片方は行きたい。もう片方は行きたくない。では、どうする？

気が進まないパートナーを伴うカップルカウンセリングの研究は、多くの人が予想するより励みになる——ただし、証拠が実際に何を言っているかを理解した場合に限る。

非対称は例外ではなく、むしろ常態である

Most couples arrive at the question of counselling unevenly. One partner has already spent months — sometimes years — cataloguing what is wrong. The other has not. Clinical researchers have a name for this configuration. A 2003 study by Doss, Atkins, and Christensen, published in the *Journal of Marital and Family Therapy*, surveyed 147 married couples in the process of seeking marital therapy and identified three distinct steps in the help-seeking process: problem recognition, treatment consideration, and treatment seeking. On average, wives completed all three steps before their husbands. ¹ The pattern has been replicated across subsequent research and appears in same-sex couples as well, where one partner reliably moves toward help faster than the other. ²

This asymmetry is not a sign that the reluctant partner has stopped caring. A 2022 study by Hubbard and colleagues, published in the same journal, asked nearly 300 people who had expressed interest in couples therapy what had actually stopped them from attending. The responses sorted into six distinct categories: cost, logistics, treatment modality, trustworthiness, relational factors, and clarity of the therapeutic process. ³ Stigma appeared as a separate thread — reported by 38 percent of men and 26 percent of women. The refusal, in other words, is rarely simple indifference.

アウトカムデータが実際に示すこと

Before addressing the one-partner problem specifically, it is worth establishing what the baseline evidence looks like for couples who do attend. A major 2012 review by Lebow, Chambers, Christensen, and Johnson in the *Journal of Marital and Family Therapy* examined the preceding decade of couples therapy research. The review found that couple therapy positively impacts 70 percent of couples receiving treatment, with effectiveness rates comparable to those of individual therapies and vastly superior to control groups not receiving treatment. ⁴

A 2022 update by Lebow and Snyder in *Family Process* extended that picture: the average person completing couples therapy is better off at termination than 70 to 80 percent of individuals who received no treatment — an improvement rate that the authors note rivals or exceeds the most effective psychosocial and pharmacological interventions for individual mental health disorders. ⁵ Several meta-analyses and major reviews have confirmed the efficacy of behavioural and cognitive-behavioural couple therapy across trials in the United States, Europe, and Australia. ⁶ A 2025 review in the *Journal of Family Therapy* by Carr, covering 25 years of evidence from meta-analyses, systematic reviews, and controlled trials, found that systemic interventions are as effective as evidence-based individual psychotherapeutic interventions for relationship distress, and more effective for some presentations. ⁷

六年という数字——そしてより新しい研究がそれを複雑にする理由

The statistic cited most often in discussions about delay is that couples wait an average of six years after problems begin before seeking help, a figure widely attributed to John Gottman's clinical observations. ⁸ It has circulated long enough that it is now treated as established fact. The problem is the evidence base. A 2021 study published in the *Journal of Marital and Family Therapy* — the first large-sample investigation of this specific question, with 270 couples seeking conjoint therapy and 101 seeking individual therapy for relationship problems — found something different. The actual average interval from onset of problems to entering couples therapy was 2.68 years, with the great majority of couples entering within two years. ⁹

The clinical implication the authors draw is important: most couples have not waited so long that their problems are irresolvable. The six-year figure, derived from a sample of fewer than 20 couples, overstates the delay. Both numbers, however, point toward the same conclusion: earlier help-seeking consistently predicts better outcomes. Research by Doss and colleagues (2009) on what predicts therapy success identifies earlier intervention as one of the strongest predictors of good outcomes. The pre-therapy stage — the period when one person knows something is wrong but the couple has not yet sought help — is precisely the window during which intervention has the most traction.

臨床用語で「気が進まない」とは何か

カップルセラピーにおける気が進まなさは、臨床家が互いに区別するいくつかの形をとる。きちんと頼まれれば来る、懐疑的だが出席する意思のあるパートナー。一度は来るが再訪を拒むパートナー。何らかの助けには開いているが、特定の形式——合同セッション、特定のセラピスト、「therapy」という言葉そのもの——に異議を唱えるパートナー。そして、少なくとも当初は、完全に拒むパートナー。これらの立場はそれぞれ異なる応答を求めるが、いずれも進歩を閉ざしはしない。

A 2015 research study from a university-based marriage and family therapy clinic found that soft-mandated and voluntary clients show similar success rates in treatment. ¹⁰ The reluctant partner who comes under protest is not, on average, arriving at a meaningful disadvantage. What does predict poor outcomes is unilateral termination: the same study found that cases terminated by one partner without agreement had the lowest success rates across all modalities. The distinction between a reluctant attender and a non-attender matters considerably.

一方が十分に乗っていないときの治療同盟の働き方

The therapeutic alliance — the quality of the working relationship between client and therapist — is one of the strongest predictors of outcome in both individual and couples therapy. In couples work, this becomes more complex because there are, effectively, three alliances to manage: therapist with partner A, therapist with partner B, and therapist with the couple as a unit. A 2023 randomised controlled trial published in *Family Process*, examining alliance trajectories in Emotionally Focused Therapy versus treatment as usual, found that female partners reported higher alliance than male partners after the first session across both treatment groups. Prior research cited in the same study found that alliance measured during the third session and at termination was predictive of positive outcomes in couples who attended more than three sessions.

This means that the early sessions — precisely when a reluctant partner is most likely to be evaluating whether to continue — carry disproportionate weight. Therapists trained in evidence-based couple models are specifically equipped to manage the split alliance: to be useful to both partners without being perceived as partisan by either. Research on this point is consistent in identifying the management of unequal alliance as a distinct clinical skill, one that separates specialist couple therapists from general practitioners who see couples occasionally. Therapists should also attend to each partner's early family-of-origin experience, which research suggests can help predict strains in the therapeutic alliance that may emerge later in treatment.

パートナーが拒む理由——そして各理由について研究が示すこと

Hubbard et al.'s 2022 study in the *Journal of Marital and Family Therapy* offers a structured account of why couples don't attend, sorting resistance into six distinct categories rather than treating it as a single barrier. ³ Cost was the most frequently cited obstacle — reported by 55 percent of potential clients, with 30 percent specifically citing lack of insurance coverage as a distinct barrier from raw cost. Logistics — scheduling conflicts, childcare, travel — were cited by 36 percent. These are practical barriers that carry practical solutions, including online delivery. Current research suggests online couples therapy is comparably effective for most presenting concerns, including communication issues and emotional disconnection.

The fear that the therapist will take sides — that the session will become a formal hearing in which the reluctant partner is found at fault — is among the most common emotional objections. Some of the most common fears about attending couples therapy include worry about blame or judgment, anxiety that therapy won't work or will make things worse, and concern about social stigma. These fears are worth naming directly, because they are both specific and addressable. Evidence-based couple therapy models are structured around the couple as a system, not the individual as the problem. The therapist's role is to be useful to both people in the room.

一人だけが行くとき：関係的介入としての個人療法

If a partner declines to attend conjoint sessions, the willing partner is not without options. Individual therapy focused on relational dynamics — rather than on the self in isolation — can produce measurable changes in the couple system even when only one person is in the room. Research shows that when even one partner is engaged in therapy, some improvement in individual coping and communication is achievable. Some therapists offer individual sessions first specifically to help a reluctant partner become more comfortable with the process before joint sessions begin.

The assumption embedded in the question 'is it worth going if only one of us wants to' is that therapy requires two equally motivated participants to function — but the outcome literature does not support that assumption. Both partners do not need to be equally motivated at the start. One partner can be less motivated initially and still make progress, provided they remain engaged in the process; the research distinguishes clearly between reluctance and complete disengagement. The pre-therapy stage, when one partner is willing to engage and the other is not yet there, is itself a clinical opportunity rather than simply an obstacle.

より早い介入が実際に変えるもの

*International Journal of Environmental Research and Public Health* に掲載されたプレパイロット研究は、臨床水準の苦痛にまだ達していない非臨床カップルに対する IBCT に基づく紛争予防プログラムを検討した。実験群のカップルは、差異の受容、共感的な接合、関係満足に有意な改善を示した。three-year follow-up で利得は維持された。著者は、大半のカップルが高い苦痛を経験して初めてセラピーを求め、問題が深刻になるまで待つべきだというこの前提を「dangerous」と述べる。

The mechanism behind that risk is not difficult to identify. The higher the level of conflict when a couple initiates therapy, the greater the possibility of therapeutic failure and the greater the risk of one or both partners developing symptoms of anxiety, depression, or other behaviours that jeopardise their health. The pre-therapy period — when something is clearly wrong but no help has been sought — is therefore not a neutral waiting room. It is a period during which patterns are consolidating and the conditions for therapy are either being preserved or eroded.

セッション数とセラピスト資格がそれにどう関わるか

Evidence-based couples therapy protocols typically involve twelve to twenty sessions, usually delivered weekly. Some couples notice improvement within the first four to six sessions, while deeper changes to attachment patterns and entrenched conflict styles may take several months. Dropping out after three or four sessions — common among couples who arrive expecting rapid resolution — is one of the most consistent predictors of poor outcomes across the literature. An adequate course of therapy requires commitment to the full protocol, and incomplete treatment reliably underperforms.

Therapist qualification is not a secondary consideration. Not all practitioners who see couples are trained in evidence-based couple models. Emotionally Focused Therapy (EFT), the Gottman Method, Integrative Behavioral Couple Therapy (IBCT), and Cognitive Behavioral Couple Therapy (CBCT) each require specialist training. A general therapist without couples-specific credentials may lack the clinical tools to address the particular dynamics of conjoint work. When selecting a therapist, the clinical question to ask is not whether they see couples but whether they hold specific training in a validated couple therapy modality. Professional bodies including the AAMFT, BACP, and the NBCC publish directories that include practitioner specialisations.