Last updated: October 21, 2026

Individual Therapy or Couples Counseling: Which Fits?

Reviewed by Rebecca Rabin, PsyD, MA license PSY8258

In short: They do different jobs. Couples counseling works with both partners on the relationship itself. Individual therapy works with one person on their own patterns across relationships. Dr. Rabin offers individual therapy only. No authoritative rule says which fits whom, and where there is abuse, The Hotline does not encourage counseling with an abusive partner.

If a relationship is the reason you are thinking about therapy, one of the first questions is who should be in the room. Sometimes the answer is obvious. Often it is not, especially when one person is more interested in getting help than the other.

This article describes both options plainly. One point up front: Dr. Rabin offers individual therapy only. She does not offer couples, marriage, family or sex therapy. That is why this guide describes couples methods only as things that exist, and does not name couples therapists or practices.

What is the difference between the two?

Couples therapy treats the relationship, usually with both partners present. The American Association for Marriage and Family Therapy (AAMFT) puts it this way: "In part, marital therapy is about partners working to validate and accept each other, to gain insight and learn to manage differences." Some approaches, it says, "promote skills and practice; others examine the roots of the problem, looking at process between the couple rather than the details of a particular argument."

Individual therapy treats one person. When relationships are the focus, the work looks at your side of what keeps happening: what you hope for, what you fear, and how you react. Because you are the only one present, it can follow a pattern wherever it shows up, with a partner, family, friends or colleagues.

The trade-off is that an individual therapist hears one account. Gurman and Burton (2014), writing from a couple therapy perspective, list among the pitfalls of treating a couple problem individually "therapist side-taking" and "inaccurate assessments based on individual client reports."

What are the main couples approaches?

These are approaches other clinicians offer. They are described here so the names make sense if you come across them.

Emotionally focused couple therapy (EFCT). Its training body, ICEEFT, describes emotionally focused therapy as "drawing primarily from attachment theory" and says the couples form "helps couples to build strong, healthy relationships by exploring and changing emotional dynamics to enhance mutual understanding and closeness."
Behavioral couple therapy (BCT). A 2019 meta-analysis describes BCT and EFCT as "well-established treatments to reduce couple distress."
The Gottman method. The Gottman Institute describes it as "an approach to couples therapy that includes a thorough check up of the couple's relationship."

In practice, AAMFT says, "Most marriage and family therapists integrate modalities and tailor their approach to best fit the couple they are working with."

What does the research say about couples therapy?

There is a real evidence base, with honest disagreement about how long gains last.

Roddy and colleagues, 2020. This meta-analysis of 58 studies covering 2,092 couples found a large effect of couple therapy on relationship satisfaction from before to after treatment, that couples on waitlists did not significantly improve, and that gains were "generally maintained over short- and long-term follow-up." Every couple studied was opposite-sex.
Rathgeber and colleagues, 2019. Looking only at randomized trials (33 studies, 2,730 participants), this meta-analysis found medium effects at the end of treatment and small effects six months later, "but these gains were not maintained after 12 months" in the behavioral couple therapy studies that measured that far. The authors warn of possible publication bias.
Jackson and colleagues, 2026. The most recent review in this guide's research applied formal criteria to 40 studies and found that "no couple therapy models met the standards for strong empirical support." Seven, including emotionally focused, Gottman and integrative behavioral couple therapy, "demonstrated modest support."

These figures describe averages in study samples. They do not predict what would happen in one particular relationship.

When might each one fit?

No authoritative source gives a rule for choosing, and the research behind this guide found none beyond a few lines from AAMFT. Treat these as things to think about, not criteria.

Both partners want to work on it. AAMFT says, "Successful outcomes are possible when both partners are equally invested and open to making positive changes to their relationship."
One partner will not come. AAMFT says, "If your partner just won't go, you can begin to do some things yourself." Gurman and Burton note that individual work on a couple problem "may evolve from a partner's refusal of conjoint therapy." See when your partner will not go to therapy.
Both at once. AAMFT says, "In cases of marital distress, it is often helpful for each partner to work with an individual therapist as well."

Why does abuse change the answer?

Where one partner controls, threatens or frightens the other, the advice changes. The National Domestic Violence Hotline says: "We at The Hotline do not encourage anyone in an abusive relationship to seek counseling with their partner. Abuse is not a relationship problem." Couples counseling, it explains, "cannot, however, fix the unequal power structure that is characteristic of an abusive relationship," and "An abuser may use what is said in therapy later against their partner."

A couples therapist may not see the abuse either. In a national survey of 620 couple therapists, carried out in 2000 and published in 2009, "Less than 4% of respondents indicated consistently following key published guidelines for DV screening." The authors concluded that domestic violence (DV) "may be under-identified by couple therapists."

If this sounds familiar, unhealthy or abusive? sets out the official warning signs. The Hotline is free, confidential and open 24/7: call 1-800-799-SAFE (7233) or text START to 88788. SafeLink, Massachusetts' statewide 24/7 toll-free domestic violence hotline, is at (877) 785-2020. If you are in immediate danger, call 911.

Where does Dr. Rabin's work fit?

Dr. Rabin's relationship therapy page says it plainly: her work is individual therapy focused on you and your relationships, and it is not couples or marriage counseling. The work is psychodynamic and attachment-based. It traces how early relationships shape present connections, and it uses the therapy relationship as a place to notice patterns as they happen and practice relating differently.

If you are looking for couples counseling, look for a clinician who offers it, and ask about their training in the approach they use and how they check for safety. Marriage and family therapists are one profession trained for this work; AAMFT describes them as "trained in psychotherapy and family systems."

If you are unsure which kind of help fits, a free consultation of about 15 minutes with Dr. Rabin, requested through the contact page, is a place to talk it through. Fees are on the fees and insurance page.

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Sources

Last reviewed October 2026. This guide is general information, not medical advice or a diagnosis. If you are in danger, call 911. If you are in crisis or thinking about harming yourself, call or text 988.

Frequently Asked Questions

Does Dr. Rabin offer couples counseling?

No. She offers individual therapy only, focused on you and your relationships. She does not offer couples, marriage, family or sex therapy. If you and a partner want to work together in the same room, you would need a clinician who offers couples therapy. You can still ask on a consultation call whether individual work makes sense for you alongside it.

Is couples therapy worth suggesting if my partner seems reluctant?

That is for the two of you to decide. AAMFT notes that "a positive outcome is more likely if both partners commit to and willingly participate in the therapy." If your partner will not come, it describes individual work as one option. When your partner will not go to therapy covers that situation in more detail.

Is attachment-based individual therapy the same as emotionally focused therapy?

No. Emotionally focused therapy draws on attachment theory, according to its training body, and has a couples form that works with both partners together. Attachment-based individual therapy, as Dr. Rabin's page describes it, also draws on attachment ideas but works with one person. Dr. Rabin does not offer emotionally focused couple therapy.

Does a 2026 review mean couples therapy does not work?

No. It found that no single couples model yet meets the standard for strong support, most often because samples were too small or findings had not been independently replicated. Seven models showed modest support. Other meta-analyses found clear average gains in relationship satisfaction, with disagreement about how long those gains last. Modest support is not the same as no support.

Wondering what kind of help fits?

A short conversation can help you decide. Dr. Rebecca Rabin, PsyD offers a free 15-minute consultation to talk through what you are facing and whether individual therapy with her, or a different kind of help, is the right next step. Read how individual relationship therapy in Brookline works.

Schedule a Free 15-Minute Phone Consultation