Couples therapy is one of the most demanding services for a psychologist: there are three patients in the room (her, him/her, the bond).
First couples session at three
- Joint welcome (5 min).
- Framing and confidentiality (5 min).
- Reason for consultation (15-20 min).
- Couple history (15-20 min).
- Initial hypothesis (5-10 min).
- Closing with next appointment.
Individual sessions yes or no
- Couple only (classical systemic).
- Couple + 1-2 individuals.
- Mixed.
Framing and confidentiality
- Cancellations: 24-48h.
- Between-session communication: only administrative.
- Confidentiality of individuals.
- Per-session fee and payment method.
Delicate cases
- Recent infidelity: specific framing.
- Violence: couples therapy contraindicated.
- Hidden separation.
- Active addictions.
Rhythm and duration
- Sessions of 60-75 minutes.
- Frequency: fortnightly at start.
- Total duration: 12-25 sessions per case.
Clinical software for couples therapy
- Linked couple file.
- Agenda with two holders per appointment.
- Separate notes: couple, individual A, individual B.
- Invoicing to one or both.
Typical mistakes
- Not setting individual session rules.
- Treating as two parallel practices.
- Taking sides.
- Continuing with active violence.
Preguntas frecuentes
Common questions about couples therapy.
How much does a couples session cost?
€70-130 in Spain, by city and format.
Are individual sessions advisable in couples therapy?
Depends on approach. Pure systemic avoids individuals.
Who pays the session: one or both?
Couple's decision: pay by one, equal split or alternating.
Does online couples therapy work the same?
In most cases yes. Delicate cases better in-person.
When is couples therapy not advisable?
Active violence, addiction without treatment, unilateral separation decision.