Premarital therapy on the rise in Florida
Add Axios as your preferred source to
see more of our stories on Google.
Illustration: Aïda Amer/Axios
Couples are saying "I do" to premarital therapy.
Why it matters: As the stigma of talk therapy disappears, couples therapy has gone from a marriage-saving Hail Mary to a wedding prerequisite in Florida.
- Meanwhile, divorce rates have dropped.
By the numbers: 38% of just-married or engaged couples in the South did premarital counseling or couples therapy, according to The Knot 2025 Real Weddings Study shared with Axios.
- The number of family or couples therapy appointments made via mental health tech company Headway has surged 140% from 2023 to 2025, according to data shared with Axios.
Between the lines: Couples therapy still isn't available to everyone, but access has improved.
- The Mental Health Access Improvement Act, effective January 2024, allowed marriage and family therapists (MFTs) to bill Medicare for mental health services.
"'I don't want the relationship that my parents have'... that's a quote I hear all the time from people that are reaching out to me," says Dan Sneider, a licensed clinical social worker who practices in Florida.
- "I have more early-20s couples than I would have had five, ten years ago," and I'm seeing "higher demand" for premarital therapy, he says.
Catch up quick: In the '80s and '90s, popular couples therapy methodologies were established, taught and practiced.
- Premarital counseling led by religious leaders has been around for longer, and is still encouraged in some religions, including Christianity and Judaism. It typically involves discussing marital responsibilities and commitments within a spiritual framework.
- Couples counselors can lead therapy in or outside of a faith, and offer help working through a variety of conflict and communication challenges. And today, many therapists also offer premarital-specific help.
Yes, but: Premarital counseling isn't meant to be a salve for cold feet.
- "The worry with me comes when [fiancés are] looking for reassurance about the relationship," and when one person thinks sessions will "fix" something wrong with the other partner, says Carolyn Rubenstein, a psychologist practicing in Florida.
- That said, therapy "can be a great way to enter marriage or the next phase with some great strategies and tools for [managing] conflicts," she says.
The bottom line: Before young couples get too caught up in planning the details of their weddings, they're taking a hard look at what they want in marriage.