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  • Scott & Jenn Welch

The Stages of Marriage/Relationship Counseling

Just minutes after the crash, the paramedics were using the jaws of life to carve Tom and Mary out of their mangled vehicle. The couple was rushed to the Central Hospital Emergency Room where a team of doctors and nurses frantically took over CPR, worked to stop the bleeding, stabilize vitals, and start IV fluids. Thanks to the amazing work of the hospital staff, both Tom and Mary regained consciousness and within the first hour, tests were ordered, and X rays were taken to determine the severity of their injuries. Shortly after the third hour, Tom began feeling better and started to complain about the lack of attention he was receiving from the emergency room staff. Neither he nor Mary had seen a doctor in over 45 mins.


“What’s taking so long?” We’re doing better. When will we be ready to go?” Tom probed.


“The doctor would like to keep you both overnight for observation,” the nurse stated.


“That’s ridiculous!” Tom shouted.


With a calm voice of reason, the nurse explained, “If you leave the hospital before we fully understand the extent of your injuries you might find yourselves right back here in the Emergency Room in even worse shape.”


Indignant, Tom jumped out of the bed, yanked the IV out of his arm, grabbed his wife’s hand and the two of them left the hospital, against medical advice.

Emergencies happen in relationships! Your relationship may have slowly eroded over the years due to communication and conflict management challenges. Or perhaps you’ve just experienced a screeching tailspin as you and your partner find yourselves caught in the mangled wreckage from the discovery of an affair, addiction, or the shock of hearing the words, “I don’t love you anymore.” You and your spouse may need emergency help!


Though many couples seek relationship counseling, studies have shown that 20-57% of people in therapy do not return after the initial session (Lambert). Another 37-45% only attend therapy a total of two times (Schwartz). The Emergency Room stage of relationship counseling takes focused time and attention. When a couple stops treatment too early after a traumatic relationship event it can cause additional damage, pain, and suffering.


Stabilizing the relationship and acquiring skills that will make a meaningful difference in the way you engage with one another usually takes more than an hour. In the Emergency Stage it is best to set up an intensive repair/retreat session that lasts anywhere between 3-8 hours that can be done in one day or spread over a weekend. It is important to choose a therapist who has the skills to analyze the scope of the problem and prioritize your critical needs regarding emergency treatment and relationship stabilization to help you through this perilous time.


The second stage of relationship counseling is the Admission Stage. Tom and Mary were going to be admitted for observation. No one wants to end up back in the emergency room because they had internal bleeding that was causing a potentially deadly clot. If left untreated, that clot could result in a life-altering stroke. Similarly, it is important to schedule weekly or bi-weekly sessions with your therapist after your intensive therapy experience. These meetings will help you identify what led up to the crisis and will provided guided practice and feedback to make the relationship saving changes that were identified as critical during your Emergency Room Stage. Together, you and your counselor can develop a treatment plan to outline what you want to accomplish during these sessions. The Admission Stage may last several weeks to months depending on the intensity of the problems you are addressing in these therapeutic sessions.


The third stage of relationship counseling is the Follow-Up Stage. After a hospital stay you are asked to follow up with your primary care physicians to make sure your progressing well. Your medication, diet and exercises are updated. The Follow-Up Stage of relationship counseling is when you can graduate from the once or twice a week therapy schedule and instead follow up just once or twice a month. During this stage you are checking in on how the use of the new strategies and skills are working in your relationship. Are you experiencing the changes you desire? Are you feeling connected again emotionally and physically? This stage can last anywhere from a couple of months to over a year.


The final stage of relationship counseling is called the Maintenance Stage. Preventive maintenance is the best way to keep things running well. Your counselor should be able to use assessments and inventories to show you how the skills you have learned are being used and where you might need more focused attention. They can also help you set goals as a couple to continue growing together in the best relationship you’ve ever had!

It is important to remember that the issues you and your partner struggle with were not developed over night, nor will they be corrected overnight. Successful therapy takes time and the cost of that investment is spread out over months or years, unlike the exorbitant cost of a break-up or divorce, which is paid in a lump sum!


Tom and Mary found themselves back in the Emergency Room just two days after they left the hospital. Their internal bleeding was so severe that their hospital stay was three times longer than it would have been if they had consented to the time and attention, they needed to fully understand the extent of their injuries and get the treatment they needed. They spent thousands of dollars that could have been avoided if they would have followed the doctor’s direction in the Emergency Room stage of their crisis! Effective counseling should not be focused simply on helping a couple survive crisis. Successful counseling helps each partner become proficient in acquiring and practicing the use of skills and strategies that can take your relationship to a whole new level of health and fulfillment.


If you are experiencing a relationship emergency, give us a call! We can lead you through an intensive session to help you process trauma and stabilize your relationship. If you sense you are ready to work together to embrace new communication and conflict management skills or work toward shared meaning in your relationship, let us set up a few weekly sessions for you to guide you to your goal. Our hope is to quickly help you find a level of connection that will have you looking forward to new depths of connection in your relationship!


Healthy people with strong vital signs make committed choices to improve their BMI. Here, we work to enhance your BME through our 4-week “Best Marriage Ever” program! In BME, couples with strong relationship vitals engage in data-based assessments that provide a clear, in-depth picture of the health of their relationship. The results are used to identify your strengths as a couple and create individualized, data-based goals and intentional strategies to make your relationship even better!


Great relationships do not just happen; they are the results of consistent investments of time, understanding, mutual respect, affection, forgiveness and commitment. No matter where you and your partner are today, if you desire this type of fulfilling relationship, we would love to help you! Give us a call.


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Mosaic Counseling of Florida

Serving Orlando, Tampa, & All of Florida

407-777-5679