Couples Therapy: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Couples Therapy?
A psychologist, a talk therapy specialist, or a psychiatrist, a doctor who treats mental health conditions, can provide couples therapy. Social workers and counselors offer talk therapy too. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is couples therapy?
Couples therapy is a treatment that helps partners work through their conflict together. It is built on one idea. Guiding partners through conflict as a team works better than working with only one partner alone.
It is used for relationship distress. This means one or both partners are unhappy with the relationship, and there is conflict.
Talk therapy, also called psychotherapy, covers many treatments. They help people change troubling emotions, thoughts, and behaviors. People may seek talk therapy for relationship or family problems.
Symptoms
Unhappiness and ongoing conflict are the main signs.
It can affect health. Both partners may have more physical and mental health problems.
It can also cause health and social problems for children, other family members, co-workers, and friends.
Causes and who gets it
The link between relationship distress and poor health goes both ways. Distress can lead to depression, anxiety, and substance abuse. It can also result from couples having to cope with those problems.
Other causes vary. They include a terminal illness, a long-term disease, or a mental health disorder. They also include infidelity or unresolved childhood trauma.
Studies have looked at couples therapy for adults whose distress has any cause.
How doctors diagnose it
A first step can be a visit with a health care provider. The provider can rule out a physical health issue.
Mood changes or trouble concentrating can be due to a medical condition.
Before you start, a first talk with a therapist can show how treatment will proceed. It can also show whether you feel comfortable with the therapist.
Treatment
Overall results suggest that couples therapy could improve relationship satisfaction for couples in distress.
Couples who are more distressed going into therapy might see larger gains.
The research has limits. Most studies were small. Their results may not apply to everyone. The review found mixed results for other relationship outcomes. The evidence on mental health outcomes is not clear.
Therapists may use one main approach or mix several. This depends on their training and on your needs.
There is no formal approval process for talk therapies like there is for medicines.
When to see a doctor
Talk to a health care provider or therapist if relationship problems are weighing on you. Also tell a provider about mood changes, because a medical condition may be the cause.
If you have been in therapy for a reasonable time and are not getting better, talk to your therapist.
If you are thinking about harming yourself, call or text 988 (the Suicide and Crisis Lifeline) right away.
Call 911 or your local emergency number right away if you or anyone else is in danger of being hurt.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can check for physical causes of mood, stress, or sleep problems. They can also refer you to a licensed therapist and follow your overall health.
Common questions
Does couples therapy work?
It may help, but the research is limited. Results for other outcomes, such as mental health, are not clear.
Who provides couples therapy?
Many kinds of professionals offer talk therapy. Examples include psychiatrists, psychologists, social workers, counselors, and psychiatric nurses.
What should I ask a therapist before I start?
Ask about the therapist's training and experience, the approach they use, and the goals of therapy. Also ask whether meetings are confidential, and ask about fees and insurance.
Are there different kinds of talk therapy?
Yes, there are many kinds of talk therapy. Therapists may use one main approach or mix several, depending on their training and on your needs.
What if therapy does not seem to help?
Talk to your therapist if you have been in therapy for a reasonable time and are not getting better. You might also look at other mental health professionals or approaches.
Sources
- NCBI Bookshelf (CADTH) - Couples Therapy for Adults Experiencing Relationship Distress
- NCBI Bookshelf (CADTH) - Couples Therapy Review: Conclusions and Implications
- NIMH - Psychotherapies
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
