Couples Therapy Statistics: Why Couples Seek Therapy, Success Rates & Trends (2026)

Why do couples seek marital therapy? Communication problems are the number one reason, cited by 57% of couples -- tied with lack of emotional affection (also 57%) -- in the most widely cited study on the question (Doss, Simpson, & Christensen, 2004, Professional Psychology: Research and Practice). And therapy works: 70-75% of couples report meaningful improvement.

Key Takeaways

• Communication problems are the number one reason couples enter therapy, cited by 57% of couples and tied with lack of emotional affection at 57% (Doss et al., 2004, Professional Psychology: Research and Practice).
• 70-75% of couples who attend therapy report meaningful improvement in their relationship (Lebow et al., 2012, Journal of Marital and Family Therapy).
• 90% of couples in therapy report improvements in emotional health, physical health, or both (Relationship Counselling Study, Tavistock Centre for Couple Relationships, 2016).
• EFT achieves a 70-73% recovery rate, with 86% showing significant improvement (Johnson et al., 1999, Clinical Psychology: Science and Practice).
• The average couple waits 6 years after problems begin before seeking help (Notarius & Buongiorno, 1992, cited in Gottman & Silver, 1999, The Seven Principles for Making Marriage Work).

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Why Do Couples Seek Marital Therapy? Top Reasons by Percentage

The most widely cited research on this question surveyed 147 married couples beginning therapy (Doss, Simpson, & Christensen, 2004, Professional Psychology: Research and Practice). Two concerns tied for first place: problematic communication and a lack of emotional affection, each reported by 57% of couples.

57%

Source: Doss, Simpson & Christensen, 2004, Professional Psychology: Research and Practice

Note: Percentages add up to more than 100% because most couples report multiple concerns. Data from Doss, Simpson & Christensen, 2004 (147 couples).

More recent survey data tells a similar story. In a December 2025 YouGov survey of 2,514 US adults commissioned by Grow Therapy, 45% cited ongoing or unresolved conflicts and 43% cited a struggle to communicate effectively as reasons for attending couples therapy. Infidelity or broken trust was cited by 23% overall -- rising to 34% among divorced adults.

These concerns overlap considerably with the issues that evidence-based modalities are designed to address. Communication and emotional disconnection map directly onto EFT and Gottman interventions -- if communication is your main concern, see our guide to couples therapy for communication. And if you are unsure whether your situation warrants professional help, review the signs you need relationship counseling.

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Overall Couples Therapy Effectiveness

Research consistently shows that couples therapy works for most people who commit to the process. Multiple meta-analyses and longitudinal studies point to strong outcomes across modalities. (For a plain-language walkthrough of this evidence, see does couples therapy actually work?)

70-75%

Source: Lebow et al., 2012, Journal of Marital and Family Therapy

A landmark meta-analysis by Shadish and Baldwin (2003, Journal of Consulting and Clinical Psychology) examined 30 randomized controlled trials and found that the average couple in therapy was better off than 80% of couples who received no treatment. This effect size (d = 0.84) places couples therapy among the more effective forms of psychotherapy overall.

Beyond relationship satisfaction, therapy produces measurable benefits for individual well-being:

• 90% of couples in therapy reported improved emotional health (Tavistock Centre for Couple Relationships, 2016)
• Relationship distress is linked to a 35% increase in risk of physical illness, making effective couples work a health intervention as well (Robles et al., 2014, Psychological Bulletin)
• Partners of people with depression who attend couples therapy show twice the rate of depression remission compared to no-treatment controls (Barbato & D'Avanzo, 2008, Cochrane Database of Systematic Reviews)

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EFT Success Rates

Emotionally Focused Therapy (EFT) is one of the most rigorously studied couples therapy modalities. Developed by Dr. Sue Johnson, EFT focuses on restructuring the emotional bond between partners.

70-73%

Source: Johnson et al., 1999, Clinical Psychology: Science and Practice

The research base for EFT is substantial:

• 86% of couples show statistically significant improvement after a full course of EFT (Johnson et al., 1999, Clinical Psychology: Science and Practice)
• Recovery rates of 70-73% are measured by movement from clinical distress to non-distress on the DAS (Dyadic Adjustment Scale)
• Gains are maintained at 2-year follow-up, with some couples continuing to improve after therapy ends (Halchuk et al., 2010, Journal of Marital and Family Therapy)
• EFT has shown effectiveness specifically for couples dealing with trauma, chronic illness, and attachment injuries (Dalton et al., 2013, Journal of Couple & Relationship Therapy)

A 2019 meta-analysis by Wiebe et al. (Journal of Marital and Family Therapy) reviewed 27 studies involving over 1,400 couples and confirmed large effect sizes for EFT across diverse populations, including military couples, couples facing infertility, and couples where one partner has depression.

EFT for Specific Populations

For a deeper look at how EFT works in practice, see our guide on EFT for couples.

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Gottman Method Data

The Gottman Method is built on over four decades of research by Drs. John and Julie Gottman at the University of Washington. Their approach is known for its predictive accuracy and structured framework.

94%

Source: Gottman & Levenson, 2000, Journal of Marriage and Family

The Four Horsemen Research

The Gottmans identified four communication patterns -- criticism, contempt, defensiveness, and stonewalling -- that predict relationship failure with remarkable accuracy:

• Contempt is the single strongest predictor of divorce (Gottman, 1994, What Predicts Divorce?)
• Couples showing all four patterns during a 15-minute observed conversation could be classified as divorce-bound with 94% accuracy at 6-year follow-up (Gottman & Levenson, 2000, Journal of Marriage and Family)
• Couples who learned to replace the Four Horsemen with healthier alternatives showed a significant reduction in divorce risk (Gottman & Silver, 2012)

Sound Relationship House Outcomes

The Gottman Method builds on the Sound Relationship House theory. While there are fewer independent randomized controlled trials of the Gottman Method compared to EFT, the existing research shows:

• A 2-day "Art and Science of Love" workshop produced lasting improvements in relationship satisfaction at 1-year follow-up (Gottman & Gottman, 2008, The Gottman Institute Research Summary)
• Couples who completed the Gottman Method showed a reduction in hostile communication and an increase in positive affect during conflict discussions (Gottman et al., 2012)
• The method has been particularly studied in the context of new parents, where a 67% reduction in postpartum relationship decline was observed in couples who completed the "Bringing Baby Home" intervention (Shapiro & Gottman, 2005, Journal of Family Communication)

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DBT for Couples

Dialectical Behavior Therapy for couples is a newer but growing area of research. The Fruzzetti model (Couples Dialectical Behavior Therapy, or C-DBT) applies DBT principles -- mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness -- to couple dynamics.

Key findings from the research:

• Couples in C-DBT showed significant improvement in relationship satisfaction and emotional regulation compared to waitlist controls (Fruzzetti & Fantozzi, 2008, Cognitive and Behavioral Practice)
• The approach was originally developed for couples where one or both partners have borderline personality disorder or significant emotion dysregulation, and demonstrated notable reductions in conflict intensity (Fruzzetti & Iverson, 2006)
• C-DBT produced reductions in both emotional and physical aggression, making it one of the few couples modalities with evidence for reducing partner violence (Fruzzetti & Lebow, 2015)
• Individual improvement in DBT skills (particularly mindfulness and distress tolerance) predicted improved couple outcomes, suggesting a mechanism by which the approach works (Fruzzetti, 2006, The High Conflict Couple)

While the evidence base for DBT with couples is still growing compared to EFT or CBT-based couple interventions, early results are promising -- particularly for high-conflict couples and those with co-occurring individual mental health conditions.

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Modality Comparison

Sources: Johnson et al., 1999; Gottman & Levenson, 2000; Baucom et al., 1998; Fruzzetti & Fantozzi, 2008; Christensen et al., 2004.

For a full breakdown of couples therapy approaches, see our couples therapy treatment page.

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Divorce Statistics After Counseling

One of the most common questions is whether couples therapy actually prevents divorce. The data is nuanced.

26.9-40%

Source: Doss et al., 2016, Journal of Consulting and Clinical Psychology; Gottman & Levenson, 2000

What the Research Shows

• A study of over 4,000 couples by Doss et al. (2016, Journal of Consulting and Clinical Psychology) found that roughly 38% of couples who attended therapy went on to divorce within 5 years
• The general divorce rate for first marriages in the US is approximately 40-50% over a lifetime (American Psychological Association, 2023), so therapy appears to offer a meaningful protective factor, particularly in the short to medium term
• Couples who complete a full course of therapy (rather than dropping out early) have substantially better outcomes -- dropout is one of the strongest predictors of eventual divorce (Mondor et al., 2013, Family Process)
• The timing matters: couples who begin therapy before problems become entrenched have significantly lower divorce rates than those who wait (Wright et al., 2008, Journal of Family Psychology)

Therapy vs. No Therapy

Sources: Doss et al., 2016; Shadish & Baldwin, 2003; Lebow et al., 2012.

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When Couples Seek Help

One of the most concerning statistics in the field involves how long couples wait before starting therapy.

6 years

Source: Notarius & Buongiorno, 1992, cited in Gottman & Silver, 1999

This delay has significant consequences:

• By the time most couples enter therapy, negative patterns are deeply entrenched and harder to change (Gottman, 1999)
• Couples who seek help within the first 1-2 years of noticing problems have a significantly higher success rate than those who wait 5+ years (Wright et al., 2008, Journal of Family Psychology)
• Men are more likely to delay seeking therapy than women, and this gender gap in help-seeking is a consistent finding across multiple studies (Addis & Mahalik, 2003, American Psychologist)
• Common barriers include stigma, cost concerns, believing problems will resolve on their own, and difficulty finding a therapist both partners agree on (Eubanks Fleming & Cordova, 2012, Family Process)

The Marriage Checkup

Research by James Cordova and colleagues has shown that brief "marriage checkup" interventions -- even 2 sessions -- can motivate couples to address issues earlier and serve as a gateway to more formal therapy when needed (Cordova et al., 2014, Journal of Consulting and Clinical Psychology). Couples who participated in a marriage checkup showed improved relationship satisfaction and were more likely to seek further help if appropriate.

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Cost of Couples Therapy

Cost is frequently cited as a barrier to starting therapy. Here is what the data shows for 2026:

Insurance Coverage

• Only about 25-30% of insurance plans cover couples therapy as a standalone service -- it often must be coded under an individual diagnosis such as an adjustment disorder (American Association for Marriage and Family Therapy, 2023)
• When insurance does cover couples therapy, the average copay ranges from $30-$75 per session
• Some employers now offer couples therapy through Employee Assistance Programs (EAPs), typically covering 3-6 sessions at no cost (Society for Human Resource Management, 2024)

For a complete guide, see our article on couples therapy cost and does insurance cover therapy.

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Online vs. In-Person Couples Therapy

Telehealth has expanded access to couples therapy, and the research is beginning to catch up:

• A 2021 study by Wrape and McGinn (Journal of Marital and Family Therapy) found that online couples therapy produced outcomes comparable to in-person for most presenting concerns
• Completion rates are higher for online therapy, likely due to reduced logistical barriers like scheduling, commuting, and childcare (Hertlein et al., 2021, Journal of Family Therapy)
• Online therapy may be less effective for couples with high-conflict dynamics or active safety concerns, where in-person assessment is preferred (Lebow, 2020, Family Process)
• A survey by the American Association for Marriage and Family Therapy (2023) found that 62% of couples therapists now offer some form of online sessions, up from 18% pre-pandemic
• Client satisfaction ratings for online couples therapy are generally equivalent to in-person (Benson et al., 2022, Couple and Family Psychology)

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Factors That Predict Success

Not all couples benefit equally from therapy. Research has identified several factors that predict better outcomes:

Timing. As discussed above, earlier intervention is consistently associated with better results (Wright et al., 2008). If you are weighing whether now is the right moment, our guide on when to start couples therapy walks through the research.

Mutual commitment. When both partners are actively engaged and willing to do the work, outcomes improve significantly. Having one reluctant partner reduces effectiveness but does not eliminate it (Anker et al., 2010, Journal of Consulting and Clinical Psychology).

Therapist training and specialization. Therapists specifically trained in a couples modality (EFT, Gottman, IBCT) produce better outcomes than generalist therapists providing couples therapy without specialized training (Gurman, 2015, Clinical Handbook of Couple Therapy).

Therapeutic alliance. The quality of the relationship between the therapist and both partners is one of the strongest predictors of success. A "split alliance" -- where one partner feels more understood than the other -- is associated with poorer outcomes and higher dropout (Friedlander et al., 2011, Journal of Counseling Psychology).

Severity of issues. Moderate relationship distress responds better to therapy than severe distress. However, even severely distressed couples can benefit, especially with structured approaches like EFT or IBCT (Christensen et al., 2004, Journal of Consulting and Clinical Psychology).

Absence of active untreated individual pathology. When one partner has untreated depression, anxiety, PTSD, or a substance use disorder, couples therapy alone is less effective. Coordinated treatment (individual + couples therapy) tends to produce the best outcomes in these cases (Whisman, 2001, Journal of Consulting and Clinical Psychology).

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Frequently Asked Questions

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For related reading on this site, see:

• Couples therapy overview
• EFT for couples
• Gottman Method explained
• DBT for couples
• Couples therapy cost
• Online vs. in-person therapy