Ask An Expert: Does Your Marriage Need Couples Therapy?

If you own a fine-tuned German sports car, you take it in for scheduled maintenance, even if it’s purring like a kitten. Marriage is the same way. It’s a scary concept for some people who might think that seeking professional counseling means that they are on the road to divorce. Maybe the spark has dimmed or you find yourselves bickering more. Or maybe things are great and you just want some routine marriage maintenance…but does your relationship really need a therapist?  We talked to Dr. Karen Ruskin, author, PsyD, LMFT, about the reasons why a couple might truly benefit from seeing a therapist and how to find one who is qualified to really help.

Love&: What are some signs a couple might benefit from therapy?

Dr. Karen: My book, Dr. Karen’s Marriage Manual, offers concrete tips for a healthy and happy marriage and includes a section which addresses the top reasons why a couple may seek out counseling and what you can expect.

The bottom line: if you think you may need couples counseling, then go for couples counseling. Why wait until the problem has been going on for years and your relationship has declined? I cannot begin to tell you how many times that, once a couple starts working with me, they say they wished they had come to me years ago and could have avoided so many problems they are experiencing.

Love&: Do you think it’s wise to have some therapy or counseling before issues even arise? If so, what can you learn?

Dr. Karen: Yes, I have had couples come to me for pre-marital counseling. You can learn the specific challenges that are most common for couples and how to attend to them when they arise. You can also learn healthy methods of communication, conflict solution resolution skills, and address expectations of marriage and each other’s roles. By addressing the thoughts, expectations, wants, needs, and concerns early on—before issues arise—you can actually prevent certain issues. And if issues do arise, you’ll have the tools to work with them.

Love&: How do you even start looking for a therapist?

Dr. Karen: There are several ways. Ask your primary care physician whom he or she trusts. They often have a few names of people they received good feedback about. You can also contact your insurance company and ask for a list of names in your surrounding area. Your friends my have recommendations. Websites such as as well as and others are good resources that list therapists in your area, and you can narrow down your search to marriage therapists. Whether searching online or asking your doctor, look for an LMFT. That stands for Licensed Marriage and Family Therapist. Although there are other therapists who specialize in couples’ issues, seeking out an LMFT will narrow down your search and increase the chances that the therapist has received a very specific education in working with couples.

Love&: What should you expect during your first appointment?

Dr. Karen: Every marriage therapist has a different style. So, rather than me telling you what to expect in terms of style, the number one thing you should expect is that both people feel like their voice is heard. You see, when going for couples counseling, the couple is the client, not either individual person. They should make that clear both in explanation as well as in their communication with you. I’d like to say that in the first session you should expect a therapist who asks you what you are hoping to achieve from couples counseling. Though not all couples therapists work that way in the first session, I feel it’s a very important question to ask upfront.

Love&: What qualities are you looking for in your marriage counselor once you meet them?

Dr. Karen: Someone who is vested in your care and who you feel genuinely cares about your goal achievement. Someone who is involved in your treatment process. Someone who asks questions, hears the answers, and utilizes what is discussed to help you to help yourselves get to a better place. Someone who hears both of your voices, discovers what your goals are, and helps you to work towards those goals. Someone who offers insight and tips to help you move toward goal achievement. Finally, you want someone who is kind and compassionate.

Love&: What do you do if you don’t click?

Dr. Karen: Communicate that to the therapist and ask them if you can inform them about what isn’t working so they can help make a referral to another therapist who might be a better fit. Unfortunately, people don’t always feel comfy doing that. I inform every couple at their very first session that if at any point they feel like it is not a good fit, to please let me know so that I can help them to find what they are looking for. And I educate the therapists in my practice about this concept so that they too will communicate that in the first session. It can be a really hopeless feeling for a couple if they are not clicking with their therapist and they feel stuck and awkward about saying something. I believe it is our job as therapists to help them find what they need—whether it is with us or with someone else.


You can learn about Dr. Karen Ruskin and find more information on marriage and family therapy at, and Twitter: @DrKarenRuskin