Sooner than you think. Most couples wait an average of six years after problems start before they get help. You don't need to be in crisis to benefit from couples work, and you definitely don't need to have "tried everything" first.

If you're finding yourselves having the same fight on repeat or if you're not in crisis but you can feel the two of you drifting, that's a good time to start couples therapy. The couples who tend to get the most out of therapy are the ones who come in before contempt has taken root, not after.

I use the Gottman Method for couples therapy, an evidence-based and structured approach. Treatment will begin with an assessment phase where I will meet with both of you together, then each of you individually to assess common pitfalls and relationship strengths.

Typically sessions focus on:

• Reducing negative affect in conflict (the Four Horsemen)

• Increasing positive affect during conflict (Fair Fighting Rules)

• Increasing positive affect outside of conflict (creating a culture of fondness and admiration)

Yes, but there are times when couples therapy is not effective or not recommended.

Couples therapy is shown to be effective when both people are engaged in treatment. This means both individuals are showing up, doing the work between sessions, and willing to look at their own part in the their relationship patterns.

Where it gets harder is when only one partner is invested and the other is there to appease them, or when there's something underneath that couples work alone can't treat such as active, unaddressed addiction, severe mental health issues or crises, ongoing infidelity that hasn't been disclosed, or safety/abuse concerns in the relationship. In those cases, couples therapy is not recommended until other issues are effectively addressed.

In short, in order for couples therapy to work, the couple needs to be engaged, willing and stable enough to make the most out of treatment.

Treatment length will depend on the couple and their presenting problems, but typically treatment lasts about 6 months. At that point, couples may still have conflict, but they have the tools in place to handle their issues more effectively. However, treatment length varies based on the couple’s presenting problems and progress in couples therapy.

Not at all. In fact, plenty of couples are now entering couples therapy as a part of pre-marital counseling or to address problems and strengthen their relationship skills before deciding to get married.