Couples Therapy in Boston
Couples often seek therapy when they feel stuck in the same painful argument, distant in ways they cannot easily explain, or unsure how to move forward without causing more damage.
At Webster Clinic, couples therapy is a thoughtful, physician-led form of treatment that helps partners understand the patterns between them, not just the complaints on the surface.
We work with couples in chronic conflict, couples facing a breach of trust, couples strained by parenting or household pressures, and couples trying to decide more clearly and less destructively what comes next. Our approach is psychotherapy-centered, relationship-focused, and integrated within a psychiatric practice when broader mental health needs are part of the picture.
For chronic conflict, shutdown, resentment, and repeating arguments
For betrayal, disconnection, and strained trust
For stress around parenting, money, and household roles
For couples navigating change, uncertainty, or major mental health concerns
Private-pay care enables time, continuity, and depth, with fees discussed during the office manager call.
Located in Back Bay and serving Beacon Hill, Brookline, Cambridge, Somerville, Newton, and surrounding areas. Telehealth is available for established patients in Massachusetts, and for new patients where in-person care is not accessible.
Appointments are often available within a week.
What couples therapy is
Couples therapy focuses on the relationship itself: the patterns of communication, misattunement, blame, withdrawal, pursuit, protection, and longing that develop between two people over time. While individual histories, attachment styles, and psychiatric symptoms may shape what happens in a relationship, the treatment does not reduce the couple’s difficulty to one “identified patient.” It looks closely at the space between partners and works to make that space more truthful, less reactive, and more usable.
This is one way couples therapy differs from individual therapy. In individual treatment, the focus is on one person’s internal world. In couples therapy, the focus is on how two people affect each other, misunderstand each other, protect themselves from each other, and sometimes fail to show the care they actually feel.
The goal is not to produce a scripted or artificial relationship. It is to help partners understand what they are doing together, interrupt patterns that repeatedly injure the relationship, and build a more stable, more direct, and more emotionally intelligent way of being with one another.
Who we work with
We work with adults in romantic relationships, including monogamous couples, married spouses, engaged couples, long-term partners, couples living together, couples living apart, and polyamorous or otherwise non-traditional relationship constellations.
Some couples come in because they fight constantly. Others rarely fight at all, but live in a tense or emotionally thinned-out truce. Some still love each other deeply but no longer feel like a team. Some are facing a major decision and want a place to think clearly. Some are trying to repair what feels broken. Others are trying to decide, with more honesty and less harm, whether repair is possible.
Couples therapy can also be especially helpful when relationship strain is unfolding alongside depression, anxiety, trauma, postpartum changes, burnout, substance use concerns, neurodivergence, or more serious psychiatric illness. Because Webster Clinic is a physician-led practice, the couple’s work can be held inside a larger clinical frame when that is useful.
Common reasons couples seek couples therapy
Across all of these situations, the clinical question is the same: what is the relationship carrying, and what kind of help would actually change something? The list below reflects the range of concerns couples bring to us.
Dr. Jacqueline Buchanan, Dr. Christine Crawford, and Dr. Cecil Webster are explicitly center LGBTQ+ care as well.
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Some couples know their problem well: they argue often, escalate quickly, and leave conversations feeling misunderstood, dismissed, or attacked. The details vary, but the pattern becomes familiar. One partner presses harder. The other shuts down. One grows sharper. The other becomes more withholding. Both feel alone in the relationship.
Couples therapy helps identify that pattern in real time, slow it down, and understand what each partner is protecting. Often the visible conflict sits on top of something more vulnerable: fear of irrelevance, fear of dependence, shame, disappointment, loneliness, or old injuries that keep getting reactivated in the present.
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A betrayal does not always begin and end with the event itself. After trust is broken, couples are often left with a destabilized sense of reality: what happened, what it meant, how long it has been unfolding, whether the truth is complete, and whether the relationship can be repaired.
Couples therapy provides a structured place to address betrayal directly. That includes accountability, emotional truthfulness, and a serious look at the conditions that made the breach more likely. It also helps couples distinguish between explanation and excuse. Some couples come to repair trust. Others come to understand whether repair is truly possible. Either way, the work is to move out of confusion, concealment, and repetitive injury toward greater clarity.
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Not all troubled couples are loud. Some are organized, competent, and functional on the surface, but emotionally disconnected. Conversations become logistical. Tenderness becomes rare. The relationship starts to feel more like management than partnership.
In these couples, therapy helps bring back recognition, directness, and emotional contact. The work is not simply to “communicate better” in a generic sense. It is to understand why meaningful contact has become difficult, what each partner has stopped risking, and how the relationship can once again feel alive rather than merely maintained.
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Many couples are not fighting only about dishes, money, or scheduling. They are fighting about fairness, invisibility, responsibility, exhaustion, dependence, appreciation, and who gets to have needs. Parenting intensifies these questions. So does work stress. So do life stages in which one person is carrying more of the emotional or practical load.
Couples therapy helps partners examine how roles got assigned, how those roles are experienced, and where resentment has accumulated. It helps couples move from accusation and defensive scorekeeping toward more intentional, collaborative decision-making. For many couples, this is one of the most relieving parts of treatment.
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Relationships are often stressed not only by conflict, but by change. Marriage, a first child, infertility, pregnancy, postpartum life, grief, illness, career shifts, relocation, caregiving for parents, opening or closing a relationship, and changes in identity can all alter the balance of a couple’s life together.
Transitions often bring grief even when the change is welcome. Therapy helps couples make room for that reality without turning against each other.
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At times, one or both partners may be reconsidering identity, orientation, gender, monogamy, or the shape of the relationship itself. These conversations can feel destabilizing even in strong couples. Therapy can provide a place to think honestly, stay grounded, and speak with more complexity than day-to-day conflict usually allows.
This is not a separate niche on the page so much as one important domain of couples work. It belongs alongside the larger question of how couples adapt when reality changes.
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Depression, anxiety, trauma, bipolar disorder, psychosis, personality structure, substance use, and neurodevelopmental differences can profoundly affect a couple’s life. Sometimes one partner feels they have become a caregiver rather than an equal. Sometimes both partners are exhausted by cycles of crisis, accommodation, resentment, and guilt.
Couples therapy can help partners better understand what is illness-driven, what is relational, and what requires clearer boundaries, added support, or parallel individual treatment. In a psychiatric practice, these distinctions can be handled with more nuance than in settings where the relationship and the mental health picture are kept too far apart.
What couples therapy is like at Webster Clinic
Couples therapy at Webster Clinic is active, thoughtful, and emotionally serious without becoming theatrical or formulaic.
We listen for recurring patterns, but also for what those patterns are defending against. We pay attention to timing, tone, escalation, evasion, blame, silence, and the subtle ways couples miss each other even when trying to connect.
Sessions often involve helping partners speak more directly to one another, understand what has been hard to say, and stay in contact long enough to make a different experience possible. At times, treatment may also include structured reflection, real-time interventions in the room, and guidance about how to recognize destructive patterns earlier.
When clinically useful, we may recommend a mix of joint meetings and individual meetings. That is not because the treatment stops being couples therapy. It is because some relationships need a fuller understanding of each partner’s experience, history, or internal obstacles in order for the joint work to move forward productively.
A psychotherapy-centered approach inside a physician-led practice
One of the advantages of doing couples therapy at Webster Clinic is that the work can remain centered in psychotherapy while still benefiting from a broader psychiatric frame when needed.
Not every couple needs psychiatric evaluation or medication. Many do not. But some relationships are under strain in part because one or both partners are also dealing with depression, anxiety, trauma, postpartum symptoms, burnout, or more serious mental health challenges. In those cases, it can be helpful for the couple’s therapy to live within a practice that understands both relationship dynamics and mental health treatment at a high level.
This allows for a more integrated approach when appropriate. A couple may be seen jointly while one partner also receives individual psychotherapy or psychiatric care elsewhere in the clinic, or while broader treatment recommendations are considered in a coordinated and thoughtful way.
Why couples choose Webster Clinic
Couples who come to Webster Clinic are often looking for something more substantial than generic communication advice. They want treatment that is psychologically minded, clinically serious, and able to hold complexity.
Our approach is especially well suited to couples who:
feel trapped in entrenched conflict and want help understanding the pattern beneath the argument
want a serious setting in which to address betrayal or longstanding mistrust
are carrying resentment around parenting, emotional labor, money, or household inequity
suspect that one or both partners’ mental health is affecting the relationship
want help deciding more clearly and less destructively what the future of the relationship should be
Who We Are
In addition to having tremendous experience with couples therapy, Webster Clinic physicians trained at Harvard Medical School, McLean Hospital, Massachusetts General Hospital, and Cambridge Health Alliance. Dr. Buchanan trained at Columbia University College of Physicians and Surgeons, completed her child and adolescent psychiatry fellowship at Cambridge Health Alliance, and subsequently completed an intensive certificate program in family systems therapies — training that directly informs the family therapy work at Webster Clinic. Dr. Crawford completed her psychiatry residency and child and adolescent fellowship at MGH/McLean, holds board certification in both adult and child and adolescent psychiatry, and served as Vice Chair of Education in the Department of Psychiatry at Boston University School of Medicine. She is often sought out for careful work for complex needs of children and adults. Dr. Webster has held a Harvard Medical School faculty appointment since 2013, is a graduate in general psychoanalysis, and is an advanced candidate in child psychoanalysis at the Boston Psychoanalytic Society and Institute, where he serves as a board trustee.
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Jacqueline Buchanan MD
Child, adolescent, and adult psychiatrist
Columbia University College of Physicians and Surgeons, MD
Child and Adolescent Psychiatry Fellowship, Cambridge Health Alliance / Harvard Medical School
Certificate in Family Systems Therapies
BPSI Child Track Fellow in Psychoanalytic Psychotherapy
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![A woman with long dark hair, wearing a purple dress, smiling and sitting on an olive green armchair in a room with a bookshelf and a potted plant in the background.]()
Christine Crawford MD MPH
Child, adolescent, and adult psychiatrist
Residency and Child Psychiatry Fellowship, MGH / McLean Hospital / Harvard Medical School
Board Certified, Adult and Child and Adolescent Psychiatry
Served as Vice Chair of Education, Department of Psychiatry, Boston University School of Medicine
Associate Medical Director, NAMI
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Cecil R Webster Jr MD
FOUNDER & CEO
Child, adolescent, and adult psychiatrist
Psychoanalyst
Lecturer in Psychiatry, Harvard Medical School / McLean Hospital
Board Certified, General and Child and Adolescent Psychiatry
Graduate in General Psychoanalysis and Advanced Candidate in Child Psychoanalysis, Boston Psychoanalytic Society and Institute
FAQs
Is couples therapy only for couples on the verge of breaking up?
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No. Some couples come in because the relationship feels fragile. Others come in because they want to strengthen something important before it deteriorates further. Some of our LGBTQ+ couples want to shore up decision making before having children. Couples therapy can be useful both for repair and for prevention.
Do you offer marriage counseling?
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Yes. Many people still search for marriage counseling, and that term is completely reasonable. At Webster Clinic, we more often use the broader term couples therapy because we work with married and unmarried couples alike. We are explicitly skilled in LGBTQ+ couples, and those in polyamorous relationships as well.
Do both partners have to be equally motivated?
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Not always. It helps if both partners are willing to participate seriously, but they do not need to arrive with identical levels of optimism, insight, or confidence. Often part of the work is helping each person say more clearly what they fear, want, or doubt.
Can couples therapy help after infidelity?
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Yes. It can help couples address betrayal in a more structured and honest way. In some cases that leads toward repair. In others, it leads toward a clearer understanding of what cannot be rebuilt. Either outcome is more useful than remaining trapped in confusion, accusation, and concealment.
Is family therapy the same thing as parent guidance?
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Not exactly. Parent guidance focuses specifically on helping parents understand and respond to their child more effectively. Family therapy more explicitly addresses the relationships and patterns among family members. The two often overlap, and sometimes parent guidance is where family treatment begins.
Will you ever meet with us individually?
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Sometimes. When clinically useful, treatment may include a mix of joint meetings and selected individual meetings. That decision is made thoughtfully and in service of the couple’s work.
What if one partner has depression, anxiety, trauma, or another psychiatric condition?
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That is common. Relationship difficulties and mental health concerns often affect each other. Because Webster Clinic is a psychiatric practice grounded in psychotherapy, we can think carefully about how individual symptoms and relationship patterns interact.
Do you help couples who are unsure whether to stay together?
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Yes. Some couples seek treatment not because they have decided to stay, but because they want to think and speak more clearly, with less cruelty and less confusion, about what is possible.
Do you work with LGBTQ+ couples?
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Yes. We work with LGBTQ+ couples and with couples navigating questions related to identity, orientation, gender, family roles, and the meaning of change within a relationship. Some couples come in with concerns that are not unique to LGBTQ+ life at all. Others are working through questions that carry particular emotional, cultural, or social weight. Our aim is not to force those experiences into a narrow framework, but to understand the couple in its full context and help both partners think and relate more clearly. We are comfortable with questions around sex, sexuality, desire, and sensuality in its many constellations.
Do you work with non-traditional relationships, including polyamorous or open relationships?
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Yes. We work with monogamous couples as well as couples in polyamorous, open, or otherwise non-traditional relationship structures. The goal is not to impose a single model of what a healthy relationship should look like, but to help partners be more honest, more intentional, and more thoughtful about the agreements, expectations, vulnerabilities, and conflicts within their relationship.
Do you offer in-person care?
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Yes. We offer in-person care in Boston’s Back Bay and telehealth for Massachusetts-based patients when clinically appropriate.
Speak with our office
If you are looking for couples therapy in Boston, our office can help you think through whether Webster Clinic may be a good fit with a complementary 15-minute phone consultation. We can also help clarify whether couples therapy, individual treatment, parent guidance, or another starting point makes the most sense.
Or call 617.859.5953