Deciding to try marriage counseling is a big step. For many couples, going to see a professional for help with their relationship feels like a last resort. It’s only after months — sometimes years — of struggling with frustrations, hurt feelings, and smoldering resentments that marriage counseling starts to seem attractive. And sometimes it takes a flat-out crisis to finally push couples through the door.

This is a common question. All relationships have ups and downs, and it’s hard to know the difference between a passing rough patch or a more serious situation that isn’t going to change on it’s own. Even if your relationship feels pretty difficult, it can easy to talk yourself out of marriage counseling (“Things will get better” or “We’re just under a lot of stress right now” or “This week has been better”).

So here are 3 clues that you really do need to get help.

People often wonder whether couples therapy works. Specifically, they wonder whether couples therapy will work for them.

(And to clarify, the terms “couples therapy,” “couples counseling,” and “marriage counseling” are interchangeable. Marriage counseling is the term that’s used when a married couple is in therapy together, and couples counseling is the general term used for the same therapy when a couple is committed, but isn’t married. The kinds of techniques the marriage counselor uses and the goals of therapy are often similar).

You’ve just had another frustrating, hurtful experience with your partner. You think — “Something has got to change.” But you are the point where you have run out of ideas for how to change things on your own. It’s time to get professional help. You hope that there is someone out there who can help the two of you start hearing each other, and grow back together again.

But who? How do you know if someone is a good, effective marriage counselor who can help you? And how do you avoid getting involved with a hack? Learn what to look for, and what to avoid.

Only a few approaches to marriage counseling and couples therapy are “evidence-based,” meaning that the theory and techniques used have been shown by research to help couples make lasting positive changes to their relationships. Without a strong understanding of effective, evidence-based strategies couples therapy (and regular therapy, for that matter) can feel wishy-washy, unfocused, and like a waste of time. Worse, couples who try 
“couples counseling” that is evidence-based (and therefore, ineffective) can leave the experience feeling that their relationship is a lost cause. Not true! 

Educate yourself about the different types of evidence based couples therapy, and why they matter. Then you can have the effective, focused experience that creates real and lasting change in your relationship.

During our first meeting we started to sort through their concerns. They described periods of relative peace and calm punctuated by “tense moments” that sometimes led to fights. Karen seemed frustrated but I could see that under the surface she was really hurting. With just a few gentle questions from me the hurt poured out and she told me that she felt very lonely and uncared for by her husband sometimes.

Couples new to marriage counseling often wonder, “How can marriage counseling help us?” or my favorite “We’ve already talked about it all– how will talking about it again in your office make it different?”

Here are some ways that marriage counseling works to help you improve your relationship:

Many couples want to do marriage counseling but worry about the expense and wonder if health insurance will pay for it. They think, “Loop-hole!” But the reality is different. Yes, you can use health insurance to pay for family therapy with you and your partner, but only in certain situations — and it might not be the type of work you’re hoping for. Learn more about whether insurance will pay for marriage counseling in YOUR situation, and the pros and cons of doing so.