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Couples therapy

Q: I’m curious to hear your views about the correct use of the word “couple” when referring to therapy. Is it “couple therapy,” “couples therapy,” or “couple’s therapy”?

A: All three appear regularly in popular and scholarly publications. A fourth version, “couples’ therapy,” isn’t seen as much.

Which term should you use? Well, usage writers haven’t weighed in on the subject, but these are our thoughts.

If you’re writing for publication, use the one preferred by the publication. Otherwise, we’d recommend “couples therapy.” It showed up first in print, it’s the only one in standard dictionaries, and it appears more often than the others in medical dictionaries.

The Oxford English Dictionary defines “couples therapy” as “any form of therapy aimed at relieving problems in a sexual or domestic partnership.”

The earliest written examples date from the mid-1960s, but the usage probably existed earlier, since experiments with this therapy began a decade earlier.

The earliest example that we’ve found in our database searches is from Family Therapy and Disturbed Families, a 1967 book edited by Gerald H. Zuk and Ivan Boszormenyi-Nagy.

A chapter in the book, written by Carl A. Whitaker and John Warkentin, is entitled “The Secret Agenda of the Therapist Doing Couples Therapy.”

As we’ve said, earlier examples probably exist, since Whitaker began experimenting with couples therapy in the mid-1950s, according to Reshaping Family Relationships: The Symbolic Therapy of Carl Whitaker (1999).

The authors of the book, Gary Connell, Tammy Mitten, and William Bumberry, discuss Whitaker’s early work:

“While it was perfectly acceptable for both partners to be in their own individual therapy, the idea of exposing them to each other during a therapy hour was unorthodox. When the presenting complaint seemed relational, Carl began inviting both partners to attend.”

The OED also has a citation for “couples therapy” from the same year as the Whitaker/Warkentin example above:

“The reason you took up couples therapy is because you got bored with individuals.” (From an interview with Whitaker, recounted in Techniques of Family Therapy, 1967, by Jay Haley and Lynn Hoffman.)

The term has been used steadily ever since. Oxford has this more contemporary example, from the British magazine Diva (May 27, 2000): “We had spent a fortune on couples therapy and, believe me, we really worked hard when we were in that room.”

The singular form, “couple therapy,” which the OED defines as meaning the same as “couples therapy,” has been around since the 1970s.

The dictionary’s earliest example is the title of a 1970 article in the American Journal of Orthopsychiatry: “Behavioral Approaches to Family and Couple Therapy.”

This later example is from a Texas newspaper, the San Antonio Express-News (Sept. 17, 2005): “The sex therapist may want to work with him alone at first, then eventually include couple therapy.”

The OED doesn’t have any citations for “couple’s therapy,” but we’ve found several dating from the 1970s.

The earliest is from a 1970 issue of Voices, a journal of the American Academy of Psychotherapists: “The therapist is always involved during couple’s therapy with the struggle between the spouses.”

We’ve found entries for the therapy in only two standard dictionaries, Meriam-Webster Unabridged and the Merriam-Webster Online Dictionary.

Both entries are for “couples therapy,” which the Unabridged defines as “usually short-term counseling designed to help couples understand and resolve problems, dissatisfaction, and conflict in their relationship.”

It gives this example from the March 1990 issue of Vogue: “For wealthy addicts or poor ones, addiction is never an isolated problem, but often requires treatment for depression or anxiety, or couples therapy for the many addicts in dysfunctional relationships.”

We’ve found several medical dictionaries with entries for “couples therapy,” including the online Dorland and Merriam-Webster medical references. However, the entry in Mosby’s Medical Dictionary (9th ed.) is for “couples’ therapy.”

As for the various terms for the therapists themselves, the plural “couples therapist,” defined in the OED as “a practitioner of couples therapy,” is the oldest.

This is the OED’s first citation: “The sex therapist must be an extremely skilled psychotherapist and couples therapist if he is to be successful.” (From Helen Singer Kaplan’s The New Sex Therapy, 1974.)

And this is the dictionary’s earliest example for the singular form, “couple therapist,” defined as meaning the same as “couples therapist”:

“There may be a perception of one of the therapists in family therapy which is dominated by his role as an individual or couple therapist.” (From an article by Roger L. Shapiro and John Zinner, collected in Exploring Individual & Organizational Boundaries, edited by W. Gordon Lawrence, 1979.)

The OED doesn’t have a citation for “couple’s therapist.” The earliest we’ve found is from Soul Survivors: A New Beginning for Adults Abused As Children, a 1989 book by J. Patrick Gannon:

“If you select an experienced couple’s therapist, who is savvy in the issues that survivor relationships present, it may be well worth the time and the expense.”

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