Relationship therapy

What is relationship therapy?

Relationship therapy, commonly called couples therapy in English, is a form of psychotherapy in which partners work with a therapist on their relationship: on how they treat each other, communicate and tackle recurring conflicts. In the Netherlands it is also called systeemtherapie or relatie- en gezinstherapie. It is meant for couples who can no longer work it out together. This page explains the concept and is not medical advice.

What relationship therapy looks like in practice

The core is that you sit there together. Take a couple stuck in the same fight for months who can no longer work it out at home. At a relationship therapist it isn’t one of them who tells the story, but both sitting there together, and the therapist looks at what happens between them instead of who is right. According to the Dutch Association for Relationship and Family Therapy, systeemtherapie is “a form of psychotherapy, also called relationship and family therapy”, where the distinctive thing is that important close ones such as the partner are involved in the therapy. The therapist focuses on the way people treat each other, not on one guilty party.

How relationship therapy works

Relationship therapy treats not the separate complaint but the pattern between two people. One of the best-researched forms is emotionally focused therapy (EFT), which leans strongly on attachment style: recurring conflict is read there as protest against a broken emotional bond, not as a character flaw. From the extensive meta-analysis by Spengler and colleagues from 2024, EFT comes out as an evidence-based treatment that works for a range of problems and whose improvement holds up to two years after it ends. The therapist helps the couple see and change the pattern, instead of deciding who wins.

Forms of relationship therapy

Relationship therapy exists in different schools, but they share that the couple sits in the room together. In the Netherlands much relationship therapy falls under systeemtherapie, which involves the partner and sometimes other close ones in the treatment, according to the NVRG. Emotionally focused therapy focuses on the emotional bond and the attachment beneath it. The method named after relationship researchers John and Julie Gottman builds on research into what couples who last do differently. Which form fits depends on the couple and the therapist, and the choice for it runs through a registered practitioner, not through a self-test.

What relationship therapy can deliver

What relationship therapy can give a couple is above all understanding and a different way of talking. For the two of you together it means a stuck conversation gets going again and that you learn to read the other’s reaction instead of fighting it. For you personally it can help that you no longer feel like the only one with a problem, because the gaze shifts from who is doing something wrong to what happens between you. The research on EFT shows that this improvement also holds for many couples after the therapy. What it is not: a quick repair or a guarantee. Relationship therapy asks that both partners want it, takes time, and can also end in the conclusion that separating is the most honest outcome. And it is something other than individual therapy: the relationship is the client here, not one person.

What relationship therapy is not

“Relationship therapy is a last resort for when it’s almost over.” It doesn’t have to be. It is just as much for couples who are early and want to turn a pattern before it sets.

“The therapist picks a side and says who’s right.” No. Systeemtherapie looks at the pattern between people, not at guilt. There is no winner to point out.

“It’s the same as a good conversation you have yourself.” No. A relationship check-in is maintenance you do yourself; relationship therapy is professional help with a trained therapist present, for when that maintenance no longer suffices.

“Relationship therapy is only for married couples.” No. It is open to any couple who want to work on the relationship together, whether you’re married, living together, just started, or in a relationship with more than two people. The form of the relationship does not decide whether you can go for it.

Further reading and where to go

• Attachment style explains the attachment theory much relationship therapy draws back on.
• Relationship check-in describes the maintenance you do yourself, the step before professional help.
• The NVRG keeps a quality register of relationship and family therapists, so you can find a registered therapist.
• Thuisarts.nl recommends talking about it with, among others, your GP, and the GP is the usual starting point in the Netherlands for a referral.

Where this fits on my site

I don’t offer relationship therapy, and that is deliberate: for that you go to a relationship and family therapist, usually through your GP. What I do is something other than help with a stuck relationship. If you’re unsure whether the two of you will work it out, the GP is the right first address. If you have a general question and just want to talk for a bit, that’s fine with no obligation, but I’m a gigolo, not a therapist.

Sources

• Wat is systeemtherapie. Dutch Association for Relationship and Family Therapy (NVRG). Gives that systeemtherapie is “a form of psychotherapy” also “called relationship and family therapy”, that important close ones such as the partner are involved in the therapy, and that the NVRG is a professional association and quality register for these therapists.
• A comprehensive meta-analysis on the efficacy of emotionally focused couple therapy. Paul M. Spengler, Nicholas A. Lee, Stephanie A. Wiebe & Andrea K. Wittenborn, Couple and Family Psychology: Research and Practice, 2024. Gives that EFT is an attachment-theory-based, evidence-based relationship therapy that works for a range of problems and whose gains are retained up to two years after the treatment.
• Problemen thuis. Thuisarts.nl, Dutch College of General Practitioners. Gives the advice to talk about it with, among others, your GP, the usual starting point for a referral to a relationship therapist.

Related terms

Relationship therapy draws strongly back on attachment style: how people attach often shapes the pattern the therapy treats.

• Attachment style. The attachment theory much relationship therapy, and EFT in particular, leans on.
• Relationship check-in. The maintenance you do yourself, the step before professional help.
• Co-regulation. Coming to rest together, one of the things relationship therapy tries to restore.
• Ethical non-monogamy. Couples with more than one partner can also go to a relationship therapist.