Five Types Of Therapy That Can Help Heal Your Relationship

With over 400 therapy modalities available to individuals, couples, families, and groups, couples have many choices on who to see for support. No matter the challenges you face in your relationship, a therapist can help you and your partner learn new skills, communicate openly, and make positive changes. When considering couples therapy, note that you do not have to have a mental health diagnosis or severe concerns to talk to a therapist. Many couples also use couples therapy as a tool to grow their connection with each other. 

What should I expect from couples therapy?

Several types of psychotherapy aim to solve relationship issues and create stronger bonds , while others are better suited to addressing individual concerns. Many psychotherapeutic techniques for managing mental health conditions, like exposure therapy, eye movement desensitization and reprocessing (EMDR), family therapy, and mindfulness-based stress reduction (MBSR), were designed to help individuals alone, but have donated some of their most effective features to couples therapy.

The robust approach to relationship therapy seen in modern couples counseling offers an integrated approach to managing relationship challenges. Some of the most common challenges that couples face may include the following: 

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Most types of therapy can be used during a relationship and can be a valuable preventative tool. Couples and marriage counseling are not only beneficial for those on the verge of separation. They can help improve communication and prevent unwanted events from occurring in the future. The therapist may also recommend one or both partners seek treatment for individual mental health conditions that may be impacting the relationship.

Many couples may avoid seeking a therapist due to fear that the therapist will take one person's side over the other or ask the couple to break up. However, therapists do not tell a couple what they should do. Instead, therapy is often designed to help you both improve and make decisions for yourself. The therapist can teach you what they know about healthy relationship behaviors and be an advocate as you decide how to proceed as a team. 

Five types of relationship therapy for couples 

Couples can try many types of therapy, including general formats. There are also specialized approaches that take a specific focus on a particular technique or area. Below are five relationship therapy techniques that couples can utilize to improve their relationship and overall mental health. 

Imago relationship therapy

Imago relationship therapy (IRT) is a type of couples counseling designed to improve communication, understanding, and closeness between partners.

During sessions, couples can learn new ways to improve their relationship by performing exercises and talking to one another to facilitate meaningful dialogue. This process can help them understand each other's emotions and reconnect if emotional intimacy is struggling in the relationship. 

This form of therapy was developed by Harville Hendrix and Helen LaKelly in the 1980s. It was conceptualized based on the theory that the adverse experiences and feelings you experience during childhood may arise during adulthood and impact your relationships. By understanding these old wounds, couples can be more understanding and have empathy towards one another, facilitating healing and a more "conscious relationship."

Imago therapy aims to improve these outcomes by developing the skills and empathy often necessary for positive relationships. In addition, couples can be given skills to avoid unwanted behaviors such as blaming and criticizing. 

Emotionally focused therapy

Like the Imago techniques, emotionally focused therapy (EFT) aims to reduce unwanted feelings between couples, such as anger and distrust, which can lead to marital conflicts. EFT is also used alongside techniques like eye movement desensitization and reprocessing (EMDR) to treat individual mental conditions like eating disorders and bipolar disorder. There can be a few similarities between IRT and EFT.

Emotionally focused therapy was also founded in the 1980s by Susan Johnson and Leslie Greenberg and is primarily based on attachment theory, but it also utilizes systemic and humanistic approaches. Attachment theory involves how your attachment to your parent or caregiver during infancy may pave the way to how you attach to others as an adult. This concept is also essential in IRT and provides the foundation for these techniques.

However, the approach between the two therapeutic modalities separates them. EFT consists of several steps to identify the problems in the relationship and restructure these interactions to discuss how they feel more openly. The following are the steps that Susan Johnson developed for EFT: 

• Step 1: Evaluation, making contact, and recognizing tensions between couples from an attachment standpoint.
• Step 2: Identification of the cycle of unhelpful interactions that sustain anxiety and bring about insecure attachment.
• Step 3: Discerning the underlying feeling or emotion not yet expressed in couples' interactions that is being concealed.
• Step 4: Reframing the problems resulting from the cycle of adverse interactions, unmet urges, needs, and emotions to explore the cycle.
• Step 5: Voicing attachment needs to each other. 
• Step 6: Promotion of acceptance by each spouse. 
• Step 7: Smoothing the way to express needs and wants and restructuring new models of interaction based on perceptions and knowledge obtained from the process.
• Step 8: Providing new solutions for old challenges.
• Step 9: Strengthening new positions and patterns of behavior.

Emotionally focused therapy is empirically supported, and research has demonstrated its efficacy. One study involving infertile couples experiencing marital issues has shown that EFT significantly improved "satisfaction, cohesion, consensus and affection expression of the partners." Its high success rate makes it an attractive option for many couples looking to improve their relationship.

Narrative therapy

Everyone has a story, and people's life stories are emphasized in narrative therapy. For change to occur, a couple's challenges are externalized, which can be done verbally or through writing. Narrative therapy is based on the narrative theory, which states that "people tend to consider their life a consistent and logically important story so that they can advance their goals and expectations for the future." 

Clients can discuss their concerns by narrating them, and afterward, they can rewrite the unwanted aspects of their story, which may have been harmful to their relationship. This strategy makes narrative therapy unique from many others. 

In addition, studies show that people can re-create their lives by creating different narratives with unique outcomes. When clients can separate themselves from their challenges, they may see their challenges as more manageable. A narrative therapist can assist them in the process of creating a new story by helping them build more coherent and comprehensive narratives. This process can allow individuals to change their thoughts and beliefs. 

Many couples are unaware they have hidden parts of their story contributing to their emotions until they externalize these unwanted conflicts. Because of this, narrative therapy has been helpful for relationships and has also shown success in helping people with depression, anger, and body image issues. 

Gottman method therapy

The Gottman method is another effective treatment method that can help couples address relationship challenges. Developed by Dr. John and Julie Gottman, the Gottman method states that there are nine different components to the therapeutic process, including the following: 

1. Building Love Maps: Knowing your partner's psychological world, such as their worries, what makes them happy, and their love language
2. Sharing Fondness And Admiration: Showing your partner how you appreciate and love them
3. Turning Toward Each Other Instead Of Away: Knowing that needs can be communicated and responded to
4. The Positive Perspective: Using a positive approach to solve problems and repair relationships
5. Managing Conflict: Instead of resolving conflicts, they are managed because conflict can be an ordinary, functional, and sometimes positive part of relationships
6. Making Life Dreams Come True: Each person speaks openly about their hopes and aspirations
7. Creating Shared Meaning: Finding meaning in your connection together instead of separately 
8. Trust: The person knows that their partner has their best interests in mind, not just their own
9. Commitment: Both parties are committed to cherishing each other's positive qualities instead of focusing on the negative ones that often get magnified in conflicts

According to the Gottmans, conflict can be perpetual or solvable. If a couple's long-term goal is commitment and emotional stability, the Gottman method is developed to ensure long-term love and connection between couples. It is often used in marriage therapy, and the Gottman Institute holds couples retreats for individuals seeking an immersive experience. 

Using the Gottman Method, couples can strengthen their relationship by reducing harmful verbal communication and replacing it with positive dialogue, increased empathy, intimacy, respect, and a breakdown of any barriers that can create a sense of stagnancy. 

Integrative behavioral couple therapy

Integrative behavioral couple therapy (IBCT) is a modern form of behavioral therapy designed for relationships. It was based on an early form of counseling known as traditional behavioral couple therapy (TBCT), which was, at the time, the most empirically supported option. 

While TBCT focused on positive-to-negative exchange ratios, professors Andrew Christensen and Neil Jacobson expanded on it by focusing on positive behavioral change through communication and solving problems, which led to the creation of IBCT. Couples' distress can be conceptualized and explained through a simple mnemonic device: DEEP, which is as follows: 

• D: Differences between partners such as personality, interests, and goals
• E: Emotional sensitivities and vulnerabilities
• E: External circumstances, such as stressful events
• P: Patterns of interaction that couples experience when trying to address the problems created by the DEE parts

IBCT protocol often consists of two separate phases: an evaluation and feedback phase (for three sessions) and an active treatment phase (for the rest of the sessions). In the first stage, the therapist can learn about the couple's concerns and what brings them to treatment while offering ideas for treatment. In the second stage, the therapist can take an active role with both partners to help them improve communication and how they interact with one another. 

Counseling options 

No matter the concerns you are experiencing in your relationship, there may be a form of couples therapy unique to you. You can consider the options above or search for other forms of couples therapy in your area by using an online search engine. Note that many couples therapists do not take insurance, so you might be able to find a more cost-effective option by reaching out to an online therapy platform like Regain, which offers a match-based couples therapy system with thousands of therapists specializing in many types of couples therapy. 

Through online couples therapy, couples can choose between phone, video, or live chat sessions with their licensed therapist. In addition, many online platforms cost around $60 to $90 a week, which can be much more affordable than the $175 to $275 cost per hour for many traditional in-person couples therapists. When couples split the cost of online therapy, each person can pay around $30 to $45 a session. 

If you're unsure about the effectiveness of internet-based modalities, note that online couples therapy has been found as effective as in-person therapy and can decrease symptoms of depression, anxiety, or stress in those attending. You can sign up at any point, and online therapy can also allow you to switch your therapist quickly if you don't find a match at first.