What to Expect in Couples Therapy
What to Expect in Couples Therapy: Your Complete Guide
If you're considering couples therapy or have already scheduled your first session, you probably have questions about what to expect in couples therapy. What happens in the first session? How long does it take? What will the therapist ask? Will it feel awkward? These are common questions, and having a clear sense of what the process looks like can help you feel more prepared and less anxious about starting. This guide walks through what couples therapy looks like from beginning to end.
Couples therapy at Sagebrush Counseling. We help couples navigate the therapy process with clarity and support from the first session onward. Telehealth throughout Maine, Montana, and Texas.
Schedule a Complimentary Consult →Before the First Session
Before you even meet with a therapist, there are a few steps involved in getting started. The first is finding a couples therapist who is the right fit. Not all therapists are trained in couples work, and finding someone with specific expertise in relationship therapy makes a significant difference. If you're not sure where to start, our guide on how to find a couples therapist covers what to look for and what questions to ask.
Once you've identified a therapist or practice, the next step is typically a phone consultation or intake call. This is a brief conversation where you can ask questions about the therapist's approach, availability, and whether they have experience with the specific issues you're facing. It's also a chance for the therapist to get a sense of whether they're a good fit for your situation. Not every therapist is the right match for every couple, and a good therapist will tell you if they think you'd be better served elsewhere.
Some practices, including Sagebrush, offer a complimentary consultation before you commit to starting therapy. This removes some of the pressure and gives both you and the therapist a chance to see if the fit is right before moving forward.
What to prepare
You don't need to prepare extensively for the first session, but it can be helpful to spend a few minutes thinking about what you're hoping to get from therapy. What are the main issues you want to address? What would need to change for you to feel better about the relationship? You don't need to have everything figured out, but having a sense of what's bringing you in can help the therapist understand where to focus.
The First Session
The first session in couples therapy is different from ongoing sessions. It's primarily assessment and goal-setting. The therapist is trying to understand what's happening in your relationship, what's brought you to therapy, and what you're hoping will change. This means the first session involves a lot of questions.
What the therapist will ask
Most couples therapists will ask about the history of your relationship, how you met, what brought you together, and what the relationship was like in its early stages. They'll ask about the current problems, how long they've been happening, and what you've tried so far to address them. They'll ask about your communication patterns, how you handle conflict, and whether there are specific issues like infidelity, trust breaches, or significant life stressors that are impacting the relationship.
The therapist will also ask each partner individually what they're hoping to get from therapy. Sometimes partners come in with aligned goals, and sometimes they don't. Both are workable, but it's useful for the therapist to understand where each person is starting from.
Will you talk about your feelings in front of your partner?
Yes, and this is one of the things that makes couples therapy feel vulnerable. You'll be talking about difficult feelings, unmet needs, and sources of hurt or frustration, and your partner will be sitting right there hearing it. For many couples, this is one of the hardest parts of the process. But it's also one of the most valuable. The therapist helps structure these conversations so they're productive rather than destructive, and over time, most couples find that being able to talk about hard things in session makes it easier to talk about them outside of session too.
What happens at the end of the first session
At the end of the first session, the therapist will typically offer some initial observations about what they're noticing in the relationship and will propose a plan for how to move forward. This might include identifying the main issues to focus on, talking about what the therapy process will look like, and discussing frequency and duration of sessions. This is also when you'll decide whether you want to continue working with this therapist or if you'd prefer to explore other options.
The first session is about assessment and building trust. You're not expected to solve anything in that first hour. You're just starting the process of understanding what needs attention.
Ongoing Sessions: What Therapy Looks Like Week to Week
After the first session, ongoing couples therapy typically follows a more consistent structure. Most couples meet weekly or biweekly, with each session lasting 50 to 60 minutes. Some therapists offer longer sessions, particularly if travel time or schedules make weekly shorter sessions difficult.
What happens in a typical session
Most sessions begin with a check-in. The therapist will ask what's been happening since the last session, whether there have been any conflicts or significant conversations, and whether anything urgent needs to be addressed. This check-in helps the therapist understand what's most alive for the couple in that moment.
From there, the session might focus on a specific issue that came up during the week, or it might continue working on a theme that's been developing over multiple sessions. The therapist will guide the conversation, ask questions, point out patterns, and help both partners understand what's happening between them. This often involves slowing down moments of conflict or disconnection and examining what each person is experiencing and needing in those moments.
Research by Johnson (2004) on emotionally focused therapy found that one of the most effective interventions in couples therapy is helping partners identify and express the vulnerable emotions beneath their reactive ones. Anger, for instance, is often covering fear or hurt. Withdrawal is often a response to feeling overwhelmed or inadequate. The therapist's job is to help both partners see and express what's underneath the surface reactions.
Will every session feel productive?
No. Some sessions will feel like breakthroughs, and others will feel slow or frustrating. This is normal. Progress in couples therapy is not linear. You may have sessions where old patterns resurface, where one partner shuts down, or where the conversation feels stuck. These are still useful sessions because they give the therapist and both partners information about what's happening and what needs attention.
Homework and practice
Many couples therapists assign homework or suggest practices to work on between sessions. This might be as simple as noticing a pattern and tracking when it shows up, or it might involve trying a new communication tool during conflict. Homework isn't about adding more work to your life. It's about taking what's being learned in session and practicing it in real time, which is where the real change happens.
Couples therapy designed to help you build the skills and connection you need. Telehealth in Maine, Montana, and Texas.
Schedule a Complimentary Consult →Common Misconceptions About Couples Therapy
There are several common misconceptions about what couples therapy involves, and addressing them can help set more realistic expectations.
It's not mediation. The therapist is not there to referee or decide who is right. Couples therapy is about understanding the patterns between you and learning to change them, not about assigning blame or finding a winner.
It's not a quick fix. Meaningful change in a relationship takes time. If you're looking for a session or two that will solve everything, you'll be disappointed. Most couples see meaningful improvement over several months, not weeks.
It's not just for relationships in crisis. Some couples come to therapy when things are already very difficult, but many come when things are just starting to feel off. Early intervention is often more effective than waiting until patterns are deeply entrenched.
The therapist won't take sides. A skilled couples therapist remains neutral and works to understand both partners' experiences. If you're hoping the therapist will validate that you're right and your partner is wrong, that's not what will happen.
How Long Does Couples Therapy Take?
One of the most common questions couples ask is how long therapy will take. The answer depends on the issues you're addressing, how entrenched the patterns are, and how engaged both partners are in the work.
Research by Christensen and colleagues (2004) on couple therapy outcomes found that most couples who benefit from therapy see meaningful improvement within 12 to 20 sessions. Some couples need less, particularly if they're addressing a specific issue or using therapy as a tune-up. Others need more, especially if they're working through significant breaches of trust, long-standing resentment, or complex relational dynamics.
When do you know you're done?
Therapy ends when both partners feel they've addressed what brought them in and feel equipped to continue the work on their own. This doesn't mean the relationship is perfect or that conflict has disappeared. It means both partners have the tools to navigate difficulty without the relationship breaking down, and they feel reconnected in ways that feel sustainable.
Some couples return to therapy periodically for tune-ups or when new challenges arise. This is normal and often a sign that couples have learned to use therapy as a resource rather than as a last resort.
What If You're Not Sure You're Ready?
If you're on the fence about whether to start couples therapy, that hesitation is understandable. Starting therapy can feel vulnerable, and there's often anxiety about what it means for the relationship. Does seeking therapy mean things are worse than you thought? Will it help, or will it just highlight how broken things are?
These concerns are common, but they're also part of why many couples wait too long to get help. If you're noticing signs that your relationship is struggling, like recurring conflicts, emotional distance, or difficulty communicating about important things, those are reasons to consider therapy sooner rather than later. If you're unsure whether you're ready, you can read our post on 10 signs it's time for couples therapy to help you assess where things stand.
Most couples who finally get to therapy say they wish they had come sooner. The patterns that feel impossible to change when you're stuck in them often become more workable when you have support and structure to address them.
Getting Started at Sagebrush
If you're ready to start couples therapy or want to learn more about what the process would look like for your relationship, the complimentary consultation is a good place to start. It's a brief, low-pressure conversation where you can ask questions, talk about what's happening in your relationship, and get a sense of whether Sagebrush is the right fit.
All sessions are via telehealth, so there's no commute and no waiting room. You join from wherever is most private and comfortable. To understand more about the online format, you can read about how online therapy works at Sagebrush.
We serve couples throughout the state of Maine (including Brunswick and beyond), the whole of Montana, and anywhere in Texas, including Austin, Houston, Dallas, and Midland.
All sessions via telehealth. Join from anywhere in your state.
Couples Therapy at Sagebrush
Support for couples who want to reconnect, repair, and build the relationship they're looking for. Join from anywhere in Maine, Montana, or Texas. All sessions are virtual.
Schedule a Complimentary ConsultationKnowing what to expect in couples therapy can make the process feel less intimidating and help you make the most of it from the start. If you're considering therapy, the fact that you're thinking about it is already a step toward making things better.
— Sagebrush Counseling
1. Johnson, S.M. (2004). The practice of emotionally focused couple therapy: Creating connection (2nd ed.). New York: Brunner-Routledge.
2. Christensen, A., Atkins, D.C., Berns, S., Wheeler, J., Baucom, D.H., & Simpson, L.E. (2004). Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples. Journal of Consulting and Clinical Psychology, 72(2), 176–191. View on PubMed
3. Snyder, D.K., Castellani, A.M., & Whisman, M.A. (2006). Current status and future directions in couple therapy. Annual Review of Psychology, 57, 317–344. View on PubMed
This post is for informational purposes and is not a substitute for professional couples therapy or mental health care.
