01
Start with where the pain shows up
A useful first question is where the problem feels most alive. If most of your distress shows up in the relationship, in the same fight, the same silence, or the same feeling of being misunderstood by one person, couples sessions give both partners a place to look at that pattern together.
If the distress follows you into every setting, at work, with friends, and when you are alone, individual therapy can give you room to understand what you are carrying before asking a partner to change alongside you.
02
Signs couples therapy may fit first
Couples therapy often makes sense when both partners are willing to attend, when conflict follows a recognizable cycle, or when differences in communication, neurotype, or attachment keep turning ordinary moments into injuries. It can also help when one partner has received a new ADHD or autism diagnosis and both people want to understand how it affects the relationship.
Partners do not need identical goals. They do need some shared interest in understanding what happens between them.
- The same argument keeps returning
- Repair attempts are not landing
- A diagnosis has changed how you see each other
- Both partners are willing to attend
03
Signs individual therapy may fit first
Individual therapy may come first when a partner is not ready to attend, when you need room to sort out what you want, or when anxiety, depression, burnout, or trauma make joint conversations hard to manage. It can also be the better choice when you are considering separation and want to think clearly before deciding anything.
Choosing individual work does not mean giving up on the relationship. Understanding your own patterns often changes how you show up with a partner, and it can make later couples sessions more productive.
04
When safety is a concern
Couples therapy is not the right setting when one partner feels afraid of the other or is being controlled, threatened, or harmed. In that situation, individual support and safety planning come first. If you are in danger, call 911. For immediate crisis support, call or text 988.
A therapist should ask about safety early, and you can raise it yourself at any point, including privately.
05
You can change course
The first choice is not permanent. Some people begin individually and invite a partner later. Some couples pause joint sessions while one partner focuses on individual work, then return together. A therapist can explain what they offer and how they handle these shifts.
Bethany offers both individual and couples therapy by telehealth, in 60-minute sessions, to adults located in Missouri. In a video consultation, you can describe your situation and ask which format makes more sense to start with.