How Do Couples Therapists Use Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a well-known therapeutic method for creating change in an individual's thoughts, feelings, and behaviors. While many people are aware of its uses in individual therapy, some may be surprised to learn that CBT can be effectively used in couples therapy as well. Some couples therapists may use this modality to help partners in a relationship identify flawed ways of thinking and interacting and give them the tools to learn to move them in a healthier direction. Read on to learn more about the application of this type of therapy in the context of couples counseling.

What is cognitive behavioral therapy?

One reason for this is that it’s been proven by extensive research to be an effective method for treating many different kinds of mental health conditions and behavioral concerns. Some of the conditions that can be treated by CBT include eating disorders, depression, anxiety, bipolar disorder, post-traumatic stress disorder, attention-deficit hyperactivity disorder (ADHD), and obsessive-compulsive disorder. In addition to many mental health conditions, it is also sometimes used to treat chronic pain and other physical health conditions. There are many varieties of CBT, including short-term brief therapies.

The core tenet of CBT is that thoughts are what cause feelings and behaviors. That’s why its aim is to target flawed, unhealthy, or otherwise unhelpful patterns of thinking, because in doing so, an individual’s feelings and behavioral patterns may change as well. A key component of CBT is developing a sense of mindfulness so that the individual can recognize when these thought patterns are occurring and consciously shift them in a healthier direction.

How CBT works in couples counseling

In the context of individual therapy, it’s easy to see how CBT could be helpful. Take an individual who has a mental health concern, such as an anxiety disorder, for example. Helping them recognize when they’re experiencing anxious thoughts that are unlikely to be true or to come to fruition can be the first step toward adjusting them to include a more realistic perspective. By practicing this process repeatedly over time—both during therapy and outside of sessions—the individual can gradually reshape some instinctive thought patterns that can cause distress. 

CBT can work in much the same way in couples counseling. A therapist can help each individual learn to identify any flawed patterns of thinking they may have regarding their relationship, vulnerability, communication, or similar topics and learn to challenge them so they cause problematic feelings or behaviors less often. Some ways a therapist may use CBT in the context of couples counseling may include the following.

Recognizing and handling triggers

It’s not uncommon for old wounds, past trauma, or insecurities to come to the forefront in a romantic relationship. Feeling triggered—or having a strong emotional reaction that’s based on a past negative experience and is typically out of proportion to the situation at hand—is common. It is especially common in those who are experiencing post-traumatic stress. Traumatic stress triggers are often challenging to handle without professional help. With behavior therapy, a therapist can help you and your partner identify situations that commonly make one or both of you feel triggered and explore why as well as evaluate for an underlying stress disorder. Then, they may be able to help you recognize when it’s happening and shift your perspective in the moment to result in calmer conversations.

Challenging automatic thoughts

One of the basic tenets of cognitive behavior techniques is that everyone has automatic thoughts, or snap judgments or conclusions that arise instantly in our minds. When these thoughts are flawed overly negative, or compulsive, such as in obsessive-compulsive disorder, they can result in distressing feelings and behaviors. A cognitive behavioral therapist can help couples learn to recognize the automatic thoughts they may both have in relation to one another and practice challenging them. 

For instance, one person may automatically assume that any time their partner is tired, stressed, or in a sour mood it has to do with them and something they did. A cognitive behavioral therapist may help them learn to recognize and challenge the validity of that thought, which may include considering other explanations or using verbal communication to inquire about the root of their loved one’s mood.

Identifying core beliefs

Another central theory of CBT is that our thoughts are shaped by our core beliefs. These deep-seated beliefs are often formed in childhood, and many people aren’t consciously aware of them before undergoing CBT. Since core beliefs can have such a significant impact on our thoughts, feelings, and behaviors, identifying them can be helpful in the context of a relationship. Flawed core beliefs—such as a fundamental feeling of unworthiness or the view that emotions are a sign of weakness, for instance—can be a source of conflict between couples. Again, becoming aware of them and consciously working to transform them can help a pair improve their relationship.

Setting goals for change

Once the individuals in a couple have become more aware of the relationship between their thoughts, feelings, and behaviors and what beliefs may be causing them, they can begin to work toward change. Goal setting in the context of therapy can be a powerful tool in helping “individuals to identify specific behaviors to change and how to go about doing so”. For instance, a therapist might help a couple devise a goal for more connected, calm conflict resolution, or for more frequent emotional check-ins and communication.

What CBT for couples is not

The idea of changing core beliefs, thoughts, feelings, and behaviors may sound intimidating to some. After all, these elements make up most of who we are. However, it can be helpful to remember that the intention of a cognitive behavioral therapist is not to change who you are. Their job isn’t to tell you what to think or who to be. Instead, you can think of them as an objective observer who can help you get in touch with what your core beliefs, thoughts, feelings, and behaviors are, since it’s common to operate on autopilot without ever stepping back to recognize why we do the things we do. They’re simply there to shine a light on these parts of ourselves we may not otherwise see, and to give us the tools to evaluate and transform them if we choose to.

They may also be able to gain a clearer perspective of how underlying issues, like post-traumatic stress disorder (PTSD). A traumatic stress disorder can significantly impact a romantic relationship, making it helpful to have an outside perspective that is non-judgemental.

It’s also important to remember that the job of a couples counselor of any type is not to pick sides or make judgments about who was right or wrong in a particular situation. Again, they’re simply facilitators who can help you communicate more openly with your partner so you can both come to see the perspective of the other. While some may be nervous about discussing the details of their relationship with a neutral party, it can be helpful to recall that therapists are specifically trained to offer a nonjudgmental safe space where clients can express their feelings honestly and constructively.

How to find a couples therapist

If you and your partner would prefer to meet with a couples therapist in person, you can do an online search for providers in your area. Since cognitive behavioral methods are such a popular methodology, you’re likely to find that many providers practice it. You can learn about a particular provider’s preferred methodologies on their website, or by asking them directly on the phone or during a consultation. Or, if you’d prefer to meet with someone from the comfort of your own home, virtual couples therapy is an option as well. One study suggests that couples who receive therapy via video call may feel “safer and less judged” than those who received in-person treatment and that they were more comfortable forming a connection with their therapist which enabled effective treatment.

Online therapy may also be a convenient option for long-distance couples who can’t meet together in a therapist’s office regularly, or for those who can’t find the time due to busy schedules. With a virtual couples counseling platform like Regain, you and your partner can get matched with a licensed, experienced couples therapist who you can meet with via phone, video call, and/or in-app messaging to address any challenges you may be facing in your relationship. Since you, your partner and your provider can all attend virtual sessions from different physical locations, many people find this medium to be available and convenient.