Do I need Couples Therapy or Individual Therapy?
"Should we do couples therapy or should I come alone?" This question comes up frequently in my Seattle practice, often loaded with hope, fear, and confusion. The answer isn't always straightforward, sometimes you need couples therapy, sometimes individual, sometimes both, and sometimes individual work is the path to better relationships. Let me help you understand the differences and make an informed choice.
Understanding the Fundamental Differences
Individual Therapy Focus
Centers On:
Your personal growth
Individual patterns
Internal experience
Personal history
Self-development
The Work Involves:
Understanding yourself
Healing your wounds
Changing your patterns
Building self-awareness
Developing tools
You are the client.
Couples Therapy Focus
Centers On:
The relationship system
Interaction patterns
Communication dynamics
Shared goals
Mutual growth
The Work Involves:
Improving communication
Understanding cycles
Building intimacy
Resolving conflicts
Creating partnership
The relationship is the client.
When Individual Therapy Is the Answer
Personal Issues Affecting Relationship
Individual Therapy If:
Depression impacting partnership
Anxiety creating problems
Trauma affecting intimacy
Addiction present
Personal crisis occurring
Work on yourself to help relationship.
Not Ready for Couples Work
Choose Individual When:
Considering leaving
Affairs ongoing
Abuse present
Partner unwilling
Need clarity first
Sometimes you need your own space first.
Growth Benefits Partnership
Individual Work Helps When:
Codependency patterns
People-pleasing habits
Boundary issues
Self-esteem problems
Identity questions
Healthier individuals create healthier relationships.
When Couples Therapy Is Needed
Relationship Patterns Stuck
Couples Therapy For:
Same fights repeating
Communication breakdowns
Intimacy disappeared
Trust broken
Distance growing
The system needs attention.
Shared Goals
Work Together On:
Rebuilding after affair
Navigating major transitions
Parenting alignment
Improving intimacy
Strengthening connection
Some things require both people.
Prevention and Enhancement
Couples Therapy Also For:
Premarital preparation
Relationship tune-ups
Preventive maintenance
Deepening connection
Growing together
Not just for crisis.
When You Need Both
Common Scenario
Many Benefit From:
Individual therapy for personal issues
Couples therapy for relationship
Coordinated approach
Different therapists
Complementary work
Example: Individual: Processing childhood trauma Couples: Improving communication patterns Result: Both healing simultaneously
Sequencing Options
Path 1:
Start individual
Gain stability
Add couples
Continue both
Adjust as needed
Path 2:
Start couples
Identify individual needs
Add personal therapy
Work parallel
Integrate learning
The Gray Areas
When It's Not Clear
Consider These Questions:
Is the problem mine or ours?
Would this exist without partner?
Do I know what I want?
Is partner willing to work?
What's my primary goal?
Relationship Issues in Individual Therapy
You Can Work On:
Your relationship patterns
Your communication style
Your attachment issues
Your part of dynamics
Your choices
But can't change partner from individual therapy.
Individual Issues in Couples Therapy
Sometimes Addressed:
How depression affects relationship
Trauma's impact on intimacy
Anxiety in partnership
Individual growth needs
Personal development
But depth limited in couples format.
Common Misconceptions
"Couples Therapy Means We're Failing"
Actually:
Shows commitment to growth
Demonstrates care
Preventive and wise
Strength not weakness
Investment in future
Successful couples do therapy too.
"Individual Therapy Is Selfish"
Actually:
Benefits whole system
Models self-care
Brings better self
Reduces projections
Healthier for everyone
Oxygen mask principle applies.
"Therapist Will Take Sides"
In Reality:
Individual: Your advocate
Couples: Relationship advocate
No villains or heroes
Systems perspective
Everyone responsible
Different roles, not sides.
Making Your Decision
Start Individual If:
You Need:
Personal clarity
Individual healing
Self-understanding
Boundary development
Identity work
Or If:
Partner refuses therapy
Abuse is present
Addiction active
Affair ongoing
Safety concerns
Start Couples If:
You Both:
Want to improve
Commit to process
Feel stuck together
Share goals
Ready to work
And:
Both relatively stable
Safety established
Willingness present
Hope exists
Investment mutual
Special Considerations
When Individual Therapy Threatens Partner
Common Dynamic:
Partner fears being blamed
Worried about changes
Feels excluded
Jealous of therapist
Scared of growth
Address By:
Reassuring commitment
Sharing appropriately
Including when possible
Staying connected
Being patient
When One Partner in Therapy
Can Create:
Growth imbalance
Power shifts
Communication gaps
Different paces
Relationship stress
Navigate By:
Open communication
Patience with process
Eventually both engaging
Couples work perhaps
Trust in journey
Practical Considerations
Insurance Coverage
Typically:
Individual: Usually covered
Couples: Often not covered
Diagnosis required individual
Relationship issues excluded
Check your benefits
Finding Therapists
Different Specializations:
Individual generalists common
Couples specialists fewer
Different training required
Not all do both
Referrals available
Time and Cost
Consider:
Individual: One schedule
Couples: Two schedules
Session length differences
Frequency needs
Total investment
My Practice Approach
What I Offer
Individual Therapy:
Personal depth work
Trauma resolution
Relationship patterns
Self-development
Your journey
For Couples Work:
Trusted referrals
Coordination possible
Support transition
Continued individual
Integrated approach
Making Progress Either Way
Remember:
Both paths valid
Both create change
Both require courage
Both offer hope
Both can transform
The best choice is starting somewhere.
Your Next Step
During our consultation, we can explore:
Your specific situation
Individual vs. couples needs
Best starting point
Referral options
Coordinated care
Whether individual or couples, help is available.
