Relationship Therapy: What It Is, Who It's For, and When to Go

By Clay Klaus-Wade ·

The short answer

Relationship therapy is therapy where the relationship itself is the focus. Instead of one person working on their own history and patterns, two or more partners come together to understand what's happening between them: the arguments that keep looping, the distance that crept in without anyone deciding it should, or the big transition nobody quite knows how to talk about.

I use the word relationship therapy rather than couples therapy on purpose. Relationships come in more shapes than the word "couple" can hold, and the work is the same at its core: helping the people involved understand each other, and themselves, a little better.

When should you go to relationship therapy?

There's a persistent myth that relationship therapy is a last resort, the thing you try right before you call it quits. In reality, it tends to work best well before that point. Some good reasons to go:

  • You're having the same fight over and over, and it never really resolves
  • One or both of you feel lonely inside the relationship
  • Trust has been hurt, whether by an affair, a broken agreement, or something quieter
  • You're facing a big change: moving in, getting married, having or not having kids, a new job, an illness, or a loss
  • Your relationship structure is changing, like opening up or renegotiating agreements
  • You love each other and want to keep getting better at it

You don't need to be in crisis. Sometimes the most valuable work happens when things are basically good and you'd like to keep them that way.

Does relationship therapy work?

The research is encouraging. A major review of couple therapy research in the Journal of Marital and Family Therapy concluded that couple therapy helps roughly 70 percent of couples who receive it, with effects comparable to individual therapy and far better than no treatment at all (Lebow et al., 2012). The same review noted something I think is worth being honest about: gains can fade over time without continued attention, which is why some couples come back for check-ins after the main work is done.

Across approaches, the review points to a few shared ingredients of effective relationship therapy: seeing the relationship as a system rather than blaming one person, working with emotion and not only behavior, helping partners say the things they've been avoiding, and building on what's already working. A strong, balanced relationship with the therapist, where each partner feels understood, matters too.

Can I go to relationship therapy alone?

Yes. Sometimes a partner isn't ready to come, and sometimes the relationship you want to understand is one you're in, are leaving, or are still grieving. Individual therapy that focuses on relationships can be enormously helpful, especially for understanding the patterns you bring with you from one relationship to the next.

How attachment shapes our relationships

My approach to relationship work is shaped by attachment theory. In the 1980s, researchers Cindy Hazan and Phillip Shaver proposed that adult romantic love works a lot like the attachment bonds we form as children, with similar patterns of security, anxiety, and avoidance (Hazan & Shaver, 1987). In practice, that means a lot of conflict between partners isn't really about the dishes or the text that went unanswered. It's about the deeper question underneath: are you there for me, and can I count on you?

When partners start to see that question, and the fears and longings that come with it, the fight usually changes shape.

Therapy for LGBTQ+ and consensually non-monogamous relationships

Every relationship deserves a therapist who takes it seriously as it is. For LGBTQ+ partners, that means a therapist who understands the particular stresses queer relationships can carry, without assuming a straight template applies.

The same is true for consensually non-monogamous (CNM) relationships, including polyamory, open relationships, and other structures. CNM is more common than many people assume: in two nationally representative samples of single adults in the United States, about one in five reported having been in a consensually non-monogamous relationship at some point in their lives (Haupert et al., 2017). People in CNM relationships come to therapy for the same reasons anyone does, and sometimes also to talk through agreements, jealousy, compersion, time, and the logistics of loving more than one person. What they shouldn't have to do is defend the structure of their relationship to their therapist.

Relationship therapy at Layered Health

Layered Health is a Philadelphia-based psychotherapy practice opening in Summer 2027. I offer relationship therapy for couples and for people in consensually non-monogamous relationships, grounded in attachment theory and a deep respect for the many ways people build lives together.

If you're looking for relationship therapy in Philadelphia, I'd love to hear from you.

Contact me

Frequently asked questions

When should a couple go to therapy?

Ideally before things reach a crisis. Good reasons include recurring arguments, feeling disconnected, hurt trust, major life transitions, or simply wanting to strengthen a relationship that's working.

Does couples therapy work?

Research suggests it helps about 70 percent of couples, with effects comparable to individual therapy. Gains can fade over time, so some couples return for occasional check-ins.

Can I go to relationship therapy alone?

Yes. Individual therapy focused on relationships can help you understand your own patterns, navigate a relationship your partner isn't ready to bring to therapy, or process a breakup.

Do you work with polyamorous and open relationships?

Yes. Layered Health offers affirming relationship therapy for consensually non-monogamous relationships, including polyamory and open relationships, without asking anyone to justify their relationship structure.

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