Understanding barriers to couples therapy

Abstract

What prevents couples from entering therapy? Given that the rate of couple help‐seeking is low, we need a better understanding of barriers to couple help‐seeking. To expand our understanding of these barriers, we asked almost 300 people who expressed an interest in couples therapy, to clarify what kept them from seeking help. A content analysis of participant's responses found six distinctive categories: cost of treatment, logistics, the modality of treatment, trustworthiness, relational factors, and a clear therapeutic process. Additionally, some responses suggested that stigma and concerns around the emotional work involved deterred couples from seeking help. This expanded understanding of barriers to couples therapy can assist both researchers and clinicians address them in more intentional ways.

Facilitators and barriers to the implementation of emotionally focused couple therapy in a large mental health agency: A preimplementation study.

“…The intake coordinators are not able to determine if an individual diagnosis that could be reimbursable for couple therapy is present, and thus default to indicating that it must be paid out-of-pocket. A recent study found the cost of treatment to be one of the most frequently identified barriers to couple therapy by clients (Hubbard & Anderson, 2022). As participants in our study identified, offering couple therapy only as an out-of-pocket paid service creates barriers for many couples seeking help who cannot afford to pay for conjoint therapy.…”

“…However, couple therapy may or may not be covered by insurance for a given case, as the diagnostic codes of relational issues are rarely listed as reimbursable procedures (Clawson et al, 2018). Thus, despite the clear evidence of the effectiveness and cost-effectiveness of couple therapy, barriers exist that prevent adequate reimbursement (Asfaw et al, 2020; Russell Crane & Payne, 2011), which thereby contribute significant barriers to the provision of couple therapy services (Hubbard & Anderson, 2022) and further exacerbate public health concerns by limiting access to effective treatments (e.g., Barbato & D’Avanzo, 2020).…”

The influence of relationship pattern labeling on intimacy, acceptance, and relationship satisfaction

“…Given that couples therapy, the environment where relationship patterns are typically invoked, is difficult to access for many people, it is imperative, from a public health perspective, to create and test mechanisms that can be built into accessible and effective online interventions (Hubbard & Anderson, 2022;Johnson et al, 2002). Relationship health affects not just partners, but children as well, suggesting that increases in relationship health can have positive health impacts for the entire family and societal system (APA, n.d.).…”

Dyadic digital health interventions: Their rationale and implementation

“…Interventions delivered via telephone and text messaging can reach even more individuals. Indeed, these accessibility and cost benefits of delivering care to dyads through their digital devices could address about half of the identified major barriers to distressed couples seeking couple therapy [ 7 ].…”