If your relationship is stuck in repeated fights and cold silences, go to couples therapy together: waiting around will basically not fix it by itself

Cost

It costs money. It is charged per session, which differs by place and hospital, and this item gives no figure. In the studies people generally went once a week, and one trial ran for about 8 months. The hard part is that both must go, and must keep going to the end.

What you get

A 2020 meta-analysis pooled 58 studies and 2,092 couples. After couples therapy, the before-and-after change in relationship satisfaction was g = 1.12 (range 0.92–1.31), which the authors call a large effect. g is an effect size; see the README glossary. For couples assigned to a waiting list, the same period gave g = 0.12 (−0.04 to 0.29), with no clear improvement. The worse the relationship at the start, the more it improved. A 2012 review states that couples therapy improved things for 70% of the couples treated. Another randomized trial recruited 134 couples in long-running, serious distress and gave them about 8 months of two kinds of behavioral couples therapy. At the end the changes in satisfaction were d = 0.90 and 0.71. By year 5, 50.0% and 45.9% of couples under the two approaches still showed clear improvement. By clear improvement the authors mean "clinically meaningful improvement." At the same time, 25.7% and 27.9% had separated or divorced

Notes

The dispute is how long the effect lasts. In another meta-analysis that included only randomized trials, g was 0.60 at the end and 0.44 six months later. At 12 months only behavioral couples therapy had data, with g = 0.06, so almost nothing was kept. Another review pooling 20 meta-analyses says clinically meaningful effects appear in 40% to 50% of people. "70% improved" and "four to five in ten clearly improved" use different standards, so don't compare them side by side. The 5-year trial had no untreated control group, so it cannot say whether divorce became more or less common. The 2020 pooled analysis was all heterosexual couples, and no randomized trial from China was found for this item either, so discount this when applying it to yourself. Where to go in China: the Mental Health Law (精神卫生法) provides that psychotherapy must be done in a medical institution, and psychological counselors may not carry out psychotherapy. You can ask a hospital's psychiatry or psychology department whether it offers couples therapy. If you look for a provider outside a hospital, first ask about their qualifications and what training they have had. If there is domestic violence, don't do it together at first. The 2016 meta-analysis states that its conclusions apply only to mild to moderate cases where both sides turn to violence in a conflict. Violence marked by controlling the other person and serious harm is not included. The field also worries about retaliation at home after the session. If you are being hit, see §8.43 (experiencing domestic violence) first. For how to talk when arguing, see §10.17 (argue about the issue, not the person), and to think through whether to leave, see §10.15 (the cost of getting out). The beneficiary is you and your spouse.

Evidence grade

A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.

Sources

1. Roddy MK, Walsh LM, Rothman K, Hatch SG, Doss BD (2020). Meta-analysis of couple therapy: effects across outcomes, designs, timeframes, and other moderators. Journal of Consulting and Clinical Psychology, 88(7), 583-596. https://doi.org/10.1037/ccp0000514
2. Lebow JL, Chambers AL, Christensen A, Johnson SM (2012). Research on the treatment of couple distress. Journal of Marital and Family Therapy, 38(1), 145-168. https://doi.org/10.1111/j.1752-0606.2011.00249.x
3. Christensen A, Atkins DC, Baucom B, Yi J (2010). Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology, 78(2), 225-235. https://doi.org/10.1037/a0018132
4. Rathgeber M, Bürkner PC, Schiller EM, Holling H (2019). The efficacy of emotionally focused couples therapy and behavioral couples therapy: a meta-analysis. Journal of Marital and Family Therapy, 45(3), 447-463. https://doi.org/10.1111/jmft.12336（争议方）
5. Shadish WR, Baldwin SA (2003). Meta-analysis of MFT interventions. Journal of Marital and Family Therapy, 29(4), 547-570. https://doi.org/10.1111/j.1752-0606.2003.tb01694.x（争议方）
6. Karakurt G, Whiting K, van Esch C, Bolen SD, Calabrese JR (2016). Couples therapy for intimate partner violence: a systematic review and meta-analysis. Journal of Marital and Family Therapy, 42(4), 567-583. https://doi.org/10.1111/jmft.12178
7. 全国人大常委会 (2018 修正). 精神卫生法（第二十三、五十一条）. https://flk.npc.gov.cn/detail?id=2c909fdd678bf17901678bf7448a066d（国家法律法规数据库）

Translated from the Chinese original. Original book, section 10, tip 20. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer