Couple Therapy for high conflict relationships is a speciality, but it’s not one with one particular training, schooling, or background. You won’t find a list of “high conflict couples therapists" in a list or database.
This is unfortunate, because couples struggling through a high conflict relationship need help, and the reality is not all couples therapists are equipped to work with more intense, highly distressed partners.
However, there are strategies you can use to evaluate potential therapists for their skillset and fit, both before you find them and once you start working together.
How To Find A Couples Therapist
Your best possible source for a couples therapy referral is an individual therapist who knows you or your partner well. If you have a trusted individual therapist, start by asking them. They may know a therapist who would be a good fit, or they may have a network they can reach out to. Many therapists belong to listservs or local facebook practice groups where they can ask something like the following:
“Looking for a seasoned couples therapist very comfortable with higher conflict, more intense couples.”
Although therapists in training can be absolutely wonderful providers (every therapist was once in training!), I suggest that you limit your search to licensed providers. That means looking at therapist's license (feel free to ask if they are fully licensed or still in supervision). For psychologists, they should clearly state "licensed psychologist" and have a license number they can provide you (this information is publicly available and can be searched on their state board's website). For marriage and family therapists, fully licensed professionals indicate their status with "LMFT" (vs. AMFT which indicates someone is an associate, or still in supervision). It is always perfectly acceptable to ask questions about a therapist's license. LPC means licensed professional counselor and indicates full licensure.
If you do not have a trusted therapist you can rely on for referrals, I recommend Therapy Den to start your search.
How To Tell If A Therapist Can Handle High Conflict Relationships
Again, there is no "high conflict certification" to look for, so you'll need to do a bit of digging.
When you are looking through potential therapists’ bios, there are a few things to keep in mind.
Do they specialize in couples? Many therapists see both individuals and couples, but because high conflict is such a challenging area, it is best to go with someone whose passion is primarily couples work.
Does their training prepare them for high conflict couples work? This can take a bit of sleuthing on their website or asking questions directly.
Have they worked in settings where clients with more severe concerns are likely to be (hospitals, substance use treatment centers, outpatient psychiatric clinics)? Even if they didn't do any couples work in those settings, experience with more severe problems is a helpful qualification. If, for example, someone has worked primarily in college counseling, you probably want to follow up and ask where they were trained to work with more distressed couples.
Are they trained in a specific, evidence-based couples therapy modality? My preference is Integrative Behavioral Couple Therapy, but Emotionally Focused Couple Therapy can also work well.
Can they manage the session effectively? This is something you may have to try out for a session or two to discover, though asking them verbally about session management is a good place to start. If you find that you and your partner fight the whole time you're in therapy, your therapist is not effectively managing the session and will either need to step in more actively or refer you to someone who is better able to prevent conflict during appointments.
Do they conduct a thorough assessment? Assessment occurs prior to therapy and usually takes 3-4 sessions. In working with high conflict couples, it is absolutely vital that your therapist meet with each of you individually at least once. This is because high conflict dynamics can overlap with abuse, and certain types of abuse cannot be safely treated in couples therapy. Also, high conflict couples often struggle to talk about their concerns in front of each other as each person will constantly trigger the other with their perspective, so individual appointments let you share your experience without activating your partner.
How To Tell If Couples Therapy Is Working
Couples therapy is effective. It works, and it doesn't take years to help. Before starting therapy, you can ask how long the therapist expects it to take before you see results.
Once you start, expect to work hard and consistently for about 8-10 sessions before seeing results. This means regular sessions, not one session and then a month break. After 12-25 sessions, you should be seeing noticeable changes.
If your relationship is not improving, your couples therapist should bring up the lack of progress. If they don't, bring it up yourselves. Ask if there is anything different to try, or if they have observations about why you're not improving.
Some tough love - one reasons couples struggle in therapy is if they do not apply skills they are learning outside of session. If you're not doing your homework, you probably won't get good results.
If you're not making progress, you can decide whether to set fresh goals and a renewed focus on your treatment plan and try again with your current therapist, or seek a different therapist with a different skillset. This is absolutely okay to talk about with your therapist. You can ask what they recommend and decide if their recommendations feel like a fit.
How Many Couples Therapists Should You Try?
In the end, if your relationship is not improving AND you have a couples therapist with solid experience in high conflict work AND you have both put in a good effort, you may make the decision to end your relationship. This is very personal and not something I or anyone else can tell you to do.
Many high conflict couples DO go through several couples therapists before finding the right fit. I often see couples who have already worked with 3-5 therapists, and I do not necessarily see that as a bad sign. If you still have hope and commitment, you can absolutely search again for someone who is more suited to help you.
But, if you found a therapist who is well equipped to help, gave it a good shot, and are not getting results, you will need to grapple with the possibility that currently your relationship is not receptive to the available treatments. You can then decide if you want to continue with the relationship as it is, knowing it might not change, or end it.
I hope this overview of finding and working with a high conflict couples therapist has helped. For partners in California, Oregon, or Minnesota, I provide evidence-based couples therapy for high conflict relationships.
If you live elsewhere, I created the The Take A Break Guide to help high conflict couples increase their relationship safety quickly.