The Positive Impact of Couples Therapy Is Nearly Universal, Verywell Mind Survey Finds

Barriers, especially cost, prevent wider access to treatment

couples therapy

Verywell / Madelyn Goodnight

People in couples therapy are nearly unanimous in their belief that it helps strengthen their relationship, but issues like cost and availability are leading many to miss out on the benefits, a new Verywell Mind survey of 1,106 US adults who are living with their partner found.

Among respondents who are in couples therapy, 99% say it has had a positive impact on their relationship, and three out of four (76%) say it has a high or very high impact. Despite a hefty price tag of over $300 a month on average, 94% say it is worth the investment and 83% say it is a priority in their relationship.

In fact, most couples who stopped therapy did so because it worked.

Only 37% of adults surveyed, however, had been to couples therapy at any point in the past, and only 10% were currently in couples therapy.

Despite its apparent value, relatively few couples go to therapy together. There's no one-size-fits-all for a happy relationship, but the near unanimous approval of couples therapy by those who know its effects is eye-opening.

When Do Couples Decide to Seek Therapy?

There are certain stigmas around the idea of seeking individual therapy—namely that it suggests you have a mental health "problem". Couples therapy may carry a similar stigma, in that many believe it is only for couples who are dealing with serious relationship issues like infidelity, abuse, dishonesty, or other toxic behaviors.

Just as seeking individual therapy may or may not be tied to a clinical mental health diagnosis, getting couples therapy doesn't have to mean your relationship is in trouble:

  • 34% of cohabiting US adults in couples therapy started going to couples therapy before marriage
  • 18% proactively sought out therapy before issues arose
  • 75% say that both partners agreed to do couples therapy

COVID was a major decision point for couples, with 88% saying they started during the pandemic and many citing its related stressors as part of their decision to seek help.

56% attend both in-person and online, the latter matching the growing trend of online therapy providers.

Couples May Regret Not Starting Sooner

Many couples do seek therapy somewhat early in the relationship:

  • 1 in 3 (36%) say they started discussing couples therapy within the first 3 years of the relationship
  • 35% started couples therapy before moving in together 
  • 34% started couples therapy before getting married

That said, most couples don't follow this path. The median couple started therapy 4 years into the relationship, and 14% had been together for over 10 years before discussing couples therapy. Results suggest many feel they shouldn't have waited so long:

  • 68% of cohabiting couples—and 88% of those in couples therapy—feel that it’s best to start couples therapy before there are serious problems
  • 62%—and 91% of those in couples therapy—say that people would have better relationships if they were more open to therapy

The survey results suggest a lot of couples may feel that proactive therapy would have helped prevent issues they are dealing with deeper into the relationship. Couples therapy is—in large part—designed to provide strategies to improve your communication, help you understand where your partner is coming from, and help you and your partner be more aware of each other's triggers.

These are things any couple could benefit from—not just those facing serious issues. The versatility of couples therapy can be seen in the wide variety of therapy types that respondents had tried:

Why More Couples Aren't in Therapy

Even if interest in preemptive couples therapy were higher, it's not always as simple as agreeing to try it. Cost and accessibility remain significant barriers for many people, making therapy an extra expense of time and money that cannot be spared. 75% of people in couples therapy say they have access to insurance that helps cover costs.

Therapy-goers tend to have higher income and are more likely to be employed full-time and have a Master's degree. Nearly 1 in 4 (22%) cohabiting US adults who aren't in couples therapy have considered it, but faced obstacles that made it difficult or stopped them altogether.

Barriers to Therapy

  • 38% of those who considered therapy found it to be too expensive to go
  • 32% said they didn't go because their partner didn't want to
  • 20% didn't go because it was too inconvenient
  • Among people in couples therapy, 1 in 3 said it was difficult to find a therapist

It can be complicated enough to find a suitable individual therapist, but couples therapy can be even more complex—the provider needs to be a fit for both partners. When that match is made, however, the benefits are apparent. Most couples tend to stick with therapy for awhile, cost-permitting:

  • 36% have been in couples therapy for over a year
  • 61% intend on attending couples therapy for up to another year
  • 67% attend couples therapy 2-4 times per month

Cost and accessibility aside, certain ideas around what couples therapy means for a relationship may play a part in limiting the number of people who try it:

  • 21% of all respondents—and 32% in couples therapy—say that couples in therapy are likely to break up
  • 56% say couples therapy is for very serious problems

If you don't want to acknowledge serious issues in a relationship, you may tend to avoid therapy.

Relationships Can Benefit From Individual Therapy Too

While couples therapy is most directly focused on relationship issues, we found that individual therapy can also have a major positive impact on a partnership. 1 in 3 (36%) who are in couples therapy are also in individual therapy, many of whom (29% of those in couples therapy) say they were in individual therapy before starting couples therapy:

  • 56% say that their partner started therapy during the relationship
  • 41% encouraged their partner to start therapy 
  • 57% say their partner’s therapy has had a high impact on their relationship
  • 90% say their partner's therapy has had a positive impact on their relationship

For the most part, the feedback around therapy for both individuals and couples is convincingly positive. But the vast majority of couples in the survey, despite aspirational views of therapy, either don't seek it out or don't follow through.

Whether it's due to cost, time constraints, a dearth of compatible therapists, or simply personal choice, the number of people benefiting from couples therapy appears far fewer than the number of people who could benefit.


Verywell Mind surveyed 1,106 US adults aged 18+ from January 4th to 12th, 2023 who are living with their partner/significant other. The survey was fielded online via self-administered questionnaire to an opt-in panel of respondents from a market research vendor. Quotas were used to ensure representation to match U.S. Census estimates for gender, race/ethnicity, region and LGBTQ+ individuals.

By Nick Ingalls, MA
Nick Ingalls, MA is the associate editorial director at Verywell Mind, managing new content production and editorial processes. He has been with Verywell since its inception in 2016.

Research and analysis by
Amanda Morelli,
Amanda Morelli

Amanda Morelli is the senior director of data journalism at Dotdash Meredith. She has over 10 years of research experience and assists with data visualization and analysis.

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Neetu Gupta,
Neetu Gupta

Neetu Gupta is the Director in the Corporate Research & Insights team at Dotdash Meredith. She leads a team of survey programmers, data analysts, panels managers, and researchers

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Sanskriti Sharma
Sanskriti Sharma

Sanskriti Sharma is a Manager in the Consumer Strategy & Insights team at Dotdash Meredith.She helps in executing consumer insight projects for multiple Dotdash Meredith brands by converting data into actionable insights that help simplify brand decisions.

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