These three questions are often asked of me when couples come for their first couple therapy session. Often clients hope for a fairly simple answer, but all three depend on the specific couple. In this article I discuss ways of thinking about these questions, which it’s helpful for clients and the therapist to discuss together along the way. Rather than them being answered in the first session, they are better thought about over time.

I’m going to start with the question about when to end. The aim of therapy from the start is alwaysto end – to create lasting change so that the therapist no longer becomes necessary – the couple can take on the thinking of the therapist and own it themselves, in their own way. 

I hope that over time, a point comes when the couple feels they have not only understood their difficulties and how they need to address them but can take back ownership of their relationship and feel that (within reason) whatever curved balls life throws at them they will be able to come together and think together about how to respond. 

This doesn’t always happen, of course – there are three possible outcomes of couple therapy – change happens, and the relationship feels good enough to endure; change happens but it leads to the decision by one or both partners that they want to end the relationship; or finally, change doesn’t happen and because a separation is unthinkable, they stay together unhappily. 

The ‘how often’ question is probably a simpler one. Couple therapy, and indeed individual therapy, is usually weekly, and for good reason – it’s a tried and tested frequency, and strikes the balance between being able to create lasting change and not being so intense as to be too much for people to manage in their lives. 

While some couples ask me for fortnightly sessions, it’s not usually recommended. It can provide a ‘comfort’ that there’s a space to take problems to, if and when they emerge, but it’s hard to create lasting change with fortnightly sessions, as the work becomes slow and frustrating, and it’s hard to keep a thread from one session to the next. And, as I said earlier, the aim of therapy is to make itself unnecessary through facing difficulties and tackling them. Fortnightly sessions can end up taking more than twice as long and therefore end up more costly overall. 

Finally, how long does it take overall? That depends on several things, and it really depends on the participants, not the process or what the therapist does. Some people are more open to change than others, and often one partner needs longer than the other to decide to change. Generally, younger people are more used to change, while older people tend to be more established in the way they are and find change harder. If the partners’ early lives were especially difficult for them, their coping methods can be long established and if they are unhelpful to the relationship they may need more time to adapt.

Finally, couple (and indeed individual therapy) aims to create change. Change tends to start to happen when couples stop blaming the other partner and take separate responsibility for their part in the problems and decide what change they can offer the other.