Couples therapy approaches, explained

Updated October 1, 2026 · Information, not medical advice · How we write guides

Many couples therapists name the approach they use. This guide explains the ones that come up most often in our listings: who developed each one and what sessions tend to focus on, based on what the organization behind it says. It doesn’t rank them: which one suits you depends on the two of you and on the therapist, and many therapists in our listings name more than one.

Gottman Method

Developed by Drs. John and Julie Gottman. Therapy usually begins with an assessment: a joint session, a conversation with each partner and questionnaires, followed by feedback. The work then focuses on friendship, managing conflict and building shared meaning, based on the institute’s Sound Relationship House theory.¹ 225 verified therapists in our listings mention it.

Emotionally Focused Therapy (EFT)

Developed by Dr. Sue Johnson and grounded in attachment theory. In couples work, it helps partners recognize and change the negative patterns that cause distress, so they can build a more secure emotional bond.² 268 verified therapists in our listings mention it. For a side-by-side look, see Gottman Method vs. EFT.

Imago Relationship Therapy

Created in 1980 by Drs. Harville Hendrix and Helen LaKelly Hunt. “Imago” is Latin for image: the idea is that we carry an unconscious picture of love, formed in childhood, into the relationships we choose as adults. The approach aims to turn conflict into growth while partners stay connected, and it is offered both in therapy and in multi-day workshops.³ 22 verified therapists in our listings mention it.

PACT (Psychobiological Approach to Couple Therapy)

Developed by Dr. Stan Tatkin. PACT combines three areas: neuroscience, attachment theory and arousal regulation (how each partner manages their energy and alertness from moment to moment). Therapists pay close attention to shifts in face, body and voice and work with what happens in the session itself. Sessions can be longer than a standard hour.⁴ 12 verified therapists in our listings mention it.

Discernment Counseling

Developed by Dr. William Doherty for couples where one partner is leaning out of the relationship and the other wants to keep working on it. It is not couples therapy in the usual sense: it runs for at most five sessions, mixing time with each partner and structured time together. The goal is clarity and confidence about a direction: staying as things are, separating, or committing to a period of couples therapy with divorce off the table.⁵ 17 verified therapists in our listings mention it.

Prepare/Enrich

An online relationship assessment followed by feedback sessions with a trained facilitator. There are versions for premarital couples and for married couples, and it looks at areas such as communication, personality, stress and the relationship’s strengths and growth areas.⁶ 50 verified therapists in our listings mention it.

SYMBIS

Short for Saving Your Marriage Before It Starts, by Drs. Les and Leslie Parrott. It is an assessment used with a certified facilitator, designed mainly for engaged couples but also used by married couples. Its facilitators include pastors as well as counselors, and many churches use it in premarital programs.⁷ 5 verified therapists in our listings mention it.

Relational Life Therapy (RLT)

Developed by family therapist Terry Real. It teaches practical relationship skills and works on patterns each partner brings, such as shame, grandiosity and emotional distance, with the aim of replacing self-protection with closeness.⁸ 16 verified therapists in our listings mention it.

Internal Family Systems (IFS)

Developed by Dr. Richard Schwartz. IFS sees each person as a system of inner “parts”, some protective and some wounded, guided by a core Self. It began as a psychotherapy for individuals and has been adapted for couples.⁹ 170 verified therapists in our listings mention it.

Choosing an approach

You don’t need to settle on a method before contacting a therapist. A few situations where the approach does matter:

One of you is unsure about staying. Discernment Counseling is designed for this situation.
You’re engaged or about to marry. Prepare/Enrich and SYMBIS are assessment-based programs designed for this stage.
You want a clear structure. Ask whether the therapist starts with an assessment, as the Gottman Method does, and whether they give exercises between sessions.

In a first call, ask how they work and what the first few sessions would look like. Our guide to choosing a couples therapist has more questions to ask.

On each city page you can filter verified listings by approach. Find couples therapists by city.