Can Therapy Help Friendships? How Friendship Counseling Works
Can I Really Do Couples Therapy with a Friend?
Short answer? Yes. And it’s more common than you’d think.
Not long ago, someone from NPR reached out while working on a story about friends who go to therapy together. They were surprised to learn just how many friendship pairs I’ve worked with over the years—friends who needed a space to heal, grow, or simply talk things through with someone trained to help.
What they shared stuck with me: more and more friends are craving deeper support, but when they searched online, all they found were services for “couples” or “families.” Nothing that said “friendship therapy.”
It’s true. You probably won’t find a “friendship therapy” tab on most websites. Not because therapists don’t offer it, but because—until recently—it just wasn’t something many people asked for. That’s changing. And I’m so glad it is.
How Can a Couples Therapist Help Friends?
Here’s the thing: couples therapists are trained in something called systemic therapy. That means we don’t just look at individuals—we look at relationships, dynamics, and how people affect one another.
Whether it’s a romantic couple, a pair of siblings, or two longtime friends, our focus is on the system between you.
When friends come to therapy, we explore things like:
How you communicate
What you each need emotionally
Where misunderstandings pop up
How your past (and your differences) shape your friendship today
It’s not about blame—it’s about understanding how you work together, and how to make that work healthier.
Why Would Friends Go to Therapy Together?
There’s no one reason. Some friends come because they’ve had a falling out and want to repair the relationship. Others come to process grief or change. Some are navigating a major life transition, like one friend having a baby while the other is single and feeling left behind.
Here are a few common reasons friends choose therapy together:
A major rupture or conflict that feels unresolved
Distance or disconnection—you’re not fighting, but you’re not close anymore
One friend struggling, and the other wants to be supportive but isn’t sure how
Unspoken tension or misalignment about boundaries, time, or energy
A desire to grow together, especially if your friendship is important to your overall wellbeing
There doesn’t have to be a crisis. Sometimes it’s just, “This relationship matters to me, and I want us to feel closer.”
What Happens in a Friendship Therapy Session?
Think of it like couples or family therapy, but built around your friendship dynamic.
Your first session will likely involve questions like:
How did you two meet?
What makes this friendship meaningful to you?
What have been some of your best (and hardest) moments together?
What patterns or dynamics are getting in the way right now?
What do you hope changes through therapy?
After that, your therapist might recommend a few sessions individually, so they can get to know each of you better. You’ll have space to explore your feelings, share what you might be holding back, and get clarity on your own needs.
Then, together, you’ll start having the conversations that haven’t been easy to have on your own. And the best part? You’ll be doing that work in a space designed to be safe, neutral, and supportive.
The therapist won’t take sides. Their role is to help you both understand each other better, communicate more effectively, and build a relationship that works for the people you’ve each grown into.
Will My Therapist Think It’s Weird That I’m Coming With a Friend?
Not at all. In fact, many therapists wish more friends came in for support.
We’re often taught that friendship should just “work” without effort. But the truth is, friendships are just as layered and emotional as romantic relationships—and just as worthy of attention and care.
If your friendship is important to you, it’s never weird to invest in it.
How Friendships Change After College and Into Adulthood
Let’s be real—friendship looks different at 30 than it did at 20.
In college or young adulthood, friendship often happens by proximity. You’re living with roommates, seeing people in classes, bumping into familiar faces at coffee shops or parties. There’s a built-in ease to connection.
But as life changes, so do your friendships. People move away. Jobs get demanding. Partners and children enter the picture. Suddenly, friendship requires intentionality—and that can feel unfamiliar or even awkward.
You might notice:
You’re craving deeper, more emotionally available friendships
Some friends feel distant, but you’re not sure how to reconnect
You’ve outgrown certain friendships but feel guilty about letting go
You want new friendships, but don’t know where to start
Friendship therapy can help you navigate those transitions. It’s a space to grieve what’s changed, get honest about what you want now, and build relationships that fit the season you’re in.
When You Go to Therapy to Talk About Friendships
Sometimes you don’t come to therapy with a friend—but you still want to talk about friendship.
Maybe you’re:
Still heartbroken over a friendship that ended
Feeling anxious in social settings
Noticing patterns in your relationships that keep repeating
Struggling to trust people, even though you really want connection
Constantly feeling like the “giver” in every friendship
This kind of work happens in individual therapy, and it’s incredibly powerful.
At Sagebrush Counseling, we often support clients in exploring their friendship history—who showed up, who didn’t, what shaped their beliefs about connection, and what kind of relationships they’re longing for now. It’s about honoring your experiences and building new relational patterns that feel good and mutual.
You don’t have to wait until a friendship ends to do this work. If you’ve ever felt lonely in a room full of people or wondered why connection feels just out of reach, therapy can help.
Questions to Explore in Friendship Therapy
If you're thinking about starting therapy with a friend—or you’re in individual therapy and want to explore your friendship dynamics—here are some conversation-starters that might come up:
What does this friendship mean to you right now?
When did you feel closest to one another—and why?
Are there any hurts that haven’t been named yet?
What do you wish your friend understood about you?
What’s something you appreciate about each other but haven’t said?
What boundaries do you need (or struggle to express)?
Are there unspoken roles you’ve each taken on (like the caretaker, the fixer, the avoider)?
How do you repair conflict—or do you avoid it?
What’s your vision for the future of this friendship?
How do each of you define emotional safety?
You don’t have to know the answers. The goal is to open space for honesty, curiosity, and care.
Is It Normal to Outgrow a Friendship?
Yes. 100% yes.
Friendships evolve just like people do. And sometimes, what once fit perfectly no longer does. Maybe you bonded over shared interests or a life stage, and now your paths have taken different turns. Or maybe you’ve grown emotionally in ways your friend hasn’t—and the dynamic feels out of sync.
Outgrowing a friendship doesn’t make you disloyal or unkind. It simply means you’re becoming more aligned with who you are now.
Therapy can help you process that shift without shame. You can explore the grief that comes with losing closeness, the guilt that might pop up, and how to either redefine the relationship or lovingly let it go.
Some friendships are meant to stretch and grow with us. Others are meant to be cherished chapters in our story. Both are valid.
How to Talk to a Friend About Going to Therapy Together
It’s natural to feel nervous about bringing this up. You might worry your friend will think you’re blaming them, or that they’ll shut down.
But a great way to approach it is to frame it from a place of care rather than conflict.
Here are a few ways to open the conversation:
“I really value our friendship, and I’ve been feeling a little stuck. Would you ever be open to talking to someone together to figure out how we can feel more connected?”
“Our friendship matters a lot to me. I know we’ve been through some ups and downs lately, and I think therapy could give us the space to sort through things with support.”
“This might sound a little out there, but I heard about friendship therapy recently, and I actually think it could help us navigate where we are right now.”
The key is to let your friend know they’re not “the problem”—the relationship is something you both care about, and you’re inviting them to work on it with you.
What If Therapy Doesn’t Fix Everything?
This is such an important question—because therapy isn’t magic. It’s not about “fixing” people or relationships. It’s about creating a space where you can reflect, understand, and make intentional choices.
Sometimes, therapy brings you closer. It helps you communicate better, work through hurt, and reconnect on a deeper level.
Other times, therapy helps you see that the friendship has run its course—or that it needs to shift into something different. And that’s not failure. That’s clarity. That’s growth.
If you leave therapy with a clearer understanding of yourself and what you need in relationships, that’s still a win—even if it doesn’t look the way you expected.
Can Friendship Therapy Work Virtually?
Absolutely. In fact, many of our friendship sessions happen online.
Virtual therapy is a great option for long-distance friendships, friends with busy work or parenting schedules, or anyone who just prefers the comfort of their own space.
In a virtual session, you and your friend log in from wherever you are—on separate screens or together in the same space. The therapist facilitates the conversation just as they would in person, helping you explore challenges, improve communication, and build a stronger connection.
At Sagebrush Counseling, we’ve found that virtual sessions can actually help friends open up more quickly. There’s something about being in your own space that makes the process feel less intimidating and more grounded.
If friendship therapy is something you’ve been curious about, but logistics have gotten in the way—virtual is a gentle, accessible place to start.
When to Go to Individual Therapy After a Friendship Breakup or Loneliness
Not all friendship struggles need to be worked through together.
Sometimes, you’re the one feeling the weight of a friendship fallout, or the quiet ache of loneliness, and you don’t even know where to start. Maybe the friendship ended without closure. Maybe you still see their posts on Instagram and wonder why it hurts so much. Or maybe you’ve drifted from everyone in your circle and suddenly feel like you don’t have “your people” anymore.
That kind of pain is real. And therapy can help.
In individual sessions, we create space to:
Grieve the loss of a friendship (yes, that’s a thing)
Process complicated emotions like anger, guilt, or confusion
Explore patterns in your relationships that feel familiar or stuck
Rebuild confidence and self-worth after being ghosted or shut out
Reflect on what kind of friendships you want moving forward
Sometimes the loneliness isn’t about one friendship—it’s about a deeper sense of disconnection. Individual therapy can help you understand why relationships have felt hard, how your past experiences play a role, and what new skills or boundaries might help you feel more supported.
You don’t have to fix it alone. You just have to start somewhere—and therapy is a brave, healing place to begin.
Friendship Therapy Can Be a Game-Changer
Therapy gives you a third option: to grow together. To repair, reconnect, and relate to each other with more honesty and care.
At Sagebrush Counseling, we welcome friends into the therapy room. If you and a friend want to explore what’s working, what’s not, and how to make your bond stronger—we’re here for that. Reach out anytime to schedule a free consultation and see if friendship therapy feels like the right next step.
