Is Couples Therapy Right for Me?

Mar 4

Welcome to this educational resource backed by medical research & inspired by questions from hundreds of our past and current patients. You’ll find helpful info on mood, anxiety, depression, mental illness, hormones, treatments, and resources. — Anna Glezer, MD

There are a couple of questions that often come up in our practice when it comes to couples counseling. One is, "Can couples therapy help me?" And, more often, "How do I convince my partner to join me?" Let me answer these by dispelling several myths about couples counseling.

Myth 1: Couples counseling is for those whose relationship is struggling.

You do not have to be on the brink of divorce or break up to choose couples counseling. Counseling can be a healthy choice for maintaining a strong relationship. I recommend thinking about it the way we think about preventative care in primary care. You visit the doctor for your annual check up to make sure you don't get sick or get your mammogram, and this is similar. Common goals for couples work include:

To strengthen communication
Improve intimacy
Prepare for an upcoming change, like a new baby. Many couples may have good equilibrium with but a change like a child can definitely shake things up.

Some hear couples counseling and think their partner wants a divorce, but this can be far from the truth. Instead, it is a place to work through common disagreements. The most common reasons why couples disagree based on my experience include:

Finances
Communication styles are different
Parenting disagreements/child rearing.

Myth 2: I've already decided I want a divorce. What's the point?

Separation can be amicable or it can be fraught with challenges. For your own mental health, and, if you have kids for theirs, wouldn't you prefer a more cordial separation? Couples counseling can help resolve differences, resentments, and teach skills and tools to more effectively manage conflict.

Myth 3: A counselor will choose a side and I don't want to hear what I'm doing wrong by another person.

An experienced couples therapist's job is to be nonjudgmental. Their job is not to tell you how to be, but to help each person listen to the other and figure out how to communicate and work together. It's never 100% one person's fault.

One caveat is that I do not recommend couples counseling if there is an abuse situation.

Myth 4: Seeing a counselor means there's something wrong with me.

There can be the stigma of mental illness for the word therapist or counselor. However, you do not need any kind of diagnosis to seek therapy.

Myth 5: "We should be able to figure this out on our own."

When I hear this question, my first response is to genuinely ask why. We turn to experts for so many things. Without thinking, if our car breaks down, the majority of us turn to a mechanic for their expertise rather than tinkering ourselves. Similarly, the therapist can take the role of the guide. If you are traveling in a new city, you can use maps and try to figure out where you are going. But it could be much more effective to turn to a guide who will help you learn the streets and the maps.

Myth 6: It takes too much time or money.

This is a common obstacle I hear from my patients. This applies to individual therapy as well. I recommend thinking about this in the setting of your priorities and values. Re-examining those values and resetting priorities can make it such that taking an hour each week feels like a good investment. Think about the return on that investment. Effective couples work can defuse conflict and infuse positive sentiment into a relationship.

If the issue is time, I often recommend couples to consider committing to a weekend workshop or retreat rather than Individual sessions. For example, there are workshops called Hold Me Tight.

Myth 7:

This is a common question. I recommend first thinking about when to approach the conversation. Do not bring it up in the middle of an argument, but rather at a time when you are both in a calm mindset. During that discussion, you can go over many of the myths noted above.

Second, consider starting alone. An experienced couples counselor can help you troubleshoot how to engage a partner effectively.

Finally, ask your partner if they would consider committing to just a few sessions. That can feel more manageable because some have the belief that engaging in therapy means a very long term commitment.

Does couples therapy work?

Yes. There is data answering this question. A 2020 Meta-analysis published in the Journal of Consulting and Clinical Psychology found that it has a good effect on important relationship domains, including overall satisfaction, intimacy, and communication. It also found that there are both short and long term effects.

What are the types of couples counseling styles?

There are many types of couples counseling styles, just as there are for individual therapy. Here are several of the most common:

Gottman Method: This was developed decades ago by a psychologist couple. They focus on the Four Horsemen of the relationship (Criticism, Contempt, Defensiveness, Stonewalling). The goal is conflict management rather than resolution. A 2019 article demonstrated its effectiveness for marital satisfaction and intimacy.

Emotionally Focused Therapy (EFT): This was developed in the 1980s by Dr. Susan Johnson and Les Greenberg. The focus is on figuring out what drives a person's emotional response. A study in 2019 reviewed the effectiveness of EFT over 2 decades and found it effective and sustained.

Cognitive Behavioral Therapy (CBT): In this style, the therapist helps you identify thought patterns that are interfering with the relationship and communication.

Narrative Therapy: In this style, the focus is on the stories you have about your world and provides a way to rewrite your story.

Finally, I want to make note that for those struggling with intimacy issues, you can consider sex therapy with a clinical sexoligist. This is a specific type of therapy and you can find an expert through the American College of Sexologists (ACS). These clinicians are board certified by the American College of Sexologists, the American Board of Sexologists, or American Association of Sexuality Educators, Counselors and Therapists (AASECT).

Helpful Resources:

Emotionally Focused Therapy: https://iceeft.com/what-is-eft/
Meta-analysis on the Effectiveness of Couples Therapy: https://psycnet.apa.org/record/2020-43103-001
EFT Review: https://pubmed.ncbi.nlm.nih.gov/30605013/
Gottman Therapy article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037577/
Book for couples on the Gottman Method: 7 Principles for Making Marriage Work: https://www.gottman.com/product/the-seven-principles-for-making-marriage-work/

Key Reasons Why Our Practice is Out-of-Network

The first, and most important, set of reasons deals with the many impediments to maintaining the highest standard of patient care that our team prides itself on:

Insurance companies can limit the number of visits you are allowed and also dictate the type of therapy we must offer/provide. In some cases they can even limit the amount of time patients have per visit.
Insurance companies tend to prioritize symptom management over addressing underlying issues and promoting long-term well-being. This can lead to a focus on medication management rather than comprehensive therapy and support.
Insurance companies frequently require prior authorizations for medications, treatments, and even initial evaluations. This process is time-consuming, requires extensive documentation, and can delay necessary care for patients.
Many of the types of treatments we offer at Women’s Wellness Psychiatry, which are integrative and holistic, may be seen as unconventional by insurance payors, and therefore not sufficiently reimbursed. This can include visits that focus on lifestyle medicine, nutrition, nutraceuticals, and many others.

The second set of reasons deals with the complex administrative and business aspects, which can significantly jeopardize our ability to run a profitable business and continue our care to current and future patients.

Insurance companies often offer significantly lower reimbursement rates than the provider's standard fees. This can make it financially unsustainable for us to maintain a practice, especially with rising overhead costs (rent, utilities, staff, etc.), and overall skyrocketing costs of being a business in California.
Negotiating higher rates with insurance companies is time-consuming and almost always unsuccessful when you are a solo practitioner or small group practice.
The complexities of communicating regularly with insurance companies and adhering to their documentation and other requirements are often time-intensive. We believe that this time would be best spent working 1:1 with patients.
Reducing this administrative burden also allows our clinic to recruit the most talented clinicians who are passionate about patient care.
Insurance companies can take weeks or even months to process and pay claims, creating cash flow problems for the practice. This delay can make it difficult to cover operational expenses and invest in practice improvements.

How we try to help

While we do not participate in any managed care networks, many PPO insurance plans do provide out-of-network coverage for mental health services provided by licensed professionals. It is your responsibility to remain informed about the presence or absence of insurance coverage for our work together.

We do not bill insurance companies directly, but will provide a statement (called a Superbill) that can be used for filing claims for reimbursement. We can also recommend companies that can assist you with filing claims with your insurance company.

Lastly, because filing reimbursement claims with insurance companies is a really frustrating & time-consuming process, Women's Wellness is now registered on Reimbursify, an app for your phone that makes it quick & easy (under a minute!) to file claims, get paid, and keep track of prior submissions all in one place.

A few additional points on Reimbursify:

Submit any and all out-of-network receipts -- and your first claim is free. All subsequent ones are just a small fee per submission
No paperwork or countless forms to fill out -- just a few inputs & scan the claim with your phone
-If a claim gets rejected, you'll know exactly why, and resubmissions are always free

Fully secure & HIPAA compliant

Please note that Reimbursify is a completely separate company and is not in any way affiliated with Women’s Wellness Psychiatry.

In Conclusion

Our decision to be out-of-network is driven by a commitment to providing the highest quality of care for each of our patients. By avoiding the constraints of insurance companies, our practice offers significantly more personalized, flexible, and holistic treatments and helps to ensure our ongoing business viability.

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Personalized, holistic psychiatric care that treats your unique needs.

Over the past nine years, I’ve built a team of exceptional Reproductive & Holistic Psychiatrists and Psychotherapists who share this philosophy. Together we’ve helped hundreds of patients in our communities and look forward to helping you achieve your wellness goals!

~ Anna Glezer, MD - Founder; Reproductive Psychiatrist

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Anna Glezer, MD