In the face of looming problems that range from abuse, blending families, to who does the chores, couples are encouraged to seek couples therapy. Yet, what happens when therapy fails to address the problems in a relationship. What options are left?

At the age of 42 with two children in elementary school, Mary Ann Lowry was diagnosed with a chronic pain condition. Lowry explains her husband had a hard time coming to terms with her illness. "He frequently used verbal abuse to try to convince me to be healthy," she says. "The therapists tried to help him see that sickness, death, pain… are part of life. He couldn't come to terms with my physical limitations and despite their best efforts the therapists weren't able to break through the hard core resistance to accepting my health situation.  When I finally had to leave work and go out on full disability, he was not able to support the decision."

Despite the money, time and effort spent in counseling trying to work on their marriage, it failed. Lowry and her husband went to individual and couples counseling on and off for 11 years and still the marriage ended.

I.G. Frederick went through a similar situation. "I signed on for couples counseling thinking it could help repair a 20-year relationship. Instead, it convinced me that my marriage was irreparably broken." Frederick explains, "I have learned that our choice of counselors may not have been the best—she's been divorced three or four times herself."

Irina Baranov of the Council for Relationships has seen several examples where therapy didn't work for a couple. While there are many reasons, Baranov points to a five key elements that make it difficult for success in therapy.

1. When couples come in to do "couples" work, when they really need to recover individually from past trauma or abuse.
2. One partner is forcing the other to go against his/her will.
3. When the goals of therapy aren't clear.
4. When the couple isn't comfortable being in a small room discussing intimate details with a stranger.
5. When the therapy or therapist is a bad match for the couple.

"Therapy isn't for everyone," says Baranov. But there are other options. Local organizations like the Council for Relationships, churches, hospitals and community centers often offer marriage seminars and classes for couples. Bookstores are often full of books and DVDs that can give a couple the tools to navigate the tricky waters of their relationship. Also, Baranov suggests that couples make time for one another and seek out new experiences together. Explains, Baranov, There's no substitute for uninterrupted time alone with your partner, to just focus on each other and show interest, attention, affection and love.  [And] whether it's travel or cooking, language or art classes, anything new that you do together, tends to add a little more glue to the bond."

Marilyn Barnicke Belleghem M.Ed., a Registered Marriage and Family Therapist suggests that before a couple goes into counseling that they find a good therapist and evaluate their credentials, their biases and get to know where the therapist is coming from. "Therapists are people too," explains Belleghem, "sometimes a therapist and a couple just don't match up and that's okay."