When Couples Therapy Misses the Mark: Why Some Approaches Can Worsen Conflict (and How EFT Offers a Solution)

does marriage counseling work? a couple hold hands wondering if EFT marriage therapy in Reno will help

Does Marriage Counseling Work? It Depends


I read a forum post recently where the author was gathering opinions about, “does marriage counseling work?” My internal voice was, “well of course it does!!” But this isn’t always true: it depends on a number of factors. In this article I’m speaking to couples who are wondering whether marriage counseling works, and perhaps more importantly, whether it will make things worse. After all, if things are bad then at least doing nothing isn’t likely to make them worse, right? At least you won’t go down the same road as your friends who ended up worse off after therapy.

In my years as an Emotionally Focused Therapist, I’ve had the privilege of guiding many couples through meaningful change and growth in their relationships. I’ve seen many couples reconnect and rediscover love and trust with EFT. However, I’ve also encountered situations where well-intentioned therapeutic interventions had inadvertently exacerbated existing challenges.

I recall one couple, I’ll call them Sarah and Mark, who sought my help after months of behavioral-based couples therapy. They were nearing the end of their rope, their communication patterns mired in blame and defensiveness. Mark felt unheard and dismissed, while Sarah felt perpetually criticized. Their previous therapist had focused on instructing them regarding communication techniques, but this only seemed to intensify their conflicts. Each new “technique” became another tool for discord. Conflict began to center around who was at fault for not following the therapist’s instruction!

Sarah and Mark’s experience is unfortunately not uncommon. Many couples enter therapy seeking support, only to find themselves feeling more disconnected and discouraged. Our local Reno therapists, Emotional & Relationship Counseling Associates, understand this potential risk.

The Challenges of Traditional Marriage Therapy

Often, traditional couples therapy can become mired in continually identifying problems and assigning blame. As Sue Johnson, the pioneer of EFT, aptly observes, “Many couples come to therapy talking about communication problems when what they really need is help with the underlying emotions driving those problems.” (1)

Instead of fostering understanding and connection, this approach can leave couples feeling increasingly isolated and misunderstood. John Gottman, a leading researcher on marital stability, echoes this concern: “Most couples therapy focuses on changing behaviors, but what really needs to change is the emotional connection.” (2)

Specific challenges of traditional couples therapy models include:

  1. The Blame Cycle: Some approaches inadvertently encourage partners to focus on each other’s perceived flaws, fostering criticism and defensiveness, which can further erode their bond.
  2. Surface-Level Focus: Traditional therapy may get caught up in the content of arguments, overlooking the deeper emotional needs fueling those conflicts. This is akin to addressing symptoms while neglecting the underlying cause.
  3. Neglecting Attachment Needs: Humans have an innate need for connection. When these needs are unmet, we often react with fear, anger, or insecurity. Traditional therapy may not always address these fundamental needs, leaving couples feeling alone and unsupported.
  4. One-Size-Fits-All Solutions: Many therapists rely on standardized techniques and interventions that may not resonate with the unique dynamics of each couple. This can lead to frustration and a sense of being misunderstood.

Does Marriage Counseling Work? EFT: A Path to Emotional Safety and Connection

Emotionally Focused Therapy (EFT) offers a different path. It recognizes that conflict is often a cry for connection, a desperate attempt to get our partner’s attention and feel loved and secure. In simple terms, Emotionally Focused Therapy (EFT) for couples is a roadmap to understanding and healing the emotional wounds that cause conflict in your relationship.

EFT guides couples through a process of:

  • Uncovering Hidden Emotions: EFT helps you and your partner identify and express the deeper emotions that are often hidden beneath the surface of your arguments. These emotions might be fear, hurt, loneliness, or feeling unloved. Once these emotions are out in the open, you can start to make sense of them and address them.
  • Creating a Safe Space: Your therapist will create a safe and supportive space where both of you can feel comfortable sharing your emotions without fear of judgment or criticism. This safe space is crucial for healing and building trust.
  • Understanding Your “Dance”: EFT therapists help you recognize the negative patterns or “dances” you get stuck in during conflicts. These patterns often involve one person pursuing connection and the other withdrawing. Understanding this dance helps you break free from it.
  • Changing Your Steps: With the therapist’s guidance, you’ll learn new ways to respond to each other’s emotional needs. This involves expressing your own needs more clearly and responding to your partner’s needs with empathy and understanding.
  • Building a Stronger Bond: As you learn to communicate more openly and connect on a deeper emotional level, you’ll start to feel closer and more secure in your relationship. Trust and intimacy will grow, and you’ll be better equipped to handle challenges together.

Does Marriage Counseling Work? Only if it gets to the root of distress

Think of EFT like learning a new language – the language of emotions. Instead of speaking in accusations and criticisms, you’ll learn to express your needs and feelings in a way that your partner can understand and respond to. This new way of communicating can transform your relationship from a battleground into a safe haven.

It takes time and effort to change deeply ingrained patterns. I saw this positive change unfold with Sarah and Mark. As we delved into their deeper emotions, they began to understand the pain and fear that fueled their conflicts. Mark realized that Sarah’s criticism stemmed from a fear of abandonment, while Sarah recognized that Mark’s withdrawal was a way of protecting himself from feeling hurt. As they learned to express their needs more vulnerably and respond with compassion, their relationship began to heal.

Very importantly, when Sarah and Mark found themselves stuck in their negative pattern at home, they had a strategy. They were able to slow things down and realize they were bogged down. This gave them an opportunity to regroup and talk in more emotionally vulnerable terms. Specifically, to describe how their respective criticism and defensiveness were reactions to feeling disconnected and misunderstood.


Does marriage counseling work? Couples therapy can be a valuable tool for healing and growth, but only when it addresses the root of the problem: the emotional disconnection that drives conflict. Emotionally Focused Therapy (EFT), as offered by practices like Emotional & Relationship Health Counseling Associates in Reno, offers a roadmap for couples to navigate their emotional landscape, heal old wounds, and create a more secure and loving relationship. If you’re considering couples therapy, choose wisely. This article outlines questions you might ask a prospective therapist. Your relationship is worth it.


(1) Johnson, S. M. (2004). The Practice of Emotionally Focused Couple Therapy: Creating Connection. Brunner-Routledge. (2) Gottman, J. M., & Silver, N. (2015). The Seven Principles for Making Marriage Work. Harmony.

Will My Insurance Cover Therapy? A Helpful Form

Offices of Emotional & Relationship Health Counseling Associates, Therapists in Reno. Helping clients answer, "how do I know if my insurance covers therapy?"

Emotional & Relationship Health Counseling Associates

Insurance Verification Form for Therapy Benefits

Why Verify Your Therapy Insurance Benefits?

A common question (view our FAQ’s here) we are asked at our therapy center in Reno is, “how do I know if my insurance covers therapy?” Understanding your insurance coverage for mental health services is an important step in making informed decisions about your care. This form will guide you through a conversation with your insurance company to help you understand your out-of-network benefits for therapy sessions.

Send us an email to receive a printable version of this form.

Before You Call:

  • Gather your insurance card and any relevant policy information.
  • Have a pen and paper ready to take notes.
  • Be prepared to wait on hold or be transferred to different departments.

Call your insurance company at the Member/Customer Services line. They may ask for your patient ID number. Each insurance carrier organizes its phone menu options differently, but you should listen for the options of checking benefits and eligibility and checking mental or behavioral health benefits. If possible, choose to speak to a live representative. If this is not a menu option, you may be able to reach one by verbally asking for a representative or for customer service. You may be transferred before reaching the representative who can tell you your benefits. Note the date you call and the call reference number.

Client Name: _________________________

Date: _________________________

Insurance Company: _________________________

Member/Customer Service Phone Number: _________________________

Call Reference Number: _________________________

  1. Benefit Period: (The year your coverage is active) _________________________
  2. Out-of-Network, Outpatient Mental/Behavioral Health Benefits:
    • Individual or Family Benefits (or both): _________________________
    • Deductible:
      • Individual: _________________________
      • Family: _________________________
    • Amount Met Towards Deductible:
      • Individual: _________________________
      • Family: _________________________
    • Coinsurance Rate (Percentage patient pays): _________________________
    • Out-of-Pocket Maximum:
      • Individual: _________________________
      • Family: _________________________
  3. Pre-Authorization Requirements: _________________________
  4. Claims Address: _________________________

Additional Notes: _________________________

How Do I Know if my Insurance Covers Therapy? An Example:

Let’s say the representative gives you these benefits:

Benefit period: 9/1/15-8/30/16

Deductible: $1,000 Amount met towards deductible: $300

Coinsurance rate: Insurance responsibility: 60% Patient responsibility: 40%

Out-of-pocket maximum: $5,000


These benefits are applicable during your benefit period. This means that on 9/1/16, a new benefit year begins. The benefit year is important to know because it tells you when the accumulation towards the deductible starts over. Many insurance companies will tell you the effective dates of the policy before they tell you the benefit period. This can be confusing, because both of them are dates and may be given at the beginning of the call, but make sure you ask for the benefit period specifically. You can ignore the effective dates for this worksheet.

Often, a deductible must be met before reimbursement is possible. In this example, that means that the patient has to spend $1,000 out of pocket before reimbursement can begin. Insurance companies will reimburse a percentage of the usual and customary fee for a therapy session. They will not tell you the usual and customary rate, but it is determined by typical session costs in your region. Often, this rate is lower than the actual fee you paid for your session.

The percentage of the usual and customary fee that the insurance company covers is known as the coinsurance rate. Be sure to find out what percentage the insurance company will cover and what percentage you will cover after the deductible is met. In this case, the insurance company will cover 60% of the fee after the deductible is met. For this example, let’s say the usual and customary rate is $100. The insurance company will send back $60 for every session after the deductible is met. The patient will have had 60% of the usual and customary rate reimbursed.

Your insurance company will put a limit on how much money you spend before they cover out-of-network mental health services at 100%. They will either limit the amount you pay out of pocket in general – the out-of-pocket maximum – or they will limit what you pay after the deductible as part of your coinsurance responsibility – the coinsurance maximum.

Emotional & Relationship Health Counseling Associates

Relationship Counseling / Therapists in Reno, NV


Special thanks to my friend and colleague, Dr. Laurie Watson, creator of the Foreplay Radio Sex Therapy program.

Marisol Villagrana, LSW

Bilingual therapy in Reno with Marisol Villagrana. Emotional & Relationship Health Counseling Associates, Reno, NV

Meet Marisol Villagrana, LSW

Hi! I’m Marisol Villagrana, a Licensed Clinical Social Worker Intern (LSWI), and I’m excited to join Emotional & Relationship Health Counseling Associates in Reno.

Originally from Oregon, I hold a Bachelor of Arts in Psychology with a minor in Philosophy from the University of Oregon. Before pursuing my master’s, I spent several years working in mental health. Inspired by my son, I decided to earn my Master’s in Social Work from the University of Denver. During my studies, I provided therapy to adults in rural Oregon, utilizing Cognitive Behavioral Therapy (CBT) and incorporating elements of Dialectical Behavioral Therapy (DBT). Moreover, I taught mindfulness exercises and distress tolerance skills.

As a bilingual, Latina therapist in Reno, I offer services in both English and Spanish language.

Outside of work, I enjoy spending time with my family, friends, and my pets – two huskies and two cats. If you need compassionate and dedicated support, I’m here to help. Therefore, I invite you to contact me to schedule a session or learn more about how we can work together. My standard session fee is $100.

Spanish Speaking Therapist in Reno

¡Hola! Soy Marisol Villagrana, Pasante de Trabajadora Social Clínica Licenciada (LSWI), y estoy emocionada de unirme a Emotional & Relationship Health Counseling Associates en Reno.

Originalmente de Oregón, tengo una Licenciatura en Psicología con una especialización en Filosofía de la Universidad de Oregón. Antes de obtener mi maestría, pasé varios años trabajando en salud mental. Inspirada por mi hijo, decidí obtener mi Maestría en Trabajo Social de la Universidad de Denver. Durante mis estudios, brindé terapia a adultos en zonas rurales de Oregón, utilizando Terapia Cognitivo-Conductual (CBT) e incorporando elementos de Terapia Dialéctica Conductual (DBT). Además, enseñé ejercicios de atención plena y habilidades de tolerancia al malestar.

Como terapeuta bilingüe y latina en Reno, ofrezco servicios tanto en inglés como en español.

Fuera del trabajo, disfruto pasar tiempo con mi familia, amigos y mis mascotas: dos huskies y dos gatos. Si necesitas apoyo compasivo y dedicado, estoy aquí para ayudarte. Por lo tanto, te invito a contactarme para programar una sesión o aprender más sobre cómo podemos trabajar juntos. Mi tarifa estándar por sesión es de $100.

Hillary Harris, M.A.

Hillary Harris is a clinical intern who provides therapy Reno, NV with Relationship Counseling Associates

Meet Hillary Harris

Hi, I’m Hillary Harris, a Clinical Professional Counselor Intern therapist in Reno. Whether you’re experiencing loneliness, misunderstanding, disconnection or unhealed wounds, I can help. I have specialized training in Emotionally Focused Therapy (EFT), a gold-standard for relationship counseling.

Research consistently shows that a strong therapeutic relationship, also called the therapeutic alliance, is vital for successful treatment. My goal is to create a supportive and collaborative environment where we can build emotional and relationship resilience. Using my specialized training, I help clients identify and disrupt negative cycles to foster lasting change. I’m passionate about working with couples, first responders, military personnel, those experiencing relationship loss, and individuals with PTSD. Additionally, I am part of a highly-collaborative team and do regular case consultation with our Clinical Director, Cornelius Sheehan, LCSW and Clinical Lead, Amanda Stewart, LCSW.

My military experience gives me insight into the unique challenges of high-stress jobs with chronic exposure to intense content. Additionally, for those interested, I am also comfortable incorporating Christian faith-based principles to support the client’s personal values and belief.

At Emotional and Relationship Health Counseling Associates, our team provides attentive and personalized support. If you’re searching for a therapist in Reno, call us. We can discuss our approach and see if we’re the right fit. We offer a free consultation.

My standard session fee is $120. Our team is here to help you navigate your challenges and support your healing and growth. Contact us today to schedule an appointment. This is your first step towards improving your emotional wellbeing and relationship health. I look forward to supporting you on the path of self-awareness, self-acceptance, joy, and meaning.

A Discussion of Family Therapy for Military Families

emotionally focused family therapy for military families. an interview with Con Sheehan, LCSW on attachment parenting

Con Sheehan, LCSW does attachment-based EFFT, Emotionally Focused Family Therapy in Reno. Con was recently a guest on the Communicate and Connect Podcast.

Ep. 50 with Con Sheehan on Emotionally Focused Family Therapy

In The Communicate and Connect Podcast for Military Relationships, marriage counselor Dr. Elizabeth Polinsky explains relationship science and discusses educational tips for improving your relationship and navigating military family life.

From Dr. Polinsky: “In this podcast you’ll find insights into how children cope with feelings of caregiver inaccessibility and how this can influence their behavior and life choices, including the risks of substance use. We also discuss specific challenges faced by military families, such as managing parental roles during deployment and the unique stresses that can impact both children and parents.

To aid our understanding, Con shares examples from his practice, focusing on creating a family environment where each member’s needs are understood and met. We’ll emphasize the importance of repair, availability, and intentional parenting—even discussing how therapy, even short-term, can be instrumental for families.”

Click here to learn more about family therapy in Reno with Con and his colleagues at Emotional & Relationship Health Counseling Associates.

Dr. Sue Johnson (1947-2024) revolutionized relationship therapy

Dr. Sue Johnson, (1947 to 2024) was the innovator of Emotionally Focused Therapy, EFT.

Remembering Dr. Sue Johnson

If you’ve heard me describe the work I do or have been a student, you’ve heard me talk about Dr. Sue Johnson. I felt (continue to feel) an enormous loss with her passing, April 23rd. No individual was more important to the development of relationship therapy than Sue. Her work and writing were grounded in seeing people’s good intent and using emotional experience to bring it back online, no matter how deeply it was buried. Sue saw the good, AND at the same time did not tolerate bad-faith engagement. She was soft, slow and warm Dr. Sue in the video demonstrations of her work, but another Sue emerged when good-faith left the discussion. I loved these things about her!

I found my professional home with her.

My work was becoming centered in attachment theory when I met Sue in the clinical research and then in a book called, “The Practice of Emotionally Focused Therapy; Creating Connection,” in 2000. A few years later I met her very briefly in person at the Evolution of Psychotherapy conference in Anaheim, CA. I remember my sense of her being on this little island where emotion was prized, in a huge sea of cognitive-behavioral waters. Sue made so much sense! I was working frequently with court-mandated clients and “changing thinking” was NOT an effective mechanism for change, but it was the prescribed one. Focusing on emotional experience through an attachment lens proved to be the key to true change. Fortunately, years later, I found a formal path to learning EFT. My clinical work went to a place it never would have without Dr. Sue Johnson. A week doesn’t go by without me feeling deep gratitude for Sue and Emotionally Focused Therapy. Thanks to Sue, I could profoundly impact my clients’ lives in ways I never imagined when starting my career.

In this same professional home I met colleagues from around the world, some of whom are now amongst the most dear and important people in my life. They are family. I’m glad Sue knew how grateful we were for the connections she fostered – connections evident at EFT summits, trainings, and online.

Sue Johnson embodied what she taught.

I wasn’t a close, personal friend of Sue. But I did spend some time with her and did correspond with her periodically- and this always felt close and personal. You could feel her attentiveness and focus in a way that I can only describe as “honoring”. Sue engaged in this way, and I think this way of attending was a big part of what she helped therapist students find in their work. I’ll treasure my correspondence with her, the opportunity I had to do a live case consultation with her and my role in continuing to grow a community of EFT therapists in the Reno/Tahoe area.

My heart goes out to the Sue’s family, the people closest to her and other colleagues experiencing her loss. Sue’s work will not only live on, but will continue to be expanded upon and proliferate. Here is a link to an article in the Ottawa Citizen where you can learn more about Sue and her work.

Cover photo of Dr. Sue Johnson (PHOTO BY BRUNO SCHLUMBERGER /Postmedia)

Relationship Counseling in Reno: Support for Healthy Relationships

Relationship Counseling in Reno offices of Emotional & Relationship Health, Counseling Associates. Therapy in Reno

Relationship Counseling in Reno: Support for Healthy Relationships

Our therapists in Reno provide skilled relationship counseling, where individuals and couples can explore and enhance their emotional connections within the framework of attachment-science-based therapy.

What is Relationship Counseling?

Relationship counseling is an intentional, focused, structured process. One where clients engage with a therapist to dissect and address the nuances of their relationship. It’s a chance to look, without judgment or side-taking, at the emotional undercurrents that influence relationship functioning. In a safe, accepting therapeutic setting, couples experience articulating their feelings, listening and being listened to, and validating each other’s experiences. Very importantly, this process is not about assigning blame. Rather, it is about discovering, distilling and uncovering. Specifically, uncovering how each partner’s early experiences and the behaviors these experiences have shaped contribute to how they show up in relationship. It’s a step toward mutual understanding and empathy, providing a foundation for more authentic and supportive interactions. By participating in counseling, couples commit to a journey of self-discovery and joint growth, laying the groundwork for a more resilient and fulfilling partnership.

Benefits of Relationship Counseling

Improved Communication

One of the primary benefits of relationship counseling is the enhancement of communication skills. Counselors facilitate discussions that help partners articulate their needs, fears, and desires more clearly, fostering a deeper understanding. This process is crucial for breaking down walls of misunderstanding and building bridges of care. In this way couples learn not just to talk but to communicate with intention, listening not only to words but to the emotions and meanings beneath them. This heightened level of communication fosters a sense of closeness and trust, enabling partners to express themselves freely and understand each other on a more profound level.

Conflict Resolution Skills

Effective conflict resolution is another significant benefit of relationship counseling. With this aim, couples learn to approach disagreements with a mindset geared toward resolution and mutual understanding rather than victory. The counselor introduces strategies to de-escalate tensions, promote constructive dialogue, and explore underlying issues contributing to conflicts. This approach helps partners see conflicts as joint problems to solve rather than battles to win, shifting the dynamics from adversarial to collaborative. As couples develop these skills, they find that conflicts become less frequent and less intense, and they’re able to navigate disagreements with greater ease and understanding.

How Relationship Counseling Works

Understanding the Issues

The initial phase of relationship counseling involves delving into the couple’s history, individual backgrounds, and the specific challenges they face. This exploration is guided by the principles of attachment-science-based therapy, which emphasizes the importance of secure emotional bonds. The therapist helps the couple identify patterns of interaction that may be rooted in their attachment styles, offering insights into how these patterns influence their relationship. This phase is crucial for setting the stage for meaningful change, as it lays bare the dynamics that need addressing. By gaining a comprehensive understanding of the issues at hand, couples and therapists can collaboratively devise a path forward that honors each partner’s needs and the relationship’s potential for growth.

Developing Action Plans

With a clear understanding of the relationship’s dynamics, couples move on to developing actionable strategies to address their challenges. These plans are tailored to the couple’s unique situation, focusing on fostering secure, supportive interactions based on attachment science. Goals always include enhancing emotional availability, improving responsiveness, and creating a more secure attachment bond. The therapist works closely with the couple, providing guidance, support, and feedback as they experiment with new ways of relating to each other. This phase is dynamic and interactive, with the therapist adapting strategies as the couple evolves, ensuring that the action plans remain relevant and effective in promoting healthy, lasting changes in the relationship.

Finding the Right Counselor

Selecting a therapist who aligns with your values and understands the nuances of your relationship is pivotal. In Reno, where we practice attachment-science-based therapy, it’s essential to find a counselor with expertise in working with relationships. Our approach at Emotional & Relationship Counseling Associates, focuses on building and reinforcing secure attachment bonds, a fundamental aspect of healthy relationships. When choosing a counselor, consider their background in attachment theory, their experience with couples, and their approach to therapy. It’s often helpful to schedule an initial consultation to gauge the therapist’s compatibility with your needs and to discuss your goals for counseling. The right therapist should provide a safe, non-judgmental space where both partners feel comfortable and supported, fostering open communication and genuine progress in the relationship. In this supportive environment, couples can explore their dynamics, address their challenges, and work collaboratively towards a stronger, more connected partnership.

Questions To Ask a Prospective Couples Therapist

Cornelius Sheehan, LCSW, seated. Therapist in Reno for Relationship counseling

Starting couple’s therapy is a significant step towards improving your relationship. However, finding the right therapist for you and your partner can be difficult. It requires an evaluation process, for which you need the right criteria. You want confidence that the therapist’s expertise aligns with your specific needs. A prospective therapist should be willing to do a brief consultation before you begin working together. Below, I’ve shared a list of what experience has taught me are some of the most important questions to ask a therapist you’re considering working with. I’ve divided the questions into three categories: 1) A Therapist’s qualifications. 2) The therapist’s theoretical perspective on relationship distress, and on wellness. 3) The therapist’s process.

Here is a checklist of questions you might ask during a consultation with a potential new couple therapist to find out if they’re right for you:

Couple Therapist Qualifications

Experience and Professional Engagement
Approximately what percentage of your practice over the last two years has been dedicated to working with couples?” And, “do you have a regular consultation process wherein you discuss your work?” These questions aim to assess the therapist’s dedication to couples therapy. A therapist applying techniques learned for individual therapy to the complexities of a couple’s dynamics can fall far short of what a relationship needs.

Specialized Couple Therapy Training and Qualifications
What specific training in couples therapy have you undertaken?” Exploring their specialized training provides insight into their qualifications and dedication, facilitating the process of finding the right therapist for you. Prospective therapists should be able to describe application of a method of therapy relative to their training. An EFT Couple Therapist can describe their process in a detailed fashion.
“Do you have specific training regarding difficulties related to sexuality?” This is an important question for couples struggling with problems relating to sexuality to ask.

Feedback and Evaluation Process
“How do you provide feedback and evaluate progress in therapy?” This question allows couples to understand how the therapist assesses progress and navigates therapeutic milestones. A transparent feedback mechanism is vital for ensuring that therapy remains aligned with the couple’s goals and for making necessary adjustments to the therapeutic approach.

Couple Therapist’s Theoretical Orientation

Therapist’s Theoretical Orientation
“What theoretical perspective guides your work with couples?” It is essential that the therapist operates from a solid theoretical foundation, such as Attachment Theory, which is at the heart of Emotionally Focused Couple Therapy (EFT). The approach a therapist takes should be grounded in solid theory. Also, there should be a structured methodology to effectively address relationship distress.

Does the Therapist Understand When NOT to Do Couple Counseling?
“What are the Contraindications to Couple Therapy?” A prospective therapist should be clear about this. They should describe when the type of couple’s therapy they do might not be the best choice or should be approached with caution. Common contraindications follow: Severe mental illness and substance use disorders that interfere with participation. Misaligned agendas for therapy. Ongoing affairs that threaten a partner’s sense of security. Also, a risk of violence that prohibits vulnerability. In some cases, addressing the contraindicating issue (such as through individual therapy, addiction treatment, or safety planning) can make couple therapy like EFT a viable option later on.

Therapist’s Focus: Emotional Connection or Behavioral Contracts?
“How important is the emotional bond versus behavioral contracts in your approach to couple dynamics?” Herein, a therapist who emphasizes strengthening the emotional connection addresses the core issues of relationship distress effectively. The late Dr. Sue Johnson’s insight, “it’s about the bond, not a bargain,” poignantly captures the essence of couple therapy.

Perspective on Enhancing Communication Skills
“How do you work to enhance communication skills in your therapy sessions?” Ideally, the therapist’s approach should highlight the importance of fostering trust that your partner is available, responsive and emotionally engaged. By contrast, a focus on mere communication techniques can interfere with the depth of understanding in the relationship. “I statements” and similar “communication tips” don’t come online readily when intense emotion gets stirred. This is a very important distinction in finding the right therapist for you.

Couple Therapist’s Process

Expectations for Therapy Duration and Frequency
“What are your expectations for the duration and frequency of therapy sessions?” This question helps set realistic expectations for the therapy process. For example, you want to understand how long it might take to see improvements and how often sessions will occur. Therapy is a significant investment. It’s crucial for planning and commitment to the therapeutic journey that you know what to expect.

Strategies for Enhancing Connection Outside Therapy
“What strategies do you recommend for couples to enhance their connection outside of therapy sessions?” A therapist who offers practical tools, exercises and resources for couples to work on between sessions demonstrates a proactive approach to therapy. This can help accelerate progress by encouraging partners to actively engage outside the therapeutic setting.

Approach to Individual Sessions
“Do you conduct individual sessions with partners?” Generally, therapy should involve both partners, with individual sessions reserved for specific assessment purposes. This approach reflects the therapist’s commitment to treating the relationship as the central client. Further, you probably don’t have the right therapist for you if they don’t have a clear policy about how to treat informations shared during individual sessions!

Ensuring Impartiality
“How do you maintain impartiality in your sessions?” Asking this question probes the therapist’s strategy for navigating complex couple dynamics. Thereby, ensuring they view the relationship as an interconnected system. I think it’s so important to feel confident about a prospective therapist’s answer to this question. This is because the experience of therapist bias toward one partner is a primary reason clients cite for therapy “failing.”

Summary: Finding the Right Therapist for You

Selecting the right couple therapist is a process. Importantly, one that requires careful consideration and inquiry. The list of questions provided herein are designed to provide meaningful insights. Specifically, insights into a therapist’s approach, philosophy, and their suitability for navigating the complexities of your relationship. We invite your questions and offer a no-cost, confidential consultation.

I hope this approach helps ensure you get couple counseling underway with the right therapist. Ideally, you’ll be with a compassionate, well-trained professional who provides a clear vision of process and goals. And of course, one who can effectively support and guide you through the challenges and opportunities of strengthening your relationship.

Cornelius Sheehan, LCSW is an experienced couple's therapist in Reno, NV and writes about helping you find the right therapist and get the most out of therapy.

“The Science of Relationships: Healing, Emotion, & Connection with Drs. Sue Johnson & Jim Furrow”

Drs. Sue Johnson and Jim Furrow discuss attachment and improving relationships, with Pam King

With & For“, a podcast hosted by Dr. Pam King.

This is a wonderfully warm and informative program where Sue and Jim discuss the core importance of relationship, and improving relationship. The following topics are covered:

• Living in a way this is, “fully alive.”

• How to bring together the spectrum of emotional realities with our lived experience

• Today’s loneliness epidemic; what to do about it

• The importance of empathy and caring in the healing process

• What is attachment science? And, the role of attachment figures in thriving relationships

• Improving relationships: therapeutic and relational practices that lead to security, a sense of worth, and competence in life.

From the show host: “Our society doesn’t want to hear about how interdependent we are—doesn’t want to hear that if we want to thrive, we have to put people first and we have to create community. And people need connection with others like they need oxygen. If you create a world where that connection isn’t very available or it all happens on a screen, you are going to have huge problems. You are going to have huge problems with depression, anxiety, suicide, emptiness—people are going to make terrible choices.” (Sue Johnson) We need each other. We are relational beings, and our thriving—or languishing—often hinges on relationships. In this episode, psychologists Sue Johnson and Jim Furrow not only explain why relationships are so important, they offer practical advice on how to pursue healing, emotional regulation, and lasting thriving in all kinds of relationships. Sue Johnson is the creator of Emotionally Focused Therapy, the gold standard in tested, proven interventions of couples and author of many books including Hold Me Tight: Seven Conversations for a Lifetime of Love. Jim Furrow is a marriage and family therapist and an internationally renowned trainer of Emotionally Focused Therapy. This conversation goes from profound to practical, covering the biological and psychological science to explain why belonging gives way to becoming. We discuss the rampant emptiness and loneliness, fear, and depression people today experience and the connection between relationships and a sense of meaning in life. Sue and Jim also provide a framework for how to understand your attachment style and the way it impacts your relational health. And they discuss the practical ways we can grow and change so that we can engage in and sustain fulfilling and life giving relationships.”

Our EFT relationship therapists in Reno will help you learn more about improving relationships. Contact us for a free consultation.

“Side by Side: Navigating OCD Treatment with EFT Couple Counseling”

Couple coping effectively with OCD, walking outdoors with their son

Last week I did a presentation on what I was very surprised to find is an under-recognized area of OCD treatment: the impact of attachment theory on relationships affected by OCD.  Thrive Wellness co-sponsored an OCD Symposium in Reno that provided the opportunity to discuss OCD from a relational perspective. This article shares (in broad strokes) some key points from the presentation. In the “conclusions” section I focus on specific ways Emotionally Focused Therapy (EFT) can support couples facing the challenges posed by OCD in a connected, teamed-up way.

Understanding OCD within the Relationship Context

OCD’s influence on relationships extends beyond the individual symptoms of compulsions and obsessions. It can disrupt the normal flow of emotional connectivity and communication, leading to misunderstandings and emotional distance.

Assessment and Education

The therapeutic process begins with assessing the specific ways OCD affects the relationship and educating both partners about the disorder. This foundational step helps demystify OCD and sets the stage for collaborative problem-solving.

Identifying Patterns

Identifying negative interaction patterns is crucial to improving your relationship. For instance, compulsive behaviors might lead to frustration in one partner, resulting in a cycle of withdrawal and disconnection. Recognizing these dynamics allows couples to start addressing them.

Facilitating Emotional Engagement

Creating a Safe Space: A core aspect of EFT is creating a safe environment for both partners. This involves encouraging openness and vulnerability, especially for the partner with OCD, to share their fears and needs without fear of judgment.

Expressing Emotions: The therapist guides both partners in expressing their feelings related to the OCD symptoms, uncovering often-hidden emotions like isolation or resentment. This step is vital for understanding each other’s experiences.

Reframing the Problem: Viewing OCD as a shared challenge rather than a source of division is a powerful reframing technique. It encourages a united approach to managing the disorder’s impact on the relationship.

Enhancing Connection and Understanding

Through guided conversations, the therapy helps deepen the emotional connection. The partner with OCD explores and expresses their deeper fears, while the other partner learns to articulate their emotional experiences, leading to a strengthened bond.

Promoting Acceptance and Building New Patterns

Accepting the presence of OCD in relationship while working on effective management strategies is a delicate but necessary balance. The therapist works with the couple to develop new responses to OCD symptoms that foster connection rather than disconnection.

Consolidating Gains

Therapeutic progress is solidified by experiencing and discussing new ways of interacting outside of therapy sessions. This step is crucial for ensuring that the relationship continues to grow stronger, even in the face of OCD.

Collaborative Approach with Individual Therapy

A collaborative approach, involving coordination with the partner’s individual OCD treatment, ensures that therapy addresses both the couple’s relationship dynamics and the individual’s OCD management.


The OCD Symposium in Reno served as a valuable forum for discussing the integration of attachment theory into the treatment of OCD-affected relationships. Emotionally Focused Therapy offers a framework for couples to navigate OCD’s challenges, emphasizing the importance of a secure emotional bond and effective communication.

Here’s how EFT could be effective for couples where one or both partners have OCD:

  1. Improving Communication: EFT helps couples communicate more effectively, especially about sensitive issues like the impact of OCD on their relationship. It encourages partners to express their feelings and needs more openly and empathetically.
  2. Enhancing Emotional Support: By focusing on emotional attachment, EFT helps partners become more responsive to each other’s needs. For someone with OCD, having a supportive partner who understands their struggles can be crucial for managing symptoms.
  3. Reducing Relationship Stress: OCD can add significant stress to a relationship, which can exacerbate OCD symptoms. EFT aims to reduce relationship tensions by improving emotional connection, which can, in turn, create a more supportive environment for managing OCD.
  4. Building a Secure Attachment: A secure attachment can provide a solid foundation for individuals with OCD to face their fears and engage in exposure and response prevention (ERP) therapies more effectively. Knowing they have a supportive and understanding partner can make facing OCD challenges less daunting.
  5. Improving Coping Strategies: Couples can learn to identify and modify maladaptive coping strategies that may be reinforcing OCD symptoms. EFT encourages healthier ways of coping with emotional distress, which can indirectly help in managing OCD.
  6. Enhancing Treatment Compliance: Individuals with OCD who feel supported in their relationships may be more likely to adhere to individual OCD treatment plans, including medication and cognitive-behavioral therapy (CBT).

Closing thoughts about OCD and Relationship

It’s important to note that while EFT can improve the relationship dynamics that affect and are affected by OCD, it does not directly treat OCD symptoms. For direct treatment of OCD, evidence-based approaches such as CBT and ERP are recommended. Couples therapy, including EFT, can be a complementary approach to these treatments, especially for addressing the relational aspects of living with OCD.

The journey towards understanding and managing the relational impact of OCD is ongoing. As we continue to explore this intersection, the insights gained can guide more nuanced and effective approaches to support couples in strengthening their relationships in the face of OCD.

Feedback and dialogue on this topic of OCD in relationship are welcome. Please share your thoughts or experiences regarding the role of attachment theory in OCD treatment. For further discussion or inquiries, feel free to contact me at: con@erha-reno.com.