A Feminist Approach to Enhancing Couples and Family Therapy

By Ariana Wade, MA, AMFT

From the highest levels of political power to the day-to-day rhythm of household life, gender disparities shape how we relate, love, and live. These inequalities don’t stop at the door of the therapy room—they often sit right between couples on the couch.

In this article, I’ll explore how gender dynamics impact mental health and relationships, and why therapists must use a feminist and social justice framework to foster true change.

The Gender Gap: More Than a Paycheck Issue

Recent data reveals that women spend 25% more of their lives dealing with severe health issues compared to men (Whiting, 2024). Married women, in particular, live an average of 500 days less than their male partners (Napoli, 2023).

Add to that the fact that women perform 76% of household duties and childcare globally (World Health Organization, 2024), and we begin to see a profound imbalance in emotional, physical, and logistical labor.

Even in public life, most Americans believe women are still vastly underrepresented in political and business leadership roles (Schaeffer, 2024). These inequalities shape our partnerships, our identities, and our mental health.

Gender Disparities in the Therapy Room

In individualistic cultures like the U.S., both partners often seek personal freedom and equal opportunity in relationships. But true equality is difficult when one partner—typically the woman—is carrying the heavier emotional and domestic load.

Therapists must be careful not to reinforce these imbalances. Asking women to take responsibility for improving the relationship can unintentionally place the burden back on them—despite their already overwhelming mental load (Hare-Mustin, 1978).

Instead, therapy should ask: How can both partners share responsibility and reimagine equality together?

Moving Beyond Coping: The Role of Social Justice in Therapy

Teaching coping skills is helpful—but it’s not enough. As Budge and Moradi (2018) suggest, therapy should actively challenge systems of power and privilege.

That includes:

Centering conversations around male privilege and systemic gender roles
Using an intersectional lens to account for how gender intersects with race, class, sexuality, and ability
Avoiding the trap of asking women to advocate for themselves without also asking men to relinquish unacknowledged privilege

The goal isn’t blame—it’s balance.

Tools for Change: The Model of Relationship Equality

To create more equitable dynamics in therapy, clinicians can use the Model of Relationship Equality by Knudson-Martin and Mahoney (2009). It outlines four areas where power often plays out:

Relative Status – Who gets to make decisions?
Attention to the Other – Whose needs are prioritized?
Accommodation Patterns – Who adjusts more in the relationship?
Well-Being – Whose emotional and physical health is supported?

Using these domains, therapists can gently uncover inequality and support couples in redistributing power, time, and care more fairly.

Therapy That Honors Both Partners

Feminist-informed therapy doesn’t mean taking sides. It means recognizing the systems at play, validating each partner’s experience, and helping clients reimagine relationships that are emotionally, mentally, and structurally balanced.

By adopting a gender-sensitive and justice-oriented approach, therapists can: