Couples Therapy with Rachel Santellano, LSW
Couples Therapy for When the Question Is “Are We Really Doing This?”
Many couples come to therapy not because their relationship is falling apart, but because they’re standing at a crossroads. You may care deeply about each other and still feel unsure about what comes next — whether that’s getting engaged, getting married, having children, or deciding if this relationship is truly the right long-term fit. These moments often bring underlying differences into sharper focus and can create tension, avoidance, or recurring conflict when the questions feel too big to navigate alone.
I work with couples who are in these in-between stages — when commitment is being discussed, delayed, questioned, or quietly avoided. Couples therapy can be a place to slow the conversation down, name what’s actually getting in the way, and figure out how to move forward with more clarity and honesty rather than pressure, resentment, or ultimatums.
Pre-Proposal, Premarital, and Pre-Kids Counseling
Couples often assume they should feel completely certain before taking the next step, but clarity usually comes from understanding, not avoidance. I work with couples who are thinking about proposing, preparing for marriage, or considering starting a family and want to address important questions before resentment or misalignment takes hold.
In this work, we focus on how you communicate under stress, how you handle disagreement, and how each of you shows up when things feel uncertain. We talk openly about expectations, emotional needs, conflict patterns, and how past experiences may be shaping your reactions now. The goal isn’t to push you toward a timeline or a specific outcome — it’s to help you make decisions with awareness, accountability, and mutual respect.
Accountability in Couples Therapy (Shared, Not One-Sided)
When commitment feels uncertain, couples often fall into familiar patterns — one partner pushes for answers while the other pulls back, or both hope the tension will resolve on its own. In couples therapy, accountability means helping each partner understand how they contribute to that dynamic and what they can do differently.
Accountability isn’t about assigning blame or forcing agreement. It’s about learning to speak honestly, listen without defensiveness, and take responsibility for your own reactions rather than waiting for your partner to change first. This work can feel challenging at times, but it often creates the clarity and emotional safety couples need to move forward — together or separately — with intention.
Life transitions can intensify anxiety within a relationship, especially when the future feels unclear or shared decisions feel heavy. Changes around commitment, roles, or direction often bring up fear and vulnerability for both partners. Couples therapy helps make sense of these reactions so transitions can be navigated with greater understanding and intention.
What I Help Couples Work On
- Communication breakdowns and recurring arguments
- Commitment ambivalence and uncertainty about the future
- Pre-proposal and premarital concerns
- Preparing for major transitions like marriage or having children
- Emotional distance, resentment, or trust issues
- Differences in needs, expectations, or conflict styles
Frequently Asked Questions About Couples Therapy
Do you work with couples who aren’t sure they want to get married or stay together?
Yes. I often work with couples who feel uncertain about long-term commitment. Therapy can help you understand what’s driving that uncertainty and decide how you want to move forward with clarity and respect.
Is couples therapy helpful before proposing or having kids?
Absolutely. Pre-proposal, premarital, and pre-kids counseling can help couples address communication patterns, expectations, and stress before taking the next step.
Will couples therapy help us decide whether to stay together?
Therapy isn’t about pushing couples in one direction. My role is to help you have clearer, more honest conversations so you can make thoughtful decisions with accountability and mutual understanding.
Do both partners need to be equally motivated to start couples therapy?
Not necessarily. Many couples start therapy with different levels of motivation or clarity. We can work with that and focus on improving communication and understanding.