We currently have little idea of precisely who goes for couples therapy. This is a report of the results of a validated online assessment of relationship and individual functioning based on 39,251 heterosexual, 1,022 lesbian, and 438 gay couples about to begin couples therapy. Using validated and reliable questionnaires of relationship and individual functioning, this report presents and compares, for each sexual-orientation, the percentage of couples, pre-therapy, who are coping with a variety of relationship problems. To test for the replicability of results, the sample was divided randomly into two subsamples and statistical tests were performed on each sample. Couples initiating therapy suffer from greater distress and many more co-morbidities than has been presumed in previous literature, and same-sex couples present a particular set of both strengths and challenges compared to heterosexual couples. Gay-male and lesbian couples were very different on trust and monogamy, as were heterosexual and lesbian couples. Based on this epidemiologically sized sample, the challenge to our field may be to create interventions with much larger effect sizes than we currently have.
© 2019 American Association for Marriage and Family Therapy.