Book a Free Consultation

Almost nobody calls a therapist already knowing whether they need individual, couples, family, or sex therapy. Most people call knowing only that something is wrong and that the usual fixes haven't worked. That is a perfectly good place to start, and figuring out the format is part of the work.

The types of therapy differ in one fundamental way: who is considered the client, and where the problem is understood to live. An individual therapist treats you. A couples therapist treats the relationship between two people. A family therapist typically treats the system the whole household runs on. A sex therapist treats sexual health and intimacy, which can be a problem inside one person, between two people, or both. When you can locate where the difficulty actually sits, the format usually becomes obvious.

Individual Therapy: When the work is yours. It's the right fit for anxiety, depression, grief, trauma and its aftermath, burnout, identity questions, life transitions, self-esteem, perfectionism, family-of-origin patterns, and the recurring feelings that seem to follow you from job to job and relationship to relationship. You can absolutely talk about your marriage or your parents here, and many people do, but your partner or parent isn't in the room, so the goal is your clarity, healing, and growth rather than the repair of the relationship itself. That distinction matters. If your stated goal is "I want us to stop having the same fight," individual therapy will help you understand your half of it; it will not change the other person's half, and it can't hold both sides of a dynamic at once.

Couples Therapy: When the relationship is the client. Both partners attend, usually together, and the therapist's job is not to decide who is right. It's to change the cycle the two of you get stuck in… the one where the same argument arrives in different costumes every few weeks. This is the right format when the conflict is repetitive and unproductive, when communication has collapsed into criticism and withdrawal, when trust was broken by an affair or a betrayal, when parenting or money or division of labor has become a battlefield, when you feel more like roommates than partners, or when you're trying to decide whether to stay together at all.

Family Therapy: When the household is the client. Family therapy treats the family as a system, because in families the symptom and the source are rarely in the same person. It's indicated when a child or teenager is struggling and their behavior is tangled up with what's happening between the adults, when siblings are in constant conflict, when a blended family is trying to become one family, when someone is ill or has died and everyone is grieving differently, when a family is weathering a divorce, a move, a job loss, a substance use problem, or when a teenager withholds from their parents and the two of them need a room where conversations can actually happen. Who attends varies: sometimes two parents and their teen(s), sometimes a parent and an adult child, sometimes several generations around the same set of chairs. It can also look a lot like parenting coaching, which is often exactly what a family needs.

Sex Therapy: When the focus is sexual health and intimacy. Sex therapy addresses sexual concerns directly. Sex therapy is talk therapy with specialized training behind it, focused on what's happening in the body, in the mind, and between partners. It's the right fit for low or absent desire, desire that doesn't match a partner's, pain with penetration, erectile or ejaculatory difficulties, trouble with arousal or orgasm, performance anxiety, compulsive or out-of-control sexual behavior, healing after betrayal or sexual trauma, navigating differences in sexual interests, exploring orientation, gender, or relationship structure, and for anyone whose sexual life has quietly become a source of shame rather than connection. Sex therapy is delivered in individual, couples, or combined formats depending on the concern.