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9,721 people sought marriage counseling help in California in the last year

Discover how starting marriage counseling can support your own journey toward a happier, more fulfilling life.

Meet with a provider as soon as this week

Our therapists in San Francisco are booked, but we have 11 other therapists in CA available for an online or in-person session.

Starting Marriage counseling

What is Marriage counseling?

Marriage counseling, also known as couples therapy and relationship counseling, helps couples work through their specific relationship issues. Thriveworks marriage counseling in San Francisco, CA is led by licensed professionals — often licensed marriage and family therapists (LMFTs) — who are experts in their field and best-equipped to help couples. Some examples of common focuses within Marriage counseling include:

  • Jealousy
  • Trust issues
  • Infidelity
  • Opposing values
  • Different visions for the future
  • Disagreements in parenting
  • Lack of trust
  • Financial distress
  • Sex issues

How does Marriage counseling work?

Marriage counseling works by helping couples identify and better navigate their unique challenges. Following an initial assessment of the couple in terms of strengths and needs, the therapist would then discuss their therapeutic goals and any possible approaches or ways of working together as therapist and couple.
Couples attend sessions together, whether they meet in person or by video. In addition to regular marriage counseling sessions, each partner may also be asked to attend a few individual sessions to supplement their progress. This will allow their counselor to get to know each individual better, assess each of their personal needs, and develop the very best treatment plan moving forward.

Is Marriage counseling conducted in person or online?

Marriage counseling at Thriveworks is conducted both in person and online by video. We encourage you to choose the option that works best for you and your partner.

How long does Marriage counseling last?

On average, couples attend marriage counseling for 12 weeks. However, marriage counseling may last longer or shorter, dependent on the couples' needs, the challenges they'd like to work through, and the pace of their progress. Marriage counselors and therapists at Thriveworks in San Francisco, CA work with their clients to create goals, decide on ideal timelines, and establish treatment plans.

Need more help deciding?

Something has changed. Your marriage is not how it was a year ago or three years ago or five years ago. When did the shift start? It may be hard to say when it started. It may also be hard to say what exactly changed. But you feel it. Intimacy was once easy and sweet. Conversations once flowed. Now, some interactions with your spouse leave you feeling confused. Others leave you angry and upset. Others leave you feeling nothing at all. Maybe you never thought this would happen to you and your spouse. Sure, your wedding vows included a promise to love each other “in good times and bad, in sickness and health, for richer or poorer.” You just never knew there would be so many hard times. What is next? Is this marriage worth saving or is it time to part ways? Many spouses are experiencing relational problems and asking these difficult questions. Many spouses are also working with a marriage counselor to help them find their answers.

“Marriage is not a noun; it’s a verb. It isn’t something you get. It’s something you do. It’s the way you love your partner every day.”
—Barbara De Angelis

The divorce rate for first marriages is intimating—40 percent. The rates for second and third marriages are even more so. And yet, when some couples hit difficult patches, they work through those challenges. You and your spouse are the only ones who can decide what the next right step is for your marriage, but if you are struggling and you want help, know that many spouses are going to marriage therapy to work toward a healthier relationship—whether the marriage continues or not.

The marriage therapists at Thriveworks San Francisco understand that being in a relationship can be difficult. Everyone has struggles. Spouses often need help, and that is why we offer marriage counseling.

Should We Start Marriage Counseling?

There are any number of issues why spouses start marriage counseling. The decision to start therapy is often personal, and there are no right or wrong reasons to begin. In fact, if you are even considering going, it may be a sign that marriage counseling might help. Here are a few of the reasons some couples have chosen to reach out for help…

1) There has been cheating.

    • If someone in the marriage has committed adultery, marriage therapy may be a good idea. Cheating is often an emergency. It is often the relational equivalent of a heart attack, and often, intervention is needed. Some spouses try to reconcile and rebuild trust and intimacy. Others decide to divorce. In either case, a marriage therapist may be able to keep the process as healthy as possible.

2) One or both spouses are trying to change each other.
No one is perfect, and in healthy relationships, each individual takes responsibility for their own growth. Relationships can become toxic when people are trying to change each other, and this harm can be magnified within a marriage. If spouses are not taking responsibility for their own improvement or if spouses are trying to change each other, it may be time for a relational expert to each them a better way.

3) Arguments happen all the time, or arguments never occur.
Relational experts often talk about marriage’s golden ratio. That is, happy spouses have five positive interactions for every one negative interaction. Both sides of this ratio are important. When couples are arguing all the time, they may need to grow in their conflict resolution skills so that issues can be issued directly and resolved. There may also be an underlying issue that is causing excessive tension. When couples never argue, one spouse may be dominating the other. One spouse’s perspective, feelings, needs, and thoughts may be swept under the rug. Neither arguing too much or never arguing is healthy for a marriage.

Working for a Healthier Relationship

You and your spouse may be facing one of these problems. You may be facing a different challenge. Whatever may be the case, many couples wonder how marriage therapy could help. Here are a few practical ways that marriage counseling may help you and your spouse establish a healthier relationship:

  • Helping spouses recognize toxic patterns. Certain ways of relating are more harmful than others. When spouses become aware of toxic patterns and when they are open to change, they can often learn new ways of connecting.
  • Setting sensible expectations for growth. People rarely change over night. It takes time to implement sustainable growth. Yet, growth needs to occur. Marriage therapist can often tell when spouses are stalling and when they are growing slowly.
  • De-escalating conflict. Conversations about heated topic can easily escalate into personal attacks. Marriage therapists can often help spouses have difficult conversations in a productive manner.
  • Advocating for each individual. Each individual within the marriage matters. Each spouse’s needs and preferences and feelings should be honored. Marriage counselors do not just advocate for the relationship but also each individual within the relationship.

Marriage Therapy Appointments at Thriveworks San Francisco

If you and your spouse are struggling, you are not alone. No relationship is perfect. If you are ready for help, you are not alone. Many spouses go to marriage counseling. Considering reach out to Thriveworks San Francisco. When you call for an appointment, you may be meeting with your therapist the following day. We offer evening and weekend appointments, and we accept many insurance plans. Call today.

Pricing & insurance

Our therapists accept most major insurances. We cover 180 million Americans – and offer self-pay options, too.
Learn more about pricing for therapy and counseling services at Thriveworks.

Our San Francisco therapists and counselors accept 23 insurance plans

  • Aetna

  • Blue Shield of California | BCBS

  • Cigna | Evernorth

  • Cigna | Evernorth EAP

  • Cigna | Evernorth Medicare Advantage

  • Compsych

  • First Health Network

  • Humana Exchange

  • Humana HMO/POS

  • Humana PPO/EPO/HDHP

  • Imperial Health Plan Medicare Advantage

  • JP Farley Corporation

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Self-pay costs at San Francisco
Talk therapy

Talk therapy

Includes individual, couples, child/ teen, & family therapy

First session


Ongoing sessions


Talk therapy


Includes reducing symptoms with medication & management

First session


Ongoing sessions


Hear from our clients

5.0 Learn about verified reviews
My entire experience so far has been great.. both my psychiatrist and therapist have been a good fit in my treatment.. I am learning new skills with each visit, and gain a little more insight as well.. the convenience of having video visits is an added plus since my anxiety keeps me from driving right now.
Read more My entire experience so far has been great.. both my psychiatrist and therapist have been a good fit in my treatment.. I am learning new skills with each visit, and gain a little more insight as well.. the convenience of having video visits is an added plus since my anxiety keeps me from driving right now.
Joe Feb 2024 verified review

Where to find us

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Getting here

Thriveworks Counseling & Psychiatry San Francisco is located in the same building as Sport Healing & Massage Arts, Tylovastein Hana Hyde Street Community Service, Tenderloin Outpatient Clinic, Olay Spa, California Center for Sleep, and many other businesses. We are located at the intersection of Sutter Street and Hyde Street. Across the street is Ace’s sports bar and Dignity Health Medical Group. Colombini Bistro and Crostini & Java are also next door to our office.

Phone number

(628) 266-4525

Languages spoken by CA providers

  • Russian
  • English
Sunday 8:00am - 9:00pm
Monday 8:00am - 9:00pm
Tuesday 8:00am - 9:00pm
Wednesday 8:00am - 9:00pm
Thursday 8:00am - 9:00pm
Friday 8:00am - 9:00pm
Saturday 8:00am - 9:00pm

Shown in PT

Sunday 8:00am - 5:00pm
Monday 7:00am - 9:30pm
Tuesday 7:00am - 9:30pm
Wednesday 7:00am - 9:30pm
Thursday 7:00am - 9:30pm
Friday 7:00am - 9:30pm
Saturday 7:00am - 6:00pm

Shown in PT