Couple therapy (or relationship therapy) is a related and different process. It may differ from relationship counseling in duration. Short term counseling may be between 1 to 3 sessions whereas long term couples therapy may be between 12 and 24 sessions. An exception is brief or solution focused couples therapy. In addition, counseling tends to be more 'here and now' and new coping strategies the outcome. Couples therapy is more about seemingly intractable problems with a relationship history, where emotions are the target and the agent of change.

Marriage counseling or marital therapy can refer to either or some combination of the above.

The methods may differ in other ways as well, but the differences may indicate more about the counselor/therapist's way of working than the title given to their process.

Marriage counseling originated in Germany in the 1920's as part of the eugenics movement. The first institutes for marriage counseling in the USA began in the 1930s, partly in response to Germany's medically directed, racial purification marriage counseling centres. It was promoted in the USA by both eugenicists such as Paul Popenoe and Robert Latou Dickinson and by birth control advocates such as Abraham and Hannah Stone who wrote 'A Marriage Manual' in 1935 and were involved with Planned Parenthood. They promoted eugenic sterilisation also known as negative eugenics .

Other founders in USA include Lena Levine and Margaret Sanger.

It wasn't until the 1950's that therapists began treating psychological problems in the context of the family . Relationship counseling as a discrete, professional service is thus a recent phenomenon. Until the late 20th century, the work of relationship counseling was informally fulfilled by close friends, family members, or local religious leaders. Psychiatrists, psychologists, counselors and social workers have historically dealt primarily with individual psychological problems in a medical and psychoanalytic framework . In many less technologically advanced cultures around the world today, the institution of family, the village or group elders fulfil the work of relationship counseling. Today marriage mentoring mirrors those cultures.

With increasing modernization or westernization in many parts of the world and the continuous shift towards isolated nuclear families the trend is towards trained and accredited relationship counselors or couple therapists. Sometimes volunteers are trained by either the Government or social service institutions to help those who are in need of family or marital counseling. Many communities and government departments have their own team of trained voluntary and professional relationship counselors. Similar services are operated by many universities and colleges, sometimes staffed by volunteers from among the student peer group. Some large companies maintain a full-time professional counseling staff to facilitate smoother interactions between corporate employees, to minimize the negative effects that personal difficulties might have on work performance.

Increasingly there is a trend toward professional certification and government registration of these services. This is in part due to the presence of duty of care issues and the consequences of the counselor or therapist's services being provided in a fiduciary relationship. See also alienation of affection.

Before a relationship between individuals can begin to be understood, it is important to recognize and acknowledge that each person, including the counselor, has a unique personality, perception, set of values and history. Individuals in the relationship may adhere to different and unexamined value systems. Institutional and societal variables (like the social, religious, group and other collective factors) which shape a person's nature, and behavior are considered in the process of counseling and therapy. A tenet of relationship counseling is that it is intrinsically beneficial for all the participants to interact with each other and with society at large with optimal amounts of conflict. Conflict is not intrinsically adverse to relationship happiness. In fact 60% of divorces occur in low conflict marriages. And where conflict arises as inevitably it does, to manage those conflicts consciously.

Most relationships will get strained at some time, resulting in their not functioning optimally and producing self-reinforcing, maladaptive patterns. These patterns may be called negative interaction cycles. There are many possible reasons for this, including insecure attachment, ego, arrogance, jealousy, anger, greed, poor communication/understanding or problem solving, ill health, third parties and so on.