When Couples Therapy May Not Be the Best First Step
Couples therapy works best when both partners are safe and able to participate in good faith. In some situations, such as ongoing abuse, untreated addiction, significant untreated mental health distress, or an active undisclosed affair, couples therapy is not the right first step, and another form of support should come first.
Questioning whether couples therapy is the right choice is thoughtful, not a sign of failure. This page covers the specific situations where another step should come first, and what that step looks like for each one.
At-a-glance: when couples therapy isn't the right first step
When there is domestic violence, couples therapy is not the right first step
If there is abuse (physical, sexual, emotional, financial, or coercive control), couples therapy is not the right first step and can be unsafe. Couples therapy assumes both partners are working in good faith, and in an abusive dynamic, that assumption breaks down.
Joint sessions can give the abusive partner another setting in which to exert control. The person being harmed may feel afraid to speak honestly for fear of retaliation at home, and what gets shared in session can be used as ammunition later.
A 2012 review in the Journal of Marital and Family Therapy by Stith, McCollum, and Rosen found that conjoint therapy is generally contraindicated when one partner fears the other, because the power imbalance undermines the therapeutic process and can increase risk.
When abuse is present, safety comes first, not relationship repair. The person being harmed should seek individual support: opening up to a trusted person, connecting with a therapist on their own, or reaching out to a domestic violence resource. These services can help with safety planning and guidance for next steps, whether or not the relationship continues.
If you are being abused: Contact the National Domestic Violence Hotline by calling 1-800-799-7233 or texting START to 88788. They can help you create a safety plan to protect yourself and, if necessary, leave the relationship safely. If you are in immediate danger, call 911. For a mental health crisis, call or text 988.
When addiction, untreated significant mental health symptoms, an ongoing affair, or a decided exit comes first
Beyond abuse, four common situations call for a different first step before couples therapy: active, untreated addiction; an ongoing, undisclosed, or unended affair; one partner who has already decided to leave; and untreated significant mental health symptoms.
| Situation | Why couples therapy isn't the first step | Better first step |
|---|---|---|
| Ongoing abuse or coercive control | Joint sessions can increase danger and be used to control | Safety planning, domestic violence resources, individual support |
| Active, untreated addiction/compulsive behavior | Addiction drives the conflict and undermines the work and can be considered a competing attachment | Addiction treatment plus individual therapy |
| An ongoing, undisclosed, or unended affair | Therapy depends on honesty and good-faith participation | Honesty, individual reflection, and recommitment to the partnership and repair |
| One partner has already decided to leave | Standard couples therapy assumes both want to repair | Discernment counseling, individual therapy |
| Untreated significant mental health symptoms | Individual stabilization is essential for relational stabilization | Individual therapy, psychiatric consultation |
Untreated, active addiction/compulsive behavior
When one partner has an active, untreated substance use or compulsive disorder, couples therapy tends to be ineffective. For many of these couples, the addiction is a primary driver of conflict: broken trust from lying or broken commitments related to substance use, financial strain, or the other partner feeling secondary to the addiction.
Research by O'Farrell and Fals-Stewart, reviewed in the Journal of Marital and Family Therapy (2003), found that when addiction treatment and couples therapy are combined, outcomes improve for both substance use and relationship satisfaction. Standard couples therapy without addressing the addiction first tends to be less effective, because the addiction continues to drive the conflict.
The first step is for the person struggling with addiction to seek treatment: working one-on-one with a therapist, entering a rehabilitation program, or both. Once the addiction is being actively treated and the relationship is stable enough for both partners to participate safely, couples therapy can be the next step. From there, the couple can address how the addiction affected the relationship, improve communication, and rebuild trust with less attachment competition from the addiction.
An ongoing, undisclosed, or unended affair
If one partner is having an affair they refuse to end or disclose, couples therapy is not the right starting point. The therapeutic process depends on honesty and the emotional safety for vulnerability while both partners are working toward the same goal. When infidelity is active and hidden, that foundation does not exist.
The partner who had the affair needs to reflect honestly and end the outside relationship before couples therapy can be meaningful. Individual therapy can help them explore what led to the affair. The partner who has been cheated on may also benefit from individual therapy to process the pain and decide whether they want to try to repair the relationship.
Once the affair has ended and both partners are choosing to work on repair and recovery, couples therapy for infidelity repair is a valid and effective next step. It can help couples address betrayal trauma, rebuild trust, and move forward.
One partner has already decided to leave
When one partner has already made up their mind to leave, traditional couples therapy may not be effective. It relies on both people wanting to repair the relationship, and if one partner is no longer invested in that goal, the work cannot gain traction and lead to unnecessary injury.
In this situation, discernment counseling is often a better fit. Developed by William Doherty and colleagues at the University of Minnesota, discernment counseling is a short, structured process designed for couples where one partner is leaning toward ending the relationship and the other wants to save it. A 2016 study in the Journal of Marital and Family Therapy found that roughly half of couples who completed the process chose to enter couples therapy, with the rest choosing to separate with greater clarity.
If you do decide to separate, individual therapy can help you process the decision and adjust to what comes next.
Untreated significant mental health symptoms
While it is not uncommon for individuals in couples therapy to have a diagnosed mental health condition, when the symptomatology is significantly unstable, it can be incredibly challenging to create an emotionally safe space to process the couples’ needs. For example, someone with significantly impaired emotional regulation might have extreme shifts in mood or thought which can make it challenging or unrealistic to expect calm and constructive communication. If someone is on the border or the edge of their window of tolerance, diving deeper into emotionally painful material can increase the intensity of symptoms and create risks such as active suicidal ideation, etc.
Beyond the risks associated with the individual symptom escalation, doing couples work can create an unfair burden on the person who is caretaking the one with more symptomatology and can unintentionally condone or minimize the responsibility/accountability of the symptomatic partner.
It is extremely important to achieve a significant reduction of symptoms and increase the tolerance and bandwidth of the person in order to have balanced and effective couples therapy.
Should you do couples therapy, or consider separating?
Couples therapy helps many couples in distress, but it is not a guarantee that the relationship continues. For some couples, the honest outcome of therapy is clarity that separating is the healthier path.
If you are weighing this question, some prompts for reflection:
- Is this relationship safe to be in?
- Are both of us willing to do the work?
- Do we have the time and energy to commit to sessions and practice outside of them?
- Has anything changed when we have tried to improve things before?
- Do I feel respected, heard, and emotionally safe?
- Would I feel healthier and happier outside this relationship?
If you are unsure, couples therapy itself can help you reach that clarity. Gaining clarity is a valid goal of therapy, and choosing to separate is not a failure.
What to do instead, and how to start
If couples therapy is not the right first step, your next move depends on what is happening in your relationship. The goal is to address the underlying issue first, so that if couples therapy becomes appropriate later, both partners can participate in a way that is safe and meaningful.
- If there is abuse: Your safety is the priority, not relationship repair. Reach out to a trusted person, connect with an individual therapist, or contact a domestic violence resource for help with safety planning and next steps.
- If there is active addiction: The partner with the substance use disorder should seek appropriate addiction treatment first. Once they are more stable and able to focus on the relationship, couples therapy becomes a realistic option.
- If there is an ongoing affair: The affair must end before couples work can begin. Both partners can benefit from individual therapy to process what has happened, explore what they want, and decide whether to attempt rebuilding.
- If one partner has already decided to leave: Discernment counseling may be a better fit than traditional couples therapy. Both partners need to be willing to work on the partnership for it to gain traction.
Even if your eventual goal is couples therapy, individual therapy is often the bridge that gets you there. It can help you build stability, gain perspective, and prepare to participate in couples work when the time is right. In other cases, individual therapy may give you the clarity to decide the relationship is not right for you.
If you are looking for a therapist, Octave offers individual therapy and can help coordinate care when additional support (such as domestic violence resources or addiction treatment) is needed. You can browse and select your own therapist, or reach out to our Care Navigation team for help finding a provider who fits your situation.
Start with individual therapy at Octave
If you are in danger, get help now
If you are in a dangerous situation, reach out for help right away:
- National Domestic Violence Hotline: Call 1-800-799-7233 or text START to 88788. They can help you create a safety plan and, if necessary, leave the relationship safely (24/7, confidential).
- 988 Suicide and Crisis Lifeline: Call or text 988 if you are having a mental health crisis or thoughts of harming yourself or others (24/7, confidential).
- Emergency: Call 911 if you are in immediate danger.
How Octave supports you
Octave provides therapy with fully licensed clinicians who average 10+ years of experience and does not work with trainees or pre-licensed associates. When couples therapy is not the right first step, individual therapy can help you gain clarity, rebuild confidence, and decide what comes next safely.
Octave is therapy only, so if your situation calls for domestic violence support, addiction treatment, or a prescriber, our Care Navigation team can help point you toward the right resources and coordinate care.
Most clients pay an average of $28/session through insurance, and 95%+ pay less than $45/session. Forty million Americans are in-network with Octave. FSA and HSA are accepted, and there is no subscription. Matching typically happens within one to three business days, with appointments usually available within one to three days of matching. Exact costs vary by plan and are always confirmed before care begins.
Frequently asked questions about when couples therapy isn't the right first step
It can. When there is abuse, joint couples therapy can give an abusive partner another arena to exert control, and it can increase the risk to the person being harmed. That is why couples therapy is generally not recommended during active abuse. The safer first steps are individual support, safety planning, and contacting a domestic violence resource like the National Domestic Violence Hotline (1-800-799-7233).
Yes, in many cases. Couples therapy can help partners recover from infidelity when the affair has ended and both people choose to work on the relationship. It is generally not the right first step when the affair is ongoing, hidden, or one partner refuses to end it, because therapy depends on honesty and good-faith participation. In that situation, individual reflection and honesty come first.
When a partner has an active, untreated substance use disorder, couples therapy alone tends to struggle, because the addiction drives much of the conflict. Addiction treatment and individual support are usually the right first steps, and couples therapy can be valuable later, once recovery is underway. Octave can provide individual therapy and help point you toward addiction resources.
There is no universal answer. Couples therapy can help many couples in distress, and it can also help you reach clarity, which sometimes means deciding that separating is healthiest. If one partner has already decided to leave, discernment counseling — a short, structured process for couples who are unsure whether to repair or part — may fit better than standard couples therapy.
Discernment counseling is a short, structured form of counseling designed for couples where one or both partners are unsure whether to work on the relationship or end it. It focuses on gaining clarity and confidence about the direction, rather than on resolving issues. It is often the right fit when one partner is "leaning out."
Often, yes. For many couples, starting with individual therapy, addiction treatment, or safety support first creates the conditions where couples therapy can help later. The goal is to do the right work in the right order, not to rule couples therapy out forever.
That is a broader question this page does not fully cover. If you are trying to evaluate whether your relationship is toxic, or to tell the difference between a toxic pattern and abuse, see our guide on whether a relationship is toxic. If you feel unsafe or controlled through fear, treat it as a safety issue and reach the National Domestic Violence Hotline at 1-800-799-7233.
Coverage for individual therapy is common under mental health parity laws. At Octave, most clients pay an average of $28/session through insurance, and 95%+ pay less than $45/session. Exact costs vary by plan and are always confirmed before care begins.
Sources
- Stith, S. M., McCollum, E. E., & Rosen, K. H. (2012). Systemic perspectives on intimate partner violence treatment. Journal of Marital and Family Therapy, 38(1), 220-232. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1752-0606.2011.00245.x
- O'Farrell, T. J. & Fals-Stewart, W. (2003). Behavioral couples therapy for alcoholism and drug abuse. Journal of Marital and Family Therapy, 29, 121-146. https://pmc.ncbi.nlm.nih.gov/articles/PMC3215582/
- Doherty, W. J., Harris, S. M., & Wilde, J. L. (2016). Discernment counseling for "mixed-agenda" couples. Journal of Marital and Family Therapy, 42(2), 246-255. https://onlinelibrary.wiley.com/doi/10.1111/jmft.12132
