Many of the clients I meet aren't sure whether they should attend sessions alone or bring their partner along - and it's one of the most common questions I get asked before we even begin.
There isn't one right answer. Many people begin therapy on their own, while others come as a couple from the outset. The best approach depends on what's bringing you to therapy, your relationship, and what you're hoping to achieve.
Should you come alone or together?
In my practice, it's roughly a 50/50 split. Some partners simply aren't ready or willing to attend. Some clients are carrying past trauma, shame, or personal concerns they want to work through privately, without their partner in the room. And some need a space to process things they're not yet ready to share. All of that is completely valid. And of course, not everyone coming to sex therapy is in a relationship - plenty of people come on their own to work on their relationship with intimacy, sexuality, or their own body.
Why involving your partner can help
That said, if you are in a relationship, a lot of this work is genuinely more powerful when your partner is involved.
One thing I hear often, when I suggest that something might be better approached as couples work, is: "But I'm the problem." I want to gently challenge that. How can one person be the problem in a sex life that two people are having together?
Take mismatched desire. Why is the person who wants less sex so often cast as being in the wrong? The issue isn't that one of you wants less - it's that you want different amounts. That's a dynamic between two people, not a flaw in one of them.
When I'm working with sexual dysfunctions - erectile difficulties, ejaculation concerns, painful sex, vaginismus - yes, one partner may be experiencing the difficulty directly. But the goal is always to create a sex life that both people feel good about. The other partner's response matters more than they often realise: they may have internalised the issue, or unintentionally added to feelings of shame. In those cases, having both people in the room is often essential to finding a real resolution.
There is always individual work to be done, but so much of this heals within the relationship itself - learning to regulate your nervous system with your partner, learning to trust and let go with your partner. A lot of what we work on simply can't be done in isolation.
It doesn't have to be one or the other
It's also worth knowing that the structure isn't fixed - things can shift as the work evolves. You might start individually and bring your partner in later, or begin as a couple and do some individual work alongside that. Different therapists handle this differently. Personally, I'll only move into couples work if we're still in the early stages - if I've been working with someone individually for a longer time, I wouldn't take on their couples work too. In either case, I'd want to meet the partner for a roughly equal number of individual sessions first, so both people feel equally known and held before we come together as a three. If couples work isn't something your individual therapist can offer, you could always see someone at Connection Clinic for that side of things while continuing your one-to-one work separately.
How confidentiality works
A question that comes up a lot is: "Will my therapist share what I've told them privately with my partner?" The short answer is no. What does vary between therapists is how they handle it if a secret emerges that could affect the couples work. In my practice, I'm clear in my contract that I can't continue working with a couple if one partner has shared something significant with me individually that they're not willing to bring into the room. Other therapists may handle this differently, so it's always worth asking about their approach early on.
Not sure where to start?
If you're not sure where to start, you can always book an initial consultation with your therapist. You'll have the chance to talk through everything that's going on, and they'll advise you on the best way forward.