answer. A careful couples therapist screens for these situations at the start, often by speaking with each partner privately, and will say plainly if another kind of help should come first. That is part of doing the job well.

Many situations that look hopeless are not on this list at all. High conflict, long silences, a known affair, or one partner who is skeptical are common starting points for couples counseling, not reasons to avoid it. If you are wondering whether too much time has passed, see is it too late for couples therapy.

Not sure which situation you are in?

A short, private conversation can help you sort out what kind of help fits. Moshe Ratson, LMFT, offers a free phone consultation and sees clients in Midtown Manhattan and Online by Video. You can contact spiral2grow on your own, without your partner, and if another service is a better fit you will be pointed toward it.

Common questions

Sources

• National Domestic Violence Hotline, National Domestic Violence Hotline
• Should I Go to Couples Therapy With My Abusive Partner?, National Domestic Violence Hotline
• Types of Abuse, National Domestic Violence Hotline
• Survivors and Victims: NYS Domestic and Sexual Violence Hotline, New York State Office for the Prevention of Domestic Violence
• About Intimate Partner Violence, Centers for Disease Control and Prevention
• Couples Therapy for Intimate Partner Violence: A Systematic Review and Meta-Analysis (Karakurt et al., Journal of Marital and Family Therapy, 2016), PubMed Central, National Library of Medicine
• Couples Treatment for Interpersonal Violence: A Review of Outcome Research Literature and Current Clinical Practices (McCollum and Stith, Violence and Victims, 2008), PubMed, National Library of Medicine
• Review of Outcome Research on Marital and Family Therapy in Treatment for Alcoholism (O’Farrell and Clements, Journal of Marital and Family Therapy, 2012), PubMed, National Library of Medicine
• SAMHSA’s National Helpline, Substance Abuse and Mental Health Services Administration
• NYS HOPEline, New York State Office of Addiction Services and Supports
• Infidelity and Behavioral Couple Therapy: Optimism in the Face of Betrayal (Atkins et al., Journal of Consulting and Clinical Psychology, 2005), PubMed, National Library of Medicine
• Discernment Counseling for “Mixed-Agenda” Couples (Doherty, Harris and Wilde, Journal of Marital and Family Therapy, 2016), PubMed, National Library of Medicine
• 988 Suicide and Crisis Lifeline, 988 Suicide and Crisis Lifeline

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.