Choosing a Couples Therapist: Credentials and Questions to Ask

Choosing a couples therapist can feel like a test you have to pass before the real work even starts. You are trying to find one person both of you can trust, who has the right training, fits your schedule and budget, and will not quietly side with one of you.

The good news is that the decision gets much easier when you break it into parts: understand the credentials, check the license, gather a short list, and use a first conversation to ask a handful of specific questions. None of this requires you to know anything about therapy models in advance.

This guide walks through each step. It is general information to help you prepare; the therapist you choose is the right person to advise on your specific situation.

Know the credentials you will see

Licensed professionals from several fields work with couples. The U.S. Bureau of Labor Statistics (BLS) says all states require marriage and family therapists to be licensed, and that licensure requires a master's degree, a state-specified number of hours of postdegree supervised clinical experience, a state-recognized exam, and annual continuing education.

The National Alliance on Mental Illness (NAMI) describes other licensed professionals who provide therapy:

• Psychologists, who hold a Ph.D. or Psy.D. and are licensed by boards in each state.
• Master's-level counselors and therapists, with licenses such as LPC (Licensed Professional Counselor) and LMFT (Licensed Marriage and Family Therapist).
• Clinical social workers, who hold a master's degree in social work and licenses such as LCSW (Licensed Clinical Social Worker) or LICSW (Licensed Independent Social Worker).
• Psychiatrists, who are medical doctors and can prescribe medication as well as provide therapy.

NAMI cautions that job titles and specialties vary by state. A license tells you someone met their state's minimum standards; it does not tell you whether they have much experience with couples. That is something to ask about directly.

Be careful with unregulated titles. "Relationship coach," "intimacy expert" and similar labels do not, on their own, indicate a clinical license. A coach may be a fine fit for skill-building, but for serious distress, mental health concerns or a relationship in crisis, look for a licensed clinician.

Verify the license

Once you have a name, check with the licensing board for that profession in your state to confirm the license is active and in good standing. For marriage and family therapists, the BLS points to CareerOneStop for information on state licensing board requirements.

If you plan to meet virtually, ask which state or states the therapist is licensed in, and confirm that covers where you will be during sessions.

Build a short list

NIMH suggests several places to look:

• Directories from professional organizations, including the American Association for Marriage and Family Therapy, the National Association of Social Workers and the National Register of Health Service Psychologists. NIMH notes it does not evaluate the practitioners listed.
• Your health insurer's list of participating mental health professionals.
• Training clinics affiliated with universities or medical schools, often run through psychiatry or psychology departments.
• Your state or county health department, which may offer mental health programs.

Aim for two or three candidates. Talking with more than one makes it easier to notice who actually fits.

Questions to ask in the first conversation

NIMH recommends a preliminary conversation before you commit, noting that "Rapport and trust are essential." These questions adapt NIMH's list for couples:

1. What are your credentials, and how much of your work is with couples? Do you have a specialty?
2. What approach do you use, and why? What is the evidence behind it?
3. How do you set goals with a couple? Do you recommend a time frame or number of sessions, and how will we know if it is working?
4. What happens if one or both of us feel we are not improving?
5. How does confidentiality work, and what are its limits? If one of us tells you something privately, how do you handle it?
6. What are your fees? Do you take our insurance, and do you offer a sliding scale based on income?
7. Do you offer sessions in person, virtually or both?

Add one more that matters a great deal: How do you check for abuse or safety concerns before and during couples work? The National Domestic Violence Hotline points out that a therapist who does not know abuse is present may be misled by the abusive partner, which can make couples work ineffective. A careful therapist will have a thoughtful answer.

Judge the fit, together

After the first conversation or session, compare notes privately. Some useful questions to ask each other:

• Did we both feel heard, or did one of us do most of the talking?
• Did the therapist seem even-handed, rather than quickly deciding who was "right"?
• Could we understand their explanation of how they work?
• Do we feel more hopeful, or just more tired?

It is normal for early sessions to feel uncomfortable. Talking honestly about painful topics is hard. What you want to avoid is a therapist who makes either of you feel dismissed, judged or unsafe. If the fit is not there, it is fine to say so and try someone else. NIMH notes that if therapy has gone on for what feels like a reasonable time without improvement, it is worth talking with your therapist and possibly exploring other professionals or approaches.

Warning signs

These are reasons to keep looking:

• Promises of guaranteed results, or a fixed outcome such as "we will save your marriage."
• Reluctance to explain their training, license or approach.
• Calling their service "therapy" when they are not licensed to provide it.
• Brushing off questions about safety, confidentiality or cost.
• Consistently taking one partner's side, or dismissing either partner's concerns.
• Pressure to pay for a large package of sessions up front.

When to look for different help first

Couples counseling is not recommended when one partner is abusive. The National Domestic Violence Hotline says it does not encourage anyone in an abusive relationship to seek counseling with their partner. If you are afraid of your partner, contact the Hotline at 1-800-799-7233 (or text START to 88788) to talk with an advocate, who can also help you think about individual counseling. If you or your partner are in crisis or having thoughts of suicide, call or text 988.

If one partner is struggling with depression, anxiety, substance use or another individual concern, individual care from a licensed professional may be needed alongside, or before, couples work. For background on what sessions involve, see our guide Couples Counseling Explained: What It Is and How It Works.

Key takeaways

• Licensed marriage and family therapists, psychologists, counselors and clinical social workers may all work with couples; titles and licenses vary by state.
• Verify any license through your state's licensing board before your first session.
• Build a short list from professional directories, your insurer, university training clinics or your local health department.
• Use a first conversation to ask about couples experience, approach, goals, confidentiality, cost and how the therapist screens for safety.
• Walk away from guarantees, evasiveness about credentials or approach, and anyone who makes either of you feel unsafe.

Sources

• National Institute of Mental Health, Psychotherapies
• U.S. Bureau of Labor Statistics, Occupational Outlook Handbook: Marriage and Family Therapists
• National Alliance on Mental Illness, Types of Mental Health Professionals
• National Domestic Violence Hotline, Should I Go To Couples Therapy With My Abusive Partner?
• National Domestic Violence Hotline, Counseling for Domestic Violence Survivors