In all cases, if the problem is repeated without change, it is better to stop that repetition and seek professional help. This is sometimes difficult. The best approach that I know is to focus on the rewards of attending therapy. If your spouse perceives the rewards of attending and completing therapy to be greater than the rewards of not presenting for therapy, he or she will go for the greater reward. The task is to make therapy more rewarding than not having therapy.
Some couples come in after one spouse has threatened divorce.
If a referral to a medical doctor is not called for, I then meet with a couple 3-7 times to get an idea of how much sex is interfering with the relationship, and how much relationship conflicts are interfering with sex. I then meet with each of the partners individually to learn about their family of origin, relationship, and sexual histories. I can accomplish that when you are able to do on your own what you are seeking help for in therapy. I watch carefully to see how each person is responding to intervention. I role model communication and decision-making techniques.