Thinking about couples counselling: what it costs and how it starts

Most couples who come to us have been thinking about it for a long time. Months, often longer. The searching usually starts on a bad night and stops again by morning, and it repeats like that for a while before anyone books anything.

So if you've been circling this, you're in ordinary company. Here's what it costs, what happens, and the questions people tend to want answered before they pick up the phone.

The money

Couples sessions at our clinic are between $140 and $250. Individual sessions are between $100 and $185. Most couples work is weekly or every other week at the start, and gets less frequent as things settle.

Extended health insurance is where it gets complicated, and it's worth understanding before you're surprised by it.

Many plans in Ontario cover services from a Registered Psychotherapist, and if yours does, we give you the paperwork your insurer needs. What catches people out is that a fair number of plans cover individual therapy but treat couples therapy differently, or exclude it. That varies by plan, not by clinic, so the only reliable answer comes from your own policy.

Two things are worth checking before you book anywhere. Ask whether your plan covers Registered Psychotherapists specifically, since coverage is often written by profession. And ask whether relationship or couples counselling is included, because it is sometimes carved out separately.

We also hold a small number of sliding scale spots. If cost is the thing stopping you, it's worth asking rather than assuming.

What happens in the room

The first session is mostly listening. Both of you talk, we ask questions, and by the end there's usually some shape to what's going on that neither of you had quite put into words.

You will not be asked to perform your relationship. There's no exercise waiting, nobody gets assigned homework in session one, and it is not a courtroom where a therapist decides who's right.

What we're doing early on is looking for the pattern. Almost every couple arrives with a list of incidents, and almost every list turns out to be the same argument wearing different clothes. Finding that shape is most of the early work, because you cannot change a pattern you're still experiencing as a series of unrelated bad evenings.

The question nobody asks first

A lot of couples want to know whether therapy will keep them together, and are slightly embarrassed to ask.

It's a fair question, and it deserves a straight answer: that isn't the goal. The goal is that you both understand what's happening between you well enough to make a real decision about it. Sometimes that decision is to stay and do the work. Sometimes it's to separate with more clarity and less damage than you would have managed alone.

We're not going to promise you an outcome. Anyone who does is telling you what you want to hear.

If you want to test that against a real person rather than a page, a free consult is thirty minutes, and either of you can book it.

Going on your own

If your partner won't come, or isn't ready, that isn't the end of it.

Individual work on a relationship is a real thing, and it's more useful than people expect. You can look at your own part in the pattern, what you're bringing to it from long before this relationship, and what you want out of it, without needing anyone else in the room to agree first. Some couples end up in joint work later because one person started alone.

If you're deciding whether to start

Two things worth knowing.

Couples usually come in later than they'd have liked, and the most common thing we hear afterwards is that they wish they'd come sooner. There's no threshold of badness you have to reach. "Things are fine, but something's off" is a completely reasonable reason to book.

And the fit matters more with couples than almost anywhere else, because both of you have to feel the room is fair. If the person you meet with isn't right, we'll set you up with someone else on the team at no extra cost.

Starting

If things are unsafe at home, that changes the picture and couples counselling is not the right first step. Call 9-1-1 if you're in immediate danger. The Assaulted Women's Helpline is 1-866-863-0511, free and 24/7. If you're in crisis, 9-8-8 is available any time. More on our crisis page.

Otherwise, a free consult is thirty minutes, and either of you can book it. You don't both have to be certain to start.