The classic image of a therapy session is two people in a room, the patient lying on a sofa staring at the ceiling, the therapist scribbling notes. The idea of couples therapy may then seem counterintuitive. Indeed, as a practice, it didn’t hit its stride until the 1980s.

Couples therapy, also known as couples counseling, is much more than just a last stop before divorce. As practitioners Joseph C. Zinker and Sandra Cardoso-Zinker write in the Gestalt Review, couples seeking therapy “may have lost what is so beautiful in life: the joy and the pleasure of having someone as a witness of their existence.”

Their reasons for seeking therapy can be as mundane as feeling angry about dividing responsibilities, or as devastating as wrestling with infidelity. Couples may hit roadblocks in communicating, or experience life events that leave them struggling to cope. Additionally, a “couple” doesn’t necessarily have to be romantic. As Zinker and Cardoso-Zinker write, “couples” in therapy range from romantic to intimate friendships to business partners. They note that “what is more important is an abiding interest in each other’s ideas and development and commitment in staying connected.”

“Therapy” is an umbrella term for different approaches to solving an emotional problem. It doesn’t, in itself, define how the solution will be found. Different therapists might treat the same couple in a variety of very different ways. Some might explore what in each partner’s childhoods is provoking their reactions, and attempt to bridge communication gaps through that. Some might work on the feelings evoked by the present situation. Therapy has many faces, but its purpose is the same.

Couples therapy starts where individual therapy ends, according to Barbara G. Feld, the head of Family Therapy Training at Mount Sinai Hospital Department of Psychiatry. While a therapist could work wonders with an individual’s “internal or intersubjective problems,” self-exploration may have limited efficacy against a confused, angry, misunderstood, hurt, or defensive partner. A third party in the room offers a non-judgemental sounding board, an impartial observer, and someone to de-escalate fights before they become too damaging.

The benefit to having more than one person in a room is so notable that now couples and even group therapy are widely accepted forms of practice. Feld found that while many couples responded to treatment as a pair, others needed even more support.

Work with the couple alone “does not address the issues of personal and couple isolation, since many families in this society are no longer contained within an extended family support system. In addition, couples rarely turn to friends to discuss their couple problems, often because they feel different and embarrassed,” she explains. Couples may find it difficult to find their way without other couples to bounce ideas off of, model alternate ways of coping, or offer a safe area to express frustration.

Couples therapy powerfully tackles one aspect of solving relationship problems that individual therapy can’t—that is, seeing the relationship in action and working with it directly.