This article by Catherine Pearson in The New York Times may interest my readers.

How to Find the Right Couples Therapist

Going to counseling with your partner can strengthen, or even save, your relationship. But first you need to pick a therapist. Here’s how to search for one and decide if they’re a good match.

By the time they walk into Kiaundra Jackson’s office for their first therapy session, many couples are in crisis. Some have waited years to get help, said Ms. Jackson, a licensed marriage and family therapist in Los Angeles. Things between the two may be “extremely horrible.” Many couples she sees are on the brink of divorce, or one partner has practically dragged the other in.

Still, Ms. Jackson believes there is hope. “I don’t think there is a time when it’s too late if both parties are still willing to put in the work,” she said.

Ideally, couples seek therapy as soon as they recognize “a certain pattern is getting set” and they don’t know how to work their way out of it, said Orna Guralnik, a Manhattan-based clinical psychologist and psychoanalyst featured in the Showtime documentary series “Couples Therapy.” She urged couples not to wait until those patterns “completely calcify” and love — or good will — runs out.

But it can be daunting to find a therapist who is a good fit for both partners, and not just because thorny relationship dynamics are at play. There’s also the practical issue of knowing where to start looking.

“It takes a lot of legwork,” said Lynn Bufka, a clinical psychologist and associate chief for practice transformation at the American Psychological Association. Mental health providers are in high demand across the United States, and there isn’t a single, centralized system for finding therapists of any specialty, including those who work with couples, Dr. Bufka said.

If you are considering couples therapy, here’s how to determine what qualities to look for in a counselor and how to make sure they’re the right match for you and your partner.

Start online and screen for credentials.

Going online to find the “right” therapist might feel like searching for a needle in a haystack, but experts say it’s a good jumping-off point.

Vanessa Bradden, a licensed marriage and family therapist and the founder and clinical director of Lakeview Therapy Group in Chicago, recommended searching for “couples therapy” and your location on Google. You can also use digital directories, like those of Psychology Today, the American Board of Professional Psychology and the American Association for Marriage and Family Therapy.

Look for therapists with a master’s degree or Ph.D. in mental health who focus on couples work, even if they also work with individuals. Checking for certain credentials can help. Consider a psychologist who is board-certified in couple and family psychology, said Anthony Chambers, the chief academic officer at the Family Institute at Northwestern University (who holds that credential himself), or a licensed marriage and family therapist. Those designations mean someone has received many hours of training focused specifically on family and relationship work.

When you search, include keywords that describe your circumstances and concerns, Dr. Bufka said. Are you dealing with infidelity? Sex or intimacy issues? Mental health concerns, like depression? Would you like to see someone who identifies as L.G.B.T.Q. or who regularly works with L.G.B.T.Q. couples? Therapists know that many people find them online, so they tend to be specific about their areas of focus, Dr. Bufka said.

Check with your health insurer about coverage.

If you have health insurance, your plan should be able to offer a list of in-network therapists. But, Dr. Bufka cautioned, you’ll probably have to do some digging to determine whether those therapists focus on couples.

And even if you find an in-network therapist, your insurance provider may not cover couples therapy, which can cost hundreds of dollars per session.

“The service may be really important and necessary to continue your relationship — or to end it in a way that doesn’t blow up for everybody — but there may not be a diagnostic code and insurance category that fits it,” Dr. Bufka said.

If you can’t afford to pay out of pocket, or if you do not have health insurance, you can ask therapists if they work on a sliding scale. You could also try Open Path Psychotherapy Collective, which maintains a directory of couples therapists who charge $40 to $70 per session, after an initial lifetime membership fee of $65.

Ask around.

Primary care doctors and clergy members can offer recommendations, Dr. Bufka said, since they often have experience working with local therapists.

Friends can also be a good resource. Though some therapists will not work with people in the same social circle, that’s less of a concern with couples work, Dr. Guralnik said. “It’s a little different,” she said. “Couples don’t tend to spend their time talking about their friends. They talk about their relationship.” Dr. Chambers noted that many couples were referred to him by their friends and that it could be helpful for someone who is wary of starting couples therapy to know the recommendation came from a trusted friend.

Still, it is a “delicate situation,” as Ms. Bradden put it. She said she would probably decline to work with friends of a couple she was currently treating, but would be open to referrals from those she had seen in the past.

Be ready with questions.

Once you have a shortlist of potential therapists, narrow down your choices by asking questions, either during an initial phone consultation or email exchange or within your first session or two. You don’t need to feel awkward about it. “We, as consumers, are purchasing a service here,” Dr. Bufka said. “We can ask questions!”

Here are a few things to bring up:

What will working with you be like, and how long will treatment last?

Most couples therapists see their work as relatively brief and solution-oriented. They help partners navigate specific conflicts around money, sex or parenting, for example, or around broader concerns like communication challenges or feelings of growing apart.

Therapists should tell you how they typically work with couples — for instance, whether you and your partner will always go to sessions together or whether you will have some individual sessions — and offer a potential timeline for treatment. According to the American Association for Marriage and Family Therapy, this type of short-term therapy is completed within 12 sessions on average. But, Ms. Jackson said, the initial timeline you are offered might change as the therapist learns more about your situation.

It helps to talk to therapists about their approach. That could mean asking about the specific theory of psychotherapy they have been trained in (like psychoanalysis) or about their style more broadly, Ms. Bradden said. Are they going to talk a lot and collaborate with you? Are they more apt to practice active listening? Those sorts of questions can help you understand what the therapy experience will be like.

Have you dealt with my issue before?

Elizabeth Earnshaw, a licensed marriage and family therapist and author of “I Want This to Work,” recommended asking counselors outright whether they have treated couples facing a similar issue.

Ideally it is not the therapist’s first time addressing a problem like yours, and, crucially, you should ask how the therapist dealt with it before to get a sense of what lies ahead and whether that approach feels comfortable and doable.

Every therapist is different, Ms. Earnshaw said. “The way I work with couples who are struggling with an affair, for example, might be very different than what colleagues might do.”

How do you handle secrets?

In individual sessions, or even between sessions, one partner might share something with the therapist but not with the other partner. “That might be something like ‘I’m having an affair,’ or ‘I’m thinking of leaving,’ or ‘I’m utilizing substances my partner doesn’t know about,’ or ‘I’ve spent all of our life savings, and my partner doesn’t know,’” Ms. Earnshaw said. “They can be really big secrets.”

Couples therapists have different ways to handle this. Some have a “no secrets” policy and will ask people to share the information with their partner in order to continue with therapy. Others will allow one partner to divulge private information without requiring that it be shared with the other partner. Those are important distinctions to know upfront, Ms. Earnshaw said.

Attend a few sessions and give some feedback.

Try a few visits before you conclude that a therapist isn’t right for you. Dr. Bufka recommended at least two, and Ms. Bradden four to six, unless something was obviously not working. You may not like your therapist equally, but neither of you should feel like the therapist is taking sides. Dr. Bufka recommended that both partners ask themselves, Do I feel respected and heard? Dr. Chambers suggested asking, Do we both feel confident in our therapist’s ability to help us?

It is also completely appropriate to offer feedback to the therapist, especially if you have concerns after a few sessions, Ms. Bradden said. Therapists are not all-knowing, and research shows that feedback can make therapy more effective.

Ms. Bradden said: “If somebody came to me and said, ‘Hey, you know what? In that last session I really wanted you to be a little more direct with me,’ I would love that.”

Source: How to Find the Right Couples Therapist (The New York Times, January 27, 2023).

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