What is relationship counseling?

Relationship counseling is a form of therapy that helps partners identify and resolve conflicts, improve communication, and increase relationship satisfaction. There are several different types of relationship counseling, including the Gottman Method, Emotion Focused Therapy, and Imago Relationship Therapy.  Regardless of the therapy model, all relationship counseling must be conducted by a licensed mental health professional with training in understanding and modifying relationship dynamics.

When is relationship counseling recommended?

Relationship counseling is a highly effective intervention for addressing relationship dissatisfaction and conflict before the patterns are stuck. It is also beneficial as a preventative strategy to keep a relationship strong. Relationship counseling can help partners discuss and make big decisions together. It also is highly recommended when partners are going through major relationship or life changes and stressors.  Some examples are:

• Frequent arguments over minor issues
• Loss of physical or emotional closeness
• Conflict over mismatches in major values (parenting, finances, politics)
• Considering getting married, having children, blending a family, moving homes
• Dealing with a partner or other family members significant illness or change in functioning
• Rebuilding trust after an affair

When is individual counseling recommended instead of relationship counseling?

Relationship counseling is not effective for every difficult situation or relationship pattern within a partnership.  Individual counseling is recommended instead when:

• There is domestic violence or coercive control.  If your partner is intentionally harming you, even if only in moments of anger, that is abuse, not a relationship issue.  If you are scared of your partner, please seek help getting to safety.  We recommend the Willow Center https://willowcenterny.org/ if you are in the Rochester area.The National Domestic Violence Hotline https://www.thehotline.org/ is another helpful resource.
• One or both of you have an untreated mental illness or substance use disorder.  relationship counseling will not directly address the mental health concerns of either individual.  If your relationship is suffering because of actions or stress caused by a mental health or substance use issue, individual counseling for that problem will be more effective.  Once the mental health or substance use issue is being treated, relationship counseling can be effective at rebuilding the relationship.  If your partner has an untreated mental illness or substance use disorder and is unwilling to engage in treatment, seeking individual therapy for yourself can help you to cope more effectively and manage your own stress and emotions related to your partner’s moods and behavior. 
• Only one partner is committed to repairing the relationship.  Relationship counseling requires honesty and commitment from both partners.  A relationship counselor will not keep secrets within the therapy.  If one of you is unwilling to participate in relationship counseling, maintaining an affair, or uninterested in changing the relationship, relationship counseling is unlikely to be effective.  If you want help and your partner doesn’t, individual therapy can help you identify your priorities, honor your boundaries, and care for your own needs. 

Why can’t I use my insurance?

Insurance only pays for therapy that is “medically necessary”.  Medical necessity requires three main things:

• An identified patient (that is, ONE person)
• A diagnosis (mental health symptoms that interfere with functioning)
• Treatment to reduce the symptoms and impairment caused by the diagnosis

Relationship counseling does not meet medical necessity criteria because the therapist is treating the relationship between partners, not one person’s diagnosed mental health disorder.

But I called my insurance and they said they cover family sessions/relationship sessions?

Insurance does pay for family psychotherapy sessions (CPT codes 90847 and 90846) when family member involvement is necessary for treatment of a client’s diagnosed mental health disorder.  For example, if a child has an anxiety disorder, treating it effectively may require a session with the parents.  Or if an adult has a psychotic disorder, effective treatment may require a session with their spouse to talk about supporting medication management.  In these situations, the family session that insurance covers is only for the benefit of one individual who needs mental health care. Relationship counseling is not for the benefit of one individual and is not medically necessary, so it is not included in the family psychotherapy sessions that insurance covers.

But me/my partner does have a diagnosis.  Why can’t you bill our relationship counseling under their insurance?

Some independent therapists are willing to misrepresent relationship counseling as medically necessary family psychotherapy by choosing one partner to diagnose and billing the sessions under that partner’s insurance.  Renew Hope and Healing does not do that- it is fraud. 

Additionally, it is harmful to you and your partner when a therapist bills insurance for relationship counseling.  Because the therapist will have to choose one partner to bill for, that one person becomes the official client.  This means that the therapist is responsible to only one partner: one partner’s health takes priority, one partner’s confidentiality takes priority, one partner’s needs take priority, one partner’s legal rights takes priority.  For relationship counseling to be effective, you and your partner need to be equally heard and valued by your therapist.