Why Partners Resist Couples Therapy — and How MFTs Can Respond

In a June 14, 2026 CBS Sunday Morning interview covered by Us Weekly, Usha Vance said therapy "didn't work" for her husband, Vice President JD Vance, and that "church does."¹ That candid remark spotlights what the data confirm: roughly one in three couples who begin therapy end it prematurely, often because one partner never fully buys in.

Resistance is not a character flaw but a predictable response shaped by trauma history, cultural norms, and mistrust of the therapeutic process. For MFT career paths, the challenge is not eliminating resistance but reading it accurately and adapting early engagement strategies to meet the couple where they actually are.

When Therapy 'Doesn't Work': What the Vance Interview Reveals About Therapeutic Fit

Some clients find profound healing in the therapist's office; others discover it in a sanctuary. When a partner says "therapy didn't work," the impulse may be to label them resistant or unmotivated. But the high-profile comments from Usha Vance about her husband, Vice President JD Vance, invite MFTs to reconsider: perhaps the therapy didn't fail, perhaps the fit was wrong. In a CBS Sunday Morning interview aired June 14, 2026, Usha Vance revealed that she once told her husband, "Therapy didn't work for you, church does."¹ That simple statement captures an essential truth for marriage and family therapists: not every client will find traditional clinical modalities to be their path to stability and change.

The Vance Family's Public Lesson on Healing Pathways

JD Vance's journey from a chaotic upbringing in Middletown, Ohio, to a conversion to Catholicism in 2019 illustrates the search for rootedness that traditional therapy sometimes cannot provide.¹ With divorced parents and a mother who struggled with substance abuse, Vance described feeling a need for something "rooted" and "stable" in his life. For him, church offered a community, a set of rituals, and a structured moral framework that the therapist's office did not supply. This does not mean that therapy is ineffective; it highlights how a client's unmet needs, for belonging, existential meaning, and intergenerational continuity, might be better addressed through spiritual or communal contexts.

Reframing 'Failure' as Therapeutic Mismatch

The distinction matters for practicing MFTs. Therapeutic failure implies a flaw in the clinician's skill or the client's engagement. Therapeutic mismatch acknowledges that even evidence-based approaches can be ill-suited to a particular person's trauma history, cultural background, or coping style. When a client's early experiences have been marked by instability, the clinical setting itself may feel artificial or untrustworthy. A therapist who insists on standard talk therapy without exploring the client's broader ecosystem of supports risks reproducing the very invalidation that may have fueled the distress.

Embracing Cultural Humility in Treatment Planning

For MFTs, this case underscores the importance of multicultural therapy competencies , the ongoing practice of self-reflection and curiosity about how a client's identity and values shape their healing preferences. Recognizing that church, spiritual communities, 12-step groups, or other non-clinical supports can be legitimate components of a treatment plan is not a concession; it's a clinically sophisticated stance. When a partner declares therapy ineffective, the therapist can use that feedback to co-create a hybrid approach that honors the client's worldview while still addressing systemic family patterns. The goal is not to convince every client that therapy works, but to help them find what does.

A Typology of Resistance in Couples Therapy

Resistance in couples therapy is not a monolithic barrier but a nuanced signal that, when correctly identified, reveals precisely where therapeutic work must begin. While many clinicians initially view resistance as simple uncooperativeness, decades of clinical observation have distilled it into three distinct types, each demanding a fundamentally different response from the therapist.¹ Recognizing these patterns transforms resistance from an obstacle into a diagnostic tool.

Realistic Resistance

This form emerges when a partner consciously opposes an intervention that feels misaligned or unacceptable.¹ It is not rooted in avoidance but in a genuine mismatch between the client's needs and the therapist's approach. A partner might object to a particular technique, feel uncomfortable with the therapist's style, or react to demographic differences like gender, ethnicity, or age.¹ Crucially, realistic resistance often signals a rupture in the therapeutic alliance that, if acknowledged openly, can strengthen the working relationship. Rather than ignoring these objections, skilled therapists invite them, reframe them as valid feedback, and collaboratively adjust the treatment plan.

Process Resistance

Here the client genuinely wants the relationship to improve but balks at the effort required to make it happen.¹ They may articulate a desire for change yet repeatedly fail to complete homework, practice communication skills, or apply new behaviors between sessions. This resistance is not about goals but about the process itself: the vulnerability of practicing new roles, the discomfort of breaking old habits, or fear of temporary instability. Effective responses normalize the struggle, set smaller incremental goals, and highlight moments when the client did engage productively, building momentum rather than assigning blame.

Outcome Resistance

Outcome resistance is the most subtle and the most critical to identify. At an often unconscious level, the client does not truly want the change that therapy would bring, because their presenting problem serves a hidden function.¹ For example, chronic relationship conflict may protect a partner from deeper intimacy, or a depressive stance may have become central to their identity and sense of stability.¹ Working through outcome resistance requires helping the client explore what would be lost if the problem were solved, often by gently naming ambivalence and examining secondary gains.

Understanding this typology equips therapists working on effectiveness over time to move beyond frustration and offer precisely targeted interventions, turning resistance into a roadmap for what the couple most needs to address.

Why Partners Refuse or Resist: Psychological, Cultural, and Practical Barriers

Therapy's recent cultural prominence has not erased the deep-seated barriers that keep many partners from making that first call. Resistance to couples counseling often masks a tangled mix of personal fears, cultural scripts, and real-world obstacles that must be understood before they can be overcome.

Psychological Barriers: Fear, Shame, and a History of Hurt

For many individuals, the very act of entering couples therapy carries meanings that can feel dangerous. Fear of vulnerability , of revealing long-held resentments, desires, or wounds , often leads to avoidance. Partners with insecure attachment styles may believe that discussing relationship difficulties will only accelerate abandonment or rejection. Shame compounds this: admitting the need for professional help can feel like a public declaration that the relationship, or the individual, is broken. Prior negative therapy experiences, where a partner felt judged or blamed, further reinforce the belief that therapy is unsafe. These psychological roadblocks are not simply stubbornness; they are protective mechanisms born from pain.

Cultural and Religious Stigma: When Seeking Help Feels Like Betrayal

Cultural norms shape who seeks therapy and why. In communities where mental health treatment is stigmatized, couples counseling may be seen as a last resort reserved for serious mental illness, not routine relationship maintenance. Among some Latino populations, for instance, national data indicate that utilization of mental health services is roughly half that of white Americans, while psychiatric hospitalization rates are double, suggesting a tendency to delay care until crises erupt.¹ Similarly, research notes that up to three-quarters of minority clients who felt unsatisfied with therapy reported that their therapist was unaware of power dynamics affecting their lives.² Gender expectations also loom large: traditional masculine norms often define emotional disclosure as weakness, making many men resistant to couples work. In conservative religious communities, marital struggles may be framed primarily as spiritual issues, not clinical ones, leading partners to seek prayer and pastoral guidance instead of a licensed marriage and family therapist.

Practical Hurdles: The Real-World Obstacles to Sitting on the Couch

Even when a partner is willing, practical constraints can extinguish the first spark of motivation. The cost of weekly sessions, which can range from $100 to $250 or more, remains prohibitive for many families, especially when insurance coverage is limited or absent. Scheduling conflicts between work, caregiving, and commute times make consistent attendance a logistical puzzle. In rural areas, a shortage of trained MFTs means traveling long distances for an appointment, a barrier that effectively rules out therapy for those without flexible schedules or reliable transportation. The perception that therapy is a luxury, rather than an investment, further undercuts the financial calculus for families already stretched thin. When combined, these practicalities can make therapy feel unreachable, even before psychological resistance enters the picture.

Couples Therapy Dropout and Resistance: What the Numbers Say

Even motivated couples often struggle to stay in therapy. These figures highlight where engagement breaks down and underscore why building trust from the first session is a clinical priority.

Therapist Strategies for Engaging Resistant Partners

Engaging a partner who attends therapy under duress or with deep skepticism requires more than a standard intake session. Marriage and family therapists (MFTs) must deploy a deliberate set of strategies designed to lower defenses, reframe the purpose of therapy, and build a fragile alliance from the first contact. The approaches outlined here are grounded in widely recognized clinical modalities, and therapists seeking deeper training should consult therapy approaches used by MFTs, professional associations like the American Association for Marriage and Family Therapy (AAMFT), and research databases where outcome studies are published.

Evidence-Based Approaches to Engagement

Several therapeutic models have been adapted to address resistance directly. Emotionally Focused Therapy (EFT), for example, emphasizes de-escalation and accessing vulnerable emotions before pushing for change, which can help a reluctant partner feel heard rather than blamed. The Gottman Method incorporates specific interventions like softened start-ups and repair attempts that can be practiced even when one partner is disengaged. Integrative Behavioral Couple Therapy (IBCT) uses acceptance strategies alongside behavior change, making it useful when a partner resists traditional problem-solving. Motivational interviewing techniques, originally developed for addiction, are now routinely woven into couples work to explore ambivalence without confrontation; MFTs working with substance-affected relationships can find further context in a guide on couples addiction therapy for MFTs. Program curricula in accredited MFT programs often detail which modalities are emphasized during graduate training.

Building the Therapeutic Alliance

Before any technique can succeed, the therapist must earn a sliver of trust. This begins with normalizing the resistance itself, acknowledging that skepticism about therapy is common and sometimes protective. In early sessions, effective therapists validate the reluctant partner's perspective, explore the meaning behind their reluctance, and set collaborative goals that do not presuppose the outcome (for example, "Let's understand what's happening" rather than "Let's fix the relationship"). Simple structural accommodations, such as alternating individual and conjoint sessions, can also reduce pressure. A commitment to multicultural therapy competencies is equally essential, since a partner's distrust may be rooted in cultural or historical experiences that mainstream therapeutic models do not automatically address. These skills are honed through supervised clinical practice, a hallmark of accredited MFT programs.

Where to Learn More

For those building a career in this field, understanding engagement strategies is both a clinical and a professional asset. Government resources like the Bureau of Labor Statistics (BLS.gov) offer data on the employment outlook for marriage and family therapists, though they do not break down the specific competencies employers value. Job listings and interviews with clinical directors suggest that therapists who can work effectively with ambivalent couples are in high demand. Aspiring MFTs should explore degree program websites, where they will find descriptions of coursework in relational therapy, resistance management, and multicultural competency. Professional associations, including AAMFT, publish clinical guidelines and host continuing education workshops on topics like discernment counseling and ethical engagement. By pursuing these resources, therapists can build a toolkit that transforms resistance from a barrier into a doorway for deeper therapeutic work.

Discernment Counseling Vs. Repair-Focused Therapy: Matching the Approach to the Resistance

The field has increasingly acknowledged that not all couples presenting for therapy are ready for repair, a recognition that has elevated discernment counseling as a critical entry point for mixed-agenda couples. Discernment counseling, developed by Bill Doherty, is designed for couples where one partner is leaning out of the relationship while the other is leaning in. Unlike standard couples therapy, which assumes mutual commitment to work on the relationship, discernment counseling helps couples clarify the future of the relationship itself before deciding whether to engage in repair work.

The Three Pathways of Discernment Counseling

It offers three possible outcomes: maintaining the status quo, moving toward separation or divorce, or committing to six months of intensive couples therapy with a clear, time-bound effort to repair the relationship. This structure empowers the ambivalent partner by giving them control over the decision, thereby reducing resistance rooted in feeling coerced. By framing the process as an exploration rather than a fix, therapists can lower defenses and foster genuine engagement.

When Repair-Focused Therapy Is the Right Fit

Repair-focused approaches like Emotionally Focused Therapy (EFT) and the Gottman Method therapy are best suited for couples who are already committed to the relationship but struggle to navigate conflict or emotional disconnection. The key diagnostic question is whether the resistance stems from ambivalence about the relationship itself or from fear of the therapy process. If a partner is unsure about wanting to stay, asking them to invest in skills-building exercises can backfire and intensify resistance. In those cases, discernment counseling is the more appropriate entry point.

A Bridge to Commitment

Discernment counseling is intentionally brief, typically one to five sessions, making it a lower-commitment option. This brevity reduces the perceived threat and can serve as a bridge to repair-focused therapy if both partners decide to pursue it. By respecting the ambivalent partner's autonomy, therapists build a foundation of trust that is essential for any subsequent therapeutic work.

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Ethical Considerations: Coerced Attendance, Ultimatums, and Contraindications

The pull between a therapist's impulse to help and the ethical mandate to do no harm is never sharper than when a reluctant client walks through the door. The presence of an ultimatum, a court order, or undisclosed safety risks forces every MFT to pause and ask whether couples therapy can truly proceed without causing further damage.

The Ultimatum Client: Can Informed Consent Exist Under Duress?

A partner who attends under threat of separation presents an immediate ethical puzzle. The therapist must discern whether the reluctant participant has any authentic willingness to engage. Without at least a sliver of voluntary agency, therapeutic work is compromised from the start. The AAMFT Code of Ethics underscores that informed consent must be freely given; if the only reason for attendance is to avoid a breakup, the therapist should assess the power dynamics carefully. A joint session may instead morph into a forum for blame, further alienating the resistant partner. In such cases, a preliminary individual session or a shift to discernment counseling can clarify whether the couple is ready for conjoint work.

Court-Ordered Couples Therapy: Appropriate Use and Contraindications

Courts sometimes mandate couples therapy in custody disputes or high-conflict divorce proceedings, aiming to improve co-parenting. In these situations, the therapist's role is narrowly defined, focusing on communication and collaboration rather than repairing the romantic bond. However, court-ordered couples therapy is unequivocally contraindicated when there is a history of intimate partner violence. Bringing an abuser and survivor together in a therapeutic setting can escalate danger, as the AAMFT Code of Ethics explicitly warns. In such cases, the therapist must advocate for individual treatment and safety planning, refusing to proceed with conjoint sessions.

Responding to Disclosures of Abuse: Prioritizing Safety

When a client reveals abuse during the course of therapy, whether it is physical, emotional, or psychological, the clinician must immediately shift focus. Couples therapy ceases to be the priority; individual safety becomes paramount. The therapist should provide resources for the victim, potentially pause joint sessions, and consider whether a referral to a domestic violence specialist is warranted. Setting boundaries in family therapy principles apply equally here: ethical practice demands that the therapist not attempt to "fix" the relationship dynamic while one partner is at risk.

A Practical Ethical Decision Framework

Before proceeding with a reluctant or coerced client, every therapist should ask three questions: - Can this client articulate at least one personal goal for therapy, however small? - Is there any known or suspected history of violence, coercion, or severe power imbalance in the relationship? - Does the legal mandate align with therapeutic goals, or does it conflict with the well-being of either party?

If the answers raise doubt, the ethical path may begin with individual sessions or a clear recommendation against couples work until safety and voluntariness are established.

Implications for MFT Training and Career Readiness

What training gaps leave new marriage and family therapists unprepared for the resistance they encounter in couples work?

The Training Gap in Resistance Skills

Many MFT programs excel at teaching theory and intervention techniques, yet few dedicate structured time to resistance management. Students often practice with willing clients in simulated sessions, which fails to replicate the real-world challenge of a reluctant partner. To close this gap, graduate curricula should embed role-play scenarios where one client actively resists, crossing arms, changing the subject, or challenging the therapist's credibility. Supervised practice with these dynamics builds the emotional regulation and tactical flexibility that classroom lectures alone cannot provide.

Building Cultural Humility into Curriculum

The Vance interview underscores why therapists must recognize when conventional Western therapy does not align with a client's worldview. JD Vance found healing in faith rather than therapy, a path that some clinicians might dismiss instead of explore. multicultural therapy competencies for marriage and family therapists teach students to ask, "What other sources of meaning matter to you?" rather than assuming that talk therapy is the universal answer. This skill proves especially critical when working with couples from collectivist, faith-based, or military backgrounds, where therapy may carry stigma or contradict cultural norms.

Continuing Education Priorities: Discernment Counseling and Motivational Interviewing

New graduates entering couples work should prioritize post-degree certifications that directly address ambivalence. Discernment counseling, designed for mixed-agenda couples where one partner leans out, gives therapists a structured protocol for honoring the uncertainty without pressuring reconciliation. Motivational interviewing adds a conversational style that reduces defensiveness by exploring internal contradictions rather than confronting them. Both approaches translate into higher engagement rates and fewer unilateral dropouts.

Career Readiness: Why Resistance Competence Protects Your Practice

Therapists who can engage resistant partners see lower caseload attrition, stronger clinical outcomes, and more consistent referrals, all of which directly affect practice viability. In a competitive outpatient landscape, the ability to keep a skeptical partner in the room for three sessions instead of one often determines whether a practice thrives or stalls. Specializing in high-resistance couples can also open doors to consultation roles, workshop offerings, and collaboration with legal or pastoral professionals, further strengthening long-term career resilience. Understanding the difference between MFT and LMFT licensure can also help graduates position themselves strategically as they build a specialty practice.

Frequently Asked Questions About Couples Therapy Resistance

Resistance in couples therapy often stalls progress before it begins. These answers draw on clinical research and real-world examples, including the recent Vance interview, to help marriage and family therapists and students navigate common impasses with clarity and confidence.

What should a therapist do when one partner refuses couples therapy?

A therapist should first respect the refusal and avoid coercion. Explore the reluctant partner's concerns through a non-confrontational phone call or separate session. Offer alternatives like discernment counseling or individual therapy for the willing partner. The Vance case illustrates that some clients may respond better to non-clinical supports, such as faith communities, so therapists can discuss those options openly and without judgment.

How can you tell if resistance means your partner wants to leave the relationship?

Resistance often signals ambivalence, not a clear decision to separate. A therapist assesses for patterns: is the partner disengaging, stonewalling, or expressing hopelessness? Explicit statements about leaving are more direct. Without those, therapist can use motivational interviewing to uncover fears, past negative therapy experiences, or unmet needs that resemble an exit wish but are actually cries for change.

Is it ethical to pressure a partner into attending couples therapy?

Pressuring a partner is generally unethical because it undermines informed consent and the therapeutic alliance. MFT ethics codes emphasize autonomy and voluntariness. Ultimatums from one partner or therapist can cause resentment and early dropout. Instead, therapists can invite the reluctant partner with genuine curiosity, explain the process, and offer a no-obligation trial session. Coerced attendance rarely leads to meaningful engagement or lasting change.

How long does resistance usually last in couples counseling?

Duration varies widely. Some partners soften after a single validation-focused session; others need several weeks to build trust. Research suggests that if a solid therapeutic alliance forms within three to five sessions, resistance often diminishes. When resistance persists, it may indicate a poor therapeutic fit, unresolved individual trauma, or a mismatch between the therapy model and the couple's cultural values, warranting a referral or modality shift.

What therapy approaches work best for resistant or ambivalent couples?

Discernment counseling is designed explicitly for ambivalent couples and helps them gain clarity before committing to repair work. For resistance rooted in attachment injuries, Emotionally Focused Therapy (EFT) can de-escalate defensiveness. Integrative behavioral couple therapy addresses practical barriers. Therapists should remain flexible, combining techniques and honoring the couple's unique context, including cultural and spiritual dimensions highlighted by cases like the Vance family.

Can couples therapy work if only one partner attends?

Meaningful change is possible but limited. Individual therapy for the attending partner can reduce reactivity, improve communication skills, and address personal contributions to conflicts, which sometimes motivates the resistant partner to join later. However, core relational patterns typically need both partners present to shift. Starting with one partner is a valid strategy to lower initial resistance, but therapists should continue inviting the other partner without pressure.