What to expect from your first couples therapy session

What to expect before your first session

Once you schedule your appointment, you may have a little prep work to do before you walk into that first session. In most cases, your therapist will send you intake paperwork that includes questions about your relationship and your goals for therapy—which each person in the partnership should fill out honestly and on their own.

Here are some example intake questions that Marino’s practice lists on their questionnaire:

• How would you describe your relationship status? Tell us how long you’ve been together.
• What brings you both to counseling at this time? Is there something specific, such as a particular event?
• Have you been in therapy before?
• What do you hope to accomplish in couples counseling?

Marino also suggests coming prepared with any questions you want to ask the therapist about what type of therapy modalities they use, their style, and how they structure sessions. This can help ensure you feel comfortable having vulnerable conversations with them.

It also helps to approach couples therapy with an open mind rather than a personal agenda. “It’s important to come to that first session knowing that there is no one winner of couples therapy,” says Christine Myers, licensed marriage and family therapist and director of clinical strategy at Thriveworks. Oftentimes, people want to convince the therapist why they’re right and their partner is wrong, she says, but that’s not a recipe for success.

“The most successful couples therapy is when the two partners join together against the problem,” Myers adds. Going into it with that “us against this common problem” mindset, “reduces those feelings of defensiveness and that need to be right, and really allows the couples to be vulnerable and each take ownership of their part in the problem.”

What happens in the first couples therapy session

For your very first session, don’t expect to dive deep into your most pressing relationship concerns. “Typically, the first session focuses on gathering historical information,” Myers says. That might include things like your past experiences, current stressors, and even any medical issues that could be impacting how each of you show up in the relationship.

“It’s really valuable to the clinician to be able to get a broad picture of all of the pieces that are at play that could be influencing the couple’s dynamic,” Myers says. For example, your therapist may ask if there’s a history of divorce in your family, or what examples of relationships you have witnessed. “Both parties bring their own suitcase to therapy, so it’s important for the couples therapists to to understand what’s in those suitcases,” says Myers.

They might also ask about your beliefs about marriage before you met your partner—was marriage something that you saw for yourself in the future, or not? Marino says she also asks couples to tell her about a healthy relationship that comes to mind in their lives, past or present. Additionally, she asks each person to describe their conflict style, and then lets the other partner provide any feedback or additional insight.

“My next question is probably my favorite question because I learn so much about them, but I have each partner tell me what their first impression was of the other,” Marino says. This allows her to collect some interesting intel and may even reveal to the other partner something they never knew before. If nothing else, it usually allows the couple to reminisce on a different, happier time.

After gathering some background info, the therapist will ask both partners to briefly explain what brings them to therapy and what they hope to get out of it, Myers says.

As far as the format, you’ll typically stay with your partner the whole time. Meeting solo with your couples therapist isn’t common, Myers says, since this can fuel accusations of favoritism. “Typically with couples therapy, if a therapist is meeting one-on-one with an individual, it’s very brief, potentially maybe one session, and very specific and tied back to an overall treatment goal,” she explains. For instance, some therapists choose to break the second session into two 30-minute individual sessions to screen for unhealthy dynamics and signs of domestic abuse.

“I try to make it clear that there’s a no secrets policy and I’m not collecting information that the other person won’t know about,” Marino says. However, she says, this gives her a chance to look for signs of violence and provide resources that a person may need.

Ultimately, your therapist will use the first session to establish their office as a safe space where you can both be vulnerable, and assess how ready you are for couples therapy, Myers says. “What differentiates couples therapy from individual therapy is that in order for it to really be successful, you need buy-in from both partners.”

What to expect after the first session

By the end of the first session, you can expect to have at least some insight on your goals for therapy and what comes next, says Myers. That might include:

• How frequently you’ll be meeting
• What you’ll be focusing on in the next session
• If there’s any homework or things to think about/prepare before the next session
• Any other services your therapist might recommend, such as trauma-focused individual therapy if one person has a history of trauma

“Hopefully you should leave that first session feeling like your therapist understands what’s going on and that there are clear next steps about what you’re going to focus on in the next session to help you towards your goal,” Myers says.

It’s also normal to walk away from that first session feeling like you have what Myers calls a “feelings hangover.” In fact, Marino says, “you will probably feel worse” than when you first walked in. It makes sense: You just allowed yourself to be vulnerable, and maybe your partner’s honest thoughts and feedback aren’t sitting well with you. It’s part of the process and something worth talking about—with your therapist and your partner.

Myers advice? “Saying, ‘Hey, we’re both committed to this process and working together,’ can help reduce some of those feelings of anxiety or overwhelm.”

How to get the most out of couples therapy

Don’t expect to have answers right away.

“The problem isn’t going to be solved at the end of the first session,” Myers notes. Hopefully you’ll have at least identified the problem and next steps, but resolving whatever brought you to therapy will take time and work. “A therapist’s job is to help you take the pieces [of the problem] and sort them out,” Myers says. They won’t be solving the puzzle for you, but they can help you see things from another angle and identify any patterns or obstacles that might be keeping you stuck.

In fact, you may never completely resolve some issues, Marino says. Sometimes couples have “gridlock conflict,” she says, which means it’s recurring and doesn’t necessarily have a clean resolution. In those cases, therapy is more about figuring out how to talk about it, make room for the other person, and repair after talking about it. “I know that’s hard to sit with, but I think it’s also hopeful to know that you’re not doomed just because you can’t solve this.”

Own your part of the problem.

For couples therapy to work, you need to be honest with yourself and the role you might play in whatever relationship dynamic you’re dealing with. “Again, the goal in couples therapy is to partner with your partner to address the issue, but you have got to own your part in the problem,” Myers says. It’s uncomfortable to analyze your behavior and admit that something you did or said was wrong, she says, but it’s crucial for moving toward that ultimate goal of attacking the problem as a team.

If something feels off, speak up.

Your therapist should never play favorites or take sides, but sometimes, it may feel like they are listening to your partner more or subtly agreeing with them. “If you’re feeling something, you should say it so it’s out in the open because it may be that the therapist doesn’t realize it in the moment,” Marino says.

“The dynamic of having three people in the room is always going to be a delicate balance,” adds Myers. In general, if you feel like you’re not being heard, it’s always appropriate to speak up and advocate for yourself. A good therapist will take that feedback to heart.

Check in with your partner after.

If you walk away from a session feeling uncomfortable or overwhelmed or sad, Myers suggests debriefing with your partner. “It’s a great opportunity to practice the skills that you’re learning in therapy,” she says. “Check in and see how they felt it went. If there is a concern, maybe jot it down and review that prior to the next session.” Any opportunity for open, honest communication can only help you on this journey.

Marino also encourages couples to have a post-therapy ritual, such as going out for pizza or ice cream afterward, that helps provide closure and reconnection. “I have found that that feels maybe like a more settled place to end, especially after the first session.”

Ask your therapist for help processing.

It’s normal to feel emotionally drained or hurt after a couples therapy session, Myers says. She recommends communicating with your partner about how you feel and, if it persists, bring it up in the next session.

“Let the therapist be a support to help you navigate that,” she says. They can do things like checking in at the beginning and end of each session to see how each person is feeling, what was hard to hear, and what was helpful. This can all help you walk away at the end feeling like you’ve processed your emotions and can sit with them more comfortably until next time.

Give yourself grace.

Couples therapy is vulnerable and can be very intense and emotional. “Remember that it’s going to take a couple sessions to really start to feel comfortable and to feel progress, and give yourself permission to feel what you’re feeling,” Myers says. If it feels overwhelming, then it probably was. Validate yourself and know that whatever emotions are swirling right now are legitimate and part of the process.

“At the end of the day, there’s such a vulnerability to people coming in and admitting that they need help with probably the most important relationship in their life,” Marino says. “It says a lot about you as a person that you are really investing in wanting to feel close to another person in a safe and respectful way.”

Frequently asked questions (FAQs)

How do I prepare for couples therapy?

Your therapist will likely send you an intake form or questionnaire to fill out ahead of time that asks questions about your history with therapy, your relationship, and what you hope to get out of couples therapy. Besides that, the best way to prepare is having an open mind and remembering that you’re there to work with your partner to resolve whatever issues you have, not for one person to “win” or be deemed “right.”

Do couples therapists take sides?

No, they’re not supposed to. A couples therapist is meant to be more like a coach than a referee. If it feels like your therapist is giving the other person more time to speak or are validating them more, it’s important to say something. Likely, the therapist doesn’t realize it and will appreciate the chance to course correct.

Is it normal to feel worse after couples therapy?

Yes, it’s normal to walk away from couples therapy feeling overwhelmed or like your feelings are a little hurt. Talking with your partner afterward can help you process. If you can’t shake the negative feelings a few days later, bring it up at your next session. Your therapist can give you tools for processing therapy so that you don’t feel so bad afterward.

How long does couples therapy usually take?

A couples therapy session is usually an hour long. Depending on your situation and treatment goals, you may go weekly, every other week, or even just once a month if you’re at a point where you’re strengthening your skills and connection and would just like a regular opportunity to reflect and make sure you’re still on track.

What if my partner doesn’t want to go to couples therapy?

Exploring why your partner is resistant can help you find a creative solution. For example, if they are afraid the therapist you chose will take your side, suggest they pick someone instead. It can also help to suggest attending just one to three sessions, which can feel more doable than making a months-long commitment.

What’s the difference between couples therapy and individual therapy?

Couples therapy is about addressing issues in your relationship, not individual concerns. It’s about working together to tackle a problem or issue. If you need help processing personal emotions, traumas, stressors, or things in your past that are affecting you in your relationship, individual therapy is a great tool to use alongside couples therapy.