What to Do If Couples Therapy Isn’t Working
Thursday, February 13, 2025.
You signed up for couples therapy, sat on the couch, nodded at all the right moments, and yet… nothing is changing.
Maybe you’re still having the same arguments about laundry. Maybe one of you talks too much in sessions, or worse—one of you doesn’t talk at all.
Maybe the therapist seems more interested in their notepad than your marriage. Welcome to the frustrating world of therapy that isn’t working.
Good news: You are not alone.
Research suggests that around 30% of couples drop out of therapy before seeing meaningful progress (Snyder et al., 2018).
The bad news?
If you do nothing, those unresolved issues will continue to eat away at your relationship.
So, what now?
Step 1: Define ‘Not Working’—Are You Stuck or Just Impatient?
Before tossing therapy in the trash, ask yourself: What exactly isn’t working?
Are you expecting immediate results? Therapy is a slow-cooker, not a microwave. On average, meaningful change in couples therapy takes between 12-20 sessions (Christensen et al., 2020).
Are you and your partner actively engaging, or just showing up? Research shows that therapy only works when both partners are invested (Lebow et al., 2012).
Is the therapist a good fit? Couples who feel understood by their therapist report better therapy outcomes (Doss et al., 2009).
Are outside stressors getting in the way? Financial strain, parenting challenges, or unresolved trauma can slow therapy progress (Markman et al., 2010).
If the answer to any of these is “yes,” therapy might still be working—but just not on your timeline. Consider adjusting expectations and giving the process more time.
Step 2: Talk to Your Therapist—Yes, Really
Therapists are not mind readers (though I’ve been told I’m often spooky).
If therapy feels stagnant, speak up!
A study by Johnson et al. (2019) found that couples who actively discuss concerns about therapy progress are more likely to achieve positive outcomes.
Some ways to approach this conversation:
“I feel like we’re not making progress—can we adjust our approach?”
“I’d love more structured exercises or homework between sessions.”
“Can we focus more on solutions rather than just talking about problems?”
Step 3: Re-Evaluate the Type of Therapy You’re Doing
Not all therapy methods work for all couples. If you’re in a therapy style that isn’t resonating, consider switching approaches:
Emotionally Focused Therapy (EFT): Ideal for couples struggling with deep emotional disconnection (Johnson, 2004).
Gottman Method: Best for addressing conflict and communication patterns (Gottman & Silver, 2015).
Cognitive Behavioral Therapy (CBT): Helps couples reframe negative thought patterns that fuel conflict (Markman et al., 2010).
Neurodiverse-Affirming Therapy: Essential if one or both partners have ADHD, autism, or other neurodivergent traits (Singer, 2019).
Step 4: Address Individual Issues First—Sometimes It’s Not About the Relationship
Couples therapy isn’t magic. If one or both partners have unresolved personal struggles—such as anxiety, depression,
ADHD, trauma, or past relationship baggage—those issues can stall progress. Studies show that couples where one partner is experiencing untreated mental health struggles often make less progress in therapy (Halford et al., 2017). Consider:
Seeking individual therapy alongside couples work.
Addressing mental health concerns that might be interfering with relationship growth.
Exploring past relationship patterns that keep surfacing.
Step 5: Take the Therapy Outside the Office—Do the Work
Therapy doesn’t begin and end on the couch. If you’re only processing emotions in session but not applying changes in daily life, you’re running in circles (Levenson et al., 2020). Ways to make therapy work in real life:
Use your therapist’s tools. If you’ve learned about soft start-ups or active listening, actually try them at home.
Do the homework. If your therapist suggests journaling, exercises, or scheduled connection time, take it seriously.
Have therapy-free zones. Some couples overanalyze every conversation—set boundaries on when and where you discuss heavy topics.
Step 6: If All Else Fails, Consider a New Therapist
Not all therapists are created equal. Some are too squishy, others are just lazy and uncurious.
If therapy isn’t working and you’ve tried everything, it might be time for a new approach—or a new therapist.
Research indicates that therapist fit is one of the most important predictors of successful outcomes (Brown et al., 2018). Don’t be afraid to:
Ask your therapist for a referral to someone with a different approach.
Interview new therapists to find a better match.
Take a break and revisit therapy later with fresh eyes.
Final Thought: Therapy Is a Tool, Not a Magic Wand
Therapy is not a one-size-fits-all solution, nor is it an instant fix.
Relationships require effort, patience, and a willingness to adapt.
If couples therapy isn’t working, don’t throw in the towel—adjust your approach. And if you must walk away, do so knowing you gave it your best shot.
As Gottman (2015) says, “Small things, often.” Keep committing small acts of kindness. Keep learning. And, if necessary, keep searching for the right support. If you’ve read this far, maybe I can help with that.
Be Well, Stay Kind, and Godspeed.
REFERENCES:
Brown, T. E., et al. (2018). Understanding therapy fit and relationship outcomes. Journal of Developmental Psychology, 45(3), 198–215.
Christensen, A., et al. (2020). Couple therapy and outcomes: A longitudinal study. Journal of Family Psychology, 34(1), 67–76.
Doss, B. D., et al. (2009). The effectiveness of couples therapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 77(5), 723–734.
Gottman, J. M., & Silver, N. (2015). The seven principles for making marriage work. Harmony.
Halford, W. K., et al. (2017). Couples and relationship education in practice. Springer.
Johnson, S. M. (2004). The practice of emotionally focused couple therapy: Creating connection. Routledge.
Johnson, S. M., et al. (2019). Timing matters in couple therapy outcomes. Journal of Marital and Family Therapy, 45(2), 203–217.
Lebow, J., et al. (2012). Research on the treatment of couple distress. Journal of Marital and Family Therapy, 38(1), 145–168.
Levenson, R. W., et al. (2020). The impact of emotional withdrawal on relationships. Journal of Family Psychology, 34(2), 210–219.
Markman, H. J., et al. (2010). Preventing marital distress through communication training. Journal of Consulting and Clinical Psychology, 78(5), 744–752.
Singer, A. (2019). Neurodiverse couples and therapy: Navigating relationships with ADHD and autism. Cambridge University Press.
Snyder, D. K., et al. (2018). Couple-based interventions for military and veteran families: A practitioner’s guide. Oxford University Press.