Can I do couples therapy with a friend?

Last year I received an e-mail from someone at NPR doing a story on friends who get therapy with each other. They were surprised to learn that over the course of my career, I’ve worked with many friends who have wanted to have therapy sessions together for one reason or another.

The interviewer shared with me that friendship therapy was becoming a bit of a “thing”. That more and more friends were admitting to want to do therapy together. And yet, they weren’t sure where to go. When they looked at therapist websites they would see “couples therapy” or “family therapy” but never “friendship therapy”. As of writing this article, you wouldn’t find it on our site either.

Why? For no other reason then I haven’t had time to put it in and, traditionally, it wasn’t something people were looking for. Now it is and I am so glad.

How can a couples therapist help friends?

Couples therapy is only called “couples therapy” because historically it was utilized to help couples. However, at the core, couples therapists are what we call “systemic therapists”. We go to school to learn about the impact of systems - how do our friends, families, lovers, colleagues, schools, and institutions impact us? What does this do to our mental health? Our functioning? And what can we do within our systems to take care of ourselves and others.

When people come to therapy with a systemic therapist, the therapist will help them see the big picture, understand how their behaviors, feelings, and thoughts are influencing each other and the relationship as a whole and learn new ways of being within relationship.

Which types of issues do friends address in therapy?

During my time as a therapist, I have met with friends for many different reasons. A few of the reasons friends come to therapy are:

  • Conflict

  • Major life changes (i.e. one friend is having a baby and the other is not)

  • Mutual grief ( for example, a mutual friend died and the friends want to process it together)

  • Improving connection (maybe distance has impacted feelings of closeness)

  • Support (for example, a friend might be struggling with depression and their friend accompanies them to therapy as a support person).

  • Concern (One friend is concerned about the other friend and wants to share these concerns in a loving, kind, and direct way with the help of a third party)

What would we do in friendship therapy?

The work in friendship therapy would be very similar to the work done in family or couples therapy. As friends, you would come in and meet with the therapist. During the first session, the therapist will guide you through a series of questions and prompts to better understand each of you and your relationship as a whole. They might explore topics like:

  • How did you meet?

  • What are some of the highlights of your friendship?

  • What has been challenging?

  • What have you tried so far in order to deal with challenges? How are those things working?

  • What are your goals for therapy?

  • Why is this friendship important and meaningful to you?

During that first session, they will likely give you feedback and set out a plan for what your other sessions might look like. Usually, when we meet with more than one person in therapy we take some time to also get to know them individually. During your individual time with the therapist you’ll take time to explore your feelings and share your concerns, thoughts, and hopes.

Once the therapist has a good sense of what is going on in the relationship, you’ll start to have important conversations together, guided by the therapist in the safety of the office (virtual or physical). You’ll also be given feedback on what the therapist notices isn’t working in the relationship and direction on new ways of communicating and behaving with each other.

Will the therapist think it’s weird I am coming to therapy with my friend?

Not at all! Friendships are some of our most important relationships - for many people they are THE most important relationships in their life. Working on improving our relationships is good for our mental, physical and emotional health.

Want to work with one of our systemic therapists with your friend? Email info@abetterlifetherapy.com

Elizabeth Earnshaw