Couple & Family Therapy in St. Louis

What even is couple and family therapy?

In couple/family therapy the process of psychotherapy is aimed at the relationship and

moving it (the relationship) from a state of dysfunctional interactional patterns to functional. Therefore, the unit of treatment is not any one individual but the dynamic interpersonal process within and between all members involved. We will often break down the problematic patterns to get to each person’s true thoughts/feelings to restructure the dynamic process and respond in ways that are more aligned with how each person truly feels and express what they need more clearly.

What does couple/family therapy look like and who is involved?

First and foremost, couple/family is relational therapy. We are looking at the interactional

patterns between family members to determine problematic patterns that result in disconnection, incongruence, and reactive responses associated with insecurity in the relationship. Couple/Family therapy will often look like each family member participating in the process of therapy but may also look like one family member or specific groups of family members (parents, siblings, parent/child, etc.).

What types of couple/family therapy services are available?

Pre-marital counseling
Couples therapy
Parent/child interaction coaching
Family therapy
Discernment counseling

How could we benefit from couple/family therapy?

Families benefit by increasing more positive interactions, feeling heard and understood,

and learning a process of how to resolve conflict and repair the relationship. They become better

able to recognize emotional build-up earlier and attune to the needs of family members. Once

people learn how to attune to themselves/others and clearly communicate, it results in more

meaningful connection and confidence to resolve/repair conflict.

How long is couple/family therapy?

Great question! Although length of therapy depends on many different variables, we use

a brief therapy approach. We offer single session family therapy consults to longer couple/family

therapy. On average, our clients are in couple/family therapy between 8 to 15 visits. The length and frequency is driven by each client depending on goals, availability and resources.

Why don’t you bill insurance for couple and family therapy?

Insurance requires 3 main items for coverage of CPT code 90847

(Family therapy with client present)

1. Identified individual client

2. Diagnosis of a mental health condition

3. Evidence of treatment to the individual and the mental health diagnosis

Right now, insurance does not accept more than one client and/or primary diagnosis codes treating “problems in the relationship”

(e.g. Z63.0-.9). First and foremost, we treat the

relationship in couple/family therapy. Secondly, we only use Z63 as primary diagnosis codes for treatment. If we submit the claim under an individual with the Z63 primary diagnosis, the claims are rejected.

There are some providers that bill family therapy (CPT 90847) under an individual’s mental health diagnosis. In that case, using family therapy to justify that family and/or couple conflict causes distress in the individual that manifests in the mental health diagnosis. We understand that there are some providers who choose to go this route for billing/treatment purposes, that is entirely up to the clinician.

At the Center for Mental Wellness, we only bill

couples therapy and family therapy under the Z63 codes when the goal is to improve the

relationship functioning.