If you’ve been thinking about couples therapy, or you’ve already taken that step of reaching out, you might be wondering what it actually looks like once you’re in the room. What are we going to do together? How long does this take? And how will you know when you’re done?
In this post, I’m going to walk you through the full arc of what couples therapy looks like in my practice, from the very first conversation all the way through to the final sessions.
A little context first: the primary framework I work from is Emotionally Focused Couples Therapy (EFT couples therapy), developed by Dr. Sue Johnson. EFT is one of the most well-researched approaches to couples therapy we have, with a strong evidence base showing that it not only helps couples feel better, but it helps the changes last. I chose EFT because it gets at something deeper than communication skills or conflict management. It works at the level of attachment, reshaping the emotional bond between partners.
What Happens in the First Sessions of EFT?
Every new couple starts with an initial consultation. This is a chance for us to meet, for you to get a feel for me and how I work, and for me to begin understanding what’s brought you in. I want to know what’s feeling hard, what you’ve already tried, and what you’re hoping for. Consultations are an opportunity to ensure the relationship feels good both ways, and that the specific issues are within my scope of competence and speciality.
From there, I normally schedule one to two conjoint sessions all together. These opening sessions are focused on initial assessment. I’ll look at both the challenges and the strengths in your relationship and get clarity around goals of the work.
Then, I’ll meet with each partner individually for an assessment session (or two). These individual meetings matter a lot. They give each person space to share things they might not feel ready to say in front of their partner yet, and they give me a fuller picture of each person’s history, attachment patterns, and experience of the relationship. It’s not about gathering information to use against anyone, but rather about showing up to our work together better prepared to help.
Most of my clients come to me because I specialize in layered, complex cases with lots of intersectionality. More complexity usually requires more than one individual session. This is assessed on a case-by-case basis.
After those individual assessments, the remainder of the work will be conjoint, meaning we will be all together, with some rare exceptions.
The Three Stages of EFT
Stage One: Finding Your Way Out of the Cycle
Once we move into conjoint sessions, we begin Stage One of EFT, and this is where most couples spend the bulk of their early work. Stage one is really about stabilization: helping you find your way out of the negative cycles of relating that have been keeping you stuck.
Here’s what I mean by that: Every couple has a cycle or a kind of dance they do when things get hard. Maybe one partner pulls away and goes quiet while the other pushes harder to get a response. Or maybe both partners come out swinging, and no one feels heard. These moves can look pretty different on the surface, but underneath them, there’s almost always the same thing: attachment needs and longings; a deep desire to feel close, safe, and valued by the person you love most.
Much of our Stage One work involves slowing things down enough to actually see the cycle, understand the moves each partner is making in moments of distress, and to begin to understand why. As your therapist and your process consultant, my job is to help you bring certain parts of your experience to your partner; particularly the parts that might be easier for them to reach and receive. The softer, more vulnerable parts that often get buried under the louder, more reactive ones.
As couples begin coming into sessions telling me that things feel more stable and that the cycle has lost some of its grip, we know it’s time to move into Stage Two
Stage Two: Deepening the Work
Stage Two is where things get a little more layered. We become a bit more psychodynamic in our approach, meaning we’ll start to look more closely at earlier experiences: childhood, relationships with caregivers, and some of the internalized beliefs about self and the world that might be quietly getting in the way of connection.
A good example might be someone who grew up in a family that was emotionally neglectful. Maybe the message they absorbed– not because anyone said it out loud, but because of the absence of connection– was something like: “My needs don’t matter. Nobody’s ever going to be there when I need them.” Those kinds of internalized messages have a way of traveling with us into our adult relationships. Even when someone is desperately craving closeness, that old belief can create a block, making it hard to reach for a partner, or hard to trust that reaching will be worth it.
Stage Two is about gently surfacing those blocks and deepening the emotional risks couples take with one another. We’re working toward what EFT calls a change event, which is a meaningful, felt shift in the emotional bond between partners that can genuinely change the trajectory of the relationship. The goal is for couples to leave therapy with something durable: not just feeling better for now, but having the foundation to stay better and avoid a return to couples therapy down the road.
Stage Three: Consolidation and Closure
Once we have hit our goals in Stage One and Two, we move into Stage Three, which is typically just a few wrap-up sessions. We’ll reflect on the journey you’ve taken together, review what’s shifted, and make sure you feel equipped to carry this forward on your own.It’s a time to celebrate, honestly.
A full course of EFT is no small feat!
My Integrative Approach: When the Path Needs a Detour
I want to be honest about something: not every couple can move through a standard course of EFT in a straightforward way, and that’s completely okay. Life is complicated, and so are people.
This is where my trauma-informed, integrative approach comes in. I hold a strong trauma lens in all of my work, and I’m always attending to whether there are trauma histories or responses that need to be addressed before or alongside the EFT work. Sometimes, charging ahead with deepening emotional vulnerability isn’t safe or appropriate, and we need to slow it down.
For couples that need something a little different, I often incorporate what I lovingly call side quests. These are intentional therapeutic detours and specialized pieces of work that serve the larger journey.
Side quests might include:
COUPLES EMDR
For trauma that’s showing up in the relationship and needs more targeted processing
SOMATIC WORK & GROUNDING TOOLS
Especially helpful for clients who experience dissociation and need support staying regulated in session
FEMINIST & NARRATIVE THERAPY
Because sometimes what’s getting in the way of a couple isn’t just between them, but around them. We might need to deconstruct some of the broader cultural, familial, or societal narratives that have shaped how each partner sees themselves, their roles, and their relationship
NEURODIVERGENT-AFFIRMING APPROACHES
I work with many mixed neurotype couples, and I’m always thoughtful about adapting the process to honor the varying ways each partner experiences the world, communicates, and connects
ENM, POLY & OPEN RELATIONSHIPS
Many of the relationships I work with involve more than a dyad or involve supporting couples in the process of opening up the relationship. This work often requires us to look at agreements, structure, “sure up” sense of safety, and deconstruct mononormative beliefs.
SEXUAL ISSUES
It’s very common for couples to come into my office navigating betrayal trauma, desire discrepancy, gender transitions, sexual trauma, or other sexual concerns. EFT gives us a powerful lens for understanding a couple’s sexual cycle, and at times we may also integrate sex therapy tools and methods to best support these goals.
These side quests aren’t detours away from the goal, they are the goal. They’re how I make sure the EFT work we’re doing has solid ground to land on.
DISCERNMENT SESSIONS
Sometimes in the course of our work together, it becomes clear that one partner is leaning out and quietly (or not so quietly) debating whether they want to stay or go. This ambivalence is more common than people might think, but it can also be incredibly destabilizing to the EFT process. If the “divorce bomb” drops or ambivalence begins to take center stage, we may need to pause couples therapy and shift our focus to the individual needs, longings, and goals of each person before we can meaningfully return to the work and shared goals together.
A Final Word
No therapy model is perfect for every client, but the bones of EFT are absolutely appropriate for the vast majority of humans I support. I chose this model because it is warm, non-pathologizing, and embracing— but also wonderful at helping people exit their specific attachment patterns that are, ultimately, blocking them from real safety and connection.
Every couple’s path through this work looks a little different, and that’s by design. What I can promise is that the process is thoughtful, the pacing is always responsive to you, and the goal is always the same: to help you build a bond that feels secure, alive, and worth showing up for.
If you have questions about anything here, or you’d like to explore whether this approach might be a good fit for you and your partner, I’d love to hear from you.
If you’re considering couples therapy and wondering whether Emotionally Focused Therapy might be a good fit for your relationship, you can learn more about my approach to EFT couples therapy here or request a consultation.
More FAQs About EFT
One of the most common questions I hear from couples is, ‘How long will we need to be in therapy?’ It’s a fair question, and an important one. The honest answer is that EFT is not a quick fix. EFT therapists are guided by the principle, ‘Slow is fast,’ because we simply cannot rush the delicate work of rewiring attachment patterns and rebuilding a sense of safety between partners.
The length of treatment varies depending on each couple’s unique history and circumstances. Couples navigating crisis, the aftermath of betrayal, domestic violence, or complex attachment trauma often require a longer runway— not because progress isn’t happening, but because stabilization is its own important phase of healing.
For these couples, working with me typically means a commitment of one to two years.
Emotionally Focused Therapy is one of the most well-researched approaches to couples therapy. Decades of studies have shown that many couples who complete EFT experience significant improvements in relationship satisfaction and emotional connection.
What makes EFT different from many other approaches is that it focuses less on surface-level communication techniques and more on the emotional bond between partners. When couples begin to understand the deeper fears, longings, and attachment needs driving their conflicts, the entire dynamic of the relationship can shift.
Instead of arguing about the same issues repeatedly, partners start to recognize the vulnerable emotions underneath those patterns and respond to each other differently.
In most cases, yes. Emotionally Focused Therapy works best when both partners are actively participating in the process.
Because the work focuses on the interaction between partners, having both people in the room allows the therapist to observe the cycle as it happens and help the couple slow it down, understand it, and shift it together.
That said, there are times when individual sessions can be helpful as part of the process. For example, if one partner has experienced trauma that is affecting the relationship dynamic, we may occasionally pause to do focused individual work before returning to the couple work.
But the core of EFT is the shared experience of learning new ways of reaching for each other.
Many couples come into therapy feeling like they have already tried to solve their problems through better communication, logic, or compromise, yet they still find themselves stuck in the same arguments.
Emotionally Focused Therapy approaches the problem from a different angle. Rather than focusing primarily on skills or conflict management strategies, EFT looks at the attachment bond between partners. It asks questions like: What happens emotionally when partners feel disconnected? What fears or longings are underneath the arguments?
Often the surface conflict is only the visible part of a deeper cycle of protection and vulnerability. When couples begin to recognize that cycle and understand the emotions driving it, they can start responding to each other in ways that create more safety and closeness.
Over time, those new interactions become the foundation for a more secure relationship.
