In today’s world, it may seem like a healthy and happy relationship is nearly impossible to build or maintain.
With all of the added stress of working in the digital age, the ubiquitous interruptions of social media, and the breakneck pace at which our lives are now lived, cultivating a good relationship with your spouse or loved one may seem like a herculean task.
While no relationship is comprised solely of sunshine and roses, it’s not impossible to enjoy a functional, positive, and mutually beneficial relationship. It might take a little bit of work from both partners, but the keys to success are at your fingertips.
Whether you and your significant other are struggling to make time for one another, finding it difficult to communicate effectively, or dealing with something a little heavier than the average stressors of modern relationships, relationship therapy (also known as relationship counseling, couples counseling, and couples therapy) can be an important key to relationship success.
Read on to learn more about how relationship therapy can benefit even the most stable and solid of couples.
Before you continue, we thought you might like to download our three Positive Relationships Exercises for free. These detailed, science-based exercises will help you or your clients build healthy, life-enriching relationships.
This article contains:
How Relationship Therapy Can Help
There are many different types of therapy that can be applied in the context of relationships, but they all have the same goal: to improve or enhance the relationship.
Generally, the term “relationship therapy (or counseling)” refers to therapy with adults in romantic relationships, although there are certainly other relationships that therapy can benefit (Good Therapy, 2017).
The nature of human interaction inevitably results in some disagreements, issues, or problems between people. This natural tendency is amplified in long-term romantic relationships such as marriage. The more time we spend with someone, the more likely it is that we will eventually face a challenge that puts the relationship at risk.
While it is expected that couples will sometimes disagree, or even get into (non-physical) fights, there’s a fine line between normal relationship stress and more serious problems.
A relationship or marriage therapist can help a couple struggling with all of these issues, whether their assistance is in the form of teaching the clients about healthy disagreements and fighting clean, or identifying and tackling the problems that seriously endanger the relationship.
The goals of each couple’s therapy experience, and even each session, may differ depending on the problems they are dealing with, but there are five general principles that guide relationship therapy (Whitbourne, 2012).
1. Change the couple’s views on the relationship
We often get caught up in familiar patterns of behavior or thought, which can make us lose sight of the bigger picture. We may have a blind spot when it comes to the ways in which we contribute to the relationship’s troubles, while focusing on what our partner is “doing wrong.”
A relationship therapist will help the couple step back and take a more objective view of the relationship in general, as well as the specific problems they are experiencing. The couple will be encouraged to stop thinking in terms of blame and start working together as a team to tackle their problems.
2. Modify any dysfunctional behavior
Perhaps one of the most important jobs of the relationship therapist is to help clients modify their behavior towards one another, specifically the behaviors that are potentially harmful. Even those with the best intentions may inadvertently cause their partner unnecessary pain or damage, whether it’s physical, psychological, or emotional damage.
The therapist will target these behaviors and guide his or her clients through the process of recognizing, acknowledging, and altering them. These behaviors can range anywhere from unhealthy communication habits to physical violence. In extreme cases, the therapist may recommend that the couple takes time apart or that one or both individuals attend further treatment or therapy for a specific issue like substance abuse.
3. Decrease emotional avoidance
Communication is the foundation of every relationship, whether it’s through spoken words, sign language, text messages or emails, or body language. For a relationship to flourish, both participants must share their feelings with one another. While we each have our own levels of comfort in sharing personal thoughts and feelings, there is a minimum level of communication that must occur to enable a healthy relationship.
A relationship therapist will aid the couple in expressing feelings they may fear sharing with each other, or initially feel uncomfortable sharing with each other. Fear inhibits effective communication, and the therapist will work with the couple to help ease any fears they have surrounding sharing their feelings.
4. Improve communication
As noted earlier, communication is essential in repairing and maintaining a good relationship. Aside from encouraging couples to share emotions with one another, couples must also learn how to constructively communicate with one another in general.
In addition to teaching the couple about healthy communication and pitfalls to avoid when sharing with one another, the therapist may coach the clients to improve their communication skills. The emphasis here is not just on communicating, but communicating effectively, which requires active listening and empathy.
5. Promote strengths
A positive psychologist or therapist who practices positive psychology techniques will likely focus on this principle more than most therapists, but all relationship therapy will work on this to some extent. Every relationship has its strengths and weaknesses, and while much of therapy will be focused on the weaknesses, effective therapy also celebrates and enhances the relationship’s strengths.
A good relationship therapist will help couples identify their strengths, but allow the clients to decide for themselves what is best about their relationship. Taking advantage of the strengths may involve engaging in specific behaviors more often, altering their overall view on the relationship, or simply learning to dwell more on the positives of the relationship than the negatives.
Focusing on these five principles can provide clients with the tools they need to face their relationship challenges together, and come out on the other side of these challenges stronger than ever.
What Romantic Relationship Theory Works for You?
The types of relationship therapy are varied, reflecting the many different theories on relationships that can be found in the literature.
While the five principles above are the basic building blocks of relationship therapy, there are numerous ways to put them into practice.
Some relationship theories complement or enhance existing theories, while others compete to explain common behaviors or specific findings in research on relationships.
A few of the most widely referenced theories on relationships are explored below. These theories should not be considered a comprehensive overview of the field, but they provide a good primer in the basics of relationship psychology.
Social Exchange Theory
One of the most influential theories in relationship psychology is the Social Exchange Theory of relationships.
This theory is founded on the idea that all relationships (including non-romantic relationships) are based on the exchanges between individuals, or the “give and take” (Cherry, 2017). Mirroring some of the basic theories in economics, politics, and even philosophy, this exchange process is intended to maximize the benefits of the relationship and minimize the costs that accompany it.
Much like the weighing of costs and benefits that business owners and executives engage in when considering their options, social exchange theory posits that people apply this same technique when considering whether to initiate or continue their relationships. If they find that the costs outweigh the benefits, they end the relationship (Cherry, 2017).
However, this process is not based solely on the exchanges between two individuals. There are three important components that influence our relationship decisions:
- The balance between what we put into a relationship (what we give) and what we get out of it (what we take)
- The kind of relationship we feel we deserve
- The chances of having a better relationship with someone else (Changing Works, n.d.)
These three factors affect how we feel about our relationships and how we think about them when considering whether to initiate, invest more time and energy into, or give up on a relationship.
Using these factors, we develop a comparison level – a standard we hold for the ratio of give-and-take in a relationship (Changing Works, n.d.). Different kinds of relationships will likely have different comparison levels – for instance, you may want a roughly equal ratio of give-and-take in a romantic relationship, while you will be far more lenient in the amount you are willing to give to a child or someone you are mentoring.
This comparison is a vital part of considering how to proceed with our relationships, but the decisions we make are moderated by how we perceive the world and people in general. If we believe that the world is full of fun, interesting, and compatible people, we will be more likely to ditch a relationship with a high give/take ratio, while we may put up with such a ratio if we don’t think we could easily find a better relationship (Changing Works, n.d.).
This theory is a useful one for explaining and predicting the course of relationships, but it does not cover all the bases. Many people may find that social exchange theory’s kinship with economics and political philosophy to be too “mathematical” and lacking in some of the more subjective, emotional components of relationships (Fournier, 2016).
This popular theory in relationship psychology proposes that the most important factors influencing our relationships throughout life are the bonds that we form first in life.
Attachment theory is based on the work of John Bowlby, a psychoanalyst who researched the effects of separation between infants and their parents (Fraley, 2010).
He theorized that the extreme behaviors infants would display (crying, screaming, clinging, etc.) to avoid separation or reconnect with a physically separated parent were actually evolutionary mechanisms, behaviors that were honed over generations to ensure that the protection and care provided by the parent or parents would continue.
These attachment behaviors are natural responses to the threat of losing these survival advantages imparted by the primary caregiver. Since the infants who engaged in these behaviors were more likely to survive, the instincts were naturally selected and reinforced over time.
These behaviors make up what Bowlby termed an “attachment behavioral system,” the system that guides us in our patterns and habits of forming and maintaining relationships (Fraley, 2010).
Research on Bowlby’s theory of attachment showed that children placed in a strange situation (involving the separation and reuniting of parents and infants) generally react in one of three ways (Fraley, 2010):
- Secure attachment
These children showed distress upon separation but sought comfort and were easily comforted when the parent(s) returned.
- Anxious-resistant attachment
A smaller portion of children experienced greater levels of distress and, upon reuniting with the parent(s), seemed to both seek comfort and attempt to “punish” the parent(s) for leaving.
- Avoidant attachment
The third category of attachment style showed no stress or minimal stress upon separation from the parent(s) and either ignored the parent(s) upon reuniting, or actively avoided the parent(s).
It is clear that these attachment styles are largely a function of the caregiving children receive in their early years; those who received support and love from their parents are likely to be secure, while those who experienced inconsistency or negligence from their parents are likely to feel more anxiety surrounding their relationship with their parents.
However, adult attachment theory takes it one step further: according to this theory, the relationships we form as adults (particularly romantic relationships) are also directly related to our attachment styles as children and the care we received from our parents (Firestone, 2013b).
Psychologist Lisa Firestone (2013b) outlines the adult attachment styles that follow the same general pattern described above:
- Secure attachment
These adults are more likely to be satisfied with their relationships, feeling secure and connected to their partner without feeling the need to be (physically) together all the time. Their relationships are likely to feature honesty, support, independence, and deep emotional connections.
- Anxious preoccupied attachment
Those who form less secure bonds with their partners may feel desperate for love or affection and feel that their partner must “complete” them or fix their problems.
While they long for safety and security in their romantic relationships, they may also be acting in ways that push their partner away rather than invite them in. The behavioral manifestations of their fears can include being clingy, demanding, jealous, or easily upset by small issues.
- Dismissive avoidant attachment
One of the two types of adult avoidant attachments, people with this attachment style generally keep their distance from others. They may feel that they don’t need human connection to survive or thrive, and insist on maintaining their independence and isolation from others.
These individuals are often able to “shut down” emotionally when a potentially hurtful scenario arises, such as a serious argument with their partner or a threat to the continuance of their relationship.
- Fearful avoidant attachment
The second type of adult avoidant attachment manifests as ambivalence rather than isolation. People with this attachment style generally try to avoid their feelings because it is easy to get overwhelmed by them. They may suffer from unpredictable or abrupt mood swings and fear getting hurt by a romantic partner.
These individuals are simultaneously drawn to a partner or potential partner and fearful of getting to close. Unsurprisingly, this style makes it difficult to form and maintain meaningful, healthy relationships with others.
This theory provides an intuitive and effective explanation for why we act the way we do in our adult relationships. Of course, the relationships we had with our parents are not the only factor influencing our adult relationships, but it’s clear that they play a large role in how we relate to others as adults.
Triangular Theory of Love
The Triangular Theory of Love posits that there are three components to all romantic relationships. These components can differ in degree, but each is present to some extent in a romantic relationship.
The three components are:
Feelings of closeness and connectedness with our partner that determine the “warmth” of the relationship.
The component that often drives us to pursue romantic relationships, manifesting as romance, attraction to one another, arousal, and sexual activity.
- Decision / Commitment
The final component involves the decision to begin a romantic relationship and, later on, to continue the relationship; this component is what drives the behaviors related to maintaining a relationship or ending a relationship (Sternberg, n.d.).
These components are not isolated from one another; they can interact and influence each other, making the resulting relationship less of a math problem and more of an art form. For example, a high degree of passion in the beginning can drive the desire to become more intimate with your partner, while enhanced intimacy can affect the level of commitment in a romantic relationship.
The multiple combinations of these three components result in eight different kinds of love:
- Nonlove – absence of all three components
- Liking – only intimacy, no passion or decision/commitment
- Infatuated love – only passion, no intimacy or decision/commitment
- Empty love – only decision/commitment, no intimacy or passion
- Romantic love – presence of intimacy and passion, no decision/commitment
- Companionate love – presence of intimacy and decision/commitment, no passion
- Fatuous love – presence of passion and decision/commitment, no intimacy
- Consummate or Complete love – presence of all three components (Sternberg, n.d.)
Consummate love is the kind of relationship most of us hope for, where we revel in the presence of intimacy, passion, and commitment in our romantic relationship.
Companionate love is a common type of love experienced by older couples who can measure their time together by the decade rather than by the year. Infatuated love is the kind of love we often feel in the beginning of a new relationship, marked by a burning passion for our new partner but without the intimacy and commitment that only time spent together can bring.
It is also common to move between these types of love in a single relationship. The relationship may start as liking, move to infatuated love, grow into romantic love, thrive in consummate love, and drift into companionate love as the age of the relationship increases.
What Struggles Are You Facing?
No matter which theory of romantic relationships you subscribe to, here are many reasons why a couple might seek help in maintaining or repairing their relationship.
These reasons include:
- Problems communicating, whether the issue is too little communication, inconsistent communication, or negative communication.
- Premarital counseling, in which couples apply their time and energy to preparing a good foundation before marriage.
- Sexual issues, which can cause frustration, anger, embarrassment, shame, resentment, and/or anxiety in one or both partners.
- Infidelity or unfaithfulness, referring to physical cheating, emotional cheating, or both.
- Assistance managing other relationships, which can have a huge impact on the romantic relationship.
- Nontraditional relationships, such as polyamory or asexual relationships, which can bring up other issues in addition to those that commonly arise in traditional romantic relationships.
- Blended families, since families with step-parents and/or step-siblings often face a unique set of challenges.
- End of a relationship, including divorce or the death of a partner, bringing a specific set of emotions like grief, anger, and sadness.
- Digital-age issues, or problems arising from modern technology, including feeling ignored, feeling insecure about you or your partner’s digital relationships, and the pitfalls of communicating by email, text, and tweet.
- Trust issues, which often make up a large portion of relationship stress and can lead directly or indirectly to many more problems down the road (Harmon, 2017).
This list is not an exhaustive list of the reasons that might bring a couple to counseling, but they hit on some of the most common issues that bring clients to a qualified therapist.
What to Expect in Relationship Therapy
Depending on the specific issues that clients seek assistance in addressing, therapists employ many different techniques, exercises, and tools in their sessions; however, there is a set of questions and activities that you will likely find in any relationship therapy experience.
Relationship therapist Thorin Klosowski (2013) provides a basic outline of what you can expect from relationship therapy:
- Questions – about you, your partner, your personal histories, your current relationship, and your history as a couple.
- Difficult discussions – it’s never easy to discuss your problems, especially when you are discussing your problems with the other person in the same room!
- Discussion of therapy progression – be prepared to talk about how therapy is helping, hurting, or not changing a thing each session; therapy is different for every couple, but a common theme in therapy is discussing how therapy itself is progressing.
These three components are virtually universal in couple’s therapy. It will always require a period of filling the therapist in on what is going on in the relationship, discussions of the problems facing the couple, and discussion of how therapy is progressing.
Interventions and Exercises in Relationship Therapy
Depending on the type of therapy or counseling you pursue, you will also be exposed to more specific questions, theories, exercises, and discussions.
A few of the most popular methods and techniques for addressing problems in romantic relationships are described below.
This exercise might seem extremely basic and overly simplistic. It is certainly a simple exercise, but don’t underestimate the power of showing appreciation!
The couple can take turns leading the exercise, ensuring that each partner gets to both voice their appreciation and hear their partner’s appreciation.
Start by facing one another, making sure to initiate eye contact.
The first partner will begin by describing one thing that he or she loves and appreciates about his or her partner. For example, the first partner could say, “I love that he does the dishes since I hate doing dishes!” or “I love her sense of humor – she can always make me laugh with a joke or a silly play on words” (Meyerson, 2008).
Next, the second partner engages in mirroring (i.e., reflects the appreciation back to the first partner). In the examples given above, this could be saying something like “So you really love that I do the dishes at home?” or “You really enjoy my sense of humor, even when I make silly puns?”
Once the second partner has mirrored the appreciation, the first partner explains what the act or trait they mentioned means to them with the sentence stem “This is so special to me because…”
For example, the partner who appreciates that he cleans up after meals might say, “This is so special to me because it makes me feel loved and cared for when you take a burden off my shoulders.” The partner who appreciates her sense of humor might say, “This is so special to me because I think having a sense of humor and having fun are important in a relationship, and I have fun with her when she makes me laugh.”
Once again, the second partner will mirror the compliment back to the first partner to confirm that they understand what he or she appreciates and accepts the compliment (Meyerson, 2008).
This simple exercise not only encourages couples to identify and share what they love about each other, it also gives them a chance to learn about what they value, both individually and as a couple. It can help them discover new ways to connect on a deeper level or enhance the positive aspects of their relationship.
The potential positive outcomes are numerous, and there are virtually no risks to this exercise.
If you’d like to learn more about sharing appreciation or give it a try with your partner or clients, you can find the exercise described in greater detail here.
The Miracle Question
The Miracle Question – an old standby for many different types of therapy! This question can be used in individual therapy as well as couples therapy, and it can be applied to a wide range of situations, issues, or problems.
The general idea of this technique is to both help the client (or couple) explicate their needs or desires and help the therapist better understand what his or her client(s) is hoping to achieve in therapy. It is especially helpful for those who have never really taken the time to clarify what they want out of their relationship, either for themselves or for their partners.
This question can generally be worded as such (Howes, 2010):
“Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, what would be some of the things you would notice that would tell you life had suddenly gotten better?”
Even if one or both clients give describe a scenario that is absolutely impossible to achieve, their answer can still be useful for understanding their goals. In the scenario of an impossible ideal future state, the therapist can dig deeper into the couple’s “miracle” by asking, “How would that make a difference?” (Howes, 2010).
This question helps the couple believe in a more positive future for themselves, a future in which their problems are solved. This exercise can result in greater motivation to work at improving their relationship, enhanced confidence in the efficacy of couples therapy, and even instantaneous (but incremental) improvement in interactions between the two people.
You can find more information on this exercise at this link.
Our Shared Qualities
Sometimes reminding the couple of the things they have in common can offer a boost in their feelings for one another and greater belief in their ability to work out their problems. This worksheet provides an opportunity to remember what makes them a great couple, and what makes their relationship worth the effort to rebuild, reignite, or improve.
The Shared Qualities worksheet instructs the couple to fill out eight sections with at least three things they have in common. The couple can complete this worksheet together, discussing and reminiscing as they make their way through the sections, or separately, with time at the end to compare their responses and note the similarities and differences.
The eight sections are as follows:
- We would like to visit…
- Movies, books, or music we like…
- We have fun when we…
- As a couple, we’re good at…
- As a couple, our weaknesses are…
- Unique things we have in common…
- Qualities we value in a person…
- Three goals for our future…
In addition to facilitating meaningful discussion and remembrance of the positive aspects of their relationship, this worksheet offers couples a chance to identify their strengths and weaknesses as a couple and plan for their shared future.
As noted earlier, it is essential to acknowledge and promote the positive in a relationship as well as acknowledge and address the negative.
Developing or clarifying goals for the future is also a vital component of couples therapy. It is important to find out whether the two individuals are on the same page in terms of their short- and long-term goals and, if not, to address the issues inherent in working towards opposite goals.
Whether a couple is struggling with some everyday relationship stressors or dealing with a major problem completing this worksheet is a good way to get them thinking and talking about their relationship and discussing how they move forward.
You can find this worksheet here.
How You Can Help Your Relationship
While relationship therapy is recommended for more serious problems between partners, therapy may not always be required.
There are many things couples can do at home to improve their relationship and address some of the issues that pop up in the course of a normal relationship.
These 12 tips from therapist Mark Hirschmann (n.d.) outline some of the most effective steps you can take to improve the foundation your relationship is built on and enhance your ability to cope and thrive as a couple:
- Take stock of what is truly important in your life. This can help you understand your own goals and desires and prioritize them.
- Accept compromise and tolerate the persistent differences. Every couple will have at least a few stubborn differences; it is vital that couples compromise when they can but also learn to accept the differences between them.
- Identify and separate your frustrations. While your partner may be extremely effective at pressing one of your buttons once in a while, learn to recognize when you are really frustrated with your partner versus when you are laying your frustrations at your partner’s doorstep unfairly.
- Catch your partner doing something right. Instead of always waiting to catch your partner in a misstep or mistake, try to “catch” your partner doing something that you love, admire, or appreciate.
- Surprise your partner with thoughtfulness. On the flipside, try to surprise your partner with a thoughtful gesture or an unprompted kindness; try not to take it personally if your partner does not notice or appreciate your gesture as much as you expect them to.
- Carve out “couple time” your partner will enjoy. It is vital to do things together that you both enjoy, but it doesn’t hurt to plan some quality time together doing something your partner enjoys, even if it’s not your favorite activity.
- Before reacting angrily, count to ten. This old piece of advice is still around for a reason – it’s a classic. Try to take at least ten seconds to cool down or think things over before reacting to something your partner did, said, or didn’t do or say.
- Negotiate an unconventional place to discuss contentious issues. This might seem like an odd bit of advice, but sometimes a shift in physical location can provoke a shift in thinking as well – you may find creative new solutions to your problems!
- Take a time out. Time out is not just for children anymore – it can be a welcome break if discussion gets heated with your partner. Give yourself a chance to cool off.
- When you know you have made a mistake, apologize. This piece of advice cannot be emphasized enough – when you make a mistake, acknowledge it, fix it if you can, and plan to avoid making it in the future.
- Provide support, solutions are secondary. Often, our partner only wants us to listen, empathize, and offer comfort or support rather than a five-step plan to tackle our problems. This is a great lead-in to the final piece of advice…
- Deeply listen to your partner. It’s not enough to simply look into your partner’s eyes and nod along – quality relationships require active or deep listening, a practice in which you listen with full attention rather than planning your response, and encourage your partner to continue sharing with you until they are truly out of things to say.
If you take only once piece of advice from this list, take the last piece. So many problems arise when we are not communicating effectively or enough. Active listening is a great way to learn more about your partner, show them your appreciation, and keep an eye out for relationship problems.
Relationship Therapy: No Crisis Necessary
In this article, we outlined the basics of relationship therapy, including a definition, a brief overview of some popular theories in relationship psychology, issues that bring couples to counseling, and ways that you can work on your own relationship.
No relationship is perfect, and there is always room for improvement. Through this piece, I hope I have provided you with useful tools for enhancing your relationship with your significant other(s). After all, is there such a thing as a relationship that is TOO good?
Have you tried relationship therapy? What did you find especially helpful for you and your partner(s)? Are there any other exercises or pieces of advice you would recommend?
As always, thanks for reading!
We hope you enjoyed reading this article. Don’t forget to download our three Positive Relationships Exercises for free.
- Changing Works. (n.d.). Social exchange theory. Changing Minds. Retrieved from http://changingminds.org/explanations/theories/social_exchange.htm
- Firestone, L. (2013b, July 30). How your attachment style impacts your relationship. Psychology Today. https://www.psychologytoday.com/blog/compassion-matters/201307/how-your-attachment-style-impacts-your-relationship
- Firestone, L. (2013a, January 8). 6 ways you can fix your relationship on your own. Psychology Today. Retrieved from https://www.psychologytoday.com/blog/compassion-matters/201301/6-ways-you-can-fix-your-relationship-your-own
- Fournier, G. (2016). Social exchange theory. Psych Central. Retrieved from https://psychcentral.com/encyclopedia/social-exchange-theory/
- Fraley, R. C. (2010). A brief overview of adult attachment theory and research. University of Illinois. Retrieved from https://internal.psychology.illinois.edu/~rcfraley/attachment.htm
- Good Therapy. (2017). Relationships and marriage. Good Therapy. Retrieved from https://www.goodtherapy.org/learn-about-therapy/issues/relationships
- Harmon, J. (2017, March 22). 10 good reasons to seek relationship counseling. Good Therapy. Retrieved from https://www.goodtherapy.org/blog/10-good-reasons-to-seek-relationship-counseling-0322175
- Hirschmann, M. (n.d.). 12 tips for couples. Relationship Therapy Milwaukee. Retrieved from http://www.relationship-therapy-milwaukee.com/twelve-tips.php
- Howes, R. (2010, January 17). The ten coolest therapy interventions: Introduction. Psychology Today. Retrieved from https://www.psychologytoday.com/blog/in-therapy/201001/the-ten-coolest-therapy-interventions-introduction
- Klosowski, T. (2013, June 10). What to expect from couples therapy. Lifehacker. Retrieved from http://lifehacker.com/what-to-expect-from-couples-therapy-512019720
- Meyerson, J. (2008). Success with couples therapy: A step-by-step approach. Social Work Today. Retrieved from http://www.socialworktoday.com/archive/mayjun2008p16.shtml
- Sternberg, R. (n.d.). Duplex theory of love: Triangular theory of love and theory of love as a story. Robert J. Sternberg. Retrieved from http://www.robertjsternberg.com/love/
- Whitbourne, S. K. (2012, March 20). 5 principles of effective couples therapy. Psychology Today. Retrieved from https://www.psychologytoday.com/blog/fulfillment-any-age/201203/5-principles-effective-couples-therapy