Longer sessions for couples: what they are and who they are for

“Just as we got to the heart of it, it was over.”

She said it in the car on the way back from the session. He just nodded. They both knew what she meant: it had taken them forty minutes to stop talking about who forgot to book the plane tickets and start talking about why she feels like a secretary in this marriage. Then the therapist glanced at the clock. By the following week, everything that had opened up had neatly closed again. In between there were two business trips, one dinner with partners from the firm and one argument exactly like all the previous ones.

The scene is a composite, but the experience is not rare. Couples who live with packed calendars, travel and responsibilities to a company or a wider family often notice that the weekly rhythm of therapy does not flow smoothly for them. Out of this, a question has grown that I hear more and more often: are there also longer sessions for couples — and who are they actually for?

In this piece I will try to answer in a general and honest way: what longer and concentrated sessions are, what we know about them, where they have advantages and where they do not.

How much does couples therapy help at all?

First, the wider picture. Couples therapy is one of the better-researched forms of psychotherapy. A review of the research published in 2012 by Jay Lebow, Anthony Chambers, Andrew Christensen and Susan Johnson concludes that around 70% of couples who come to therapy improve noticeably. That does not mean everyone stays together or everyone is happy — but it does mean that help is not a lottery.

At the same time, couples therapists have long observed that couples often seek help late. By the time a couple arrives, there is often a long history of the same arguments behind them, arguments that have only hardened over the years. I wrote about the signs that it makes sense to come sooner in When to start couples therapy: signs you need help before it is too late.

When a couple has so many years behind them, it is understandable that one hour a week feels short. The question is whether that feeling is also right.

Why the therapy hour lasts an hour

The fifty- or sixty-minute session is so taken for granted in psychotherapy that we rarely wonder where it came from. The answer is more prosaic than you might expect: it did not emerge from research showing it to be the optimal length, but from practice and the organisation of work. An hour fits neatly into a therapist’s working day and a client’s schedule.

That does not mean the hour is bad. For many people it is just right: long enough for something to open up, and short enough that afterwards you can go back to everyday life. The weekly rhythm also has an often overlooked advantage — a great deal of work happens between sessions. The couple tries out a new way of talking, stumbles, brings the experience back. Change happens in life, not only in the room.

But it does mean the hour is not a law of nature. It is a convention, and one that suits some people and some situations less well than others.

What research says about longer sessions

Caution is needed here. Concentrated forms of therapy have been studied best with individuals, not couples. In 2014, Anke Ehlers and colleagues compared intensive cognitive therapy for post-traumatic stress disorder, concentrated into a short period, with a weekly version of the same therapy. The intensive version was just as effective, and improvement came sooner. Similarly, in Norway a concentrated treatment for obsessive-compulsive disorder was developed (the so-called Bergen 4-day treatment), for which Bjarne Hansen, Gerd Kvale and colleagues report a high proportion of people helped, even several years later.

For couples therapy there is considerably less research on concentrated formats. There are reports from practice and smaller studies suggesting that couples respond well to longer sessions, but controlled comparisons with weekly therapy are few. So it is fair to say: longer sessions are promising and make sense for some couples, but we do not know that they are better in general. Anyone who claims otherwise is claiming more than the evidence shows.

What happens differently in a longer session

From the experience of therapists who work with longer sessions, and from what we know about how emotions unfold in a couple, a few differences emerge.

• Less time goes on warming up. In weekly sessions, a couple often spends the first part of the hour recounting what happened during the week. In a longer session this part remains, but there is plenty of room left after it.
• The pattern can be reached live. Couples often have a single recurring pattern — she pursues, he withdraws, or the other way round. In a longer session there is more chance for the pattern to happen in front of the therapist and be explored while it is still warm.
• There is time for the couple to settle after the hard work. One risk of short sessions is that something painful opens up and the couple then goes home with an open wound. A longer session allows things to be closed again before the end.
• Tiredness can also be a tool. When defences loosen after a longer time, people sometimes say things they would not have said in the first twenty minutes.

Sue Johnson, the developer of emotionally focused therapy, described in her book Hold Me Tight a number of key conversations through which a couple moves from a recurring cycle towards a more secure connection. Conversations like these need time and slowness — which is one reason some people find a longer session more natural for them. I wrote more about this approach in Emotionally focused therapy for couples (EFT).

These are all differences in how a session unfolds, not miracles. A longer session is not a shortcut to a relationship you would otherwise build over months.

Who longer sessions may be for

There is no single group of couples to whom longer sessions “belong”. But there are situations in which therapists suggest them more often, or couples ask about them more often.

• Couples with very unpredictable schedules. When one or both travel a great deal, a weekly rhythm is often more of a wish than a reality. If sessions come with long gaps between them, the couple keeps returning to the start.
• Couples facing a big decision. Moving abroad, taking over the family business, deciding whether to stay together. At such times a couple sometimes wants an in-depth look all at once, rather than one stretched over months.
• Couples for whom weekly therapy keeps stalling on the surface. With some couples, defences are so well practised that the hour is over before anything has moved.
• Couples at the start of therapy. A longer first session can give more room for both stories before the couple decides whether to continue. I describe how a first session goes in What happens at the first couples therapy session.

I have noticed that many people who are used to quick and efficient solutions at work want the same for their relationship: “Let’s take a day and sort this out.” The wish is understandable, but it is worth looking at closely. A relationship is not a project you complete. A longer session can open the door sooner, but you still have to walk through it.

When a longer session is not a good choice

Here is a section you rarely read in adverts for intensive programmes.

When there is violence in the relationship. If one partner is afraid of the other, a longer joint session is not a safe space. More openness can mean more danger at home. Safety then comes first, not couples therapy. The SOS helpline for women and children who are victims of violence is available on 080 11 55 in Slovenia, and in an emergency call 113 in Slovenia.

When one partner is in acute crisis. Severe depression, suicidal thoughts, active addiction — all of these first need their own care, often from a doctor or psychiatrist too. If you are having suicidal thoughts, call the crisis line Klic v duševni stiski on 01 520 99 00 in Slovenia (between 7 pm and 7 am) or the Samaritans helpline on 116 123 in Slovenia (24 hours).

When one partner comes because the other brought them. A longer session with someone who does not want to be there is a long time for both of you. With such a gap, it often makes more sense first to clarify whether, and why, you are both there.

When a couple expects a miracle from a longer session. If the expectation is that one long conversation will repair years of distance, disappointment is almost certain. Change in a relationship happens in everyday life, in a hundred small moments after therapy.

How it sounds in practice

This is how a conversation might go between partners considering a longer session (a composite, not a real person):

“I’d rather do it thoroughly once than ten times a little. Let’s take the time and sort it out.”
“You sort everything. The company, the children, me.”
“That’s not fair. I’m just being practical.”
“I know. But I don’t need one long conversation. I need you to ask me how I am, every week.”

This short exchange holds the essence. The wish for a longer session can make complete sense — but it can also be part of the pattern the couple brings: one looks for a solution, the other looks for connection. A good therapist will listen to both when deciding on the format, not only to the diary.

Longer sessions with me

Since I am often asked about this, let me be concrete. I work as a marriage and family therapist in training under supervision, and sessions take place in person in Ljubljana. I also work with English-speaking clients. As a longer format I offer, for example, the 90-minute session A Look into the Past, in which we draw a genogram together — a family tree across three generations.

A Look into the Past is designed for one person and is a complete experience in itself. But with couples it often turns out that it is precisely the story of one partner’s family of origin that explains why the same argument keeps coming round in the relationship. I wrote about why a family story needs more time in One session, three generations: why a family story needs the longer format, and about whether such a session is an introduction or a standalone experience in A Look into the Past as an entry into therapy, or as a standalone experience.

In relational family therapy, in which I am training, what matters most when working with a couple is what keeps repeating between the partners and where it comes from — rather than how many minutes an individual session lasts.

An exercise: would a longer session help you?

Before you decide on any form of therapy, it helps for each of you to answer a few questions on your own. Ideally in writing, separately, and then compare.

1. What do I want to happen? One sentence. Not “for us to stop arguing”, but what lies beneath it: “to feel heard again”, “to know whether she still loves me”.
2. What has stopped us so far? Time? Fear? A sense that talking leads nowhere? The answer tells you whether the problem lies in the format or in something else.
3. How do I feel after a long, difficult conversation? If you need a day on your own afterwards, that is important information for choosing a rhythm.
4. Is there anything I am afraid to say in front of my partner? If the answer is yes, and especially if the fear is of your partner themselves, it needs to be addressed before you decide on a longer joint session.
5. What will I do differently the day after the session? Try to imagine one concrete step. Without it, even the best session fades.

If you want to take the exercise further, the knowledge base has questions for a couple’s conversation and the exercise a conversation without interruption, which you can do at home.

What helps after a longer session

If a couple decides on a longer session, wherever it may be, the time afterwards is almost as important as the session itself. A few things therapists often recommend:

• Do not plan anything demanding for the same evening. After a deep conversation, things settle slowly.
• Do not analyse the session in the car. It is enough to say what has stayed with you. The details can wait.
• Be ready for a “backwash”. A day or two after the session, tension often returns. That does not mean it did not work — it means something has shifted.
• Keep arguments safe. If an old conflict returns, approach it with new rules. I describe how a couple learns to argue safely in therapy in How we argue safely in couples therapy.

And most importantly: a longer session is not the end of the work, but often the beginning. Change takes hold where you practise it when the therapist is not there.

What to remember

• Couples therapy is well researched and helps most couples who seek it.
• The one-hour format is a convention, not a law of nature; longer sessions are a sensible choice for some couples.
• Research on concentrated formats is promising mainly for individuals; there is less of it for couples, so keep expectations realistic.
• A longer session is not appropriate when there is violence in the relationship or one partner is in acute crisis.
• The format matters less than the question of what keeps repeating in your relationship — and the willingness to change it in everyday life.